Saitama Prefecture

ObjectiveTo compare the clinical efficacy and long-term deformity correction retention of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fractures (OVCF).MethodsWe retrospectively analyzed clinical data from patients with OVCF admitted to our hospital between January 2020 and January 2023. Patients were allocated to either the PVP or PKP group. Baseline characteristics, intraoperative variables, deformity correction [anterior vertebral height (AVH) and local Cobb angle (CA)], and symptom relief [visual analog scale (VAS) scores for back pain] were compared. The incidence of bone cement leakage was assessed, and bone cement distribution patterns were compared between the procedures. In the PKP group, the correlation between cement distribution pattern and both deformity correction loss and symptom improvement were also analyzed.ResultsPostoperatively, PKP demonstrated superior immediate anatomical restoration with greater AVH improvement (4.02 ± 0.34 mm vs. PVP 2.44 ± 0.21 mm, p = 0.005) and CA correction (-4.67° ± 0.32° vs. -3.02° ± 0.17°, p = 0.007). Both groups achieved comparable substantial symptom relief: median Oswestry Disability Index (ODI) decreased by 39.8 points in PVP and 39.7 points in PKP (p = 0.107), and median VAS decreased by 6.0 points in both groups (p = 0.420). However, at 2-year follow-up, PKP exhibited significant reversal: greater AVH correction loss (7.50% ± 0.97% vs. PVP 1.45% ± 0.57%, p < 0.001), CA correction loss (7.64% ± 1.12% vs. 1.10% ± 0.58%, p < 0.001), and worsened symptoms (VAS median 3.0 vs. 2.0, p =0.014; ODI 28.8% vs. 21.5%, p < 0.001). Critical to this divergence, PVP achieved superior cement distribution—reflected in higher Cement Distribution Score (CDS) (10.0 [IQR 9–10] vs. PKP 8.0 [8–9], p < 0.001) and Specific Surface Area (SSA) (5.66 ± 0.61 vs. 4.41 ± 0.67 cm²/cm³, p < 0.001)—with both parameters negatively correlating with loss of both AVH and CA correction, while positively correlating with improvement rates in VAS and ODI scores (all p < 0.001). PVP was associated with a significantly higher incidence of bone cement leakage compared to PKP (19.8% [20/101] vs. 8.42% [8/95], p = 0.024). PKP also incurred higher adjacent vertebral fractures (9.45% [9/95] vs. 1.98% [2/101], p = 0.023), augmented vertebra refractures (8.42% [8/95] vs. 1.98% [2/101], p = 0.041), longer operative time (44.15 ± 10.09 vs. 40.62 ± 11.71 min, p = 0.019), increased radiation exposure (24.26 ± 2.90 vs. 21.80 ± 3.35 exposures, p < 0.001), and doubled cost (8042 ± 1608 vs. 4316 ± 863 USD, p < 0.001).ConclusionBoth PVP and PKP are effective short-term treatments for OVCF. Therefore, PVP may be superior to PKP in maintaining long-term correction, particularly when bone cement distribution is optimized.

Abstract. To predict long-term future landscape evolution, understanding of the river incision model, which is the main driver of continental erosion, is especially important. For the bedrock channel incision model (detachment-limited (DL) model: erosion rate E = KAmSn where A is drainage area, S is channel gradient, and K, m, n are parameters), parameters can be estimated by the slope-area analysis if E is known. Based on the worldwide basin-averaged denudation rates of 10Be concentrations, previous studies compiled the parameter values for variable lithology. However, the scarcity of data for the soft sedimentary rock limits the applicability of global scale compilation. In addition, measuring the 10Be concentration in sedimentary rock is difficult in humid and tectonically active regions like Japan. To address this, slope-area analysis was conducted in the Kamikita Coastal Plain, Japan, where bedrock lithology (sedimentary rocks of Miocene to Pleistocene) and uplift rate (~ 0.2 mm y−1 for the past 300 ka) are assumed to be uniform. Parameter values were estimated based on river incision rates approximately derived from marine terraces (MIS 5e, 7, 9, and 11) which are widely distributed in the area. For six target rivers, DL-like behaviour was confirmed in the limited upstream and midstream areas located upstream of the alluvium distribution. Except for small rivers of A &lt; 25 km2, the concavity index m/n was between 0.35 and 0.6, which is the typical range for steady-state channels. The estimated exponent n was nonlinear, ranging between 1 and 2, which is consistent with the previous global compilations. This nonlinearity can be explained by past sea-level changes causing knickpoints at similar elevations. Finally, the erosion coefficient K was estimated to be 10−5~−6 m0.1 y−1. For the main lithology of late Pliocene and early Pleistocene sedimentary rock, the estimated K almost agreed with the global relationship between K and unconfined compressive strength qu (K ∝ 1/qu2), supporting the significant influences of bedrock lithology on K.

Drug-coated balloons (DCBs) have shown promise in prolonging arteriovenous fistula (AVF) patency by inhibiting neointimal hyperplasia. However, few studies have longitudinally evaluated vascular remodeling after DCB treatment using ultrasound. This study aimed to evaluate vascular remodeling after DCB treatment using high-frequency ultrasound. In this retrospective single-center study, 50 patients with single AVF stenosis were treated with DCB and followed by ultrasound at four time points: pre-treatment, immediately post-treatment, 3 months, and 6 months. Patients were classified into short-term (n = 24; reintervention within 6-9 months) and long-term (n = 26; patency ⩾18 months) groups. The mean follow-up time in the long-term group was 24.5 months. Nineteen patients had complete ultrasound data every 3 months up to 15 months. Parameters included lumen cross-sectional area (L-CSA), external cross-sectional area (E-CSA), and intima-media thickness area (IMT area). Baseline demographics were similar between groups. L-CSA was significantly larger in the long-term group both immediately post-DCB (14.4 ± 5.9 vs 9.9 ± 3.9 mm², p < 0.001) and at 6 months (5.3 ± 2.2 vs 3.1 ± 1.3 mm², p < 0.001). E-CSA was also greater in the long-term group at 6 months (21.7 ± 8.8 vs 14.7 ± 5.0 mm², p < 0.001). While there was no significant difference in IMT area immediately post-treatment, it was significantly greater in the long-term group at 6 months (16.3 ± 7.8 vs 11.6 ± 7.8 mm², p < 0.001). No significant changes in L-CSA, E-CSA, or IMT were observed beyond 6 months. Regular ultrasound examinations enable accurate evaluation of vascular remodeling. Initial vessel dilation and sustained external diameter enlargement may contribute to long-term morphological stability and patency following DCB treatment.

Managing vehicle speeds and ensuring road safety in residential neighborhoods have led to the widespread adoption of various traffic calming strategies, with speed humps being among the most implemented solutions. However, their implementation has raised significant concerns regarding secondary environmental impacts, particularly noise and vibration generation that can adversely affect residential communities during sensitive nighttime hours. This study addresses a critical gap in understanding the temporal dynamics of noise and vibration pollution induced by speed humps during nighttime periods in Japanese residential neighborhoods. Statistical analysis of LAeq measurements revealed significant temporal patterns: immediate increase (+2.71 dB, p p p < 0.001). Estimation method provided in ISO 9613-2 propagation modeling used to evaluate the compliance with Japan’s Environmental Quality Standards (EQS) for Noise. Collectively, these findings underscore the critical need for both event-based adaptation analyses and standard propagation models in evaluating the efficacy and temporal evolution of noise induced by the traffic calming devices.

BackgroundThe present study primarily aimed to investigate whether preoperative pain associated with rotator cuff tears correlates with the severity of synovitis in the rotator interval (RI) on arthroscopic findings retrospectively.MethodsBetween July 2017 and December 2022, 131 shoulders with arthroscopic rotator cuff repair were retrospectively investigated. The pain domain of the preoperative Constant Score and Shoulder36 were used to assess preoperative pain. Two examiners confirmed the degree of synovitis of RI in the arthroscopic findings.ResultsThe mean patient age was 68.9 years. Synovitis in the RI was found in 118 shoulders (94%) assessed by arthroscopy. The pain domain of the Constant Score significantly correlated with synovitis in the RI assessed by arthroscopic findings (P < .01), but the size and the number of rotator cuff tears did not.ConclusionThe preoperative pain associated with rotator cuff tears significantly correlated with synovitis severity in the RI assessed by AS findings, highlighting the role of synovitis as a potential contributor to pain in patients with rotator cuff tears.

Background/Objectives: Although surgeries employing cone-beam computed tomography (CBCT) for small lung lesions have been reported, the association between CBCT scan frequency and patient radiation exposure remains unclear. This study aimed to investigate patient radiation doses from CBCT during thoracic surgeries, and the patient radiation doses were compared with those from other preoperative marking methods. Methods: This multicenter prospective study included 81 patients who underwent surgery for small lung lesions requiring marking between January 2021 and June 2024 at three institutions. CBCT-guided surgeries involved the use of metal clips in a hybrid operating room with 1-4 scans, depending on the lesion. For other preoperative marking methods, hook-wire or virtual-assisted lung mapping (VAL-MAP) was used. Patient radiation doses were measured using wearable dosimeters at five anterior thorax sites, and the total dose was compared across methods. Results: The study included 81 patients: CBCT (n = 61), VAL-MAP (n = 10), and hook-wire (n = 10). CBCT cases were distributed as follows: single scan (n = 10), double scans (n = 34), triple scans (n = 15), and quadruple scans (n = 2). The radiation doses were 86.9 ± 61.7 mGy for hook-wire, 39.8 ± 27.5 mGy for VAL-MAP, and 11.0 ± 6.5 mGy for single-scan CBCT, 17.3 ± 7.8 mGy for double scans, 23.1 ± 14.0 mGy for triple scans, and 22.7 ± 0.1 mGy for quadruple scans. Although radiation exposure increased with more CBCT scans, performing up to triple scans resulted in significantly lower exposure compared to other methods. Conclusions: Intraoperative CBCT is a feasible and safe technique for identifying small lung lesions, providing lower radiation exposure compared to other preoperative localization methods.

In clinical practice, early recognition of bacteremia leads to prognostic improvement. Recently, cell population data (CPD) from the Sysmex XN-series hematology analyzer has attracted attention as a new method for the early diagnosis of bacteremia, but its usefulness in clinical practice remains unclear. We focused on the fluorescent light distribution of the neutrophil area (NE-WY) and used machine learning to determine whether predictions could be improved. Among adult patients with clinically suspected bacteremia at our hospital, 533 who did not meet the exclusion criteria were enrolled. Propensity score matching was performed for bacteremia (n = 106) and non-bacteremia (n = 427) cases. NE-WY showed the largest difference between the two groups (AUC, 0.768; sensitivity, 73.6%; specificity, 67.9%; cutoff value, 686.5(no unit)). In machine learning, the first branch of the decision tree was NE-WY, and the cutoff value was set at 689.5(no unit). Support vector machines were used to examine multiple variables, but there were no significant differences relative to NE-WY alone. This is the first report to demonstrate that NE-WY is useful for detecting bacteremia by analyzing CPD using machine learning. The combination of CPD and machine learning is expected to produce new results.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-14554-3.

To determine the association between timing of advanced airway management (AAM) and outcomes in witnessed pediatric out-of-hospital cardiac arrest (OHCA). We performed a retrospective cohort study using data from the OHCA registry in Japan. We included pediatric patients (<18y) with OHCA who received AAM. We compared patients who received AAM at 1 to 10, 11 to 20, and 21 to 30 minutes after emergency medicine service (EMS) contact with the patient with those who had not yet received AAM but remained eligible to receive it at those times, respectively. The primary and secondary outcome measurements were survival and favorable neurological outcome at 1 month, respectively. To address resuscitation time bias, we performed risk-set matching analyses using time-dependent propensity score. A total of 269 patients were included. The numbers receiving AAM in each time period were 60 in the 1 to 10 minute period, 83 in the 11 to 20 minute period, and 84 in the 21 to 30 minute period. The association between patients who received AAM in each time period and survival was compared with patients who had not yet received AAM but remained eligible to receive it in that time period: 1 to 10 minutes [risk ratio (RR): 2.12 (95% CI: 0.61-7.33)], 11 to 20 minutes [RR: 3.03 (95% CI: 1.13-8.12)], and 21 to 30 minutes [RR: 0.95 (95% CI: 0.46-1.96)]. The association with favorable neurological outcomes: 1 to 10 minutes [RR: 2.47 (95% CI: 0.42-14.56)], 11 to 20 minutes [RR: 2.54 (95% CI: 0.63-10.23)], 21 to 30 minutes [RR: 0.86 (95% CI: 0.25-2.99)]. In witnessed pediatric OHCA patients who went on to receive AAM, receiving this treatment in the time interval of 11 to 20 minutes was associated with survival, while earlier and later AAM times showed no association. Meanwhile, no association with favorable neurological outcomes was observed.

To describe a case of right posterior cerebral artery (PCA) fenestration coexisting with bilateral superior cerebellar artery (SCA) duplication. A 65-year-old woman with meningitis underwent cranial magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) using a 3-Tesla scanner. MRA was performed using a standard 3-dimensional time-of-flight technique. MRI showed sulcal hyperintensity in the bilateral occipito-parietal regions on a fluid-attenuated inversion recovery (FLAIR) sequence, suggesting meningitis. MRA revealed no pathological lesions; however, fenestration of the right PCA at the P1-P2 junction and duplications of the bilateral SCAs were incidentally observed. Using MRA, we diagnosed the first case of right PCA fenestration coexisting with bilateral SCA duplication. Although its clinical significance is limited, there may be a risk of misinterpretation or diagnostic confusion with pathological conditions such as aneurysms or dissections. Therefore, accurate identification of these arterial variations during MRA interpretation is essential. Careful observation of MRA images, along with the creation of partial volume-rendering images, is useful and important for diagnosing rare arterial variations.