A scientist may realize, during a long academic career, that a widely accepted notion is not actually factual. An example for me is the fraction of adrenaline-secreting cells in human adrenal medullary chromaffin (AMC) cells. Even the authoritative textbooks for medical physiology differ regarding the fraction of adrenaline cells in human AMC cells, stating that it is 80% or 100%. This confusion may be ascribed to the substitution of the fraction of adrenaline in the catecholamines extracted from the human adrenal medulla for the fraction of adrenaline cells in human AMC cells. In this commentary, I look into the possible cause of this substitution and highlight the importance of understanding a process to reach a conclusion.

With the increasing incidence of dementia in Japan due to an aging population and declining birthrate, supporting family caregivers is crucial. A survey was conducted at the hospital of the University of Occupational and Environmental Health, Japan from October 1, 2021, to February 29, 2024, involving dementia patients and their working caregiver relatives. The survey assessed health, living, work, caregiving status, sociodemographic factors, and the care recipient’s condition. A total of 214 patient-caregiver pairs participated; consent was obtained from 212 pairs, and data were collected from 166 caregivers. The caregivers were predominantly women, with 54 (33%) male caregivers and a mean age of 54.7 years. Health status was reported as good (33%) or fair (50%); however, 46% experienced sleep disturbances, 44% had psychological distress, 18% reported work dysfunction, and 8% noted poor social adjustment. Most of the care recipients were women (65%), with a mean age of 79.8 years. The most common diagnoses were mild cognitive impairment (37%) and Alzheimer’s disease (35%), with an average mini-mental state examination score of 21.6. This study outlines the survey protocol, focusing on the health, work, and caregiving conditions of working relatives caring for dementia patients.

To report a rare case of recurrent ectopic pregnancy in an ipsilateral fallopian tube remnant after left salpingectomy for tubal pregnancy. A 33-year-old patient presented with suspected ectopic pregnancy. The patient had previously undergone a left salpingectomy for a tubal pregnancy. Laparoscopy revealed ruptured swelling and bleeding from the left fallopian tube remnant. We diagnosed intra-abdominal hemorrhage due to ectopic pregnancy occurring in the fallopian tube remnant following a previous ipsilateral salpingectomy. Most ectopic pregnancies occur in the ampulla of the fallopian tube, but the occurrence of spontaneous ectopic pregnancy in a remnant tube is rare. There are several mechanisms underlying this phenomenon. In this study, we consider both the prevention and treatment of this rare form of ectopic pregnancy.

The hematoma cavity typically remains collapsed after intracranial hematoma evacuation, but here we report an adult case in which the cavity expanded into a cystic form, developing into a porencephalic cyst, after the removal. A 73-year-old woman was admitted to our hospital presenting with a disturbance of consciousness. A CT scan showed a subcortical hemorrhage with a blend sign and brain herniation, prompting emergent hematoma evacuation. Although there was an improvement in her symptoms after the operation, her consciousness deteriorated on the 14th day post-operation. A CT scan revealed a porencephalic cyst. Reoperation was performed, and no further recurrence of the cyst was noted. Reports of hematoma cavities expanding into a cystic form after hematoma removal are rare, and the mechanisms of such cyst expansion are not well understood. In this case, we hypothesize two pathways: 1) Residual hematoma components moving through the ventricular wall due to osmotic pressure differences between the hypertonic fluid and cerebrospinal fluid (CSF), and 2) Protein-rich plasma components leaking out of cells due to blood-brain barrier (BBB) disruption caused by cerebral hemorrhage. We also consider the possibility of a check valve mechanism.