Spatial accuracy of dose delivery significantly impacts the planning target volume margin in linear accelerator-based intracranial stereotactic radiosurgery.

The impact of three-dimensional (3D) dose delivery accuracy of C-arm linacs on the planning target volume (PTV) margin was evaluated for non-coplanar intracranial stereotactic radiosurgery (SRS). A multi-institutional 3D starshot test using beams from seven directions was conducted at 22 clinics using Varian and Elekta linacs with X-ray CT-based polymer gel dosimeters. Variability in dose delivery accuracy was observed, with the distance between the imaging isocenter and each beam exceeding 1 mm at one institution for Varian and nine institutions for Elekta.

Suspected Fatal Arrhythmic Events in Japanese Patients With Coronary Artery Disease - From the CREDO-Kyoto PCI/CABG Registries Cohorts-2 and -3.

Background: Fatal arrhythmic events (FAEs), such as sudden cardiac death (SCD) and fatal ventricular arrhythmias, are a devastating complication in patients with coronary artery disease (CAD). Therefore, in this study we aimed to assess the incidence of FAEs in more recent Japanese patients with CAD and to examine whether risk stratification of FAEs can still be feasible using the left ventricular ejection fraction (LVEF).

Methods And Results: In the CREDO Kyoto PCI/CABG registry cohorts-2 and -3, there were 25,843 patients with LVEF data who received a first coronary revascularization (LVEF ≤35% group: N=1,671, 35%45%: N=21,503).

Aspirin versus Clopidogrel monotherapy beyond 1 month after complex percutaneous coronary intervention: A pre-specified subgroup analysis of the STOPDAPT-3 trial.

Aims: There were no previous studies comparing aspirin versus P2Y12 inhibitor monotherapy following short dual antiplatelet therapy (DAPT) after complex percutaneous coronary intervention (PCI).

Methods And Results: We conducted a prespecified subgroup analysis based on complex PCI in the 1-year results of the STOPDAPT-3 trial, which randomly compared 1-month DAPT followed by aspirin monotherapy (aspirin group) to 1-month prasugrel monotherapy followed by clopidogrel monotherapy (clopidogrel group). The main analysis in the present study was the 30-day landmark analysis.

Eosinophil is a predictor of severe immune-related adverse events induced by ipilimumab plus nivolumab therapy in patients with renal cell carcinoma: a retrospective multicenter cohort study.

Introduction: Immune-related adverse events (irAEs) induced by immune checkpoint inhibitors are difficult to predict and can lead to severe events. Although it is important to develop strategies for the early detection of severe irAEs, there is a lack of evidence on irAEs associated with ipilimumab plus nivolumab therapy for metastatic renal cell carcinoma (RCC). Therefore, this study aimed to investigate the association between eosinophil and severe irAEs in patients receiving ipilimumab plus nivolumab therapy for RCC.

Pathological Features and Differential Efficacy of Cisplatin-Based Adjuvant Chemotherapy in Lung Cancer Harboring Epidermal Growth Factor Receptor Mutations.

Purpose: We aimed to elucidate the efficacy of conventional cisplatin-based adjuvant chemotherapy for patients with lung cancers harboring epidermal growth factor receptor (EGFR) mutation.

Methods: This retrospective cohort study included 110 patients (EGFR mutation group: n = 51; EGFR wild-type group: n = 59) receiving cisplatin-based adjuvant chemotherapy following complete resection of non-small-cell non-squamous-cell lung cancer (2010-2021). Clinicopathological characteristics, recurrence-free survival (RFS), and overall survival (OS) were investigated.

Clinical Insights on My Acute Ischemic Stroke Caused by a Carotid Web.

Acute ischemic stroke, a medical emergency caused by reduced cerebral blood flow, results in brain cell damage. While commonly associated with older individuals, strokes can also occur in young and middle-aged adults, posing significant socio-economic and health challenges due to the long-term impact of the condition. This poses significant socio-economic and health challenges because stroke is a leading cause of disability and mortality.

Clinical significance of the preoperative prognostic nutritional index in patients with resectable non-small cell lung cancer: a multicenter study.

Purpose: To validate the clinical impacts of the prognostic nutritional index (PNI), an immune-nutritional blood marker, in patients with resectable non-small cell lung cancer (NSCLC) using multicenter cohort data.

Methods: The subjects of this retrospective multicenter study, involving 11 hospitals, were patients who underwent curative lung resection for pathological stage IA-IIIA NSCLC. We analyzed the relationship between the preoperative PNI and postoperative outcomes.

Re-evaluating prognostic factors for cervical cancer with lymph node metastasis: a Japanese multicenter cohort study based on FIGO 2018.

Background: In 2018, the International Federation of Gynecology and Obstetrics (FIGO) revised its cervical cancer staging system to enhance clinical relevance, notably by categorizing lymph node metastases (LNM) as an independent stage IIIC. This multicenter study evaluates the prognostic implications of the FIGO 2018 classification within a Japanese cohort.

Methods: This study included 1468 patients with cervical cancer.

Prognostic significance of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio in uterine carcinosarcoma.

Introduction: Uterine carcinosarcoma (UCS) and uterine sarcomas (US) are rare but aggressive cancer with poor prognoses. The prognostic value of systemic inflammatory response (SIR) indicators, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), in predicting outcomes of UCS and US remains unclear. This study investigated the prognostic significance of SIR indicators for UCS and US.

Total en bloc spondylectomy in testicular immature teratoma: Long-term survival amidst vertebral metastasis escalated by growing teratoma syndrome.

Introduction: We present a rare case of long-term survival following metastasectomy for lumbar metastasis with growing teratoma syndrome.

Case Presentation: An 18-year-old man presented with left scrotal mass and lumbago. Alpha-fetoprotein was elevated to 648.

Pain Catastrophizing Is Associated With Health-Related Quality of Life in Patients With Hip Osteoarthritis: A Multicenter Cross-Sectional Study.

Objective: This study aimed to examine the relationship between pain catastrophizing (PC) and health-related quality of life (HRQoL), while accounting for pain intensity and other factors in patients with hip osteoarthritis (OA).

Methods: This multicenter, cross-sectional study included a total of 160 participants and was conducted at five hospitals in Japan. The primary outcome was the HRQoL status, which was assessed using the Japanese version of the 12-item Short Form.

Low-Gradient Severe Aortic Stenosis: Insights From the CURRENT AS Registry-2.

Background: Low-gradient (LG) aortic stenosis (AS) has not been fully characterized compared with high-gradient (HG) AS in terms of cardiac damage, frailty, aortic valve calcification, and clinical outcomes.

Objectives: The aim of this study was to compare the clinical characteristics and outcomes between each hemodynamic type of LG AS and HG AS.

Methods: The current study included 3,363 patients in the CURRENT AS (Contemporary outcomes after sURgery and medical tREatmeNT in patients with severe Aortic Stenosis) Registry-2 after excluding patients without indexed stroke volume or left ventricular ejection fraction (LVEF) data.

Optimal Intravascular Ultrasound-Guided Percutaneous Coronary Intervention in Patients With Multivessel Disease and Chronic Kidney Disease.

There is a scarcity of data on clinical outcomes after intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) in patients with multivessel disease and chronic kidney disease (CKD). The Optimal Intravascular Ultrasound (OPTIVUS)-Complex PCI study multivessel cohort was a prospective multicenter single-arm trial enrolling 1,015 patients who underwent multivessel IVUS-guided PCI including left anterior descending coronary artery target with an intention to meet the prespecified OPTIVUS criteria for optimal stent expansion. We compared the clinical outcomes between patients with and without CKD.

A Case of Refractory Kawasaki Disease With Yersinia pseudotuberculosis Infection Successfully Treated With Cefotaxime Following Immunosuppressive Therapy.

Kawasaki disease (KD) is a vasculitis mainly affecting children under five, with symptoms such as persistent fever, rash, red lips, strawberry tongue, conjunctivitis, and swollen hands and feet. Diagnosis is based on a fever lasting over five days plus at least four of these symptoms. Treatment includes intravenous immunoglobulin (IVIG) and aspirin to reduce complications, especially coronary artery issues.

Safety of Calcium Channel Blockers in Patients With Severe Aortic Stenosis and Hypertension.

Background: There is a paucity of data on safety of calcium channel blockers (CCB) in patients with severe aortic stenosis (AS) and hypertension.

Methods And Results: Among 2,460 patients with severe AS and hypertension receiving antihypertensive therapy in the CURRENT AS registry-2, we compared the clinical outcomes between patients taking antihypertensive therapy with CCB (CCB group) and without CCB (no CCB group). In the entire study population, CCB was prescribed in 1,763 patients (71.

Management of ERCP-related perforation: a large multicenter study.

Background And Aims: Perforation is a rare but serious adverse event associated with endoscopic retrograde cholangiopancreatography (ERCP). There is no consensus to guide clinicians in the management of ERCP-related duodenal perforations, making it difficult to determine whether surgical or endoscopic treatment is optimal. The present study retrospectively evaluated the characteristics and clinical outcomes of patients who experienced ERCP-related duodenal perforations according to the mechanism of injury.

Yersinia pseudotuberculosis-Associated Myositis.

() is a Gram-negative pathogen associated with gastrointestinal infections, such as enterocolitis. While complications like reactive arthritis can occur, progression to myositis is extremely rare. This report describes a five-year-old boy who developed myositis following a infection.

Comparison of methotrexate dosing protocols for graft-versus-host disease prophylaxis after unrelated hematopoietic stem cell transplantation.

Background Aims: Methotrexate (MTX) is used as standard graft-versus-host disease (GVHD) prophylaxis in allogeneic hematopoietic stem cell transplantation. However, the optimal dosing regimen among the various MTX regimens available remains unclear.

Methods: We used the registration data of Kyoto Stem Cell Transplantation Group to compare six MTX dosing protocols in a multicenter retrospective analysis of 816 cases of unrelated bone marrow or peripheral blood stem cell transplantation.

Changes in Shoulder and Lumbar Injury Incidence in Swimmers After Physical Examination and Exercise Programs.

Background: Previous injury and physical examination data collected by a physiotherapist were reviewed to investigate the causes of injury among competitive swimmers. Each swimmer received an injury improvement exercise program based on their injury history and physical examination findings.

Purpose: The purpose of this study was to identify trends in the number of shoulder and lumbar injuries and discern the effectiveness of exercise programs in swimmers.

Distinct brain network structure of mesial temporal lobe epilepsy compared to that of neocortical epilepsy: functional MRI study with surgically treated patients.

Objective: Mesial temporal lobe epilepsy (mTLE) and neocortical epilepsy (NE) have different anatomo-clinical characteristics. The authors hypothesized that this may be reflected in the different functional connectivity of the epileptogenic zone between mTLE and NE. The authors, therefore, examined preoperative resting-state functional connectivity MRI with regional global connectivity (rGC) analysis for surgically treated patients.

Development and validation of a claims-based algorithm to identify incidents and determine the progression phases of gastric cancer cases in Japan.

Background: Although health insurance claims data can address questions that clinical trials cannot answer, the uncertainty of disease names and the absence of stage information hinder their use in gastric cancer (GC) research. This study aimed to develop and validate a claims-based algorithm to identify and determine the progression phases of incident GC cases in Japan.

Methods: The gold standard for validation in this retrospective observational study was medical records of patients with incident GC who underwent specific treatments, defined by the claim codes associated with GC treatment.