Pancreaticobiliary Reflux with Normal and Relatively Long Common Channels Causing Cholelithiasis and Acute Pancreatitis in Children.

Pancreaticobiliary maljunction (PBMJ) has a long common channel (CC) that causes pancreaticobiliary reflux (PBR), which has been implicated in gallstones, cholangiocarcinoma, and pancreatitis. By contrast, PBR has occurred in cases with normal and longer CCs than normal but shorter than PBMJ. This pathophysiology has been primarily reported in adults and rarely in children.

Virtual Chest Radiographs Developed From Computed Tomography Images for Differentiating Central Venous Versus Misplaced Arterial Lines and for Training Radiologists.

Objective: Radiographic findings to identify central venous catheter misplacement in the arteries, which can cause lethal complications, have not been fully evaluated, and its training is difficult because it is rare. The purpose of this study is to clarify radiographic findings for differentiating central venous and misplaced arterial lines using virtual chest radiographs and elucidate their usefulness in training radiologists.

Methods: This retrospective study included 150 patients (mean age, 67 [SD, ±12] years; 97 men) who underwent colon cancer surgery between January 2018 and December 2020.

Research team diversity impacts scientific output in allergy and immunology programs.

Background: This study examined the relationship between the disciplinary diversity of research teams and research output (RO) in allergy and immunology programs funded by the National Institutes of Health (NIH) in the United States, Medical Research Council (MRC) in the United Kingdom, and Japan Society for the Promotion of Science (JSPS).

Methods: Using a dataset containing 1243, 3645, and 1468 articles funded by the NIH, MRC, and JSPS, respectively, we analyzed the correlation between disciplinary diversity and RO in allergy and immunology programs that received grants from 2017 to 2021. Diversity was measured using All Science Journal Classification codes counts, Shannon-Wiener index, and newly developed Omnidisciplinary index (o-index).

Tips for percutaneous nephrolithotomy for transplant kidney stone.

Introduction: The management of urinary tract stones, particularly kidney allograft stones, presents unique challenges for kidney transplant recipients because of their prevalence and specific clinical considerations. Here, we describe a case in which percutaneous nephrolithotomy was successfully used to fragment a large kidney allograft stone ≥20 mm in size.

Case Presentation: A 57-year-old woman who underwent ureteroureterostomy post simultaneous pancreas-kidney transplantation presented with gross hematuria after 15 years.

Cardiovascular Prognosis in Limb Ischemia Patients with Heart Failure and Systolic Dysfunction Following Major Amputation.

Chronic limb-threatening ischemia (CLTI), the severest stage of peripheral artery disease, frequently necessitates amputation. In CLTI patients, heart failure with reduced ejection fraction (HFrEF) markedly raises mortality risk, with increased peripheral vascular resistance contributing to this exacerbation. This investigation aimed to assess the impact of major amputation (MA) on the cardiovascular (CV) prognosis in CLTI patients with HFrEF by lowering peripheral vascular resistance.

Clinical outcomes by baseline metastases in patients with renal cell carcinoma treated with lenvatinib plus pembrolizumab versus sunitinib: Post hoc analysis of the CLEAR trial.

Lenvatinib plus pembrolizumab significantly improved efficacy versus sunitinib in treatment of advanced renal cell carcinoma (aRCC) in the phase 3 CLEAR study. We report results of an exploratory post hoc analysis of tumor response data based on baseline metastatic characteristics of patients who received lenvatinib plus pembrolizumab versus sunitinib, at the final overall survival analysis time point of CLEAR (cutoff: July 31, 2022). Treatment-naïve adults with aRCC were randomized to: lenvatinib (20 mg PO QD in 21-day cycles) plus pembrolizumab (n = 355; 200 mg IV Q3W); lenvatinib plus everolimus (not reported here); or sunitinib (n = 357; 50 mg PO QD; 4 weeks on/2 weeks off).

Successful Endoscopic Removal of an Ingested Thumbtack Stuck in the Ileocecal Valve in a Patient With a Psychiatric Disorder.

Foreign body ingestion is sometimes missed during the initial evaluation of a patient with a psychiatric disorder in the emergency department. This is often due to a lack of awareness regarding the need for thorough physical and diagnostic imaging examinations. Additionally, the management of ingested foreign bodies is often controversial.

Assessment and management of frailty in individuals living with dementia: expert recommendations for clinical practice.

Frailty complicates the care of individuals with dementia, increasing their vulnerability to adverse outcomes. This Personal View presents expert recommendations for managing frailty in individuals with dementia, aimed at health-care providers, particularly those in primary care. We conducted a rapid literature review followed by a consensus process involving 18 international experts on dementia and frailty.

A Case of Sympathetic Ophthalmia After Corneal Perforation.

We report a case of sympathetic ophthalmia that developed in the fellow eye following therapeutic corneal transplantation and amniotic membrane transplantation for corneal perforation caused by corneal ulceration. A 62-year-old man presented with discharge, lacrimation, and decreased visual acuity in the left eye. He was diagnosed with a corneal ulcer and treated with antimicrobial agents, but corneal epithelial erosion persisted, leading to nontraumatic corneal perforation.

Evaluation of the Efficacy and Accuracy of Super-Flexible Three-Dimensional Heart Models of Congenital Heart Disease Made via Stereolithography Printing and Vacuum Casting: A Multicenter Clinical Trial.

Three-dimensional (3D) printing is an advanced technology for accurately understanding anatomy and supporting the successful surgical management of complex congenital heart disease (CHD). We aimed to evaluate whether our super-flexible 3D heart models could facilitate preoperative decision-making and surgical simulation for complex CHD. The super-flexible heart models were fabricated by stereolithography 3D printing of the internal and external contours of the heart from cardiac computed tomography (CT) data, followed by vacuum casting with a polyurethane material similar in elasticity to a child's heart.

Bilateral Lesions in Parkinson's Disease: Gaps and Controversies.

Bilateral lesions of the basal ganglia using termocoagulation or radiation for improving tremor, bradykinesia, and rigidity in people with Parkinson's disease (PD) have been performed starting several decades ago, especially when levodopa and deep brain stimulation (DBS) surgery were not available. However, because of unclear additional benefit compared to unilateral lesion, and particularly to the evidence of increased adverse events occurrence, bilateral lesions were basically abandoned at the end of the 20th century. Therefore, bilateral DBS has become the standard procedure to treat PD.

Association of diabetic retinopathy with kidney disease progression according to baseline kidney function and albuminuria status in individuals with type 2 diabetes.

Background: Whether diabetic retinopathy (DR) can predict kidney disease progression in individuals with diabetes remains unclear. Furthermore, there are only a limited number of studies investigating the association between DR and kidney outcomes classified according to baseline kidney function and albuminuria status. Here, we examined the association of DR with kidney disease progression in individuals with type 2 diabetes.

Variations in serum concentrations of sunitinib and its metabolites in patients receiving long-term sunitinib treatment.

Purpose: The blood concentrations of some tyrosine kinase inhibitors are known to decrease with long-term administration. We evaluated the variability in the serum concentrations of sunitinib and its metabolites in patients receiving long-term sunitinib treatment.

Methods: This study prospectively recruited patients who received sunitinib for metastatic renal cell carcinoma at the Showa University Hospital between March 2020 and January 2022.

Deciphering hematopoietic stem cell development: key signaling pathways and mechanisms.

Most blood cells derive from hematopoietic stem cells (HSCs), originating from endothelial cells. The induction of HSCs from endothelial cells occurs during mid-gestation, and research has revealed multiple steps in this induction process. Hemogenic endothelial cells emerge within the endothelium, transition to hematopoietic cells (pre-HSCs), and subsequently mature into functional HSCs.

Conditioned serum-free culture medium accomplishes adhesion and proliferation of bovine myogenic cells on uncoated dishes.

To establish a sustainable cultured meat technology, a low-cost culture medium must be developed without expensive biological materials such as serum and coating substances. However, even adhering bovine myogenic cells to uncoated culture dishes in the serum-free medium is challenging. We found that serum-free culture medium conditioned by HepG2 and NIH/3T3 cells not only accomplished the cell adhesion on uncoated culture dishes (the serum-containing medium : the serum-free medium : the conditioned medium = 6722 ± 1500 : 2210 ± 319 : 5985 ± 1558 cells/cm), but also induced proliferation comparable to that observed in a serum-containing medium (the serum-containing medium : the serum-free medium : the conditioned medium = 10,050 ± 2814 : 2200 ± 707 : 8998 ± 3890 cells/cm).

Induction of cardiac alternans in human iPS-derived cardiomyocytes through β-adrenergic receptor stimulation.

Cardiac alternans (C-ALT) is a phenomenon of alternating strong and weak contractions in the heart and is considered a risk factor for the development of heart failure and arrhythmias. However, no model has been reported that can induce C-ALT in vitro using human cells, and the developmental mechanism of C-ALT has not been studied using human cells. In this study, we successfully induced C-ALT in vitro using human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs).

Associations of malnutrition factors with dysphagia mediated by ADL among nursing home residents.

Objective: The potential link between malnutrition and dysphagia along with its underlying mechanisms remains unknown. This study aimed to investigate the association between malnutrition factors and dysphagia mediated by a decline in activities of daily living (ADL) among nursing home residents.

Methods: This cross-sectional study used data from 705 nursing home residents.

Zap-X Radiosurgery System: Initial Clinical Experience in a Recurrent Gamma Knife Case Series.

Introduction: The ZAP-X® Gyroscopic Radiosurgery System (ZAP Surgical Systems, Inc., San Carlos, CA, USA) is expected to be a highly accurate next-generation treatment system that enables gyro-stereotactic irradiation of intracranial lesions. In this study, we report the initial treatment course using ZAP-X for intracranial lesions that recurred after Gamma Knife (GK) treatment.

Clinical Characteristics of Patients With Becker Muscular Dystrophy Having Pathogenic Microvariants or Duplications.

Background And Objectives: Becker muscular dystrophy (BMD) is an allelic disorder of Duchenne muscular dystrophy (DMD) in which pathogenic variants in cause progressive worsening of motor dysfunction, muscle weakness and atrophy, and death due to respiratory and cardiac failure. BMD often has in-frame deletions that preserve the amino acid reading frame, but there are some cases with microvariants or duplications. In recent years, the importance of therapeutic development and care for BMD has been emphasized.

Evidence-based diagnostic prediction score for pediatric NMDA receptor encephalitis.

Objective: Early diagnosis and treatment of anti-N-methyl-D-aspartate receptor encephalitis (NMDARE) are crucial for a favorable prognosis. Detecting the causative autoantibodies can be challenging. Probable diagnostic criteria are useful in adults less so in children.

Causative diseases of bloody sputum and hemoptysis in respiratory clinics in Japan.

Background: No previous studies have compared respiratory clinics and respiratory specialized facilities regarding causative diseases for bloody sputum and hemoptysis in Japan.

Methods: We retrospectively compared causative diseases for bloody sputum and hemoptysis between 3 respiratory clinics (clinic group) and 7 departments of respiratory medicine at hospitals (hospital group) in Japan.

Results: We collected data from 231 patients (median age, 51 years; age range, 24-96 years; 109 men (47.