Hollow Fiber Microreactor Combined with Digital Twin to Optimize the Antimicrobial Evaluation Process.

In order to reproduce pharmacokinetics (PK) profiles seen in vivo, the Hollow Fiber Infection Model (HFIM) is a useful in vitro module in the evaluation of antimicrobial resistance. In order to reduce the consumption of culture medium and drugs, we developed a hollow fiber microreactor applicable to the HFIM by integrating the HFIM function. Next, we constructed a novel control method by using the "digital twin" of the microreactor to achieve precise concentration control.

Idiopathic Multiple Localized Lipoatrophy Mimicking Amyotrophic Lateral Sclerosis.

Localized lipoatrophy is a rare condition characterized by the localized loss of subcutaneous adipose tissue. It may occur idiopathically without specific triggers. The pathogenesis of idiopathic localized lipoatrophy remains largely unknown.

Associations of gut microbiota with disease development, disease activity, and therapeutic effects in patients with systemic lupus erythematosus.

Altered gut microbiota is linked to systemic lupus erythematosus (SLE), but its association with disease development, disease activity, and post-intervention changes remains unclear. We compared new-onset SLE (NOSLE, n = 25), SLE in remission (RemSLE, n = 30), and healthy controls (HC, n = 30) cross-sectionally and conducted the first longitudinal analysis of NOSLE patients (n = 22) from pre-intervention to remission over 12 months. Significant β-diversity differences were observed in both NOSLE and RemSLE compared to HC, but not between NOSLE and RemSLE.

HYPERVIRULENT KLEBSIELLA PNEUMONIAE OSTEOMYELITIS IN A CHILD.

An 18-month-old boy presented with septic arthritis and osteomyelitis caused by Hypervirulent Klebsiella pneumoniae harboring cardinal virulence genes. The condition necessitated several surgical interventions, and a prolonged course of antibiotic therapy to effectively manage the severe infection and prevent complications, highlighting the challenges posed by Hypervirulent Klebsiella pneumoniae in pediatric cases.

Treatment success prediction in patients with methicillin-resistant coagulase-negative staphylococci infections, using vancomycin AUC24/MIC ratio: a multicentre retrospective cohort study.

Background: Although vancomycin is commonly used to treat methicillin-resistant coagulase-negative staphylococci (MRCoNS) infections, there are no clear guidelines for the optimal 24 h AUC24/MIC ratio. This study aimed to determine the target AUC24/MIC ratio associated with vancomycin-treated MRCoNS infection outcomes.

Methods: This multicentre retrospective cohort study included adult patients who received vancomycin for ≥5 days for bloodstream infections caused by MRCoNS between January 2018 and December 2023.

A case of fatal disseminated infection with masticator space abscess caused by ESBL-producing K57-ST412 hypervirulent Klebsiella pneumoniae.

A 70-year-old Japanese man with well-controlled diabetes mellitus and chronic kidney disease was hospitalized for an examination of acute renal failure and elevated inflammatory reactions. He had a history of Klebsiella pneumoniae bacteremia without extended-spectrum β-lactamase (ESBL) production five months earlier. The patient was found to have bacteremia due to hypermucoviscous ESBL-producing Klebsiella pneumoniae, and developed septic shock, multiple cerebral infarctions, and an abscess in the left masticatory muscle space.

Optimization of Silver Staining in Artificial Cytology Samples of Filamentous Fungi.

The diagnosis of respiratory fungal infections is often aided by cytopathological evidence of fungi in sputum or bronchoalveolar lavage fluid. Grocott's methenamine silver (GMS) stain, a special stain frequently used to detect fungi in cytological specimens, can be challenging to apply stably. There is a need for improved documentation of staining procedures for fungal detection in cytological specimens.

A Questionnaire Study of Leadership in General Medicine: General Physicians in Japan are Facing Challenges in Education and Research.

Purpose: General physicians are required to demonstrate diverse leadership skills depending on their environment. It is essential for them to understand the characteristics of the medical institutions to which they belong and put this understanding into practice. Leadership skills are acquired through experience and training, and their acquisition is a goal in various medical training programs.

Impact of Education on Inappropriate Antibiotic Prescription for Respiratory Tract Infection Based on Physicians' Justifications: A Web-Based Survey in Japan.

: Antibiotics are inappropriately prescribed for respiratory tract infections for various reasons. The differences of the effects of education based on these reasons has not been fully elucidated. This study assessed the impact of an educational film on antibiotic prescription patterns according to physicians' prescribing justifications.

Increased structural covariance of cortical measures in individuals with an at-risk mental state.

An anomalous pattern of structural covariance has been reported in schizophrenia, which has been suggested to represent connectome changes during brain maturation and neuroprogressive processes. It remains unclear whether similar differences exist in a clinical high-risk state for psychosis, and if they are associated with a prodromal phenotype and/or later psychosis onset. This multicenter magnetic resonance imaging study cross-sectionally examined structural covariance in a large at-risk mental state (ARMS) sample with different outcomes.

Resection of a rapidly growing chest wall cyst: a case report.

Background: When cystic lesions are detected in the chest wall, postoperative seroma and abscesses can be considered in the differential diagnoses. Herein, we present a case of a large chest wall cyst with rapid growth 5 years after thoracic surgery.

Case Presentation: A male patient in his 60s was admitted to our hospital complaining of a rapidly enlarging chest wall swelling.

Resection of infected bulla associated with isolated unilateral absence of pulmonary artery: a case report.

Background: A unilateral absence of the pulmonary artery (UAPA) is a rare congenital anomaly, which in most patients is associated with congenital cardiovascular abnormalities. Some patients with UAPAs do not have associated cardiovascular abnormalities, called isolated UAPA. Patients with isolated UAPA generally have a mild clinical course and may not be diagnosed until adulthood, but repeated complications such as infections may make surgery difficult.

Selection and evaluation of suitable quality control strains for meropenem antimicrobial susceptibility testing through preliminary external quality assessment.

Background: Quality control (QC) of carbapenem susceptibility testing for Gram-negative bacteria faces challenges due to limited measuring ranges and the lack of suitable QC strains. This study aimed to select and evaluate QC strains for meropenem antimicrobial susceptibility testing (AST) through a pilot external quality assessment (EQA).

Methods: Candidate QC strains for meropenem AST were selected based on primary AST data and genomic information from the Japan Antimicrobial Resistant Bacterial Bank.

Functional and structural analyses of IMP-27 metallo-β-lactamase: evolution of IMP-type enzymes to overcome Zn(II) deprivation.

IMP-type metallo-β-lactamases are di-Zn(II) enzymes that can inactivate a wide range of bicyclic β-lactam agents used in clinical practice. IMP-27 shares 82% amino acid sequence identity with IMP-1, the first IMP-type enzyme identified. Herein, we conducted structural determination, kinetic, and chelating agent resistance analyses of IMP-27.

Morphology of Nasal Septal Deviation in Obstructive Sleep Apnea Patients and its Treatment Method.

Objectives: Nasal septal deviation can cause nasal breathing issues, contribute to obstructive sleep apnea (OSA) development, and often hinders successful CPAP therapy. We hypothesized that although prevalent in the general population, nasal septal deviations differ structurally between OSA and non-OSA patients. This study evaluated nasal septal deviation morphology in OSA versus non-OSA patients using computed tomography (CT).

Prognostic impact based on tumor diameter of pathological N1 lymph node metastases for non-small cell lung cancer.

Background: The N parameter in the tumor-node-metastasis (TNM) classification of lung cancer is categorized according to the location of nodal metastasis, while that for some other cancers are classified according to the size and number of metastatic foci. In lung cancer, the impact of size of nodal metastasis on prognosis is unclear. This analysis aims to examine whether it is possible to subdivide the pathological N (pN) factor based on the tumor diameter of lymph node metastases.

Survival after Lung Metastasectomy from Urothelial Carcinoma: A Multi-Institutional Database Study.

Background/objectives: The efficacy of lung metastasectomy in patients with urothelial carcinoma remains inconclusive, as there is only limited evidence from small studies. In this study, we aimed to assess the prognostic outcomes of excising pulmonary metastases from urothelial carcinoma.

Methods: In this study, we utilized data from the Metastatic Lung Tumor Study Group of Japan database, a multi-institutional prospective database of pulmonary metastasectomies.

Genetic analysis of a Yayoi individual from the Doigahama site provides insights into the origins of immigrants to the Japanese Archipelago.

Mainland Japanese have been recognized as having dual ancestry, originating from indigenous Jomon people and immigrants from continental East Eurasia. Although migration from the continent to the Japanese Archipelago continued from the Yayoi to the Kofun period, our understanding of these immigrants, particularly their origins, remains insufficient due to the lack of high-quality genome samples from the Yayoi period, complicating predictions about the admixture process. To address this, we sequenced the whole nuclear genome of a Yayoi individual from the Doigahama site in Yamaguchi prefecture, Japan.

Tocilizumab in combination with standard of care in patients with severe COVID-19 pneumonia: Efficacy and safety from a phase 3 clinical trial in Japan.

Background: Coronavirus disease 2019 (COVID-19) is characterized by high interleukin-6 levels. Clinical data supporting tocilizumab, a monoclonal antibody that targets interleukin-6 receptor-alpha, for treating Japanese patients with severe COVID-19 pneumonia are needed.

Methods: This single-arm phase 3 study investigated tocilizumab (8 mg/kg) plus standard of care (SOC) in Japanese patients hospitalized with severe COVID-19 pneumonia.

CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute coronary syndromes (ACS) in 2024.

Primary Percutaneous Coronary Intervention (PCI) has significantly contributed to reducing the mortality of patients with ST-segment elevation myocardial infarction (STEMI) even in cardiogenic shock and is now the standard of care in most of Japanese institutions. The Task Force on Primary PCI of the Japanese Association of Cardiovascular Intervention and Therapeutics (CVIT) proposed an expert consensus document for the management of acute myocardial infarction (AMI) focusing on procedural aspects of primary PCI in 2018 and updated in 2022. Recently, the European Society of Cardiology (ESC) published the guidelines for the management of acute coronary syndrome in 2023.