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Article ; Online: GPT-4/4V's performance on the Japanese National Medical Licensing Examination.

Kawahara, Tomoki / Sumi, Yuki

2024 , Page(s) 1–8

Abstract: Background: Recent advances in Artificial Intelligence (AI) are changing the medical world, and AI will likely replace many of the actions performed by medical professionals. The overall clinical ability of the AI has been evaluated by its ability to ... ...

Abstract	Background: Recent advances in Artificial Intelligence (AI) are changing the medical world, and AI will likely replace many of the actions performed by medical professionals. The overall clinical ability of the AI has been evaluated by its ability to answer a text-based national medical examination. This study uniquely assesses the performance of Open AI's ChatGPT against all Japanese National Medical Licensing Examination (NMLE), including images, illustrations, and pictures. Methods: We obtained the questions of the past six years of the NMLE (112th to 117th) from the Japanese Ministry of Health, Labour and Welfare website. We converted them to JavaScript Object Notation (JSON) format. We created an application programming interface (API) to output correct answers using GPT-4 for questions without images and GPT4-V(ision) or GPT4 console for questions with images. Results: The percentage of image questions was 723/2400 (30.1%) over the past six years. In all years, GPT-4/4V exceeded the minimum score the examinee should score. In total, over the six years, the percentage of correct answers for basic medical knowledge questions was 665/905 (73.5%); for clinical knowledge questions, 1143/1531 (74.7%); and for image questions 497/723 (68.7%), respectively. Conclusions: Regarding medical knowledge, GPT-4/4V met the minimum criteria regardless of whether the questions included images, illustrations, and pictures. Our study sheds light on the potential utility of AI in medical education.
Language	English
Publishing date	2024-04-22
Publishing country	England
Document type	Journal Article
ZDB-ID	424426-6
ISSN	1466-187X ; 0142-159X
ISSN (online)	1466-187X
ISSN	0142-159X
DOI	10.1080/0142159X.2024.2342545
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Article: Fertility-sparing radical resection of juvenile clear cell adenocarcinoma of the cervix by pneumovaginal endoscopic surgery.

Kita, Masato / Yasuhara, Yuki / Sumi, Genichiro / Yokoe, Takuya / Butsuhara, Yusuke / Hisamatsu, Yoji / Okada, Hidetaka

Gynecologic oncology reports

2023 Volume 45, Page(s) 101135

Abstract: Vaginoscopy has been mainly used diagnostically due to the lack of adequate equipment for performing complicated surgeries (Johary et al., 2015). However, herein, we report therapeutic vaginal endoscopic surgery (pneumovaginoscopy) for secondary ... ...

Abstract	Vaginoscopy has been mainly used diagnostically due to the lack of adequate equipment for performing complicated surgeries (Johary et al., 2015). However, herein, we report therapeutic vaginal endoscopic surgery (pneumovaginoscopy) for secondary malignant vaginal tumors using the vNOTES technique and devices (Kita et al., 2021, Yokoe et al., 2022). To our knowledge, this report and surgical video demonstrate the first case of successful fertility-sparing R0 tumor resection of a rare primary cervical clear cell adenocarcinoma using pneumovaginoscopy. A 12-year-old girl was referred to our outpatient clinic with a chief complaint of a genital tumor and possible clear cell carcinoma on biopsy. There was no history of diethylstilbestrol exposure. MRI and CT images suggested a polypoid cervical tumor without metastatic lesions. Therefore, we performed therapeutic pneumovaginoscopic surgery with diagnostic laparoscopy and hysteroscopy. The cervical tumor was resected completely, and hysteroscopy and laparoscopy revealed no abnormalities. The total surgical time was 123 min, and the blood loss volume was minimal. R0 resection was achieved microscopically. Postoperatively, we performed a partial cervical resection around the first surgical scar to confirm no residual tumor. There were no postoperative complications, and a 2-year follow-up revealed no recurrence. The standard treatment for early-stage cervical cancer (IA2-IB1) remains radical hysterectomy with pelvic lymphadenectomy. However, fertility-sparing minimally invasive surgery has recently been introduced for clear cell adenocarcinoma of the cervix (Su et al., 2020). Our report supports the possibility of this minimally invasive surgery under exceptional conditions. This study was approved by the ethics committee of Kansai Medical University. Written and signed informed consent was obtained from the patient's legal guardian.
Language	English
Publishing date	2023-01-18
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2818505-5
ISSN	2352-5789
ISSN	2352-5789
DOI	10.1016/j.gore.2023.101135
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Article ; Online: Influence of distal glycan mimics on direct electron transfer performance for bilirubin oxidase bioelectrocatalysts.

Nishida, Sayaka / Sumi, Hinata / Noji, Haruna / Itoh, Akira / Kataoka, Kunishige / Yamashita, Satoshi / Kano, Kenji / Sowa, Keisei / Kitazumi, Yuki / Shirai, Osamu

Bioelectrochemistry (Amsterdam, Netherlands)

2023 Volume 152, Page(s) 108413

Abstract: Bilirubin oxidase (BOD) is a bioelectrocatalyst that reduces dioxygen ( ... ...

Abstract	Bilirubin oxidase (BOD) is a bioelectrocatalyst that reduces dioxygen (O
MeSH term(s)	Electrons ; Electron Transport ; Oxidoreductases Acting on CH-CH Group Donors/genetics ; Oxidoreductases Acting on CH-CH Group Donors/metabolism
Chemical Substances	bilirubin oxidase (EC 1.3.3.5) ; Oxidoreductases Acting on CH-CH Group Donors (EC 1.3.-)
Language	English
Publishing date	2023-04-01
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2010650-6
ISSN	1878-562X ; 0302-4598 ; 1567-5394
ISSN (online)	1878-562X
ISSN	0302-4598 ; 1567-5394
DOI	10.1016/j.bioelechem.2023.108413
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Article ; Online: Disseminated Infection by Scedosporium/Lomentospora During Induction Therapy for Acute Myeloid Leukemia Complicated by Nontuberculous Mycobacteria.

Kitahara, Mari / Sumi, Masahiko / Kazumoto, Hiroko / Shishido, Tsutomu / Ueki, Toshimitsu / Hiroshima, Yuki / Kamei, Katsuhiko / Kobayashi, Hikaru

Internal medicine (Tokyo, Japan)

2023

Abstract: Scedosporium/Lomentospora infections are rare and are associated with a high mortality rate in immunocompromised patients. A 69-year-old man with nontuberculous mycobacteria (NTM) died during induction chemotherapy for acute myeloid leukemia because of ... ...

Abstract	Scedosporium/Lomentospora infections are rare and are associated with a high mortality rate in immunocompromised patients. A 69-year-old man with nontuberculous mycobacteria (NTM) died during induction chemotherapy for acute myeloid leukemia because of multiple organ failure due to pneumonia. During an autopsy, Lomentospora prolificans was detected using a fungal gene analysis of the blood, lungs, spleen, kidneys, and intestines, and Scedosporium aurantiacum was detected in the lungs. NTM disease may predispose patients to Scedosporium/Lomentospora infections. Physicians should consider Scedosporium/Lomentospora spp. as an invasive fungal infection that occurs during myelosuppression, particularly when NTM is a complication.
Language	English
Publishing date	2023-10-13
Publishing country	Japan
Document type	Journal Article
ZDB-ID	32371-8
ISSN	1349-7235 ; 0021-5120 ; 0918-2918
ISSN (online)	1349-7235
ISSN	0021-5120 ; 0918-2918
DOI	10.2169/internalmedicine.2159-23
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Article: Central volume shift in acute heart failure revealed by blood volume monitoring during haemodialysis.

Sumi, Hirofumi / Ishii, Akari / Yamada, Yuki / Shibagaki, Yugo / Tominaga, Naoto

Clinical kidney journal

2021 Volume 15, Issue 5, Page(s) 1007–1009

Abstract: Central volume shift is one of the major pathophysiological mechanisms of acute pulmonary oedema in acute heart failure (AHF). Pathological vasoconstriction results in central volume shift; however, its onset and course have been rarely detected or ... ...

Abstract	Central volume shift is one of the major pathophysiological mechanisms of acute pulmonary oedema in acute heart failure (AHF). Pathological vasoconstriction results in central volume shift; however, its onset and course have been rarely detected or recorded in clinical practice. We report an exceptional case of AHF developing during haemodialysis, with marked blood pressure (BP) elevation and paradoxical repeated reduction in blood volume (BV) detected by real-time BV monitoring, accompanied by worsening dyspnoea. This inverse correlation of BV and BP during haemodialysis indicates that the theoretical central volume shift was captured in real-world AHF.
Language	English
Publishing date	2021-12-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2655800-2
ISSN	2048-8513 ; 2048-8505
ISSN (online)	2048-8513
ISSN	2048-8505
DOI	10.1093/ckj/sfab280
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Zs.A 6587: Show issues

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Article: Pump Exchange from a Left Ventricular Assist Device to a Jarvik 2000 with a Postauricular Cable Due to Abdominal Driveline Infection.

Kishimoto, Yuichiro / Yoshikawa, Yasushi / Onohara, Takeshi / Kumagai, Kunitaka / Sakaguchi, Yuki / Sumi, Naoki / Kishimoto, Nozomi / Ikeda, Yosuke / Yoshikawa, Yuki / Yamane, Kazuma / Nishimura, Motonobu

Yonago acta medica

2023 Volume 66, Issue 3, Page(s) 389–393

Abstract: Driveline infection in patients with implantable left ventricular assist devices (LVAD) remains common and crucial. Once a driveline exit-site infection reaches the LVAD component, radical treatment such as LVAD exchange may become necessary, although ... ...

Abstract	Driveline infection in patients with implantable left ventricular assist devices (LVAD) remains common and crucial. Once a driveline exit-site infection reaches the LVAD component, radical treatment such as LVAD exchange may become necessary, although the clinical results are unsatisfactory. The Jarvik 2000 device, which utilizes a postauricular cable, allows the driveline to exit the body behind the ear (postauricular) instead of through an abdominal site. Here, we report the case of a patient who had awaited heart transplantation for more than 6 years and had a critical driveline infection that almost reached the LVAD pump. The patient underwent a pump exchange using the Jarvik 2000 with a postauricular cable, with excellent results. It is a useful replacement option for patients with abdominal driveline infections, owing to its small pump pocket and the availability of an alternative pathway for the driveline.
Language	English
Publishing date	2023-07-31
Publishing country	Japan
Document type	Case Reports
ZDB-ID	840719-8
ISSN	1346-8049 ; 0513-5710
ISSN (online)	1346-8049
ISSN	0513-5710
DOI	10.33160/yam.2023.08.007
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Article: Factors related to sense of coherence in adult patients with Type 2 diabetes.

Odajima, Yuki / Sumi, Naomi

Nagoya journal of medical science

2018 Volume 80, Issue 1, Page(s) 61–71

Abstract: The influence of a diabetic person's sense of burden and blood sugar control through sense of coherence (SOC) on self-management has yet to be sufficiently clarified. The purpose of this study was to examine the utility of salutogenesis, which has sense ... ...

Abstract	The influence of a diabetic person's sense of burden and blood sugar control through sense of coherence (SOC) on self-management has yet to be sufficiently clarified. The purpose of this study was to examine the utility of salutogenesis, which has sense of coherence at its core, for the self-management of patients with type 2 diabetes. A total of 258 questionnaires were distributed to patients who were seen at one of three hospitals in an urban area in Japan, after obtaining consent from the patient. They were between 20 and 75 years old and regularly received care. Of the 185 responses, 177 were valid. The responses were analyzed by referring to the framework of salutogenesis, and the relationship between patient characteristics, SOC, the Problem Areas In Diabetes survey (PAID), and glycosylated hemoglobin (HbA1c) were studied with structural equation modeling (SEM). SOC had a main effect on PAID scores and an indirect effect on HbA1c. Moreover, age influenced SOC positively. The SOC of patients with type 2 diabetes in the present study was comparatively high. These observations suggest a direct effect of SOC on reducing the sense of burden from having diabetes and an indirect effect on decreasing HbA1c. This research suggested the possibility that diabetes can be controlled by improving SOC.
MeSH term(s)	Adult ; Aged ; Diabetes Mellitus, Type 2/metabolism ; Diabetes Mellitus, Type 2/physiopathology ; Female ; Glycated Hemoglobin A/metabolism ; Humans ; Male ; Middle Aged ; Self-Management ; Sense of Coherence/physiology ; Young Adult
Chemical Substances	Glycated Hemoglobin A
Language	English
Publishing date	2018-03-26
Publishing country	Japan
Document type	Journal Article
ZDB-ID	193148-9
ISSN	2186-3326 ; 0027-7622
ISSN (online)	2186-3326
ISSN	0027-7622
DOI	10.18999/nagjms.80.1.61
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Article: Urgent Carotid Artery Stenting with Intracranial and Carotid Stent for Symptomatic Bilateral Consecutive Internal Carotid Artery Dissection: A Case Report.

Takano, Yuki / Ishikawa, Tatsuya / Funatsu, Takayuki / Eguchi, Seiichiro / Sumi, Masatake / Yamaguchi, Koji / Kawamata, Takakazu

NMC case report journal

2022 Volume 9, Page(s) 371–376

Abstract: Spontaneous internal carotid artery dissection (CAD) is a relatively rare disease, with patients, including those with bilateral CAD, often recovering after conservative therapy. However, patients with symptomatic and progressive disease require urgent ... ...

Abstract	Spontaneous internal carotid artery dissection (CAD) is a relatively rare disease, with patients, including those with bilateral CAD, often recovering after conservative therapy. However, patients with symptomatic and progressive disease require urgent carotid artery stenting (CAS). If CAD extends to the petrous portion of the internal carotid artery (ICA), it is difficult to treat with a carotid stent alone. This report describes a rare case of consecutive spontaneous bilateral CAD that required an intracranial stent with an interval of 4 years between the first and second CAS. A 58-year-old man with a history of dyslipidemia was admitted for transient ischemic attacks. He underwent CAS with carotid and intracranial stents on the third day for the left CAD due to exacerbation of symptoms under antithrombotic therapy and new stroke on magnetic resonance imaging (MRI). He recovered well. However, 4 years after the initial treatment, the patient was admitted again because of a sudden headache, photophobia, and transient weakness of the left lower limb. He was diagnosed with CAD on the contralateral side. He underwent CAS with carotid and intracranial stents due to progressive neurological deterioration under antithrombotic therapy. After treatment, he was clinically stable without any new infarctions on a follow-up MRI. He was discharged without neurological deficit. Our case of bilateral internal CAD treatment demonstrated that early revascularization with immediate stenting with carotid and intracranial stents in CAD contributes to the prevention of extensive neurological damage, thereby providing a favorable outcome in some cases.
Language	English
Publishing date	2022-11-09
Publishing country	Japan
Document type	Case Reports
ISSN	2188-4226
ISSN	2188-4226
DOI	10.2176/jns-nmc.2022-0173
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Article: [A Case of Postoperative Recurrence of Liver Metastasis after Gastrectomy for Gastric Cancer-No Recurrence for Five Years after Twice Liver Resections].

Fukumoto, Sou / Yamamoto, Yuji / Yanagawa, Senichiro / Takaya, Momoko / Amioka, Jun / Kaneko, Yuki / Watanabe, Atsuhiro / Nishina, Mai / Mashima, Hiroaki / Sumi, Yusuke / Yamaki, Minoru / Kurayoshi, Manabu / Oshita, Akihiko / Nakahara, Masahiro / Noriyuki, Toshio

Gan to kagaku ryoho. Cancer & chemotherapy

2024 Volume 50, Issue 13, Page(s) 1895–1896

Abstract: The patient was an 89-year-old man. He underwent laparoscopic distal gastrectomy for gastric cancer and was diagnosed as T1bN1M0, Stage ⅠB. Eight months after surgery, a CT scan showed an 18 mm-sized hypodense mass in S6 of the liver, and the patient was ...

Abstract	The patient was an 89-year-old man. He underwent laparoscopic distal gastrectomy for gastric cancer and was diagnosed as T1bN1M0, Stage ⅠB. Eight months after surgery, a CT scan showed an 18 mm-sized hypodense mass in S6 of the liver, and the patient was diagnosed with recurrent liver metastasis. He was treated with 3 courses of CapeOX therapy, and the response was judged as partial response(PR). Laparoscopic partial hepatic S6 resection was performed for the single liver metastasis. The pathological results showed liver metastasis of gastric cancer. Capecitabine was started as adjuvant chemotherapy. Nine months after surgery for liver metastasis, CT scan showed a 12 mm-sized single tumor in S5 and the patient was diagnosed with recurrent liver metastasis. The patient underwent laparoscopic partial hepatectomy after 3 courses of weekly paclitaxel plus ramucirumab therapy. The pathological result showed liver metastasis of gastric cancer. After the surgery, adjuvant chemotherapy was not administered according to the patient's request. Seven years have passed since the resection of the gastric cancer, and 5 years have passed since the resection of the second liver metastasis, and the patient has not had any recurrence.
MeSH term(s)	Aged, 80 and over ; Humans ; Male ; Gastrectomy/adverse effects ; Hepatectomy ; Liver Neoplasms/secondary ; Liver Neoplasms/surgery ; Stomach Neoplasms/pathology ; Stomach Neoplasms/surgery
Language	Japanese
Publishing date	2024-02-01
Publishing country	Japan
Document type	Case Reports ; English Abstract ; Journal Article
ZDB-ID	604842-0
ISSN	0385-0684
ISSN	0385-0684
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Article: [A Case of Postoperative Peritoneal Dissemination Recurrence of CY1 Gastric Cancer with cCR after Nab-PTX Therapy].

Watanabe, Atsuhiro / Yamamoto, Yuji / Yanagawa, Senichiro / Takaya, Momoko / Amioka, Jun / Kaneko, Yuki / Nishina, Mai / Mashima, Hiroaki / Sumi, Yusuke / Yamaki, Minoru / Kurayoshi, Manabu / Oshita, Akihiko / Nakahara, Masahiro / Noriyuki, Toshio

Gan to kagaku ryoho. Cancer & chemotherapy

2024 Volume 50, Issue 13, Page(s) 1884–1886

Abstract: A 72-year-old man visited his local doctor for gastric discomfort. Esophagogastroduodenoscopy revealed a type 3 tumor on the gastric antrum, and histopathological examination revealed a moderately differentiated adenocarcinoma(tub2). The patient was ... ...

Abstract	A 72-year-old man visited his local doctor for gastric discomfort. Esophagogastroduodenoscopy revealed a type 3 tumor on the gastric antrum, and histopathological examination revealed a moderately differentiated adenocarcinoma(tub2). The patient was referred to our hospital and CT scan revealed wall thickening with contrast effect in the gastric angle but no enlarged lymph nodes in the region. The patient was diagnosed as cT3N0M0, Stage ⅡB gastric cancer and underwent open distal gastrectomy and D2 lymph node dissection. No peritoneal dissemination was observed, but intraoperative laparoscopic cytology showed Class Ⅴ. The patient was diagnosed as CY1 Stage Ⅳ gastric cancer, and treated with S-1 plus Tmab therapy starting 1 month after surgery. One year postoperative follow-up CT revealed recurrence of peritoneal disseminations, and the patient was treated with nab-PTX as a second-line therapy. Tumor shrinkage was achieved steadily, and the peritoneal disseminations disappeared at the CT after 12 courses, resulting in cCR. Thereafter, cCR continued and treatment was terminated at the 17th course. Seven years have passed since the end of chemotherapy, and the patient is still alive without recurrence.
MeSH term(s)	Aged ; Humans ; Male ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Gastrectomy/adverse effects ; Laparoscopy ; Lymph Node Excision ; Stomach Neoplasms/drug therapy ; Stomach Neoplasms/surgery ; Stomach Neoplasms/pathology
Language	Japanese
Publishing date	2024-02-01
Publishing country	Japan
Document type	Case Reports ; English Abstract ; Journal Article
ZDB-ID	604842-0
ISSN	0385-0684
ISSN	0385-0684
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