Two cases of cisplatin-induced permanent renal failure following neoadjuvant chemotherapy for esophageal cancer

AbstractIntroductionWe experienced two esophageal cancer patients who developed severe acute renal failure after neoadjuvant chemotherapy with cisplatin and 5-fluorourasil.Presentation of caseAfter administration of cisplatin, their serum creatinine increased gradually until they required hemodialysis and their renal failure was permanent. In both cases, renal biopsy examination indicated partial recovery of the proximal tubule, but renal function did not recover. After these events, one patient underwent definitive radiotherapy and the other underwent esophagectomy for their esophageal cancers, while continuing dialysis. Both patients are alive without cancer recurrence.DiscussionIn these two cases of cisplatin-induced renal failure, renal biopsy examination showed only slight disorder of proximal tubules and tendency to recover.ConclusionAlthough cisplatin-related nephrotoxicity is a well-recognized complication, there have been few reports of renal failure requiring hemodialysis in cancer patients. In this report, we present their clinical courses and the pathological findings of cisplatin-related renal failure

An Analysis of English Language Entrance Examination Data from Kansai University : Applying Language Testing Theory

大学入試は受検者の今後に大きな影響を与えるハイステークス・テストであるが，一般的に情報の開示が難しいため，その品質保証のためにテスト理論を活用してテスト自体の改善を行うという取り組みはこれまでに報告されていない．そこで本研究では，現行の関西大学英語入試問題実施データを分析し，その構造的妥当性を検証した．また，受検者の各問題セクションの合計得点が，テストの総合計点にどのように寄与しているかを探った．多次元項目反応理論による分析の結果，一般因子である英語総合能力とセクションや英文素材を反映した下位領域特有の因子による双因子モデルが支持され，現行の英語入試問題形式の構造的な側面の妥当性が確認された．また，特定セクションの合計得点が英語入試における受検者の能力弁別に役立っていることが示された．同時に，現行の英語入試問題作成における課題も明らかになったため，今後の大学入試問題作成や分析でテスト理論をより活用していくことにより，テストの品質改善が可能であることが示唆された．In this study, we analyzed an English language entrance test of Kansai University administered in the past to validate its structural aspect. We also investigated the extent to which each section of the test had an influence on the overall test score. By applying the multidimensional item response theory (MIRT), we found that a bifactor model with a general factor and lower-level factors reflecting the differences of sections and reading materials fit the data better than other models. In addition, it was confirmed that a certain section in the test effectively performed to distinguish the ability of test takers. These results suggest that the test retains desirable traits as a measurement instrument used for entrance examination purposes in terms of the structural aspect of validity and assessment of test takers\u27 ability. At the same time, this study points to the importance of applying language testing theory in the process of creating, administering, and analyzing a high-stakes test. Implications of employing test theories are discussed in view of the current situation of entrance examination administration in Japan.本研究の一部はJSPS 科学研究費補助金（科研費）16K13273，26370719，16H02051，26370719 の助成を受けて実施された

Occupational therapy using a robotic-assisted glove ameliorates finger dexterity and modulates functional connectivity in amyotrophic lateral sclerosis.

Introduction:Although rehabilitation is recommended for amyotrophic lateral sclerosis (ALS), improvement of functional decline has hardly been achieved. We investigated the effect of occupational therapy that uses a robotic-assisted glove (RAG) on hand dexterity and the functional connectivities found in the brain of ALS patients.Method:Ten patients diagnosed with ALS and admitted to the Shiga University of Medical Science (SUMS) Hospital from December 2018 to December 2021 participated in the study. These participants chose the hand side to wear RAG and exercised for two weeks. A sham movement was performed on the other side. We administered several functional assessments, including the Simple Test for Evaluating Hand Function (STEF), grip strength, pinch meter for grip strength, Canadian occupational performance measure (COPM), as well as nerve conduction study (NCS) before and after the exercise, and evaluated the results. We also analyzed six patients\u27 resting-state functional magnetic resonance imaging (rs-fMRI).Results:Two-week robotic rehabilitation improved the STEF, grip strength, and COPM scores when compared with those of the other side. However, no significant effect was observed in the pinch meter and the NCS results. The rs-fMRI data analysis revealed that the robotic rehabilitation augmented two functional connectivities between the left pallidum-right supplementary motor cortex and right insular cortex-right sensorimotor network among the patients, which had beneficial effects.Conclusion:The occupational therapy using RAG displayed improved hand dexterity. The enhanced functional connectivities around the sensorimotor network might be associated with the improvement in hand dexterity because of the RAG

Intravascular Lymphomatosis Mimicking Primary Central Nervous System Lymphoma: A Case Report and Literature Review

We herein report a 75-year-old female patient with intravascular lymphomatosis (IVL) who presented with fever of unknown origin. Examination, including contrast-enhanced CT and 67Ga scintigraphy, failed to show any lesions. Her blood levels of lactate dehydrogenase and soluble interleukin-2 receptors were high, suggesting a lymphomatous tumor. A bone marrow puncture was negative, and a random skin biopsy revealed a monoclonal proliferation of naked, large lymphocytes in the vascular space of the subcutaneous tissue, confirming the diagnosis of IVL. MRI, performed 7 weeks after admission, showed a brain mass mimicking primary central nervous system lymphoma. The mass was considered to be a collection of malignant lymphocyte cells invading from the vessels. Without the random skin biopsy, this case may have been misdiagnosed as primary central nervous system lymphoma