JMA journal最新文献

The Fukushima Model of Outpatient Pharmacotherapy for Breast Cancer was developed to improve the pharmacological treatment of patients with breast cancer in the vast region of Fukushima Prefecture. This model addresses the challenges posed by the area's lower-than-average density of breast cancer specialists. In the core medical institutions of the prefecture's most populous municipalities, we introduced a telephone consultation service managed by pharmacists at local dispensing pharmacies. The novelty of the Fukushima model lies in two distinct elements: a structured checklist-style tracking report and comprehensive patient information sheets. This innovative tool streamlines a range of processes, including patient self-assessment of symptomatology associated with treatment-related side effects, subsequent medical interventions, and a standardized protocol for reporting severe side effects to healthcare practitioners. This approach facilitates the safe administration of breast cancer pharmacotherapy in home settings. In the future, this model could be used beyond Japan to underserved regions globally, thereby increasing the standard of breast cancer care on a wider scale.

Diabetes mellitus is defined as a group of metabolic diseases characterized by chronic hyperglycemia based on insufficient insulin action. At present, treatment for diabetes aims to prevent micro- and macrovascular complications. Although advances have been made in methods of controlling the risk factors of complications, including blood glucose management, there is still no effective treatment to cure diabetes. This is largely because we do not fully understand what diabetes is. To cure diabetes, it is necessary to elucidate the whole picture of insulin actions including those other than metabolic actions in various tissues and to understand what disorders are caused by its reduction or excess. This article reviews diverse insulin actions in various organs and the effects of their deficiency on diabetes, its complications, and associated diseases.

Introduction: Individual preparedness for large-scale earthquakes is essential for safety and security in Japan, where earthquakes frequently occur. Foreign residents in Japan face barriers to gathering disaster information, and international students are likely to be more vulnerable to the effects of earthquakes due to the shorter duration of their stay in Japan. However, no studies have been conducted on international students' individual preparedness for large-scale earthquakes in Japan. This study aimed to investigate individual preparedness for large-scale earthquakes among international students in Japan.

Methods: This cross-sectional study was conducted from May to August 2023 among 360 international students aged ≥20 years enrolled at seven Japanese-language educational institutions in Osaka, Kyoto, and Hyogo prefectures. Of these, 120 (33.3%) agreed to participate in the mail surveys. Students with invalid answers were excluded and 114 (31.7%) were included in the analysis. The information obtained using a self-administered questionnaire included participants' characteristics, methods used to collect information on individual preparedness for large-scale earthquakes (information sources and languages), and individual preparedness for large-scale earthquakes.

Results: Many international students had not implemented safety measures at home and lacked information about safety confirmation, evacuation sites and routes, items to wear during evacuation, items to take in case of evacuation, or items to stockpile at home. In particular, approximately half of the participants lacked knowledge about nearby evacuation sites, and only 37.7% had confirmed their evacuation routes to nearby evacuation sites. Only 32.5% had prepared bags containing emergency items to take in case of an evacuation, and most had not packed the items, even though they were stocked at home. In addition, only 8.8% had stockpiled radios and emergency portable toilets at home.

Conclusions: It is necessary to promote individual preparedness for large-scale earthquakes among international students in Japan.

Patient-derived xenograft (PDX) models, in which tumor tissues resected from cancer patients are transplanted into immunocompromised mice, have been recently considered the most reliable preclinical models that quite accurately stimulate the real-world characteristics and microenvironments of tumors in patients. The ethical uniqueness of the PDX model, which lies in the fact that it is a hybrid of living human tumor tissue and a carrier mouse, raises several ethical concerns. This study presents four ethical points for consideration and a model ethical governance policy for the implementation and use of PDX models for research. First, PDX models carrying living tumor tissues originating from individual patients with dignity must be treated ethically as materials and data in compliance with the principle of respect for persons. Second, although PDX models themselves are patentable and can be commercialized, it is a standard view, as represented by the Oviedo Convention by the Council of Europe, that those living tumor tissues carried by PDX models shall not give rise to financial gain since those tissues are human body parts; therefore, they should be treated according to a recent ethical approach with the custodianship model as the trust property of patients of origin and shall not be subjected directly to monetary transactions. Third, PDX models must be treated with due care in an ethical manner in line with experimental animal ethics. Finally, the implementation and use of PDX models for research purposes must comply with national and international regulations on both animal experimentation and human subject research. These four points should be carefully examined and properly institutionalized as an ethical governance policy in each institution that plans on utilizing or implementing PDX models for research.

Introduction: This study aimed to compare two groups (9 years or younger [U-9] and 10 years or older [O-10]) of patients with fresh lumbar spondylolysis and elucidate their characteristics.

Methods: This study enrolled 51 elementary school students diagnosed with fresh lumbar spondylolysis through magnetic resonance imaging between March 2015 and March 2022. Study 1 included 10 and 46 patients in the early- and late-grade groups, respectively. Patient characteristics at disease onset (sex, presence or absence of spina bifida occulta [SBO] in the affected vertebra, vertebral level, unilaterality or bilaterality of lesions, presence of a contralateral terminal stage, and disease stage) were compared between the two groups. Meanwhile, Study 2 included 34 patients with confirmed successful or failed bone union. The bone union rates in both groups were compared, and the factors affecting bone union in the entire study cohort were examined.

Results: In Study 1, the proportions of SBO, bilateral, and advanced stage cases were significantly higher in the U-9 group than in the O-10 group. In Study 2, the bone union rate was significantly lower in the U-9 group than in the O-10 group.

Conclusions: The proportions of SBO, bilateral, and advanced stage cases were significantly higher in the U-9 group than in the O-10 group. The bone union rate was significantly lower in the U-9 group than in the O-10 group.

"Letters to the Editor" that address original articles significantly contribute to medical literature. Utilizing letters published in obstetrics and gynecology journals as a study model, I aimed to classify letters according to their context, providing a valuable framework for readers to comprehend the significance of letters and for authors to effectively write them. Using a sample of 40 recent letters from the Journal of Obstetrics and Gynaecology Research (JOGR), I classified letters into three main categories based on their attitude to addressed articles: Disagreement, Agreement, and Complementary. I further subclassified each category into subcategories, including "Interpretation claim," "Data addition," and "Historical viewpoint." The same procedure was carried out for the 24 most recent letters from BJOG and the American Journal of Obstetrics and Gynecology and also for the JMA Journal. Disagreement letters were prevalent in all three OBGYN journals, accounting for 1/2 to 2/3 of all letters. The rest letters were categorized either as "Agreement" or "Complimentary." Subcategorizations demonstrated different ratios of letters of the three categories among journals. I believe that the attempt to categorize and subcategorize letters offers valuable insights into the letters, potentially enhancing clarity in medical literature communication.