Shinobu Imai

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In some patients with hard-to-heal leg ulcers, tiny abnormal connections between arteries and veins disrupt normal tissue blood flow and prevent healing. This study reported results from 17 such patients treated with a minimally invasive catheter-based procedure to block these abnormal vessels using an antibiotic-contrast mixture. The procedure worked technically in all cases, and 88% of patients saw meaningful ulcer improvement over an average of nearly a year of follow-up, with no major complications.

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Researchers used an AI system to read tens of thousands of cancer patient records and automatically identify chemotherapy side effects from clinical notes, then used that data to test whether existing drugs might prevent those side effects. The system found that a common blood pressure drug class (ARBs) was associated with a 42% lower rate of mouth sores from fluoropyrimidine chemotherapy, and a sleep medication (ramelteon) showed a signal for reducing nerve damage from platinum-based drugs. This framework offers a practical way to mine real-world medical records to repurpose safe, available drugs for preventing chemotherapy toxicity.

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This nationwide Japanese study compared a procedure called CART — which filters and reinfuses a patient's own ascites fluid to return the proteins lost during drainage — against simple drainage (paracentesis) for cancer patients with fluid build-up in the abdomen. CART was associated with a 22% lower risk of death during hospitalization, shorter stays, less need for supplemental albumin infusions, and lower total costs, despite higher procedural charges. The results support broader adoption of CART for appropriate patients, especially men, those with low blood protein, and those with non-gastrointestinal cancers.

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This study measured whether hormone-blocking therapy for prostate cancer changes tiny blood vessel behavior in the back of the eye, as a window into broader vascular effects. After 6 months of testosterone suppression, resistance in the small choroidal vessels increased significantly even though overall blood flow and large-artery stiffness stayed unchanged. This suggests that testosterone loss affects the smallest blood vessels first, and that eye imaging may serve as a sensitive early indicator of vascular changes in these patients.

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A new pre-surgical device called SPACE was developed to narrow the gap in infants' palates before cleft lip and palate repair, reliably reducing the gap to under 2 mm on average before the operation. This preparation allowed surgeons to perform all three corrective procedures — lip repair, gum tissue repair, and palate closure — in a single operation at about 6 months of age, with no cases of abnormal openings forming after healing. At age 5, children treated with this one-stage approach had similar facial growth to those managed with a traditional multi-stage approach and had significantly fewer speech articulation problems.

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Researchers validated the accuracy of standard disease classification codes used in Japanese hospital billing to identify patients with chronic kidney disease in administrative data. The codes correctly identified true CKD patients about 58% of the time overall, but certain specific codes performed much better, with accuracy above 80%. This matters because researchers and policymakers increasingly rely on billing databases for large-scale health studies, and knowing which codes are reliable improves the quality of those analyses.

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This real-world study followed 150 Japanese migraine patients treated with one of three injectable antibody drugs targeting the CGRP signaling pathway over 12 months. About half of patients achieved a 50% or greater reduction in monthly migraine days at 6 and 12 months, and patient satisfaction was high and improved over time, reaching 94% by one year. Notably, patients who responded early at 3 months were very likely to still be responding at 6 months, giving clinicians a useful early checkpoint to assess whether the treatment is working.

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By mining publicly available genetic sequencing datasets from shrews, researchers identified a previously unknown virus in the paramyxovirus family — a group that includes some pathogens capable of infecting humans. The new virus, found in northern short-tailed shrews, is genetically distinct enough to qualify as its own species, and data from multiple shrew tissues suggests it may preferentially infect the kidney. Cataloguing such viruses in wild animals is an important step in understanding the reservoir of pathogens with potential to spread to humans.

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This review pooled data from four studies to examine whether calcium deposits in brain arteries affect how well clot-removal procedures work for stroke patients. Calcification that involved the inner arterial wall — rather than simply a large volume of calcium — was associated with a 74% higher chance of poor outcomes at 90 days after the procedure. Identifying the location and type of arterial calcification on pre-procedure scans could help predict which stroke patients will do poorly and may guide device selection.

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This study tested whether a simple five-level severity scale used in Japanese hospital billing records accurately reflects how impaired patients with dementia actually are in daily life. Using nearly 10,000 patients, higher scores on the billing scale consistently matched worse scores on a detailed clinical assessment of memory and function. The billing scale is a reliable enough tool to be used in research and policy planning around dementia care, though its sensitivity for catching mild cases is limited.

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Using publicly available genetic sequence data from bird studies, researchers reconstructed nearly complete genomes of a coronavirus found in pigeons and determined it belongs to a distinct species within a known family of bird coronaviruses. While the virus's genetic code is largely consistent across pigeon samples, the region at one end of the genome varies in how it is organized between different variants. The work fills a gap in understanding the diversity of coronaviruses that infect birds.

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Researchers built a mitral valve repair ring made from animal tendon that had been stripped of its cells — a biological approach intended to reduce infection risk compared to metal or plastic rings. In lab tests using pig hearts and a pulsating flow machine, the biological ring reduced leakage across a damaged mitral valve just as effectively as three commercially available synthetic rings. This proof-of-concept suggests tissue-based repair rings could be a viable future option for patients undergoing mitral valve surgery.

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A survey of over 1,200 Japanese patients who take oral medications found that twice-daily dosing — not three or more times daily as commonly assumed — is the threshold at which patients start feeling their medication schedule is burdensome. This is important for drug prescribing because simplifying a regimen from twice to once daily may directly improve how consistently patients take their medication. The finding gives prescribers a concrete target when weighing the trade-offs of different dosing schedules.

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When performing shoulder replacement surgery with a reversed ball-and-socket design, surgeons must decide how much to offset the components sideways, but this has traditionally been done inconsistently. This study found that tailoring the offset based on a specific intraoperative measurement of the space between the shoulder socket and arm bone led to significantly better range of motion and function scores compared to using a fixed offset for all patients. Personalizing implant positioning based on each patient's anatomy appears to produce meaningfully better outcomes.

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Two cancer patients with compression of the main vein draining the upper body — a dangerous condition causing severe facial and arm swelling — could not receive standard radiation therapy because they also had scarring lung disease that made radiation too risky. Both patients were successfully treated by placing a metal stent inside the compressed vein, which quickly relieved swelling and allowed early discharge. The cases demonstrate that stenting is a safe and effective alternative for patients who cannot tolerate radiation for this condition.

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This study examined why some teenagers who undergo spine surgery for scoliosis end up with an excessive forward curve in the neck afterward, and what surgeons can do during the operation to prevent it. Analysis of 45 patients showed that failing to create enough backward curve in the upper part of the thoracic spine during correction was the main independent risk factor for postoperative neck problems. Surgeons can use this finding to set a more specific alignment target during scoliosis surgery to protect the cervical spine.

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Researchers developed a faster and more sensitive laboratory method for measuring the concentration of morpholino oligonucleotide drugs — a type of gene-silencing therapy used for muscular dystrophy — in blood samples. By combining simple protein removal from plasma with a specific liquid chromatography approach, the method reliably detected drug levels as low as 1 nanogram per milliliter, ten to twenty times more sensitive than existing approved methods. This improvement could make clinical monitoring and drug development for this class of therapies more practical.

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A teenage boy with a rare inherited clotting protein deficiency developed blood clots in a leg vein after catching COVID-19, and later suffered a splenic infarction — a blood clot blocking blood supply to part of his spleen — even while on blood thinners. COVID-19 appears to have supercharged the clotting risk in a patient already predisposed to dangerous thrombosis, and the arterial event occurred even after his COVID symptoms had improved. The case underlines that patients with inherited clotting disorders need especially vigilant monitoring during and after COVID-19 infection.

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Japanese dental guidelines updated in 2014 and 2016 recommended switching from broad-spectrum cephalosporin antibiotics to amoxicillin for preventing infections after tooth removal, and this study measured whether dentists and hospitals actually changed their prescribing. Antibiotic use did shift toward amoxicillin over time, especially at hospitals with dedicated infection control teams and ward pharmacists, and costs decreased without any increase in post-extraction infections. The findings show that guidelines reduce unnecessary antibiotic use most effectively when supported by on-the-ground pharmacy and infection control staff.

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This large study examined whether older Japanese patients with heart or metabolic conditions who used a designated "family pharmacist" — a single pharmacist who coordinates all their medications — had better health outcomes than those receiving standard pharmacy care. Among over 45,000 matched patients followed for two years, having a family pharmacist was linked to a small but significant reduction in the risk of death, though it did not reduce hospitalizations overall. The results suggest continuity of pharmaceutical care may offer a modest survival benefit for elderly patients managing chronic conditions.

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A 15-year-old horse presented with long-standing clouding of one cornea, and a full eye exam including ultrasound revealed that the lens had dislocated backward into the gel-filled chamber of the eye, with thickening of the retina. Testing confirmed the horse could not see out of that eye when the other eye was covered, but navigated normally with both eyes open. The findings were consistent with old traumatic injury that had caused permanent, irreversible vision loss in that eye.

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This study identified which patients taking the cancer drug lenvatinib are most at risk for developing severe protein leakage in the urine, a side effect that can require dose reductions. Among 131 patients with thyroid, liver, or uterine cancer, those starting on higher doses and those who developed severe high blood pressure during treatment were more than twice as likely to develop severe proteinuria. Closely monitoring blood pressure and urine protein in these patients is therefore critical to managing the drug safely.

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This article describes how linear motor conveyor systems are changing pharmaceutical packaging lines by replacing fixed mechanical systems with independently controlled carriers. The technology reduces downtime during product changeovers and increases output per floor area, making it well-suited to facilities that need to package many different product types. It represents a practical shift toward more flexible, efficient manufacturing in the pharmaceutical industry.

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Researchers investigated why the antibiotic linezolid, commonly used to treat serious infections, often causes nausea and vomiting. Lab experiments showed that linezolid triggers cells lining the gut to release serotonin — the same chemical that signals the brain to induce nausea — and this happens through a pathway that doesn't involve the usual calcium-triggered release mechanism. Understanding this mechanism opens the door to potentially preventing these side effects in patients who need long-term antibiotic treatment.

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This study looked at whether the jawbone can regrow on its own after surgical removal of diseased bone caused by osteoporosis medications, and what predicts this spontaneous healing. Bone regenerated in 9 of 16 patients, and younger age was the strongest predictor — patients under 76 years old were significantly more likely to experience regrowth and did so more quickly. While encouraging, the finding means this outcome cannot be relied upon as a treatment plan, especially in older patients.

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This study measured blood flow in the choroid — the vascular layer at the back of the eye — before and after dialysis sessions in patients with diabetes-related kidney disease. In patients who had just started dialysis, blood flow dropped significantly after each session and the drop correlated with how much fluid was removed, whereas patients on long-term dialysis showed much smaller changes. This suggests the eye's blood vessels adapt over time to the stress of dialysis, and tracking these changes with a non-invasive camera may serve as a window into overall vascular health.

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Researchers used a large Japanese insurance database to compare whether different laxatives — magnesium oxide, lubiprostone, senna, and linaclotide — carry different risks of causing acute kidney injury. After following over 150,000 patients, no meaningful difference in kidney injury risk was found between any of the four drugs. This reassures clinicians that the choice of laxative does not need to be driven by concern about kidney damage.

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This study built a system that reads Japanese hospital notes using an AI language model to automatically identify drug side effects like pain, then displays those findings in easy-to-read charts showing when symptoms started and how long they lasted. Testing on cancer patients receiving the chemotherapy drug paclitaxel confirmed the system accurately detected musculoskeletal symptoms, which appeared earlier in treated patients than in controls. Making invisible, subjective symptoms visible this way could help clinicians catch and manage side effects faster.

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A patient with long-standing rheumatoid arthritis developed thyroid inflammation after starting a biologic drug that blocks TNF, and then subsequently showed signs of a previously hidden protein-deposit disease affecting his kidneys and gut. Switching to a different biologic that targets a separate inflammatory pathway quickly resolved both the kidney and digestive problems. The case highlights that TNF-blocking drugs can unmask silent conditions and that monitoring is needed when starting biologic therapy.

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Researchers examined the blood flow and structure in the back of the eye in children with a type of lazy eye caused by a large difference in prescription between the two eyes. The lazy eye had a thicker choroid — the blood-vessel-rich layer behind the retina — but lower blood flow and weaker pulse strength compared to the normal eye. This suggests that abnormal circulation in this eye layer may play a role in how lazy eye develops.

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This study looked at how well knee replacement surgery worked for patients with rheumatoid arthritis, focusing on what patients themselves reported rather than just what doctors measured. After surgery, 85% of patients were satisfied, and those who were satisfied showed bigger improvements in daily activities and quality of life — even though objective clinical scores were similar between satisfied and dissatisfied groups. The results show that asking patients how they feel after surgery reveals important information that clinical measurements alone can miss.

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Researchers tested whether a yeast-derived fiber supplement called beta-glucan could strengthen immune defenses in the throat and nose of healthy adults. In a 12-week trial, people taking the supplement maintained higher levels of protective antibodies in their upper airways and reported fewer days with cold-like symptoms compared to those on placebo. The findings support the idea that certain dietary fibers can help keep the immune defenses of the airways in better shape.

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Using a national database of over 6,600 Japanese multiple sclerosis patients hospitalized for a relapse, this study found that patients treated at hospitals seeing more MS patients took significantly longer before needing readmission for another relapse compared to patients at lower-volume hospitals. Hospital stay length, however, did not differ between the groups. The findings support the possibility that concentration of MS care at specialized, higher-volume centers improves the quality of relapse prevention therapy.

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Among 192 breast cancer patients who took tamoxifen for at least a year, about 16% developed measurable liver injury, with a subset requiring a pause or stop in treatment. Metabolic risk factors — high body weight, diabetes, elevated blood fats, and pre-existing fatty liver — were strong predictors of more serious liver injury. Patients with these risk factors need closer liver monitoring during tamoxifen therapy, and collaboration with liver specialists is advisable when significant liver abnormalities appear.

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Pharmacists and patients in Japan collaborated to develop a list of 16 questions patients can use to start conversations with their pharmacist that go beyond just medications to cover daily life, treatment concerns, and health information needs. The questions were developed through focus groups with patients and refined using expert consensus, centering on a whole-person rather than disease-only perspective. The tool is intended to encourage patients to seek guidance from pharmacists on a broader range of health topics.

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This study examined how deliberately tiring out the hip abductor muscles — the muscles on the outer hip that stabilize the pelvis during movement — changes the way healthy men land from a jump. After the fatigue protocol, participants landed with greater outward hip movement, more trunk lean, and importantly, a higher force trying to buckle the knee inward, which is a known risk factor for tearing the ACL. The findings suggest that hip muscle fatigue creates complex compensatory movement patterns across the whole body that may influence injury risk.

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Critically ill patients lose muscle rapidly, which lowers their blood creatinine — a marker used to estimate kidney function — making standard equations overestimate how well the kidneys are working. This study tested whether artificially bumping up low creatinine values before plugging them into kidney function equations improves accuracy over time. The correction reduced overestimation later in the ICU stay but caused underestimation early on, and overall accuracy did not improve, suggesting this adjustment strategy has limited clinical value.

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A paper-format risk prediction tool for a dangerous drop in blood calcium caused by the bone drug denosumab was tested with hospital pharmacists at three Japanese cancer centers. Pharmacists rated the tool positively for being clear and straightforward, but some raised concerns about the inconvenience of a paper-based tool in hospitals that mostly use electronic records. The feedback points toward the need to integrate such prediction models directly into electronic health record systems for practical clinical use.

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Researchers tested whether spreading carbohydrate intake across five smaller meals and eating vegetables and protein before carbohydrates reduces blood sugar spikes compared to eating three standard meals. In a crossover trial with 18 healthy young women wearing continuous glucose monitors, the five-meal pattern with food sequencing significantly reduced peak blood sugar and time spent above normal glucose levels throughout the day. The findings offer a practical dietary strategy for controlling blood sugar without medication.

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This article summarizes the proceedings of a 2024 scientific conference on the biology of NAD+, a molecule essential for energy production and DNA repair that declines with age. Experts discussed how different precursor supplements — such as nicotinamide riboside and nicotinamide mononucleotide — can raise NAD+ levels and what health benefits this might produce, while also identifying key unanswered questions about dosing, timing, and individual variation in response. The meeting aimed to translate laboratory findings into actionable guidance for improving human health through NAD+ pathway modulation.

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This study evaluated a modified approach to knee replacement surgery for patients whose knee joint line is tilted at an unusual angle, comparing it to the standard personalized alignment technique. The modified approach — which shifts cartilage wear correction from the thigh bone to the shin bone side — produced more neutral joint line angles and kept the implant position within accepted safety limits more reliably than the standard technique. The results support using this modified method specifically for patients with this particular knee geometry.

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Researchers showed that a specific enzyme called NAMPT, which is packaged inside tiny particles released into the bloodstream, can be transferred from human blood into mice to boost levels of an important cellular fuel molecule called NAD+ in the brain. Injecting these particles raised brain temperature and suppressed a hunger-signaling gene in mice, and exercise was found to increase circulating levels of these particles. This suggests that the anti-aging and metabolic benefits of exercise may partly work through this particle-based mechanism, and that supplementing with such particles could be a future strategy for combating age-related decline.

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Using a large Japanese hospital database, researchers described how perioperative chemotherapy use before and after bladder removal surgery for muscle-invasive bladder cancer has changed over time. Chemotherapy before surgery increased over the study period, with gemcitabine plus cisplatin as the most common regimen, but older patients with other health conditions and those treated at smaller hospitals or non-cancer-specialist facilities were much less likely to receive it. The data reveal persistent gaps in guideline-consistent care driven by patient age, health status, and facility type.

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This analysis of over 13,000 US high school students found that using digital devices for 4 or more hours per day — but not heavy television watching — was independently linked to difficulty concentrating, poor sleep, feeling persistently sad, and having suicidal thoughts. Girls and some racial and ethnic minority groups were at higher risk, while participating in school sports and having a positive body image were associated with lower rates of both heavy screen use and poor mental health. The findings suggest that promoting school engagement and positive social experiences could partially offset the mental health toll of heavy screen time.

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This report describes outcomes in eight patients who underwent a specialized blood-vessel-preserving bone graft procedure to treat avascular necrosis of the small wrist bone called the scaphoid — a rare condition where the bone loses its blood supply and collapses. All patients improved in grip strength, wrist motion, and pain scores, but patients with more advanced disease at the time of surgery showed progression on X-rays even as their symptoms improved. The procedure works best when used early in the disease course, before significant bone collapse has occurred.

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Researchers engineered tiny particles released by cells to carry three immune-signaling molecules on their surface and tested whether these particles could train immune cells to become tolerant to a specific target rather than attacking it. The engineered particles successfully converted normal immune cells into regulatory cells that suppress immune responses in an antigen-specific way, and combining them with a drug called rapamycin enhanced this effect. This cell-free approach could eventually be used to treat autoimmune diseases or allergies by teaching the immune system to stand down against a specific target.

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Researchers analyzed a large US drug side-effect database to identify unexpected adverse events linked to esketamine, a nasal spray used for treatment-resistant depression. New safety signals included homicidal thoughts and substance use disorder, and the analysis also identified potential interactions with certain antidepressants and antipsychotics that may amplify specific side effects. Women and men showed different side-effect profiles, underscoring the need for sex-specific monitoring in clinical use.