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 .
BACKGROUND:Eribulin is an approved treatment option for soft tissue sarcomas (STSs) in Japan; however, real-world data regarding its safety, efficacy, and optimal dosing strategies across heterogeneous patient populations remain limited. Thus, this study aimed to evaluate clinical outcomes, treatment tolerability, and prognostic factors in patients with STS treated with eribulin. METHODS:We retrospectively reviewed 50 patients with STS who received eribulin at a single institution between 2018 and 2024. Clinical variables, dosing schedules, tumor responses, survival outcomes, and adverse events (AEs) were analyzed. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method; group comparisons were performed with the log-rank test. RESULTS:The cohort had a median age of 66 years, and eribulin was administered as first-line therapy in 24 patients. The disease control rate was 62%; one patient achieved complete response and one achieved partial response. Median PFS and OS were 4 and 19 months, respectively. Hematologic toxicities were the most common Grade ≥ 3 AEs, with no treatment-related cardiac events observed. Dose modifications included a bi-weekly schedule or a regimen consisting of two administrations followed by a 2-week rest period with pegfilgrastim support. No treatment discontinuations due to AEs occurred in either reduced-intensity schedule; the latter regimen demonstrated the longest treatment duration. Survival outcomes were comparable across age groups, treatment lines, histological subtypes, and tumor locations. Patients aged ≥70 years achieved a median OS of 16 months, generally consistent with previously reported outcomes in elderly sarcoma populations. CONCLUSIONS:Eribulin demonstrated favorable tolerability and durable disease control across diverse patient subgroups, including elderly and comorbid patients who are often ineligible for anthracycline therapy. Although no significant prognostic factors were identified, bi-weekly dosing and two-administration/2-week rest schedules were feasible, with the latter offering the advantage of pegfilgrastim support. These findings support the integration of eribulin into individualized treatment strategies for advanced STS and highlight the need for prospective studies to refine patient selection and optimize dosing approaches.
Hot springs, hot-water bathing, and saunas are widely practiced forms of acute heat exposure and are often perceived as health-promoting. However, emergency clinicians frequently encounter patients in whom these exposures precipitate syncope, hypotension, drowning/aspiration, heat-related illness, and renal or electrolyte disturbances. This narrative review integrates these modalities within a unified "acute heat exposure" framework and summarizes pathophysiology and clinical implications from an emergency medicine perspective. We searched PubMed/MEDLINE from inception to January 2026 using controlled vocabulary and free-text terms related to heat stress, thermoregulation, hot-water immersion, sauna exposure, and acute clinical outcomes; evidence was synthesized qualitatively. Across modalities, acute heat exposure induces shared physiological responses-peripheral vasodilation, relative hypovolemia, circulatory stress, and internal heat storage-that can trigger diverse emergency presentations. We classify acute heat exposure-related illness into four domains: (1) cardiovascular events, including syncope, hypotension, and arrhythmic/ischemic complications in vulnerable individuals; (2) the heat-illness spectrum from exhaustion to heat stroke with organ dysfunction; (3) renal and electrolyte disturbances related to dehydration and hypoperfusion; and (4) neurological and traumatic complications, including falls, drowning, and aspiration. This framework may support risk stratification, evaluation, management, and prevention after hot spring, hot bath, or sauna use.
BACKGROUND/AIM:Chemotherapy-induced nausea and vomiting (CINV) remain major challenges during concurrent chemoradiotherapy (CCRT) for cervical cancer. Mannitol and furosemide are agents widely used to prevent cisplatin-induced nephrotoxicity; however, the differences in their effect on CINV have not been characterized. This study aimed to evaluate the impact of concomitant diuretic administration (mannitol versus furosemide) on the incidence and timing of vomiting in patients with cervical cancer undergoing CCRT. PATIENTS AND METHODS:This multicenter, retrospective study evaluated the impact of concomitant diuretic administration on CINV in 485 patients receiving weekly, cisplatin-based CCRT between 2016 and 2024, including 206 who received mannitol and 279 who received furosemide. RESULTS:Vomiting occurred more frequently in the mannitol group than in the furosemide group (18.4% vs. 10.4%). Time-to-event analysis found that vomiting occurred earlier with mannitol during the entire CCRT course. CONCLUSION:These findings may reflect mannitol's osmotic properties and the increased, intestinal permeability associated with CCRT-related mucosal injury. To the best of our knowledge, this study is the largest investigation to date comparing diuretic agents in this setting. The results suggested that furosemide may be a more appropriate option for patients with a high risk of CINV.
This study proposed a method to estimate the starting angle of projection data collection from streak motion artifact images using a clinical computed tomography scanner. Artifact images were obtained from projection data at different starting angles of collection using three different reconstruction methods (full reconstruction, half reconstruction, and Automatic Patient Motion Correction [APMC]) to identify reconstruction methods that are robust against motion artifacts. Data acquisition was performed using a 320-row CT. Motion artifact images were acquired in a nonhelical volume scan while moving the acrylic rod from the center of rotation to 12 o’clock. The amount of motion artifact was evaluated utilizing standard deviation obtained from a ring-shaped region of interest placed around the acrylic rod. Based on the direction of the artifacts, the proposed method could estimate the starting angle of collection with an accuracy of ± 5°; in the range of starting angles of collection of ± 20° at 12 o’clock and ± 20° at 6 o’clock, half reconstruction showed more severe motion artifacts than full reconstruction in some cases, increasing by up to approximately 61.7
