福岛医科大学

Astrocytes colocalize with fibrillar amyloid-β (Aβ) plaques in postmortem Alzheimer’s disease (AD) brain tissue; however, their spatiotemporal dynamics in vivo remain poorly understood. This multicenter study aimed to investigate the progression of astrocyte reactivity across the AD continuum, including healthy controls (HC), mild cognitive impairment (MCI), and AD, using the novel monoamine oxidase B (MAO-B)-specific PET tracer [18F]SMBT-1, while exploring its association with cognitive performance and amyloid burden. A total of 91 participants (35 HC, 44 MCI, 12 AD) underwent [18F]SMBT-1 PET, amyloid PET, T1-weighted MRI, and standardized neuropsychological assessments. Standardized uptake value ratios (SUVRs) were calculated based on [18F]SMBT-1 PET data using four reference regions for subgroup comparisons stratified by Aβ status. [18F]SMBT-1 uptake was significantly elevated in amyloid-positive MCI (MCI+) and AD groups compared with amyloid-negative HC (HC−) in the frontal, temporal, and posterior cingulate regions. Notably, astrogliosis patterns distinguished MCI subtypes: MCI+ individuals exhibited a widespread AD-like pattern, whereas the MCI− group showed a distinct profile. Furthermore, the uptake in symptomatic MCI+ individuals was significantly higher than that in asymptomatic HC+ individuals. Regional SMBT-1 uptake also strongly correlated with greater Aβ burden and worse cognitive scores. This study demonstrates that [18F]SMBT-1 is a promising tool for characterizing the spatial pattern and magnitude of reactive astrogliosis across the Aβ-defined AD continuum. Our findings further suggest that astrogliosis may represent an important mechanistic link between amyloid pathology and cognitive impairment, supporting its potential relevance in therapeutic development. Japan Registry of Clinical Trials (jRCT) jRCTs031210602, registered Feb. 07, 2022. https://jrct.mhlw.go.jp/en-latest-detail/jRCTs031210602 .

Purpose Deep learning reconstruction (DLR) is useful to reduce image noise and improve contrast resolution compared with hybrid iterative reconstruction (Hybrid IR). This study compared image quality and infarct detection between DLR and Hybrid IR using thin-slice brain CT. Materials and Methods Eighty-one patients (39 with acute infarction, 42 without) underwent 135 kVp non-contrast brain CT and MRI within 24 h of admission. CT images (2-mm thickness) were reconstructed using both Hybrid IR and DLR. Image noise was measured in white matter, gray matter, and infarct lesions. Three general radiologists independently assessed infarct presence. Sensitivity was evaluated using patient- and region-based analyses. Results DLR demonstrated significantly lower image noise than Hybrid IR in white matter, gray matter, and infarct lesions (1.69 vs. 4.40, 1.43 vs. 3.93, and 1.68 vs. 3.94 HU, respectively; all p < 0.001). Contrast-to-noise ratio was significantly higher with DLR (5.10 vs. 2.36, p < 0.001). In patient-based analysis, infarct detection sensitivity was higher with DLR (66.7%-71.8%) than with Hybrid IR (59.0%-69.2%) (p > 0.05). In region-based analysis, DLR showed significantly higher sensitivity for one reader (60.5% vs. 50.0%, p = 0.004). Conclusion In this study, DLR significantly reduces image noise and improves contrast-to-noise ratio in thin-slice brain CT. These improvements may help general radiologists in diagnosing acute cerebral infarction.

Pyoderma gangrenosum (PG) is a rare, autoinflammatory skin disorder characterized by painful ulcers, with scarce treatment options. Adalimumab is a recently approved tumor necrosis factor-alpha inhibitor for PG, for which real-world data remain limited. This study evaluated the long-term safety and effectiveness of adalimumab in patients with PG. This multicenter, prospective, open-label, single-arm, postmarketing observational study enrolled patients with PG who were prescribed adalimumab and were monitored for 52 weeks. The primary outcome was safety, assessed as the incidence proportion of infections reported as adverse drug reactions (ADRs). Secondary outcomes included other safety measures and effectiveness, estimated using the Physician Global Assessment (PGA), Investigator Inflammation Assessment, and Verbal Rating Scale (VRS) for pain. Relapse rates after remission and changes in PG subtype during the observation period were also examined. Sixty-seven patients with PG were enrolled in the study. The mean age was 61.9 years, and 77.6

BACKGROUND:To evaluate the dissemination and real-world implementation of recommendations from the 5th Edition of the Japanese Esophageal Cancer Practice Guidelines and to inform development of the upcoming 6th Edition, the Guideline Committee of the Japanese Esophageal Society conducted a nationwide Quality Indicator (QI) survey in Japan. METHODS:A nationwide, cross-sectional, web-based questionnaire survey was distributed to 381 certified institutions participating in the 2023 National Registry of Esophageal Cancer in Japan. Conducted in November 2024, the survey covered six domains-epidemiology, surgery, endoscopy, chemotherapy, radiation therapy, and pathology-reflecting key recommendations of the 5th Edition. Responses were summarized descriptively at the institutional level. RESULTS:Valid responses were obtained from 190 institutions (49.9%). Smoking cessation guidance was implemented in more than 90% of institutions, and over 90% also provided guidance on alcohol abstinence or moderation, although complete alcohol abstinence was less uniformly recommended. Minimally invasive, including robot-assisted, esophagectomy was adopted by over 90% of institutions. The proportion of institutions performing prophylactic cervical lymph node dissection varied by tumor location and stage, reflecting contemporary staging concepts. The DCF regimen was the predominant neoadjuvant therapy for stage II/III disease (94.7%), and immune checkpoint inhibitor-based chemotherapy was widely used for unresectable or recurrent disease. Advanced endoscopic diagnostic modalities, including magnifying and image-enhanced endoscopy, were widely adopted. CONCLUSIONS:This nationwide QI survey demonstrates broad adherence to guideline-based multidisciplinary management of esophageal cancer in Japan and provides an evidence base for refining recommendations in the 6th Edition of the Japanese Esophageal Cancer Practice Guidelines.

To determine the prevalence of disability-free survival (DFS) five years after elective non-cardiac surgery in older adults, and to identify preoperative factors associated with DFS using conventional statistical analyses and machine learning methods. In this prospective cohort study conducted at a single tertiary hospital in Japan, 2878 patients aged ≥55 years who underwent elective non-cardiac surgery under general anesthesia between 2016 and 2018 were enrolled and followed for 5 years. DFS was defined as survival without significant functional disability, assessed using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Multivariable logistic regression and machine learning models were used to identify preoperative predictive factors. At 5 years after surgery, 80.6