JMA journal最新文献

Medical illustration serves as a cornerstone for understanding intricate anatomical anomalies, with three-dimensional (3D) rendering emerging as a pioneering tool for emphasizing basic medical concepts and clinical practices. In Japan, the SYNAPSE VINCENT software package (SVSP; Fujifilm Medical Co., Ltd., Tokyo, Japan), internationally known as "SYNAPSE 3D," is a widely embraced solution for 3D rendering. However, despite its prevalence, resources elucidating its practical usage and offering insightful tips are scarce. In this review, we focus on the use of SVSP for 3D rendering of complex anatomical anomalies, particularly in the field of urology. We demonstrate a step-by-step process of 3D rendering. 3D rendering was performed in a sample case of a patient with horseshoe kidney and coexisting bilateral varicoceles through inputting of multiphase contrast-enhanced CT images into the application, followed by segmentation of the renal parenchyma, image registration, and segmentation of the arterial and venous systems as well as the upper urinary tract. Manual adjustments were made using the "Mask edit" and "Diameter setting" tools to ensure accuracy, particularly in cases of significant anomalies. Then, color-coded structures appeared, including the renal parenchyma, arterial and venous systems, and upper urinary tract, which provided a comprehensive visualization of the anatomical anomalies. This review highlights the effectiveness of the SVSP in visualizing complex anatomical abnormalities and detailing the practical rendering process, which could promote wider adoption of the application among urologists despite the challenges associated with the software.

To address the challenges of accurately citing Japanese medical literature in English journals, the essential guidelines "Citing Medicine" by the National Library of Medicine were reviewed, focusing on practical adjustments to enhance accessibility. Key proposals include the use of persistent identifiers (Digital Object Identifier, PubMed Identifier, and International Standard Book Number), proper citation of online content, and the inclusion of romanized Japanese article titles. The selection of accessible journal titles and the importance of consistency were also discussed to avoid confusion. Given the significant volume of Japanese medical literature, cross-lingual citation is critical for preventing the isolation of scientific discoveries. These proposals highlight the need for improved citation practices to make Japanese research activities more accessible to the global research community.

Introduction: : In India the prevalence of metabolic syndrome has dramatically increased. Hepatokines have gained considerable interest, and the role of fetuin-A in overweight and obesity incompletely understood. Therefore, this study aimed to investigate the role of serum fetuin-A in overweight and obese adults with and without metabolic syndrome in the northeastern Indian population.

Methods: This comparative study included 200 subjects (50 control, 50 overweight, 50 obese without metabolic syndrome and 50 obese with metabolic syndrome) aged 20-70 years. Lipid profile and fasting blood glucose, were measured using a fully automated analyzer. ELISA was employed to measure serum fetuin-A levels. Statistical analyses were conducted using SPSS versions 23.0. Furthermore, t-test was used to analyze the numerical investigational data of the present study. Chi squared test for the categorical data, and Pearson's correlation for the correlation analysis.

Results: Overweight and obese adults with and without metabolic syndrome had higher fetuin-A levels were than the controls. The results of this study indicated a positive correlation between fetuin-A and lipid profile, anthropometric parameters, 12 h fasting blood glucose and blood pressure. Contrarily, HDL-C exhibited a negative correlation with fetuin-A.

Conclusions: Fetuin-A is the first hepatokine associated with metabolic diseases. It controls the entire energy homeostasis of the body probably by regulating glucose and lipid metabolism. The current data belief is that fetuin-A may be a promising biomarker for predicting metabolic syndrome and its associated disorders particularly in overweight and obese adults.

Introduction: Patients with Parkinson's disease (PD) and its related disorders exhibit decreased sleep activity. However, the factors associated with this decreased sleep activity remain unknown. Thus, we aimed to explore the factors associated with sleep activity in patients with PD and its related disorders.

Methods: This study included 33 patients with PD and its related disorders and 57 healthy participants who visited our outpatient clinics between November 2018 and March 2020. We evaluated the patients' muscle masses and measured the number of times they turned during sleep. The limb skeletal muscle index was utilized to evaluate the loss of muscle mass. This study was registered in the UMIN Clinical Trials Registry (Clinical Trials Registry number: UMIN000052436).

Results: Age, maximal grip strength, presarcopenia, phase angle (legs), history of hypertension, diabetes mellitus, dyslipidemia, orthopedic diseases, and the number of turns during sleep were associated with PD and its related disorders. The number of turns was independently associated with PD and its related disorders. Receiver operating characteristic curve analysis revealed that the cutoff value for the number of turns was 6 (area under the curve, 0.986; sensitivity, 93.9%; specificity, 96.5%). The cutoff numbers of turns for men and women were 9 and 6, respectively (area under the curve, 1.0 and 0.981; sensitivity, 100% and 94.7%; specificity, 100% and 95.2%; respectively).

Conclusions: The number of turns during sleep is significantly associated with PD and its related disorders and may decrease before patients present with sarcopenia. In addition, PD and its related disorders may coexist in men who turn less than nine times during sleep.

T-cell prolymphocytic leukemia (T-PLL) is a rare and highly aggressive mature T-cell neoplasm. Although the response rate to alemtuzumab, an anti-CD52 antibody, is high, it is difficult to cure the disease with this agent alone. Therefore, hematopoietic stem cell transplantation is recommended for eligible patients. However, there are few effective salvage therapy options for patients ineligible for hematopoietic stem cell transplantation. In this study, we report the case of an elderly patient with relapsed or refractory T-PLL who underwent salvage therapy with methotrexate, hydrocortisone, vincristine, sobuzoxane, and etoposide (MTX-HOPE). The patient was an 85-year-old man. He was administered alemtuzumab twice (at the time of initial treatment and relapse) and cyclophosphamide, vincristine, and hydrocortisone chemotherapy. Furthermore, novel therapeutic drugs (venetoclax and tofacitinib) were administered based on previous case reports. However, the patient was resistant to all treatments, and the tumor cells lost CD52 expression. We administered MTX-HOPE, and the patient survived for approximately 8 months. Although red blood transfusions were necessary because of disease progression, no adverse events were observed because of treatment, and the patient was able to maintain activities of daily living until immediately before death. MTX-HOPE is a combination of classical chemotherapy agents originally developed for palliative chemotherapy in frail patients with refractory lymphoma. MTX-HOPE has been reported to be effective against T-cell tumors. Severe nonhematologic adverse events are rarely reported; however, bone marrow suppression is commonly observed. Grade 3-4 neutropenia has been documented in approximately half of the patients. Therefore, patients should be closely monitored, particularly at the onset of therapy. Consideration should be given to suspending treatment, adjusting the administration interval, or administering G-CSF if necessary. The treatment interval can be appropriately adjusted, making it a valuable treatment option for refractory T-PLL.

Hemophilia B is a quantitative or qualitative factor IX anomaly that manifests as an X-linked recessive inheritance pattern in which females are carriers. Postoperative epidural hematoma emerges as a typical complication in spinal surgery, although its incidence is infrequent. No documentation of postoperative epidural hematoma in carriers of hemophilia B exists. A 64-year-old female patient presented with progressive pain and muscle weakness in both lower limbs. Despite a history of childbirth and prior colorectal cancer surgery, the patient displayed no abnormal bleeding tendencies. Subsequently undergoing decompression surgery for lumbar spinal canal stenosis, the patient experienced paralysis and pain in both legs within 5 hours postoperatively. A magnetic resonance imaging scan revealed severe spinal canal compression attributed to a postoperative epidural hematoma, prompting emergency decompression surgery that ameliorated symptoms. The application of gelatin-thrombin matrix sealants (GTMS) facilitated hematoma removal, resulting in an uneventful recovery. In a postoperative interview, it was revealed that her grandson was undergoing treatment for hemophilia B. Additionally, she exhibited diminished factor IX levels and was diagnosed as a hemophilia B carrier. A definitive preoperative diagnosis of the carrier status is imperative. In instances where surgical intervention is warranted, the implementation of factor IX replacement and intraoperative hemostasis with GTMS is promising for potentially averting the onset of postoperative epidural hematoma.

This is an outline of the prevention of postpartum depression in obstetric institutes, with a focus on support through multidisciplinary collaboration in Japan. The onset of postpartum depression among women can be prevented by finding solutions to background factors causing mental health problems and providing multidisciplinary support.