Background: Few studies have assessed the association between prognosis and apparent diffusion coefficient (ADC) or tumor volume in metastases from breast cancer.

Purpose: To evaluate whether tumor volume and ADC on postoperative whole-body magnetic resonance imaging (WB-MRI), including WB diffusion-weighted imaging (WB-DWI), in the follow-up period are predictors of prognosis in patients with metastatic breast cancer.

Methods: 87 patients who underwent WB-MRI in the post-operative follow-up period between October 2015 and March 2020 were enrolled in this retrospective study. Metastatic tumors initially depicted on WB-DWI were segmented semi-automatically. The correlation between tumor diffusion volume (tDV) and minimum ADC extracted from WB-DWI and survival time was investigated. Receiver-operating characteristic analysis was performed and the area under the curve (AUC) was calculated. The optimal cut-off value to predict survival was obtained and sensitivity and specificity were calculated. Survival rate was compared between groups above and below the cut-off value.

Results: During the study, one patient died of a myocardial infarction, leaving a final total of 86 patients. Of the 86 patients, 38 died. Cox proportional hazard modeling showed that tDV and minimum ADC were prognostic factors. The AUC for tDV was 0.720. A cut-off value of 24.3 mL respectively. Patients with tDV>24.3 mL showed a significantly lower survival rate (p<0.0001). The AUC for minimum ADC was 0.710. A cut-off value of 0.084×10^-3 mm²/s respectively. Patients with min ADC<0.084×10^-3 mm²/s showed a significantly lower survival rate (p<0.0001).

Conclusion: Postoperative follow-up with WB-MRI could predict medium-term prognosis in patients with distant metastases of breast cancer.

Objective: Semaglutide, a GLP-1 receptor agonist (GLP-1RA), improves blood glucose control and promotes weight loss. This study aimed to elucidate the background characteristics, glycemic control outcomes, and body composition changes in patients who were administered semaglutide injections at St. Marianna University Hospital (Kawasaki, Japan), particularly focusing on evaluating the fibrosis-4 (FIB-4) index to investigate its potential association with weight loss outcomes.

Materials and Methods: We retrospectively analyzed 31 patients who received semaglutide injections between June 2021 (start of availability of the drug) and February 2022 (announcement of temporary production suspension). We reviewed patient data, including weight, body composition via impedance analysis, HbA1c levels, and the FIB-4 index. Additionally, the parameters of patients who achieved ≥3% weight reduction at 12 weeks were compared with those who did not.

Results: The cohort (51.6% men, median age 52 years) included 2 drug-naïve patients, 6 with no prior GLP-1RA use, and 23 previously treated with GLP-1RAs. Pre-treatment, the mean weight was 84.7 kg, BMI 32.0 kg/m², body fat percentage 39.0%, and HbA1c 7.5%. The FIB-4 index averaged 1.2. At 12 weeks, 48.4% achieved HbA1c <7% and weight reduction averaged -1.8 kg (-2.5%), with fat loss (-1.4 kg, -4.9%) outweighing minimal muscle loss (-0.3 kg, -0.4%). Weight loss continued at 24 weeks (-3.0%). Patients achieving ≥3% weight loss at 12 weeks had a significantly lower FIB-4 index (0.9 [0.6, 1.1]) compared to non-responders (1.5 [0.9, 2.1]; p=0.01).

Conclusion: Middle-aged, obese patients with poor glycemic control experienced significant improvements with semaglutide, particularly at 12 weeks, with sustained fat loss up to 24 weeks. Fat loss was more pronounced than muscle mass reduction. A lower baseline FIB-4 index correlated with greater weight loss success, suggesting liver fibrosis may limit weight loss outcomes. Further studies on hepatic factors influencing semaglutide's effects are warranted.

Introduction: Stigma remains a significant burden on individuals with bipolar disorder, contributing to reduced quality of life and worsened mental health. This study aimed to identify demographic and clinical factors associated with self-stigma severity in Japanese patients with bipolar disorder.

Methods: A questionnaire survey was conducted on outpatients with bipolar disorder at a university hospital in Kawasaki, Japan. Eligible participants were adults (age ≥20) diagnosed with bipolar I or II disorder based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), who provided written informed consent. Data were collected on participants' demographic, clinical, and social factors, including self-stigma severity.

Results: A total of 127 participants (bipolar I: n = 43, 33.9%; bipolar II: n = 84, 66.1%) with a mean age of 54.2 years (SD = 15.9) and mean illness duration of 20.0 years were included. Logistic regression analysis showed that higher self-stigma severity was significantly associated with lower stigma resistance (OR = 0.007, 95% CI: 0.0008-0.07) and utilization of public support services (OR = 3.04, 95% CI: 1.20-7.67).

Conclusion: Self-stigma and stigma resistance exhibit an inverse relationship. Furthermore, individuals using economic support services experience a dual burden: the distress of their disorder and the added stigma of social vulnerability such as utilization of public support services. Further research is required to explore this association and its implications for psychosocial interventions.