893 results match your criteria: "Wakayama Medical Center.[Affiliation]"

Introduction: Hybrid dialysis is widely used in Japan. Although previous reports have shown the beneficial effects of hybrid dialysis, little is known about the daily change in peritoneal ultrafiltration volume in hybrid dialysis.

Methods: A multicenter, cross-sectional study was conducted in 25 patients with hybrid dialysis.

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Background: Pancreatic cancer is often diagnosed at advanced stages, and early-stage diagnosis of pancreatic cancer is difficult because of nonspecific symptoms and lack of available biomarkers.

Methods: We performed comprehensive serum miRNA sequencing of 212 pancreatic cancer patient samples from 14 hospitals and 213 non-cancerous healthy control samples. We randomly classified the pancreatic cancer and control samples into two cohorts: a training cohort (N = 185) and a validation cohort (N = 240).

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Background And Purpose: This study aims to externally validate a predictive model for distant metastasis (DM) with computed tomography (CT)-based radiomics features in prospectively enrolled non-small-cell lung cancer patients undergoing dynamic tumor-tracking stereotactic body radiation therapy (DTT-SBRT).

Materials And Methods: The study collected retrospective data from 567 patients across 11 institutions as the training dataset and prospectively enrolled 42 patients from four institutions as the external test dataset. Four clinical features were collected, and 944 CT-based radiomic features were extracted from gross tumor volumes.

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Background And Objective: Thymic epithelial tumors (TETs) are rare and originate from the thymus. Thymomas and thymic carcinomas are the most common types of TETs. Of the two, thymomas tend to have a better prognosis and are typically localized, while thymic carcinomas have a worse prognosis and are more likely to spread.

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Thymic epithelial tumors (TETs), encompassing thymoma and thymic carcinoma, represent a rare and heterogeneous group of thoracic malignancies with varying prognoses and treatment strategies. Surgical resection is the cornerstone of therapy for localized stages, but the management of locally advanced or unresectable TETs often involves induction therapy, including chemotherapy and/or radiation therapy, as a neoadjuvant approach aimed at downstaging the tumor to facilitate subsequent resection. This review synthesizes current knowledge on the re-evaluation process and operative indications following induction therapy for TETs, highlighting the pivotal role of accurate assessment in guiding surgical decisions and optimizing patient outcomes.

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This study evaluated the effects of docetaxel and androgen receptor signaling inhibitors as second-line treatments in patients with castration-resistant prostate cancer after androgen receptor signaling inhibitors as first-line treatment. This study retrospectively evaluated the clinical outcomes of second-line treatment with docetaxel or androgen receptor signaling inhibitor in patients with castration-resistant prostate cancer who received first-line treatment with androgen receptor signaling inhibitors. Clinical backgrounds and outcomes were compared between docetaxel and androgen receptor signaling inhibitors as second-line treatment.

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Article Synopsis
  • The study focuses on remnant gastric cancer (RGC) which is rare, examining clinical findings, postoperative data, and challenges in its management among 313 patients from 17 Japanese institutions.
  • Results show that a significant portion of patients had early-stage RGC, but disease recurrence rates were notable, especially within the first few years post-surgery, with peritoneal recurrence being the most common.
  • Adjuvant chemotherapy (AC) appeared to improve recurrence-free survival significantly, suggesting that AC might offer similar benefits as in primary gastric cancer despite some limitations in the study design.
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  • Proton pump inhibitors (PPIs) were studied for their effects on upper gastrointestinal bleeding (UGIB) in patients who underwent percutaneous coronary intervention (PCI), with findings from a large patient registry of 24,563 participants.
  • Over a median follow-up of 5.6 years, PPIs significantly reduced the risk of UGIB but showed no impact on myocardial infarction or ischemic strokes, regardless of high-risk patient subgroups.
  • Although PPIs helped lower UGIB risk, they were also linked to higher mortality rates, suggesting a complex benefit-risk profile in these patients.
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  • Metaplastic thymoma (MT) is a rare type of thymic tumor that has a specific genetic fusion (YAP1::MAML2), similar to skin tumors called poromas.
  • Recent studies revealed that MT lacks YAP1 C-terminus expression, but the expression of YAP1 N-terminus in MT and other thymic epithelial tumors (TETs) needed further exploration.
  • In an examination of 14 MT cases, it was found that MT consistently showed a distinct staining pattern (YAP1[N]-positive, YAP1[C]-negative), while other TETs like type B3 thymoma exhibited variable staining, highlighting the need for more research on YAP1's role
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  • Diphenhydramine, a first-generation antihistamine, can cause severe and potentially fatal acute intoxication, especially in children.
  • A case is reported of a 13-year-old girl who experienced central nervous system depression after taking unknown drugs, revealing diphenhydramine intoxication and a false positive for tricyclic antidepressants (TCAs) in urine tests.
  • This case highlights the need for physicians to be aware of the potential for cross-reactivity when diagnosing acute drug intoxication, especially when TCA tests return positive results.
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Background: An artificial intelligence-based algorithm we developed, mrAI, satisfactorily segmented the rectal tumor, rectum, and mesorectum from MRI data of rectal cancer patients in an initial study. Herein, we aimed to validate mrAI using an independent dataset.

Methods: We utilized MRI images collected in another nationwide research project, "Open versus Laparoscopic Surgery for Advanced Low Rectal Cancer Patients".

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Serum interleukin-18 levels can improve the diagnostic performance of the PRINTO and ILAR criteria for systemic juvenile idiopathic arthritis.

Cytokine

October 2024

Department of Pediatrics and Developmental Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan. Electronic address:

Article Synopsis
  • * A total of 90 s-JIA patients and 27 controls with other febrile diseases were included in the study, where the performance of both diagnostic criteria was assessed alongside expert diagnoses and serum IL-18 measurements.
  • * Results show that while PRINTO criteria have higher sensitivity but lower specificity than ILAR criteria, combining PRINTO with serum IL-18 levels of ≥ 4,800 pg/mL significantly enhances diagnostic accuracy, achieving the best performance overall.
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  • A study in Japan compared outcomes of patients with venous thromboembolism (VTE) treated with warfarin (2010-2014) versus direct oral anticoagulants (DOACs) (2015-2020) from two multicenter registries.
  • The use of DOACs skyrocketed from 2.6% in the warfarin era to 79% in the DOAC era, leading to a significant reduction in the 5-year recurrence rate of VTE (10.5% to 9.5%).
  • However, the incidence of major bleeding remained similar between the two eras, indicating that while DOACs may reduce VTE recurrence, concerns about bleeding risks continue.
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Methotrexate may cause methotrexate-associated lymphoproliferative disorder (MTX-LPD); however, this disease is uncommon in the gastrointestinal tract. We examined six patients with MTX-LPD in the gastrointestinal tract at our hospital. All of the lesions were ulcerative.

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Pathogenic role and diagnostic utility of interferon-α in histiocytic necrotizing lymphadenitis.

Clin Immunol

September 2024

Department of Pediatrics and Developmental Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan. Electronic address:

Article Synopsis
  • Histiocytic necrotizing lymphadenitis (HNL) is a painful inflammatory disease with an unclear cause, and this study focused on the role of interferon (IFN)-α in its development and diagnosis.
  • The study involved 47 HNL patients and 43 others with similar conditions, using various techniques to measure IFN-stimulated genes and serum levels of IFN-α.
  • Results showed higher levels of ISG and serum IFN-α in HNL patients compared to those with malignant lymphoma, suggesting that IFN-α could be a key factor in HNL and a useful marker for its diagnosis and monitoring.
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Article Synopsis
  • - A new prognostic model was developed to predict cancer-specific survival (CSS) for patients with de novo metastatic hormone-sensitive prostate cancer (mHSPC) using data from 1,092 Japanese patients treated between 2014 and 2020.
  • - Key factors for predicting CSS included disease severity, liver metastasis, certain lab results, and primary tumor characteristics, leading to significant differences in 5-year CSS rates among low-risk (86%) and high-risk (22%) groups.
  • - This model displayed high accuracy and reproducibility, and it may help tailor treatment approaches for patients with mHSPC, especially in determining the intensity of therapies needed.
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Genetic Risk Stratification of Primary Open-Angle Glaucoma in Japanese Individuals.

Ophthalmology

November 2024

Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan; Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Sendai, Japan. Electronic address:

Article Synopsis
  • The study aimed to evaluate the effectiveness of genetic risk estimation in identifying primary open-angle glaucoma (POAG) among Japanese individuals through a cross-sectional analysis involving 3,625 participants.
  • Genetic risk scores (GRSs) were developed based on a genome-wide association study, with the best-performing GRS comprising 98 significant variants showing strong predictive accuracy for POAG.
  • Results indicated that individuals in the top 10% of GRS had a substantially higher likelihood of having POAG compared to those in the lowest 10%, highlighting the potential of GRS as a tool for glaucoma risk assessment in this population.*
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  • This study investigates the impact of metastasis histology in lymph nodes on the prognosis of patients with stage IV colorectal cancer (CRC).
  • Among 449 patients analyzed, those with lymph nodes showing tubular-type carcinoma had better cancer-specific survival (CSS) compared to those with poorly differentiated-type carcinoma.
  • The findings suggest that the histological type of metastatic lymph nodes can serve as an independent prognostic indicator for patients with node-positive stage IV CRC.
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An 81-year-old man with prostate cancer (cT3aN0M0), who had been undergoing hormonal therapy for 4 years and had maintained low prostate specific antigen levels, developed metastasized pelvic lymph nodes. A tissue biopsy revealed neuroendocrine differentiation of prostate cancer in the metastatic lymph nodes. Consequently, chemotherapy with carboplatin+etoposide was initiated.

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Background: Body weight loss (BWL) after gastrectomy impact on the short- and long-term outcomes. Oral nutritional supplement (ONS) has potential to prevent BWL in patients after gastrectomy. However, there is no consistent evidence supporting the beneficial effects of ONS on BWL, muscle strength and health-related quality of life (HRQoL).

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Objectives: In sepsis treatment, antibiotics are crucial, but overuse risks development of antibiotic resistance. Recent guidelines recommended the use of procalcitonin to guide antibiotic cessation, but solid evidence is insufficient. Recently, concerns were raised that this strategy would increase recurrence.

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Article Synopsis
  • The PE-SARD bleeding score was developed to predict early major bleeding in patients with pulmonary embolism (PE) but has not been fully validated externally.
  • A study using data from the COMMAND VTE Registry involving 2,781 acute PE patients categorized them into high, intermediate, and low-risk groups based on this score, revealing a clear increase in bleeding rates with higher risk scores.
  • The results indicated the score has modest effectiveness in predicting bleeding risk overall, with better performance in patients without active cancer.
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Objectives: To evaluate the diagnostic accuracy of the aortic dissection detection risk score (ADD-RS) used alone or in combination with D-dimer for detecting acute aortic syndrome (AAS) in patients presenting with symptoms suggestive of AAS.

Methods: We searched MEDLINE, EMBASE, and the Cochrane Library from inception to February 2024. Additionally, the reference lists of included studies and other systematic reviews were thoroughly searched.

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  • The study examined the impact of very low levels of low-density lipoprotein cholesterol (LDL-C) on patients with coronary artery disease, using data from over 39,000 patients who underwent coronary revascularization.
  • It was found that patients with very low LDL-C levels (<85 mg/dL) had more health issues and a higher risk of all-cause mortality compared to those with higher levels, revealing significant risks for various types of death and heart failure.
  • Overall, the research suggests that lower LDL-C levels correlate with more serious health problems and increased mortality risk, highlighting the need for careful management of cholesterol levels in at-risk patients.
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A 37-Year-Old Man With Intellectual Disability Discovered to Have Aspartylglucosaminuria: Implications for the Diagnosis of Genetic Causes.

Neurol Genet

June 2024

From the Department of Neurology (M.K., K.Y., S.H., D.K., H.Y.), Japanese Red Cross Wakayama Medical Center; Department of Neurology (M.K., S.H.); Department of Pediatrics (N.Y., A. Yokoyama, K.K., T.Y.), Graduate School of Medicine, Kyoto University, Japan; Center for Lysosomal and Metabolic Diseases (M.C.H., C.J.R., S.V., E.M.), Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Neurology (D.K.), Kyoto Kizugawa Hospital; and Department of Pediatrics (A. Yokoyama, A. Yoshida), Japanese Red Cross Wakayama Medical Center, Japan.

Objectives: The causes of intellectual disability (ID) are varied, with as many as 1,400 causative genes. We attempted to identify the causative gene in a patient with long-standing undiagnosed ID.

Methods: Although this was an isolated case with no family history, we searched for the causative gene using trio-based whole-exome sequencing (trio-WES), because severe ID is often caused by genetic variations, and inherited metabolic disorders (IMDs) are assumed to be the cause when regression and epilepsy occur.

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