This meta-analysis aimed to investigate the impact of pretreatment quality of life (QoL) on overall survival (OS) in patients with hematological malignancies. The observational studies with relationship between QoL and OS in patients undergoing either hematopoietic stem cell transplantation (HSCT) or chemotherapy were collected. Stratification by treatment was performed to examine the association between QoL and OS. Six articles were included in the analysis. Overall, significant associations with OS were observed for global QoL (hazard ratio [HR] = 1.04, 95% confidence interval [CI] = 1.01–1.08), physical QoL (HR = 1.06, 95% CI:1.02–1.10), and social QoL (HR = 1.02, 95% CI: 1.00–1.03). When stratified by treatment, HSCT showed significant associations between OS and both global QoL (HR = 1.05, 95% CI:1.00–1.11) and physical QoL (HR = 1.03, 95% CI:1.00–1.06). For chemotherapy, significant associations were also observed between OS and global QoL (HR = 1.04, 95% CI:1.00–1.09), physical QoL (HR = 1.08, 95% CI:1.00–1.17), role QoL (HR = 1.02, 95% CI:1.00–1.04), and social QoL (HR = 1.02, 95% CI:1.00–1.04). No significant associations were observed regarding emotional QoL, which was only analyzed in HSCT. The factors influencing OS may vary depending on the treatment, emphasizing the importance of recognizing QoL from the pretreatment stage.

The diagnosis and treatment of malignant spinal tumors are complex and require an integrated approach known as Jaffe’s triangle.　This review discusses recent topics in the diagnosis and treatment of primary and metastatic malignant spinal tumors.　Integrated diagnostic methods, including the development of a dumbbell scoring system for benign-malignant differentiation and the use of positron emission tomography and magnetic resonance imaging (PET-MRI), have improved diagnostic accuracy.　Curative resection techniques such as vertebrectomy, sagittal resection, and posterior resection are crucial for primary malignant tumors.　Heavy particle radiation therapy, such as carbon-ion radiotherapy, shows promise against radiation-resistant tumors, whereas novel drug therapies, such as denosumab, are effective for giant cell tumors of the bone arising in the spine.　For metastatic spinal tumors, the collaborative efforts of the Bone Metastasis Cancer Board and minimally invasive spine stabilization have expanded surgical indications and improved patient outcomes.　The treatment system has shifted towards preventive surgery and outpatient management, aiming to maintain quality of life and continue chemotherapy.　Interdisciplinary collaboration is essential for improving treatment outcomes in both primary and metastatic malignant spinal tumors.

Primary malignant spinal cord tumors (PMST) and metastatic spinal tumors (MST) are among the most difficult areas of orthopedic surgery.　Their diagnosis and treatment require multidisciplinary diagnostic and therapeutic strategies that integrate knowledge and skills in orthopedics, pathology, and diagnostic radiology (the so-called Jaffe triangle), as well as in clinical oncology and tumor biology, which have made remarkable progress in recent years.　Here, we review recent topics related to the diagnosis and treatment of PMST and MST.

Introduction: Rectal cancer is among the main causes of cancer-related mortalities worldwide, necessitating more effective treatment strategies.　It is considered that lateral pelvic lymph node dissection (LPND) for rectal cancer patients can contribute to local tumor control and that robotic LPND (Rob-LPND) may be more suitable for LPND, due to technical advantages of precise manipulation in a narrow pelvic space.

Methods: In this retrospective study, we evaluated the short-term outcomes of laparoscopic-LPND (Lap-LPND) versus Rob-LPND in patients undergoing radical surgery for rectal cancer.　Operative time, blood loss, urethral catheter reinsertion, duration of pelvic drainage tube placement, drainage volume, and postoperative hospital stay were compared between Lap-LPND and Rob-LPND.

Results: Our findings revealed that Rob-LPND was associated with longer total operation time, but there was no significant difference in operation time between the two LPND techniques.　Urinary catheter re-insertion rates were lower in Rob-LPND; also, significant reductions in drainage tube duration, total drainage volume, and postoperative hospital stay were observed.

Conclusion: Rob-LPND may reduce postoperative total drainage volume and shorten postoperative hospital stays.　These improvement in short-term outcomes suggest potential clinical advantages of Rob-LPND.

Western professionalism frameworks dominate medical education yet cause translational and ethical challenges when applied across cultures.　Increasing globalisation brings an impetus to examine these perspectives in non-dominating cultures, with a cultural understanding about what constitutes unprofessional behaviour urgently needed.　In the absence of comparative data from dominating and non-dominating cultures, we sought to use Q-methodology to examine perceptions of unprofessional behaviour amongst stakeholders in Japan and the UK.

Statements describing 48 unprofessional behaviours were sorted according to perceived severity by 58 Japanese and UK students, clinical educators, and administrators.　Factor analysis using judgemental rotation flagging factors at p<0.05 was performed.　Follow-up questionnaire responses were coded and supported the interpretation of factors.

A four-factor solution showing four distinct constructs of unprofessional behaviour was extracted: clinical responsibility (international factor), relational responsibility (Japanese-only factor), moral responsibility (UK-dominant factor), and personal responsibility (Japanese-dominant factor).　Japanese-only constructs identified behaviours disrupting personal and group relationships as more unprofessional, whereas the UK factor focused on personal motivation and ethical reasoning.

Our multi-stakeholder data provides empirical evidence into the contrasting conceptualisations of unprofessional behaviour that co-exist in practice.　We identify culturally constructed perspectives unique to both contexts, which warrant recognition and integration in local teaching and national guidelines.

This study evaluated the outcomes of simultaneous pancreas-kidney transplantation (SPK) at Fukushima Medical University between 2001 and 2024.　We retrospectively reviewed ten adult patients who underwent SPK.　We aimed to clarify the important aspects of patient management in patients undergoing SPK, focusing on perioperative outcomes and long-term complications.

The median postoperative observation period was 1,968 days.　Postoperative complications were observed in all patients.　Most were classified as Clavien-Dindo (CD) grade I or II, but major complications, including CD grade IIIa or higher, were observed in four patients (40%) with zero mortality.　Despite the loss of one kidney graft due to primary non-function, the 5-year survival rates for both patients and pancreatic grafts remained at 100%.　However, there was one case each of pancreatic graft loss, kidney graft loss, and patient death after 5 years post-transplantation, all attributed to late-onset complications, including recurrent type 1 diabetes, focal segmental glomerulosclerosis, and cardiovascular disease.

The short-term outcomes of SPK at our institution were favorable, with a trend toward a reduction in the comprehensive complication index (CCI) observed in the latter five cases compared with the first five cases, suggesting potential improvements in perioperative management.　Long-term monitoring and collaboration with physicians are essential to enhance patient outcomes.　

H3K4 methylation, primarily mediated by MLL family proteins, plays a pivotal role in the epigenetic regulation of gene transcription. Among the MLL family, KMT2A is known for its critical role in hematopoiesis. MLL family proteins feature C-terminal SET catalytic domains, requiring the formation of MLL complexes with proteins like DPY30 to maximize their enzymatic activity. Deletion of DPY30 results in a significant reduction in H3K4me1, H3K4me2, and H3K4me3 levels in bone marrow (BM) cells, underscoring the essential role of DPY30 in facilitating optimal catalytic activity within MLL family complexes. Here, we present a unique case of myelodysplastic neoplasms (MDS) associated with a novel t(2;19)(p23;q13.3) translocation. A 22-year-old pregnant woman initially sought consultation due to thrombocytopenia, which temporarily improved following a miscarriage. However, she later presented with progressive pancytopenia. RNA sequencing analysis of BM mononuclear cells using STAR-Fusion revealed the translocation breakpoint on chromosomes, resulting in the disruption of the DPY30 and CEACAM6 genes. BM failure showed marked improvement following cord blood transplantation. This case represents a novel form of MDS associated with the disruption of the DPY30 gene. Our findings underscore the importance of considering early hematopoietic stem cell transplantation for MDS cases attributed to DPY30 dysfunction.

Meta-iodobenzylguanidine (MIBG) is an analog of norepinephrine and guanethidine, and MIBG scintigraphy is useful to diagnose tumors of the sympathetic nervous system, such as pheochromocytoma, paraganglioma, and neuroblastoma.　To date, there have been few reports of MIBG accumulation in gastrointestinal stromal tumors (GISTs), so the mechanism and frequency of MIBG accumulation in GISTs are unknown.　Herein, we report and discuss three cases of GIST in which scintigraphy that was performed to exclude pheochromocytoma showed MIBG accumulation.