Background/Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) was recently proposed as an alternative disease concept to nonalcoholic fatty liver disease (NAFLD). We aimed to investigate the prognosis of patients with biopsy-confirmed MASLD using data from a multicenter study. Methods: This was a sub-analysis of the Clinical Outcome Nonalcoholic Fatty Liver Disease (CLIONE) study that included 1,398 patients with NAFLD. Liver biopsy specimens were pathologically diagnosed and histologically scored using the NASH Clinical Research Network system, the FLIP algorithm, and the SAF score. Patients who met at least one cardiometabolic criterion were diagnosed with MASLD. Results: Approximately 99% of cases (n=1,381) were classified as MASLD. Patients with no cardiometabolic risk (n=17) had a significantly lower BMI than patients with MASLD (20.9 kg/m2 vs. 28.0 kg/m2, P<0.001), in addition to significantly lower levels of inflammation, ballooning, NAFLD activity score, and fibrosis stage based on liver histology. These 17 patients had a median follow-up of 5.9 years, equivalent to 115 person-years, with no deaths, liver-related events, cardiovascular events, or extrahepatic cancers. The results showed that the prognosis for pure MASLD was similar to that for the original CLIONE cohort, with 47 deaths and one patient who underwent orthotopic liver transplantation. The leading cause of death was extrahepatic cancer (n=10), while the leading causes of liver-related death were liver failure (n=9), hepatocellular carcinoma (n=8), and cholangiocarcinoma (n=4). Conclusions Approximately 99% of NAFLD cases were considered MASLD based on the 2023 liver disease nomenclature. The NAFLD-only group, which is not encompassed by MASLD, had a relatively mild histopathologic severity and a favorable prognosis. Consequently, the prognosis of MASLD is similar to that previously reported for NAFLD.

In patients with unilateral mandibular condyle hyperplasia, whether to perform condylectomy and orthognathic surgical procedures at the same time or orthognathic surgery in two stages for remains controversial. Reported here is a case of facial asymmetry with mandibular condyle hyperplasia, for which condylectomy and orthognathic surgery procedures were performed at the same time. A 28-year-old woman was presented to our department with chief complaints of left deviation of the mandible and right temporomandibular joint (TMJ) noise. Findings obtained in several imaging examinations led to a diagnosis of facial asymmetry associated with right mandibular condyle hyperplasia. Following 3 months of preoperative orthodontic treatment, in October 2018 under general anesthesia the patient underwent a right mandibular condylectomy, Le Fort I osteotomy, right mandibular sagittal split ramus osteotomy, and left mandibular inverted L ramus osteotomy. In examinations up to 3 years after surgery, good results were noted.For this case of severe facial asymmetry with mandibular condyle hyperplasia, early surgery and condylectomy were performed simultaneously to significantly shorten the total treatment time. The effectiveness of a surgery-early approach was confirmed by no postoperative findings indicating abnormalities in the TMJ or retroversion.

The establishment of enhanced surveillance systems for mass gatherings to detect infectious diseases that may be imported during an event is recommended. The World Health Organization Regional Office for the Western Pacific contributed to enhanced event-based surveillance for the Tokyo 2020 Olympic and Paralympic Games (the Games) by using Epidemic Intelligence from Open Sources (EIOS) to detect potential imported diseases and report them to the National Institute of Infectious Diseases (NIID), Japan. Daily screening of media articles on global infectious diseases was conducted using EIOS, which were systematically assessed to determine the likelihood of disease importation, spread and significant impact to Japan during the Games. Over 81 days of surveillance, 103 830 articles were screened by EIOS, of which 5441 (5.2%) met the selection criteria for initial assessment, with 587 (0.6%) assessed as signals and reported to NIID. None of the signals were considered to pose a significant risk to the Games based on three risk assessment criteria. While EIOS successfully captured media articles on infectious diseases with a likelihood of importation to and spread in Japan, a significant manual effort was required to assess the articles for duplicates and against the risk assessment criteria. Continued improvement of artificial intelligence is recommended to reduce this effort.

In 2021, the National Institute of Infectious Diseases, Japan, undertook enhanced event-based surveillance (EBS) for infectious diseases occurring overseas that have potential for importation (excluding coronavirus disease 2019 [COVID-19]) for the Tokyo 2020 Olympic and Paralympic Summer Games (the Games). The pre-existing EBS system was enhanced using the World Health Organization Epidemic Intelligence from Open Sources system and the BlueDot Epidemic Intelligence platform. The enhanced EBS before and during the Games did not detect any major public health event that would warrant action for the Games. However, information from multiple sources helped us identify events, characterize risk and improve confidence in risk assessment. The collaboration also reduced the surveillance workload of the host country, while ensuring the quality of surveillance, even during the COVID-19 pandemic.

Students in all years, including those in lower years, were prohibited from coming to campus because of COVID-19, which began to spread in January 2020. However, we believed that a hospital tour and observership would be important practical training for first and second year medical students as part of the early exposure program, which aims to increase student motivation. Thus, we decided to conduct a virtual hospital tour and a virtual observation of medical doctors’ work. We used Zoom to conduct a virtual hospital tour for first-year students in June, and a virtual observation of physicians’ work for second-year students in December. Although this offered less of an opportunity to experience the reality of the clinic, there have been benefits in terms of increased learning content, fairness of learning opportunities delivered, and the promotion of independent learning. With regard to a “Hospital Tour” and the “Observation of Medical Doctors’ Work” , we believe that hybrid forms, which are able to skillfully combine the strengths of the two methods, would be effective.

PURPOSE: It has been suggested that resonance frequency analysis (RFA) can measure changes in the stability of dental implants during osseointegration. This retrospective study aimed to evaluate dental implant stability at the time of surgery (primary stability; PS) and secondary stability (SS) after ossseointegration using RFA, and to investigate the relationship between implant stability and cortical bone thickness. METHODS: In total, 113 patients who attended the Tohoku University Hospital Dental Implant Center were included in this study. A total of 229 implants were placed in either the mandibular region (n = 118) or the maxilla region (n = 111), with bone augmentation procedures used in some cases. RFA was performed in 3 directions, and the lowest value was recorded. The preoperative thickness of cortical bone at the site of implant insertion was measured digitally using computed tomography, excluding cases of bone grafts and immediate implant placements. RESULTS: The mean implant stability quotient (ISQ) was 69.34±9.43 for PS and 75.99±6.23 for SS. The mandibular group had significantly higher mean ISQ values than the maxillary group for both PS and SS (P < 0.01). A significant difference was found in the mean ISQ values for PS between 1-stage and 2-stage surgery (P < 0.5). The mean ISQ values in the non-augmentation group were higher than in the augmentation group for both PS and SS (P < 0.01). A weak positive correlation was observed between cortical bone thickness and implant stability for both PS and SS in all cases (P < 0.01). CONCLUSIONS: Based on the present study, the ISQ may be affected by implant position site, the use of a bone graft, and cortical bone thickness before implant therapy.
Dental Implants ; Humans ; Maxilla ; Osseointegration ; Retrospective Studies ; Transplants

　　Rotator cuff repair provides favorable outcomes for range of motion of the shoulder joint and repair of the cuff. However, we often have patients for whom shoulder elevation is difficult due to failure to improve shoulder shrugging motion. This study investigated how the shoulder shrugging motion affects activity patterns of the muscles surrounding the shoulder joint. Subjects were 50 shoulders in 50 young healthy volunteers free from shoulder joint complaints (27 men, 23 women; mean age, 26.3±4.3 years). The subjects were placed in the lateral position with the dominant arm facing upwards and suspended with a sling. They performed two types of movements: forward elevation of the arm with no particular instructions (group N) and forward elevation combined with shoulder shrugging (group S). Simultaneously, the activity of the anterior, middle, and posterior fibers of the deltoid muscle and of the upper, middle, and lower fibers of the trapezius muscle of the dominant upper limb were measured by surface electromyography and compared between the two groups. In the trapezius muscle, upper fiber activity was more enhanced in group S than in group N, whereas lower fiber activity was more strongly suppressed in group S. However, the anterior and middle fiber activity of the deltoid muscle was more strongly suppressed in group S than in group N. Thus, it was observed that an elevation pattern with shoulder shrugging reduces the strength of forward flexion.

　　The purpose of this study was to elucidate the effects of “shoulder girdle training” that is used to correct scapular muscle imbalance. We investigated 100 shoulders in 50 healthy volunteers free of any complaints related to the shoulder joint. In the posture for performing the infraspinatus test, male volunteers held a 5-kg load and female volunteers held a 3-kg load for 3 s thrice, and the muscular activity of the trapezius muscle was simultaneously measured. Next, shoulder girdle training was performed for 5 s twice, followed by muscle activity measurement in the same manner described above. Muscle activity levels before and after this training and also between the dominant and non-dominant sides were compared. The shoulder girdle training significantly reduced the level of muscle activity of the upper fibers of the trapezius muscle and significantly increased the level of muscle activity of the middle and lower fibers of the trapezius muscle (both p<0.05). Moreover, the levels of muscle activity of the upper, middle, and lower fibers of the trapezius muscle were significantly higher on the dominant side than on the non-dominant side (p<0.05).

A population-based cohort study on pediatric infectious diseases was established at Khanh Hoa Province, central Vietnam in 2006, to determine the etiology and risk factors for severe pediatric infectious diseases (SPID) such as acute respiratory infection (ARI), diarrhea and dengue which are the major causes of under 5 mortality. A population census survey was conducted in Nha-Trang and Ninh-Hoa to collect demographic, social-behavioral data and disease burden on SPID. The study site covered a population of 353,525 residing in 75,826 households with 24,781 children less than 5 years. Hospital databases from two hospitals covering the region were obtained. Linking the census and hospital databases, we were able to investigate on a variety of SPID such as environmental tobacco smoking exposure and increased risked of pediatric pneumonia hospitalization, population density, water supply and risk of dengue fever and animal livestock and risk of hospitalized diarrhea. To determine incidence, viral etiology and risk factors for pediatric ARI/pneumonia, we setup a population based prospective hospitalized Pediatric ARI surveillance at Khanh Hoa General Hospital, Nha-Trang in February 2007. The study has revealed RSV, rhinovirus and influenza A as major viral pathogens, role of multiple viral infection and its interaction with bacteria in the development of pneumonia. In addition, we are also conducting a birth cohort study to investigate the incidence of congenital infection and its impact on physical-neurological development, and role of host genetic polymorphism on SPID hospitalization in Vietnam. Population mobility, high cost of regular census update and low mortality are the challenges.

A population-based cohort study on pediatric infectious diseases was established at Khanh Hoa Province, central Vietnam in 2006, to determine the etiology and risk factors for severe pediatric infectious diseases (SPID) such as acute respiratory infection (ARI), diarrhea and dengue which are the major causes of under 5 mortality. A population census survey was conducted in Nha-Trang and Ninh-Hoa to collect demographic, social-behavioral data and disease burden on SPID. The study site covered a population of 353,525 residing in 75,826 households with 24,781 children less than 5 years. Hospital databases from two hospitals covering the region were obtained. Linking the census and hospital databases, we were able to investigate on a variety of SPID such as environmental tobacco smoking exposure and increased risked of pediatric pneumonia hospitalization, population density, water supply and risk of dengue fever and animal livestock and risk of hospitalized diarrhea. To determine incidence, viral etiology and risk factors for pediatric ARI/pneumonia, we setup a population based prospective hospitalized Pediatric ARI surveillance at Khanh Hoa General Hospital, Nha-Trang in February 2007. The study has revealed RSV, rhinovirus and influenza A as major viral pathogens, role of multiple viral infection and its interaction with bacteria in the development of pneumonia. In addition, we are also conducting a birth cohort study to investigate the incidence of congenital infection and its impact on physical-neurological development, and role of host genetic polymorphism on SPID hospitalization in Vietnam. Population mobility, high cost of regular census update and low mortality are the challenges.