Mechanism of exacerbation of traumatic brain injury under warfarin anticoagulation in male mice.

Introduction: Traumatic brain injury (TBI) is exacerbated in patients on antithrombotic medications, with warfarin leading to increased bleeding in some cases. However, the extent to which this bleeding increases lethality and its long-term effects remain unclear. This study aimed to investigate the exacerbation of TBI by warfarin treatment and comprehensively evaluate the impact of TBI on the anticoagulant effects of warfarin.

Effectiveness of benralizumab in the Tokyo Asthma Study (TOAST): A real-world prospective interventional trial.

Background: Biologics are integral in the management of severe asthma. As the effectiveness of the anti-IL-5 receptor antibody benralizumab in Japan remains elusive, this study aimed to assess its real-world effectiveness in Japanese patients with severe asthma.

Methods: This prospective, interventional, single-arm clinical trial was conducted across ten facilities in Japan between September 2020 and July 2022.

Effects of initial peritoneal dialysis prescription on clinical outcomes in Japanese peritoneal dialysis patients: a cohort study.

Effects of the initial peritoneal dialysis (PD) prescription on clinical outcomes are unknown in Japan. We conducted a cohort study using data from Peritoneal Dialysis Outcomes and Practice Patterns Study. The patients were divided into two groups by the volume of the initial PD prescription (≤ 4 L/day or > 4 L/day).

Clinical expert consensus document on bailout algorithms for complications in percutaneous coronary intervention from the Japanese Association of Cardiovascular Intervention and Therapeutics.

The efficacy and safety of percutaneous coronary intervention (PCI) for coronary artery disease has been established, and approximately 250,000 PCI procedures are performed annually in Japan. However, various complications including life-threatening complications can occur during PCI. Although several bailout procedures have been proposed to address complications during PCI, it is critically important for operators to manage each complication in real catheter rooms with confidence even in emergent situations.

Analysis of Methylation of Tumor-suppressive miRNAs and Mutations in Pancreatic Juice.

Background/aim: We previously reported the usefulness of detecting aberrant methylation in tumor suppressive microRNAs (miRNAs) in bile and plasma to discriminate pancreaticobiliary cancers from benign pancreaticobiliary diseases. This study analyzed the methylation of miRNAs in pancreatic juice to identify those specific to pancreatic cancer (PC).

Patients And Methods: Pancreatic juice was collected from 20 patients with PC, including eight with intraductal papillary mucinous carcinoma (IPMC), two with low grade-pancreatic intraepithelial neoplasia (LG-PanIN), 32 with LG-intraductal papillary mucinous neoplasm (IPMN), and seven with benign pancreatic lesions.

Saddle-shaped rotating knee prosthesis outperforms low contact stress knee: A short-term retrospective comparative study.

Purpose: This retrospective comparative study aimed to compare the native patellar alignment and clinical outcomes of the Rotating Concave-Convex (ROCC) knee, which features a saddle-shaped rotating platform (RP) insert and a deep trochlea, versus the low contact stress (LCS) knee, which has favourable long-term outcomes and features an anatomically shaped trochlea and a cruciate-sacrificing RP insert. We hypothesized that the deeper trochlea of the ROCC would further stabilize the native patella, resulting in superior clinical outcomes compared to LCS-RP.

Methods: Consecutive patients who underwent patellar-nonresurfacing primary total knee arthroplasty (TKA) using ROCC or LCS-RP were retrospectively reviewed.

A Multicenter Retrospective Study on Adjuvant S-1 Chemotherapy Versus Observation Following Major Hepatectomy for Perihilar Cholangiocarcinoma.

Background: The prognosis of perihilar cholangiocarcinoma (PHC) is poor even after curative resection, highlighting the need for effective adjuvant chemotherapy. The efficacy of adjuvant S-1 chemotherapy following major hepatectomy for PHC is unclear, and thus the aim of this study was to elucidate this.

Methods: Consecutive patients with PHC who underwent major hepatectomy (hemihepatectomy or trisectionectomy extending to segment 1 with extrahepatic bile duct resection) at three high-volume centers in Japan from 2007 to 2020 were retrospectively evaluated.

Dermoscopic Examination of Tinea Nigra on the Plantar Foot Unveils a Parallel Ridge Pattern Mimicking Acral-Lentiginous Melanoma.

A man in his thirties patient visited his previous physician with the chief complaint of a pigmented macule on the sole of his left foot that had steadily grown over the past two years. A dermoscopic examination of the lesion showed a parallel ridge pattern (PRP); therefore, acral-lentiginous melanoma (ALM) was suspected, and the patient was referred to our hospital for a more detailed examination. On closer inspection, PRP had a well-defined and irregular border with no variation in color, which is atypical for ALM which is characterized by asymmetrical structure and variation in colors.

Achieving the United Nations Sustainable Development Goals in Spinal Surgery: Patient-Centered Care and Social Contribution.

Background: In recent years, achieving a sustainable society has become an international challenge. The medical field is also being called upon to contribute to the United Nations Sustainable Development Goals (SDGs). However, awareness of the SDGs in Japan is low, and relevant efforts in the healthcare sector are particularly lagging behind.

Resistance exercise has an antihypertensive effect comparable to that of aerobic exercise in hypertensive patients: a meta-analysis of randomized controlled trials.

Hypertension increases the risk of cerebrovascular disease and death. In addition to aerobic exercise, which is currently recommended for its antihypertensive effects, recent studies have suggested that dynamic and isometric resistance exercises also have antihypertensive effects. However, the magnitude of the antihypertensive effect of such resistance exercises is not well known.

Clinical profile of IgG4-related disease in Japan based on the rare disease data registry.

We started a registry for cases of immunoglobulin (Ig)G4-related disease (IgG4-RD) in December 2019 to clarify the clinical profile of IgG4-RD. In this study, clinical information from 854 cases registered by February 16, 2024 was analyzed from multiple perspectives. Diagnosis of IgG4-RD was made in 808 cases, comprising 638 definite, 38 probable, and 132 possible.

Ocular Syphilis With Unilateral Optic Papillitis and Outer Retinopathy Complicated by Diabetic Retinopathy.

Syphilis has been increasing in adult infections in recent years, and ocular syphilis includes not only uveitis but also a variety of optic nerve and retinal lesions. We report a case of syphilis that caused unilateral optic papillitis and outer retinopathy complicated by diabetic retinopathy and improved with antibiotic treatment. The patient was a 61-year-old woman.

Necrosectomy and its timing in relation to clinical outcomes of EUS-guided treatment of walled-off pancreatic necrosis: a multicenter study.

Background And Aims: EUS-guided transmural drainage with on-demand endoscopic necrosectomy (EN) is increasingly used to manage walled-off necrosis (WON). It has not been fully elucidated how EN and its timing are correlated with treatment outcomes compared with the drainage-based approach.

Methods: Within a multi-institutional cohort of 423 patients with pancreatic fluid collections, including 227 patients with WON, 153 patients were identified who received the step-up treatment after the initial EUS-guided drainage of symptomatic WON; this included 102 EN patients and 51 non-EN (drainage) patients.

Impact of ursodeoxycholic acid treatment on Fontan-associated liver disease.

Background: Fontan-associated liver disease (FALD) is a type of progressive liver fibrosis that occurs following Fontan surgery and can be complicated by hepatocellular carcinoma (HCC). Established treatments for FALD are lacking. Therefore, we investigated the efficacy of ursodeoxycholic acid (UDCA) in patients with FALD.

Evaluation of diagnostic criteria for mild-to-advanced stages of Fontan-associated liver disease: A nationwide epidemiological survey in Japan.

Aim: Fontan-associated liver disease (FALD) is a complication after Fontan surgery, and a common cause of liver tumors and cirrhosis. However, no diagnostic criteria for FALD have been established, leading to an underestimation of its prevalence.

Methods: We conducted a national survey to elucidate the characteristics of FALD by collecting data from high-volume centers managing patients who had undergone the Fontan surgery in Japan.

Validation of the Japanese version of the scoliosis research society-30 questionnaire for adult patients with spinal deformity.

Background: The Scoliosis Research Society-30 (SRS-30) is a questionnaire that was originally developed from the SRS-22r questionnaire and is used to evaluate adolescent idiopathic scoliosis (AIS). It comprises two sections, with Section 1 containing 22 items related to the SRS-22r questionnaire and 1 item regarding self-image and Section 2 containing 7 items specifically related to postoperative status. The SRS-30 has been also found useful in evaluating spinal disorders or deformity in adults.

Higher Serum Alkaline Phosphatase is Risk for Death and Fracture: A Nationwide Cohort Study of Japanese Dialysis Patients.

Background: Monitoring of serum alkaline phosphatase (ALP) is recommended in the management of chronic kidney disease (CKD)-mineral bone disorder (MBD) because of associations with poor outcome among dialysis patients. However, such associations may have changed with several advances in the management of CKD-MBD over the last decade.

Methods: Baseline data for 241,670 dialysis patients (mean age, 69 ± 12 years; male, 65.