Clonal hematopoiesis, characterized by the age-related expansion of hematopoietic stem cell clones harboring somatic mutations, has emerged as an essential contributor to cardiovascular disease. Accumulating evidence indicates that clonal hematopoiesis driven by myeloproliferative neoplasm-associated driver mutations, particularly JAK2, is associated with an increased risk of vascular and cardiac complications, even at low variant allele frequencies. Experimental models and clinical studies demonstrate that mutant hematopoietic cells promote inflammation and pathological remodeling, thereby contributing to cardiovascular disorders such as pulmonary hypertension and aortic aneurysm. In addition, advances in circulating biomarker research have enabled less invasive assessment of cardiovascular diseases. Biomarkers, including cell-free DNA, reflect ongoing cardiac damage, while the extracellular matrix protein of collagen triple helix repeat-containing protein 1 (CTHRC1) provides insights into cardiac fibrosis. Clonal hematopoiesis and circulating biomarkers may enhance risk stratification and improve mechanistic understanding of cardiovascular pathology. This review summarizes current evidence of clonal hematopoiesis and circulating biomarkers in cardiovascular diseases.

Many countries have adopted the use of helicopter emergency medical services (HEMS). One such system in Japan is called “Doctor Heli” (Doctor Helicopter), which is sometimes used as a means of maternal transport. Since 2008, there have been 18 cases of Doctor Heli maternal transport to Fukushima Medical University Hospital, the ultimate referral center of Fukushima Prefecture. Reasons for transport included umbilical cord prolapse (UCP), placental abruption, traffic accident, and fetal bradycardia. There were two cases of intrauterine fetal death upon arrival at the hospital. Although there is no specific requirement for an obstetrician to be on board, we encountered a case of UCP in which an obstetrician examined a patient and then traveled with her via helicopter ; the baby was successfully delivered at a tertiary care facility. In cases such as UCP, where immediate assessment of fetal condition is critical, involvement of an obstetrician prior to or during transport can be vital. Because aeromedical dispatch can connect doctors and patients more quickly, it may improve perinatal outcomes.

Background : Pharmacological therapy is essential in heart failure with reduced ejection fraction (HFrEF), but its prognostic role at the time of cardiac resynchronization therapy (CRT) remains uncertain.

Methods : We retrospectively studied 272 patients (mean age 66 years ; 72% male) who underwent CRT between 2005 and 2023. Pharmacological therapy was assessed only at baseline. Medication included β-blockers (97.4%), renin–angiotensin system inhibitors or angiotensin receptor-neprilysin inhibitors (RAS inhibitors/ARNIs, 81.3%), mineralocorticoid receptor antagonists (64.7%), and loop diuretics (76.8%). The primary outcome was cardiac death or left ventricular assist device (LVAD) implantation. Cox models evaluated associations between baseline medication use, medication doses, and outcomes.

Results : During a median follow-up of 4.2 years, 126 patients (46.3%) experienced the primary outcome. Baseline use and higher β-blocker dose were independently associated with a lower risk of the primary outcome. RAS inhibitors/ARNIs use was also associated with a lower risk of cardiac death or LVAD implantation. In contrast, higher loop diuretic dose and inotrope use tended to be associated with worse outcomes.

Conclusion : Baseline use and dosing of β-blockers and RAS inhibitors/ARNIs were prognostically significant in CRT recipients, underscoring the importance of optimizing pharmacotherapy at the time of device implantation.

Background : Although increases in plasma levels of non-esterified fatty acids (NEFA) during hemodialysis (HD) have been reported, the precise time course of this elevation, its underlying pathophysiology, and effective therapeutic strategies remain unclear.

Methods : The time course of plasma NEFA and immunoreactive insulin (IRI) concentrations during HD sessions was examined in seven patients with end-stage kidney disease across three phases : no intervention (control phase), intradialytic parenteral nutrition with an amino acid solution (IVAA phase), and intradialytic parenteral nutrition with amino acid and glucose solutions (IVAA + IVG phase).

Results : Plasma NEFA concentrations, which increased beyond the normal range during the control and IVAA phases, remained within normal limits in the IVAA + IVG phase, likely due to the maintenance of plasma IRI concentrations above the fasting range.

Conclusion : Hemodialysis elevated plasma NEFA concentrations to abnormally high levels, but this increase was suppressed by intradialytic parenteral nutrition containing amino acids and glucose.

Crystal engineering plays a crucial role in the efficient design of pharmaceutical cocrystals, hinging on a deep understanding of intermolecular interactions that influence crystal packing. By leveraging these interactions, researchers can create innovative solid forms with customized physical and chemical properties. This versatile approach is especially valuable for tackling the solubility and bioavailability issues commonly associated with poorly soluble drugs. In this study, we focused on synthesizing cocrystals of itraconazole (ITZ) and proline via the kneading technique, an eco-friendly crystal engineering technique. Our work included comprehensive solid-state characterization, stability assessments, and in vitro efficacy evaluations. We specifically examined how these cocrystals performed in terms of dissolution, solubility, and antifungal activity. Our solid-state characterization results highlighted the formation of significant intermolecular interactions within the cocrystals, particularly hydrogen bonds between ITZ and the functional groups of proline. Notably, the ITZ-proline cocrystals demonstrated superior solubility and faster dissolution rates compared to pure ITZ, alongside increased crystallinity in the newly formed solid state. Additionally, the cocrystals exhibited enhanced antifungal activity and stability. Consequently, our findings have indicated that forming ITZ cocrystals with proline significantly enhances the solubility as well as stability of ITZ, thereby offering a promising antifungal strategy to combat fungal infections.

We report a case of asymptomatic duodenal perforation caused by an inferior vena cava (IVC) filter. A 43-year-old man presented with multiple filter struts projecting through the IVC wall and penetrating the duodenum, identified on esophagogastroduodenoscopy. The patient had undergone retrievable IVC filter placement one year earlier for left iliac vein thrombosis and was being followed up with computed tomography. Open surgical removal of the IVC filter and primary repair of the duodenum were performed to prevent potential hemorrhagic and infectious complications. The postoperative course was uneventful, and the patient was discharged on postoperative day 10 after resuming anticoagulation therapy.

Nontuberculous mycobacterial (NTM) tenosynovitis is a rare extrapulmonary infection that presents as a painless, slow-growing mass and often evades timely diagnosis due to nonspecific symptoms. We report the case of an 89-year-old female farmer who developed a recurrent mass in her right forearm. Despite two prior excisions, the lesion recurred, prompting further investigation. Magnetic resonance imaging revealed low-intensity areas, and intraoperative findings included rice bodies. Histopathology showed an epithelioid granuloma, while the anti-GPL-core IgA antibody test was negative. Mycobacterium intracellulare, a species within the Mycobacterium avium complex (MAC), was identified by culture from the excised tissue, confirming the diagnosis. Treatment with antituberculous agents was administered, and no recurrence was observed at one-year follow-up. This case underscores the importance of integrating imaging, intraoperative findings, and microbiological testing in the diagnosis of NTM tenosynovitis.

Cornelia de Lange syndrome (CdLS) is a rare genetic disorder characterized by distinctive facial features, fetal growth restriction, intellectual disability, and hirsutism. Few reports have described extremely low birth weight (ELBW) infants with CdLS. We report an ELBW infant diagnosed with CdLS. The infant was delivered by emergency cesarean section at 34 weeks and 1 day of gestation, weighing 994 g (−3.7 SD score). A diagnosis of CdLS was suspected based on dysmorphic features, including forehead hirsutism, cleft palate, long philtrum, wide nostrils, syndactyly of toes, femoral hirsutism, and hypospadias. Chromosomal analysis revealed a normal male karyotype (46,XY). Bilateral sensorineural hearing loss was also confirmed. Additional findings included atrial and ventricular septal defects. During hospitalization, the infant developed urinary tract infection and gastric volvulus but survived without severe complications. This case highlights that early recognition of CdLS, even in ELBW infants, is important for anticipating complications and providing timely multidisciplinary interventions to mitigate severe complications and facilitate long-term management.

We herein present an 87-year-old febrile female patient with knee joint pain. The presence of calcium pyrophosphate crystals in synovial fluids led to a diagnosis of calcium pyrophosphate dihydrate (CPPD) disease. She was treated with nonsteroidal anti-inflammatory drugs (NSAIDs), resulting in the resolution of the knee joint arthritis and inflammatory signs. However, 3 weeks from the first onset of knee joint pain, she relapsed with febrile episodes accompanied by myalgia around the shoulder and morning stiffness. Ultrasonography revealed bilateral long head biceps tenosynovitis. A diagnosis of polymyalgia rheumatica (PMR), considered to be a complication in addition to the pre-existing CPPD disease, was made according to the EULAR/ACR provisional classification criteria for PMR. Steroid therapy resolved the symptoms. This case demonstrates the importance of considering the possibility of overlapping PMR in patients with an atypical clinical course of CPPD disease. Careful differentiation of PMR and CPPD disease is necessary in elderly patients with atypical inflammatory arthropathy.

Frozen-thawed embryo transfer (FET) in hormone replacement cycles (HRC) is widely used in assisted reproductive technology (ART). However, interpreting early serum human chorionic gonadotropin (hCG) levels remains challenging, especially in the absence of endogenous luteal function. This case report describes a 30-year-old woman who underwent FET with a high-quality blastocyst under HRC. At 4+1 weeks, her serum hCG level was 6.6 mIU/mL ; hormone support was discontinued, assuming a biochemical pregnancy loss. No follow-up hCG testing or transvaginal ultrasound was done. At 8+1 weeks, she presented with acute abdominal pain and was diagnosed with a ruptured tubal ectopic pregnancy with massive hemoperitoneum. Emergency laparoscopy revealed 1,500 mL of intra-abdominal bleeding ; right salpingectomy was performed and histopathological examination confirmed a tubal pregnancy. This case highlights the diagnostic limitations of relying on a single low hCG measurement during FET cycles. Even low or borderline hCG levels are compatible with ongoing or ectopic pregnancies. Clinicians should be cautious before discontinuing luteal support and should consider continued follow-up when hCG is detectable. In ART settings where early hCG testing is routine, integrating serial hCG measurements with early imaging can avoid life-threatening delays in the diagnosis of ectopic pregnancy.

The Field Trip to Fukushima Course (Harvard T.H. Chan School of Public Health, GHP549, Winter Session 2026) built on the inaugural 2025 course to offer an educational experience for graduate students across Harvard, examining ongoing recovery challenges in Fukushima following Japan's 2011 triple disaster of an earthquake, tsunami, and nuclear meltdown. Students learned directly from stakeholders spanning local, prefectural, and national levels across a range of sectors, mainly in Fukushima and Tokyo. Organized into three groups (Radiation and Environmental Health, Disaster Preparedness and Health Systems Resilience, and Community Recovery and Social Impact), students presented their results at Fukushima Medical University on January 20, 2026. The Radiation and Environmental Health group proposed establishing a Japan-led task force on nuclear disaster response and preparedness, presented in a theater-style format. The Disaster Preparedness and Health Systems Resilience group applied a social capital framework and recommended community strengthening through Disaster Welfare Assistance Teams in the acute phase and community buckwheat farming in long-term recovery. The Community Recovery and Social Impact group designed a LINE account for information dissemination and community building among young people. Building on its inaugural year, the course offered insights into how field-based, interdisciplinary learning can contribute to graduate education in disaster preparedness, recovery, and community resilience.

Since 2011, the Fukushima Health Management Survey has attended to the physical and mental health of Fukushima residents, to maintain and improve their health into the future. As meaningful data emerged from the Survey, annual symposia were organized for Fukushima residents and other stakeholders. The 12 March 2026 International Symposium attracted 62 attendees and 8 media organizations to Fukushima Medical University’s Ekimae (Fukushima Station) Campus. Online video streaming, with original audio and simultaneous translation, accommodated another 168 attendees and 5 media organizations. Video recordings, with a choice of English or Japanese soundtracks, and presentation slides, are available on demand¹⁾. Highlights follow, with the hope that readers will explore topics in greater detail through publications and web pages of the Fukushima Health Management Survey, as well as scholarly references cited by Symposium speakers on many of their slides.