A 46-year-old man had a 3-week history of persistent cough. Chest radiography showed a mass in the left pulmonary hilum and contrast-enhanced computed tomography (CT) showed an infiltrative mass extending from the main pulmonary trunk to the left hilar region into the lung. He was referred to our hospital for multidisciplinary treatments. Echocardiography showed that the proximal side of the tumor reached the pulmonary valve. CT revealed that the heterogeneous low-density tumor extended from the main pulmonary trunk to the left and right pulmonary arteries, and the left side of the tumor extended beyond the left pulmonary hilum into the left lung. A mass shadow of 54 mm in length was also seen in the lower lobe of the left lung along the pulmonary artery. Although the left bronchus was compressed by the tumor, there was no obvious intratracheal invasion. Direct invasion to the descending thoracic aorta was suspected. He underwent the resection of the main pulmonary trunk and the left pulmonary artery along with the tumor concomitant with total left pneumonectomy. Reconstruction of the pulmonary artery and right ventricular outflow tract were performed as follows: The right ventricular outflow tract was reconstructed by using a semilunar shaped bovine pericardial patch. The pulmonary artery was replaced by using a composite graft with a Dacron tube graft and an aortic bio-prosthesis. He was discharged on the 22nd postoperative day. The pathological diagnosis of the tumor was pulmonary artery intimal sarcoma. Although there are various reconstruction methods for pulmonary artery intimal sarcoma depending on the affected site, reconstruction of the pulmonary artery and the right ventricular outflow tract by using a composite graft are considered to be a useful method.

Methods: This prospective cohort study analyzed patients with osteoporotic vertebral fractures admitted to the hospital between March 2018 and October 2019. Logistic regression analysis was performed to explore the predictors of vertebral collapse at >4 weeks after admission. Model 1 used basic medical information and physical functions at admission; model 2 used basic medical information and physical function and activity at >4 weeks after admission. Results: In the model 1 results of logistic regression analysis, cardiovascular disease (odds ratio [OR], 12.27; 95% confidence interval [CI], 1.28–117.91) was extracted as a factor affecting vertebral collapse at ≥4 weeks after admission. In the model 2 results of logistic regression analysis, cardiovascular disease (OR, 34.57; 95% CI, 2.53–471.74), movement control during one leg standing at 4 weeks (OR, 7.25; 95% CI, 1.36–38.71), and Pain Catastrophizing Scale score at 4 weeks (OR, 1.11; 95% CI, 1.01–1.21) were extracted as factors affecting vertebral collapse at ≥4 weeks after admission. Conclusions Our results indicate that physical functions and comorbidity affect collapse at ≥4 weeks after admission in patients with osteoporotic vertebral fractures.

Purpose: Scheduled administration of intravenous acetaminophen improves catheter-related bladder discomfort (CRBD) after urological surgery. However its efficacy for patients undergoing transurethral resection of bladder tumors (TURBT) remains unclear.This study aimed to investigate the efficacy of scheduled administration of intravenous acetaminophen after TURBT. Materials and Methods: At the end of surgery, patients in both the control (n=39) and the scheduled administration (n=45) groups received analgesics at the discretion of the anesthesiologists. In the scheduled administration group, intravenous acetaminophen was administered every 4 hours for 12 hours after the surgery. Both groups were administered on-demand analgesics as needed. The primary outcome was CRBD scores, and the secondary outcomes were the face rating scale for lower abdominal pain, administration rates of additional analgesics, durations of bladder catheterization, lengths of postoperative hospital stay, and postoperative complication rate. Results: The scheduled administration group had significantly lower CRBD scores than those of the control group at 8 hours postoperatively (p=0.014), and lower administration rates of additional analgesics 4–8 hours (p=0.029) and 8–12 hours (p=0.027) postoperatively compared to those of the control group. Other secondary outcomes were not significantly different between the groups (all p>0.05). The scheduled administration group did not have postoperative complications related to the scheduled administration of intravenous acetaminophen. Conclusions Scheduled intravenous acetaminophen administration alleviated postoperative CRBD and reduced the need for additional analgesics in patients who underwent TURBT. These findings can be utilized to improve the quality of postoperative care.

Background: Patients with rheumatoid arthritis (RA) are at an increased risk of osteoporosis and vertebral fractures. This study aimed to investigate factors associated with vertebral fractures and treatment goals to prevent new vertebral fractures in patients with RA. Methods: The database used in this study included outpatient data of RA patients at the authors’ hospital of RA patients taken from 2018 to 2022. The patients underwent annual imaging evaluations to assess parameters, including bone mineral density of the lumbar spine (LS; L2-4), total hip, and femoral neck, as well as vertebral fractures. Vertebral fractures were evaluated using radiographic images of the T8 to L5 vertebrae. Results: The prevalence rates of new vertebral fractures in 2018–2019, 2019–2020, 2020– 2021, and 2021–2022 were 2.0%, 1.3%, 2.3%, and 2.0%, respectively. The presence of existing vertebral fractures was associated with new vertebral fractures (p=0.003; odds ratio, 0.241; 95% confidence interval, 0.093–0.624). The cut-off T-score values for the LS for new vertebral fractures in patients with or without pre-existing vertebral fractures were -0.7 (sensitivity, 40.9%; specificity, 100%) and -1.4 (sensitivity, 69.0%; specificity, 62.5%), respectively. Conclusions The presence of pre-existing vertebral fractures is an independent factor associated with new vertebral fractures. It is important to tailor treatment goals based on the presence or absence of vertebral fractures to effectively prevent new fractures.

Background: Patients with rheumatoid arthritis (RA) are at an increased risk of osteoporosis and vertebral fractures. This study aimed to investigate factors associated with vertebral fractures and treatment goals to prevent new vertebral fractures in patients with RA. Methods: The database used in this study included outpatient data of RA patients at the authors’ hospital of RA patients taken from 2018 to 2022. The patients underwent annual imaging evaluations to assess parameters, including bone mineral density of the lumbar spine (LS; L2-4), total hip, and femoral neck, as well as vertebral fractures. Vertebral fractures were evaluated using radiographic images of the T8 to L5 vertebrae. Results: The prevalence rates of new vertebral fractures in 2018–2019, 2019–2020, 2020– 2021, and 2021–2022 were 2.0%, 1.3%, 2.3%, and 2.0%, respectively. The presence of existing vertebral fractures was associated with new vertebral fractures (p=0.003; odds ratio, 0.241; 95% confidence interval, 0.093–0.624). The cut-off T-score values for the LS for new vertebral fractures in patients with or without pre-existing vertebral fractures were -0.7 (sensitivity, 40.9%; specificity, 100%) and -1.4 (sensitivity, 69.0%; specificity, 62.5%), respectively. Conclusions The presence of pre-existing vertebral fractures is an independent factor associated with new vertebral fractures. It is important to tailor treatment goals based on the presence or absence of vertebral fractures to effectively prevent new fractures.

Background: Patients with rheumatoid arthritis (RA) are at an increased risk of osteoporosis and vertebral fractures. This study aimed to investigate factors associated with vertebral fractures and treatment goals to prevent new vertebral fractures in patients with RA. Methods: The database used in this study included outpatient data of RA patients at the authors’ hospital of RA patients taken from 2018 to 2022. The patients underwent annual imaging evaluations to assess parameters, including bone mineral density of the lumbar spine (LS; L2-4), total hip, and femoral neck, as well as vertebral fractures. Vertebral fractures were evaluated using radiographic images of the T8 to L5 vertebrae. Results: The prevalence rates of new vertebral fractures in 2018–2019, 2019–2020, 2020– 2021, and 2021–2022 were 2.0%, 1.3%, 2.3%, and 2.0%, respectively. The presence of existing vertebral fractures was associated with new vertebral fractures (p=0.003; odds ratio, 0.241; 95% confidence interval, 0.093–0.624). The cut-off T-score values for the LS for new vertebral fractures in patients with or without pre-existing vertebral fractures were -0.7 (sensitivity, 40.9%; specificity, 100%) and -1.4 (sensitivity, 69.0%; specificity, 62.5%), respectively. Conclusions The presence of pre-existing vertebral fractures is an independent factor associated with new vertebral fractures. It is important to tailor treatment goals based on the presence or absence of vertebral fractures to effectively prevent new fractures.

Purpose: Dental floss clip (DFC) traction-assisted endoscopic submucosal dissection (ESD) is widely performed owing to its simplicity. This study aimed to clarify the appropriate indications for the DFC traction method in early gastric cancer when ESD is performed by less-experienced endoscopists. Methods: and Methods: We retrospectively analyzed 1,014 consecutive patients who had undergone gastric ESD performed by less-experienced endoscopists between January 2015 and December 2020. Gastric ESD was performed without DFC in all cases before December 2017 [DFC (−) group, 376 cases], and ESD was performed with DFC in all cases after January 2018 [DFC (+) group, 436 cases]. The procedure time and rates of en bloc resection, complete resection, and adverse events of the groups were compared. Results: The procedure time did not differ significantly between the 2 groups. However, when comparing lesions >20 mm, the procedure time in the DFC (+) group was significantly shorter than that in the DFC (−) group (95±46 vs. 75±31, P<0.01). The procedure time for lesions located in the greater curvature of the upper or middle stomach and lesions >20 mm located in the lesser curvature side of the stomach in the DFC (+) group was significantly shorter than that in the DFC (−) group. Conclusions The indications for DFC during gastric ESD by less-experienced endoscopists include lesions located in the greater curvature of the upper or middle stomach, and lesions >20 mm located in the lesser curvature of the stomach.

Objective: This review aimed to investigate the effects of music therapy on functional ability in people with cerebral palsy.Materials and Methods: An electronic search of the CENTRAL, MEDLINE, and EMBASE databases was conducted. Randomized controlled trials that examined the effects of music therapy in patients with cerebral palsy were included.Results: Eight trials were eligible for inclusion in this study. We found a low risk of bias in random sequence generation and allocation concealment in all trials. The risk of bias in blinding of the outcome assessment was low in all studies. We found that music therapy had a significant effect on the Gross Motor Function Measure score (standardized mean difference [SMD] −0.42), Functional Independence Measure for Children score (SMD 0.38), and Goal Attainment Scale score (SMD −1.43). Music therapy had no significant effect on any of the other items.Conclusion: There is limited evidence that music therapy improves gross motor function and activities of daily living in patients with cerebral palsy. However, this was insufficient to allow for generalizable conclusions. Further studies with larger sample sizes are required to confirm the effects of music therapy in this population.