Fulminant Clostridioides (Costridium) difficile infection caused by a rare strain of PCR-ribotype 153 in Japan: A case report.

Clostridioides (Clostridium) difficile (C. difficile) infection (CDI), often severe when producing toxin A, toxin B, and CDT, can cause life-threatening fulminant infections, especially in vulnerable patients. This case report discusses a 39-year-old woman with no medical history who developed severe CDI after antibiotic treatment, leading to fatal hypovolemic shock.

Sarcomere gene variants did not improve cardiac function in pediatric patients with dilated cardiomyopathy from Japanese cohorts.

Dilated cardiomyopathy (DCM) is a progressive myocardial disorder characterized by impaired cardiac contraction and ventricular dilation. However, some patients with DCM improve when experiencing left ventricular reverse remodeling (LVRR). Currently, the detailed association between genotypes and clinical outcomes, including LVRR, particularly among children, remains uncertain.

Is Intraoperative Blood Loss Volume in Elderly Cervical Spine Injury Surgery Greater in Patients with Ankylosis? A Multicenter Survey.

Introduction: Preoperative estimations of blood loss are important when planning surgery for cervical spine injuries in older adults. The association between ankylosis and blood loss in perioperative management is of particular interest. This multicenter database review aimed to evaluate the impact of ankylosis on surgical blood loss volume in elderly patients with cervical spine injury.

Radiation Therapy for Cutaneous Blastic Plasmacytoid Dendritic Cell Neoplasm: A Case Report and Review of the Literature.

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a clinically aggressive hematologic malignancy derived from plasmacytoid dendritic cells. It commonly presents as cutaneous lesions. To date, no standard treatment protocol for BPDCN exists.

Vascular Access Stenosis Caused by Membranous Structure in Patients on Hemodialysis.

Purpose: A membranous structure (MS) may be seen on ultrasound at a site of vascular access (VA) stenosis in patients on hemodialysis. It can also be encountered during percutaneous transluminal angioplasty (PTA) and be impassable from one side but easily passed from the other. This study aimed to examine the characteristics of MS cases and how to treat them.

Endovascular treatment for aggressive vertebrobasilar stenosis due to giant cell arteritis: illustrative cases.

Background: Giant cell arteritis (GCA) infrequently presents with progressive symptomatic vertebrobasilar stenosis. Vertebrobasilar GCA is often refractory to medical treatments and can lead to short-term ischemic stroke recurrence, which is associated with a poor prognosis. Endovascular treatment (EVT) is a therapeutic option; however, the optimal timing and indications for its application remain unclear.

Visualization of X-ray fields, overlaps, and over-beaming on surface of the head in spiral computed tomography using computer-aided design-based X-ray beam modeling.

To visualize the X-ray fields, overlaps, and over-beaming on the skin surface during spiral head CT scanning. The measured pitch factors were determined by measuring 3 rotation times, 11 table-feed speeds, and an X-ray beam width. The X-ray fields, overlaps, and over-beaming on the skin surface were calculated via computer-aided design-based X-ray beam modeling, and the values obtained using the nominal pitch and measured pitch factors were compared.

[An adult case of adenovirus type 3 infection presenting as clinically mild encephalitis/encephalopathy with a reversible splenial lesion and increased IL-6 levels in the cerebrospinal fluid].

A 42-year-old Japanese man with a history hepatitis C who had undergone bone marrow transplantation for Burkitt lymphoma. He visited our hospital after developing a fever and sore throat. A computed tomography scan of the chest revealed pneumonia, and the patient was admitted to our hospital.

Use of the Staple Line Reinforcement Tool to Reduce the Rate and Completely Avoid Anastomotic Leakage in Functional End-to-End Anastomosis.

Background In our hospital, anastomotic leakage (AL) is observed in approximately 2% of functional end-to-end anastomosis (FEEA) cases annually. It is also usually observed at the staple line of the entry hole closure in several reoperation cases. This study aimed to investigate whether AL would occur in FEEA using a new staple line reinforcement tool, ECHELON ENDOPATH Staple Line Reinforcement (SLR) (Ethicon, Raritan, NJ, USA).

Dose modification in enzalutamide and abiraterone plus prednisolone for castration-resistant prostate cancer: A subanalysis from the ENABLE study for PCa.

Background: A head-to-head comparison between enzalutamide (ENZ) and abiraterone plus prednisolone (ABI) revealed similar survival benefits for castration-resistant prostate cancer (CRPC) in the ENABLE study for PCa. Considering that a dose reduction of ENZ and ABI has demonstrated sufficient inhibitory ability of androgen receptor (AR) signaling, we analyzed the efficacy of modified doses of these agents in the ENABLE study for PCa.

Methods: This investigator-initiated, multicenter, randomized controlled trial that was conducted in Japan analyzed the prespecified survival endpoints, prostate-specific antigen (PSA) response rate ( ≥50% decline from baseline), and safety profile in patients treated with modified doses (ENZ ≤ 120 mg/day, ABI ≤ 750 mg/day) compared with those treated with a standard dose (ENZ 160 mg/day, ABI 1000 mg/day) as a starting dose.

Prospective therapeutic studies of disseminated extranodal large B-cell lymphoma including intravascular large B-cell lymphoma.

This study aimed to establish a standard treatment for disseminated extranodal large B-cell lymphoma, including intravascular large B-cell lymphoma (DEN-LBCL/IVL), and to validate the clinical diagnostic criteria we proposed. Between 2006 and 2016, 22 patients were enrolled in a clinical trial conducted by the Hokuriku Hematology Oncology Study Group. The first cycle of chemotherapy consisted of dose-reduced cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) with delayed administration of rituximab.

Characteristics of virus and antibody response in an immunocompromised patient with persistent SARS-CoV-2 infection.

We have previously reported a clinical case in which a hospitalized patient with a history of hematopoietic stem cell transplantation for acute myeloid leukemia was persistently infected with SARS-CoV-2. This study investigated the neutralizing activity of patient sera against cultured viruses isolated at each time point. We also continued to decipher and analyze the whole-genome sequence of the virus.

An observational study on the efficacy of targeted therapy for pulmonary sarcomatoid carcinoma.

Background: Pulmonary sarcomatoid carcinoma is a rare tumor that is resistant to cytotoxic agents. This observational study aimed to evaluate the detection rate of driver gene alteration and the efficacy of targeted therapy for pulmonary sarcomatoid carcinoma.

Methods: We established a database of patients with pulmonary sarcomatoid carcinoma and their clinical information, including EGFR mutation, ALK fusion gene, ROS1 fusion gene, BRAF mutation, and MET exon 14 skipping mutation.

Severe Duodenal Bleeding with Heterotaxy Syndrome Controlled by Combined Hemostatic Strategies: A Case Report.

A 73-year-old man with a history of heterotaxy syndrome and intestinal malrotation developed hemorrhagic shock due to bleeding from a duodenal ulcer. Esophagogastroduodenoscopy failed to achieve hemostasis because of restriction of the view by massive hemorrhage. Transcatheter arterial embolization cannot achieve endovascular hemostasis due to the vascular anatomy.