Dynamic changes in body weight have long been recognized as important indicators of risk for human health. Many observational studies have shown that rapid weight gain during infancy, including catch-up growth following low birth weight delivery or adiposity rebound in early childhood, predisposes a person to development of obesity, type 2 diabetes, and cardiovascular diseases (CVD) in later life. However, the mechanisms through which cardiometabolic risk factors develop are not fully understood. Furthermore, a consensus has not been established regarding which period of weight gain contributes to development of future CVD. Therefore, in this review, we evaluate recent evidence on the relationship between early rapid growth and future obesity and cardiometabolic risk as causes of CVD, with a focus on the differential significance of rapid weight gain in infancy and early childhood. Childhood growth during early infancy before 1 year of age may be related to future obesity, but emerging evidence also suggests that toddlers showing an increase in body mass index (BMI) before 3 years of age, a period normally characterized by decreased BMI, are prone to developing cardiometabolic risk. The recognition of this growth pattern may help to identify children who will have cardiometabolic risk and permit tailored interventions to prevent development of future CVD. This review considers the evidence for developmental origins of obesity and related cardiometabolic risk, and the mechanisms involved, with a focus on the relationship between rapid weight gain in early childhood and future cardiometabolic risk. In addition, based on the knowledge accumulated to date, we present proposals for effective preventive measures for future CVD starting from childhood.

Evaluation of the circumferential resection margin (CRM) of locally advanced rectal cancer is an important prognostic factor for predicting local recurrence rate and distant metastasis and is currently the standard practice mainly in Western countries. In Japan, however, CRM assessment is not commonly performed and thus has not been sufficiently studied. Therefore, we aimed to evaluate CRM using a histopathological specimen processing method developed independently by our department. Ten patients with locally advanced rectal cancer who underwent surgery between January 2022 and March 2024 were included in the study. Although preoperative treatment was given to all the 10 patients, CRM was measurable in all cases using this method. As a result, one patient was found to be CRM-positive. The average number of lymph nodes dissected was 14, and the average distal margin (DM) was 20 mm, which was comparable to those of the current pathological specimen processing method. It is imperative to establish the global standard CRM assessment method in Japan. This also should be done in a way that aligns with the current guidelines for specimen processing methods outlined in the Japanese Classification of Colorectal, Appendiceal, and Anal Carcinoma (JCCRC). Our method was able to minimize the burden on pathologists and lower gastrointestinal surgeons as much as possible while enabling more accurate CRM measurement. In the future, it will be necessary to accumulate more cases, identify potential problems, and prospectively evaluate the effectiveness of this method in a multicenter collaborative study.

Vitamin D binding protein (VDBP) has been shown to influence asthma and chronic obstructive pulmonary disease (COPD), but its specific effects are unclear. Moreover, serum VDBP has not been investigated in asthma-COPD overlap (ACO). In this study, we compared serum concentrations of VDBP among 252 participants (63 patients with ACO, 70 with bronchial asthma, 69 with COPD, and 50 healthy donors). We also analyzed correlations of blood VDBP concentration with smoking, serum immunoglobin E, peripheral blood eosinophil and neutrophil counts, serum calcium, serum 25-hydroxyvitamin D₃, respiratory function (FEV1: forced expiratory volume in 1 s), and fractional exhaled nitric oxide in ACO, bronchial asthma, and COPD. Serum VDBP concentrations were significantly lower in the healthy donors compared with the ACO, bronchial asthma, and COPD groups (all p < 0.05), but did not differ significantly among ACO, bronchial asthma, and COPD. Analysis of correlations of various parameters with serum VDBP concentration showed a negative correlation with smoking history (pack-years) (r = −0.266, p = 0.037) and a positive correlation with FEV1 (r = 0.267, p = 0.036) for ACO, but no correlation between serum VDBP and smoking history or FEV1 for bronchial asthma or COPD. A positive correlation between serum VDBP and peripheral blood eosinophil count was found for COPD alone (r = 0.279, p = 0.039). These results suggest that VDBP influences smoking-related respiratory dysfunction in ACO and peripheral blood eosinophil count in COPD.

Backgrounds The molecular mechanisms by which prior hepatitis B virus infection leads to hepatocellular carcinoma are not established. This study aimed to elucidate these mechanisms by investigating the gene mutation profiles associated with the development of hepatocellular carcinoma in patients with prior hepatitis B virus infection.

Methods Surgical specimens were resected in our department. We analyzed cancerous and non-cancerous liver tissues from three groups: (1) patients with hepatocellular carcinoma following prior hepatitis B virus infection, (2) patients with hepatocellular carcinoma during active hepatitis B virus infection, and (3) patients with a history of prior hepatitis B virus infection but without hepatocellular carcinoma. DNA extracted from the tissues was screened for mutations potentially associated with carcinogenesis.

Results Patients who developed hepatocellular carcinoma after a prior hepatitis B virus infection exhibited mutation profiles similar to those of patients with active hepatitis B virus infection in cancerous and non-cancerous areas. This similarity suggests that no unique gene mutations are associated with hepatocellular carcinoma development in the context of prior hepatitis B virus infection. However, patients with APC mutations in non-cancerous liver tissues have a higher likelihood of hepatocellular carcinoma recurrence than those without such mutations.

Conclusions Our findings indicated that APC mutations play a significant role in the development of hepatocellular carcinoma in patients with a history of hepatitis B virus infection. Further studies are required to elucidate the role of this gene in hepatitis B virus-associated carcinogenesis.

The aim of the study is to compare postoperative outcomes and complications between Baerveldt Glaucoma Implant (BGI) and Ahmed Glaucoma Valve (AGV) implanted eyes with refractory glaucoma. This study included 48 eyes of 46 patients (BGI group) and 56 eyes of 52 patients (AGV group) who underwent BGI and AGV implantation, respectively, for the treatment of refractory glaucoma. Changes in intraocular pressure (IOP), medication score, and complications were evaluated postoperatively and compared between the BGI and AGV groups. The IOPs were significantly reduced after surgery in both groups, with significantly lower IOPs at 12, 18 and 24 months in the BGI group than in the AGV group (P < 0.05). Medication scores were significantly reduced postoperatively in both groups, with the AGV group having significantly lower scores than the BGI group at 1 week and 1 month (P < 0.05). Choroidal detachment caused by hypotony (P < 0.0005), additional glaucoma surgeries (P < 0.05) and tube exposure including Hoffman elbow due to the melting of the scleral flap (P < 0.01) were observed more frequently in the BGI group than in the AGV group. Prolapse or plate exposure caused by loosening of sutures was significantly more common in the AGV group (P < 0.05). BGI and AGV implantation effectively reduced the IOP and medication scores in eyes with refractory glaucoma, with subsequently lower IOP in the BGI group. The BGI group required more medication than the AGV group in the early postoperative period. These implantations have characteristic complications related to the nature of each device.

L-type amino acid transporter 1 (LAT1) is predominantly expressed in a wide variety of cancer cells and plays a pivotal role in providing the amino acids required for cancer growth. LAT1 inhibition has attracted considerable attention as a novel strategy for cancer therapy. However, cancer cells can cope with nutrient deprivation, which reduces the efficacy of LAT1 inhibitor. Herein, we report that phosphoglycerate dehydrogenase (PHGDH) diminishes the antitumor effects of LAT1 inhibition. LAT1 inhibitor upregulated PHGDH in MIA PaCa-2 human pancreatic cancer cells. Furthermore, the antitumor effects of LAT1 inhibitor on MIA PaCa-2 were enhanced when combined with PHGDH inhibitor. Our results suggest novel strategy to improve the efficacy of LAT1 inhibitor in cancer therapy by targeting the nutrient starvation response.

The relationship of the number of teeth with cognitive, physical, and oral functions in older adults has been widely investigated, but there are few studies with a cutoff of more than 20 and less than 20 teeth. This cross-sectional study examined the association of ≥ 20 teeth with physical and cognitive assessment scores, oral function, and subjective health status among older adults. Participants were 754 community-dwelling Japanese aged ≥ 65 years. Mean age was 78.5 ± 5.6 years and 21.6% were men. The following assessments were performed: handgrip strength, balance test, 5-m walk test, timed up and go test, Yamaguchi Kanji-Symbol Substitution Test (YKSST), repetitive saliva swallowing test (RSST), stretch cheek test, oral diadochokinesis test, chewing strength test, number of remaining teeth, and subjective health status. There were 328 participants aged ≥ 80 years (43.5%), and 52.4% of them (n = 172) retained ≥ 20 teeth. Participants with ≥ 20 teeth had significantly better scores on the balance test, stretch cheek test, and YKSST, better masticatory strength, and a lower RSST score compared with those with < 20 teeth, after controlling for age and sex. Stepwise logistic regression analysis showed that having ≥ 20 remaining teeth was associated with younger age (OR = 0.967, P = 0.036), better balance test (OR = 1.010, P = 0.009), YKSST score (OR = 1.031, P < 0.001), and masticatory strength (OR = 1.252, P = 0.004). These findings suggest that older adults with ≥ 20 teeth have better cognitive, physical, and oral functions than those with fewer teeth.

We started transcatheter aortic valve implantation (TAVI) in 2018, and while accumulating 391 cases, we have developed a transapical approach that can be performed safely with good reproducibility, so we will introduce our surgical ingenuity in this case report.

The case was an 85-year-old woman diagnosed with symptomatic severe aortic valve stenosis. Considering her age, surgical risk, and frailty, TAVI was indicated. Although the aortic annulus was small, her aortic root anatomy was suitable for TAVI. Because of occlusion and severe stenosis at the bilateral iliac arteries, a transapical approach was chosen. After 5th intercostal left thoracotomy, two horizontal mattress sutures of 3-0 prolene SH needles with felt were placed near the apex of the left ventricular anterior wall, in which the stiff wire was punctured and placed. After inserting the 18 Fr sheath, the SAPIEN3 23 mm is implanted uneventfully without peri-valvular regurgitation which was confirmed by transesophageal echocardiogram. The sheath was removed and the puncture site was closed with already placed 3-0 prolene sutures under ventricular tachycardia induced by temporary pacing in order to control blood pressure and wall tension at the apex. The postoperative course was uneventful and she was discharged to home a week after surgery.

We encountered a rare case of early-stage lung adenocarcinoma and dermatomyositis with anti-melanoma differentiation-associated protein 5 antibody (MDA5-DM). The patient was a 57-year-old man with rapidly progressive interstitial lung disease (RP-ILD). Based on prognosis predicted by detailed evaluation of the patient's MDA5-DM/RP-ILD and lung adenocarcinoma, combined immunosuppressive therapy was started before surgical treatment of his lung adenocarcinoma. After 9 months of immunosuppressive therapy, the patient underwent radical thoracoscopic lobectomy. Cancer-associated dermatomyositis, especially MDA5-DM, should be prioritized for treatment based on the prognostic prediction for each disease.

Rib osteomyelitis in children is rare. Here, we report a case of rib osteomyelitis in an 11-year-old girl who presented with chest pain as the only complaint. Based on physical examination and blood tests, pleurisy was suspected as the initial diagnosis, but contrast-enhanced computed tomography and magnetic resonance imaging confirmed the diagnosis of right rib osteomyelitis. The patient was treated with antibiotics and made a full recovery. Clinical manifestations of acute osteomyelitis include fever and localized pain; however, only 36% of patients with rib osteomyelitis have fever. Pediatricians need to consider rib osteomyelitis in the differential diagnosis of chest pain in children, even in the absence of fever.

This report describes a challenging case of a completely thrombosed giant cerebral aneurysm in which the differentiation of the lesion from a cavernous hemangioma was complicated by the lack of continuity with normal vessels. A 66-year-old man presented with nausea, vomiting, and left-sided neurologic symptoms. Head Magnetic Response imating (MRI) revealed a 37 mm mass with mixed intensity and concentric pattern on T2-weighted images (T2WI) lateral to the right parietal lobe and thalamus. T2* showed multiple hypointense lesions. Cerebral angiography showed normal middle cerebral artery (MCA) branches and no contrast inflow into the mass, posing a challenge in differentiating a thrombosed aneurysm from a cavernous hemangioma. Intraoperatively, direct visualization demonstrated continuity of the mass with the right MCA M4 segment through a narrow neck, confirming the diagnosis of a thrombosed aneurysm. While most thrombosed aneurysms show inflow of contrast material into the lumen on angiography, MRI signal patterns similar to hematomas can complicate differentiation from cavernous hemangiomas. In cases where preoperative imaging reveals mass lesions with characteristics similar to those of thrombosed aneurysms, it is critical to consider the possibility of a completely thrombosed giant aneurysm, even in the absence of apparent continuity with normal vessels on neuroimaging, to allow for optimal surgical planning.

A 54-year-old woman with unstable angina underwent coronary stent deployment. She was started on rosuvastatin therapy before undergoing percutaneous coronary intervention (PCI). However, arriving at low-density lipoprotein cholesterol (LDL-C) levels lower than 70 mg/dL required more than a month of treatment. This was accomplished by increasing the rosuvastatin dose by 10 mg and adding ezetimibe. Chronic-phase coronary computed tomography angiography (CCTA) did not show stent restenosis but revealed plaque progression in the left main trunk (LMT). A combination of rosuvastatin, ezetimibe, and the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor was administered to promote regression of the plaque. Follow-up CCTA performed 12 months after the initial scan showed regression of the LMT plaque and the appearance of new calcification in the proximal plaque of the left anterior descending (LAD) artery. The aggressive lipid-lowering strategy that combined rosuvastatin, ezetimibe, and a PCSK9 inhibitor successfully achieved plaque regression without the occurrence of cardiovascular events.