Juntendo medical journal最新文献

{"title":"Revisiting the Concept of DIC: A Phenotype-guided Framework for Modern Hemostatic Medicine.","authors":"Tomaz Crochemore, Ecaterina Scarlatescu","doi":"10.14789/ejmj.JMJ25-0066-R","DOIUrl":"https://doi.org/10.14789/ejmj.JMJ25-0066-R","url":null,"abstract":"<p><p>Disseminated intravascular coagulation (DIC) has long been described as a catastrophic systemic activation of coagulation with suppressed anticoagulant and fibrinolytic pathways, culminating in macro- and microvascular thrombosis, hypoperfusion, and multiple organ dysfunction. It may arise from acute inflammatory, traumatic, or infectious diseases, where consumption of fibrinogen, platelets, and coagulation factors, together with dysregulated fibrinolysis, lead to bleeding and poor outcomes. Contemporary evidence demonstrates that DIC is not a single or uniform pathological entity, but rather the advanced and convergent phase of distinct coagulopathies triggered by heterogeneous systemic insults such as sepsis, trauma, burns, malignancy, and obstetric complications. Similar to acute respiratory distress syndrome and dialysis-dependent renal failure, organ-failure syndromes with different etiologies, DIC should be recognized as advanced failure of the coagulation system, characterized by excessive thrombin generation, impaired fibrin formation, depletion of endogenous anticoagulants, and fibrinolytic imbalance. We propose reframing DIC as part of an etiologic and phenotype-guided framework within modern hemostatic precision medicine. The recognition of sepsis-induced coagulopathy (SIC), trauma-induced coagulopathy (TIC), and obstetric-associated coagulopathy (OAC), exemplifies this paradigm shift. Each condition exhibits unique inflammatory triggers, endothelial activation, and hemostatic trajectories evolving through identifiable phenotypes, from macrovascular hypercoagulability to microvascular fibrinolytic shutdown and, ultimately, to hypocoagulation, hyperfibrinolysis and hemorrhage. Early identification of these phenotypes through viscoelastic testing and biomarkers such as D-dimer, fibrinogen, protein C, antithrombin, and plasminogen activator inhibitor-1 allows targeted, goal-directed interventions. This strategy supports precision-guided anticoagulant therapy in thrombotic phenotypes and hemostatic resuscitation in hemorrhagic states, ultimately improving clinical outcomes in critically ill patients.</p>","PeriodicalId":520470,"journal":{"name":"Juntendo medical journal","volume":"72 1","pages":"45-53"},"PeriodicalIF":0.0,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12997355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Status of Physical Literacy in Japan: A Narrative Review of Research and Practical Applications.","authors":"Kenta Toyama, Koya Suzuki, Misaki Matsunaga","doi":"10.14789/ejmj.JMJ25-0026-P","DOIUrl":"https://doi.org/10.14789/ejmj.JMJ25-0026-P","url":null,"abstract":"<p><p>In recent years, physical literacy has attracted increasing attention globally. Interventional studies have been conducted in several countries. However, there is still no established Japanese definition of \"physical literacy.\" In 2022, the Japan Sports Agency became the first government agency in Japan to discuss physical literacy from the perspective of improving children's physical fitness and establishing exercise habits. Consequently, conference presentations centered on physical literacy began to appear gradually. However, the extent of physical literacy research and utilization in Japan remains unclear. Therefore, this study investigates the progress of research on physical literacy in Japan to the present day. After assessing the current situation, we identified issues and considered how physical literacy could be utilized in Japan's physical education and sports settings in the future. Once the final version of the Japanese physical literacy assessment scale is completed, various studies, including intervention studies, can be conducted across a wide range of fields. It is hoped that physical literacy research will be implemented in society and will contribute to the maintenance and promotion of the health of the Japanese.</p>","PeriodicalId":520470,"journal":{"name":"Juntendo medical journal","volume":"72 1","pages":"17-29"},"PeriodicalIF":0.0,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12997346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Reported Pain and Quality of Life Outcomes Following Iatrogenic Gallbladder Perforation During Laparoscopic Cholecystectomy.","authors":"Rana Basit Ali Rajput, Ali Raza, Muhammad Waleed Khan, Iram Javaid Kiani, Iqra Maqbool Rajput, Khaula Rafeeq, Mohit Kumar","doi":"10.14789/ejmj.JMJ25-0057-OA","DOIUrl":"https://doi.org/10.14789/ejmj.JMJ25-0057-OA","url":null,"abstract":"<p><strong>Objectives: </strong>Intraoperative gallbladder perforation (IGP) is a frequent adverse event in laparoscopic cholecystectomy; however, its influence on patient-reported pain and health-related quality of life (HRQoL) is underinvestigated. This research evaluated the level of postoperative pain and HRQoL in patients with and without IGP.</p><p><strong>Materials design: </strong>A longitudinal observational study was conducted on 300 adults who underwent elective laparoscopic cholecystectomy.</p><p><strong>Methods: </strong>The Brief Pain Inventory-Short Form (BPI-SF) and EQ-5D-5L assessed pain and HRQoL at 1 point in time (baseline) and at 2 points in time (3 and 6 months). Pearson's chi-square test, Mann-Whitney U test, Kruskal-Wallis test, and general linear models were used as statistical tests.</p><p><strong>Results: </strong>IGP was present in 80% of participants and was significantly associated with increased pain (r = 0.25, p < 0.001) and reduced HRQoL (r = -0.20, p < 0.001). HRQoL showed a moderate negative correlation with pain (r = -0.35, p = 0.001). Females complained about more pain and reduced QoL (p < 0.001). The IGP group also scored more in BPI-SF (baseline: 64.5 vs. 55.3; 6 months: 58.1 vs. 48.0) and continued to score lower in EQ-5D-5L. Even though pain and HRQoL improved over time, the difference between the IGP and non-IGP groups was substantial.</p><p><strong>Conclusion: </strong>Iatrogenic gallbladder perforation results in postoperative pain and a decrease in HRQoL that persisted up to six months postoperative. The use of preventive surgery and specific postoperative management is mandatory to enhance patient outcomes.</p>","PeriodicalId":520470,"journal":{"name":"Juntendo medical journal","volume":"72 1","pages":"134-141"},"PeriodicalIF":0.0,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12997341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in Radiation Therapy for Unresectable Locally Advanced Non-Small Cell Lung Cancer: From Technical Advances to Immunotherapy Integration.","authors":"Naoya Murakami","doi":"10.14789/ejmj.JMJ25-0059-R","DOIUrl":"https://doi.org/10.14789/ejmj.JMJ25-0059-R","url":null,"abstract":"<p><p>The management of unresectable locally advanced non-small cell lung cancer (NSCLC) has undergone significant transformation over the past three decades. This review summarizes the evolution of radiation therapy for unresectable locally advanced NSCLC, from radiation therapy alone to concurrent chemoradiotherapy, and the subsequent integration of immunotherapy or targeted therapy against driver mutations as consolidation treatment. Technical advances in radiation delivery, including the progression from two-dimensional radiotherapy to three-dimensional conformal radiotherapy (3D-CRT), followed by intensity- modulated radiotherapy (IMRT), have improved therapeutic outcomes while reducing toxicity. The PACIFIC trial established durvalumab, an anti-programmed death ligand 1 (PD-L1) antibody, consolidation as the standard of care following concurrent chemoradiotherapy, resulting in significant improvements in survival. More recently, the LAURA trial demonstrated the efficacy of Osimertinib, an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), consolidation in EGFR-mutated NSCLC. However, radiation pneumonitis remains a potentially fatal radiation-induced toxicity that can prevent patients from receiving optimal treatment. Careful attention to dose-volume parameters, particularly lung V20Gy and mean lung dose, is essential for safe treatment delivery. Risk prediction models have been developed to identify high-risk patients, particularly those with pre-existing interstitial pneumonia. The successful transition to consolidation immunotherapy requires meticulous radiation pneumonitis management to maximize clinical benefit. This review summarizes current evidence and provides guidance for optimizing treatment approaches in this challenging patient population.</p>","PeriodicalId":520470,"journal":{"name":"Juntendo medical journal","volume":"72 1","pages":"30-37"},"PeriodicalIF":0.0,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12997351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-Assisted Thoracic Surgery for Lung Cancer in Juntendo University -Safety and benefit.","authors":"Mariko Fukui, Kenji Suzuki, Yoshihiro Itagaki, Yukio Watanabe, Shunsuke Uchida, Takeshi Matsunaga, Aritoshi Hattori, Kota Imashimizu, Kazuya Takamochi","doi":"10.14789/ejmj.JMJ25-0040-P","DOIUrl":"https://doi.org/10.14789/ejmj.JMJ25-0040-P","url":null,"abstract":"<p><p>As of 2017, robotic surgery accounted for less than 1% of lung cancer operations. The adoption of robotic surgery for lung cancer has rapidly increased, now comprising over 15% of such procedures. Juntendo University initiated robotic thoracic surgery in 2017 and currently performs approximately 250 robotic surgeries annually, including 150 for lung cancer. While robotic surgery offers advantages such as a three-dimensional field of view and enhanced dexterity through multi-jointed instruments, managing intraoperative complications-particularly bleeding-has been considered a limitation. To address these challenges, our hospital has implemented optimized operating room layouts, conducted emergency thoracotomy simulations, and developed safe surgical protocols. In recent years, the precision of robotic systems has enabled minimally invasive approaches to complex procedures. We have successfully performed advanced surgeries using robotic or robot-assisted techniques, including bronchoplasty, pulmonary artery reconstruction, deep lymph node dissection, and operations involving severe adhesions that are typically difficult with conventional minimally invasive methods. With continued advancements in robotic surgery, a growing number of patients are expected to benefit from minimally invasive treatment options.</p>","PeriodicalId":520470,"journal":{"name":"Juntendo medical journal","volume":"72 1","pages":"3-7"},"PeriodicalIF":0.0,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12997343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enigmatic Role of IL-31 in the Itch and Inflammation of Vernal Keratoconjunctivitis.","authors":"Masahiro Okamoto, Mitsutoshi Tominaga, Keitaro Mashimo, Ayumi Usui-Ouchi, Nobuyuki Ebihara","doi":"10.14789/ejmj.JMJ25-0022-OA","DOIUrl":"https://doi.org/10.14789/ejmj.JMJ25-0022-OA","url":null,"abstract":"<p><strong>Objectives: </strong>Vernal keratoconjunctivitis (VKC) is a recurrent allergic inflammation of the conjunctiva characterized by itchiness. The cytokine IL-31 is involved in itch and inflammation in other conditions, so we investigated whether it plays similar role in VKC.</p><p><strong>Methods: </strong>We estimated messenger RNA (mRNA) IL-31 expression in giant papillae (GP) with real-time polymerase chain reaction (RT-PCR). We used immunohistochemistry to examine IL-31 receptor (IL-31R) expression in neurons and epithelial cells in GP. We then performed fluorescence-activated cell sorting and immunofluorescence to examine IL-31R expression in cultured human conjunctival epithelial cells (HConEpiCs) either treated or not treated with various cytokines. Next, we examined the expression of phosphorylated signal transducer and activator of transcription 3 (P-STAT3) and suppressor of cytokine signaling 3 (SOCS3) in the epithelium of GP and control specimens using immunohistochemistry. Last, we used DNA microarray analysis and RT-PCR to investigate whether recombinant IL-31 induced expression of various genes in HConEpiCs.</p><p><strong>Results: </strong>IL-31 expression was elevated in GP compared with control specimens. Although many neuron fibers innervated GP, none was found to express IL-31R. IL-31R was expressed in the epithelium of GP and in HConEpiCs, and its expression in HConEpiCs was not altered by any of the investigated cytokines. Recombinant IL-31 increased SOCS3 mRNA expression. Strong P-STAT3 expression was observed in the epithelium of GP, but SOCS3 expression was not observed.</p><p><strong>Conclusions: </strong>Increased IL-31 in GP of VKC patients may not directly influence itch sensation via neuron fibers and inflammation via the expression of P-STAT3 and SOCS3.</p>","PeriodicalId":520470,"journal":{"name":"Juntendo medical journal","volume":"72 1","pages":"113-121"},"PeriodicalIF":0.0,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12997356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Myositis Overlap Conundrum: Differentiating Polymyositis from Inclusion Body Myositis.","authors":"Moe Hein, Win Lae Lae Aung, Eaindra Myat Thu, Abm Ashraful Huda","doi":"10.14789/ejmj.JMJ25-0061-CR","DOIUrl":"https://doi.org/10.14789/ejmj.JMJ25-0061-CR","url":null,"abstract":"<p><p>We describe the case of a 77-year-old woman who presented with progressive weakness in both lower extremities, dysphagia to both solids and liquids, and severe weight loss. Her recent experience with statin-induced rhabdomyolysis was initially considered to be associated with her high creatine kinase (CK) level. Nevertheless, she became weaker and experienced dysphagia even after the cancellation of statin therapy. Lab tests indicated that there were constantly high CK (3347 U/L) and positive anti-PM-Scl-100 antibody, which indicated an autoimmune inflammatory myopathy. Lower limb MRI revealed diffuse myositis, and muscle biopsy revealed active myopathy with inflammation and rimmed vacuoles, characteristic of polymyositis/inclusion body myositis (IBM). She received high-dose corticosteroids and then intravenous immunoglobulin (IVIg) and methotrexate as treatment for polymyositis. Although she experienced an improvement in her limb weakness, she was still dysphagic. The case demonstrates that the diagnosis of inflammatory myopathies in older people is complex, and there is a need to identify inclusion body myositis early in the course to inform proper management.</p>","PeriodicalId":520470,"journal":{"name":"Juntendo medical journal","volume":"72 1","pages":"147-153"},"PeriodicalIF":0.0,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12997344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Challenge of Sublobar Resection for Early-stage Non-small Cell Lung Cancer: Current Status and Future Perspectives.","authors":"Aritoshi Hattori, Takeshi Matsunaga, Mariko Fukui, Kazuya Takamochi, Kenji Suzuki","doi":"10.14789/ejmj.JMJ25-0062-P","DOIUrl":"https://doi.org/10.14789/ejmj.JMJ25-0062-P","url":null,"abstract":"<p><p>Lobectomy and lymph node dissection have long been the standard surgical procedures for clinical stage IA lung cancer, based on a randomized trial published in 1995. That randomized trial showed better overall survival (OS) and recurrence-free survival (RFS) with lobectomy than with limited resection (segmentectomy or wide wedge resection) for clinical T1N0 non-small cell lung cancer. In addition, a three-fold higher rate of locoregional recurrence after limited resection was observed. However, recent advances in diagnostic imaging, such as thin-section computed tomography (TSCT), have improved the accuracy of clinical staging and the assessment of ground-glass opacity (GGO) in lung cancer, which is now recognized as being associated with less invasive pathology and a favorable prognosis. Subsequently, to evaluate the efficacy of sublobar resection for early-stage lung cancer, three major JCOG trials (JCOG0802/WJOG4607L, JCOG0804/WJOG4507L, and JCOG1211) were conducted. These studies stratified patients according to the consolidation-to-tumor ratio (CTR) on preoperative TSCT findings. These studies have recently disclosed their results, and they support the efficacy of sublobar resection, although several questions remain in daily clinical practice. In this perspective article, we summarize the current status and optimal surgical strategy for early-stage lung cancer based on these randomized controlled trials and discuss future perspectives, including the potential expansion of segmentectomy to larger or node-positive lung tumors.</p>","PeriodicalId":520470,"journal":{"name":"Juntendo medical journal","volume":"72 1","pages":"8-16"},"PeriodicalIF":0.0,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12997357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Bleeding Severity and Quality of Life in Adults with Immune Thrombocytopenia.","authors":"Marvelous Popoola, Sharmeen Malik, Kaushalendra Mani Tripathi, Ashok Kumar, Irem Karatas, Muhammad Muneeb Khan, Basil Khalil, Shough Alharata, Farah Saleh, Sidra Hariss, Majd Aldin Oudeh, Hiba Manaf, Khuzami Moaied Rashad Odeh","doi":"10.14789/ejmj.JMJ25-0055-OA","DOIUrl":"https://doi.org/10.14789/ejmj.JMJ25-0055-OA","url":null,"abstract":"<p><strong>Objectives: </strong>Immune thrombocytopenia (ITP) is a disorder that is characterised by a low count of platelets and an increased risk of bleeding. It can cause symptoms which affect normal functioning and well-being. The study has discussed how bleeding severity is linked to the quality of life (QOL) of ITP patients in adulthood.</p><p><strong>Materials and methods: </strong>A cross-sectional study was done to examine 300 patients with primary ITP admitted to tertiary care hospitals. Bleeding severity was measured with the help of the International Society on Thrombosis and Haemostasis Bleeding Assessment Tool (ISTH-BAT), and HRQoL was measured with the help of the WHOQOL-BREF. The data were analysed using Pearson's correlation, t-tests, ANOVA, and multiple linear regression.</p><p><strong>Results: </strong>Most participants (92.7%) were female, with a mean age of 49.8. Overall, HRQoL showed a significant negative correlation with bleeding severity (r = -0.42, p < 0.001). Women had higher bleeding scores (p < 0.001) and lower HRQoL scores (p = 0.017) than men. Worse bleeding and lower HRQoL were linked to older age (p < 0.001). Regression analysis revealed bleeding severity (β = -0.32, p = 0.001), female gender, old age, prolonged disease duration, frequent bleeding episodes, hospitalisation, and comorbidity as significant predictors of worse HRQoL.</p><p><strong>Conclusion: </strong>Adults with ITP have a worse quality of life in relation to greater bleeding severity. The holistic treatment that is concerned not only with the physical condition, but also with the emotional needs can contribute to the general welfare.</p>","PeriodicalId":520470,"journal":{"name":"Juntendo medical journal","volume":"72 1","pages":"127-133"},"PeriodicalIF":0.0,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12997340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Magnetic Resonance Angiography in Pre-Operative Assessment of Four Uterine Artery Variants in Women with Symptomatic Uterine Fibroids.","authors":"Hitomi Kato, Juliana Yumi Ishisaki, Yoshiki Kuwatsuru, Masafumi Arai, Naoki Takemasa, Ryohei Kuwatsuru","doi":"10.14789/ejmj.JMJ25-0048-OA","DOIUrl":"https://doi.org/10.14789/ejmj.JMJ25-0048-OA","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of non-contrast-enhanced magnetic resonance angiography (NCE-MRA) for assessing uterine artery (UA) anatomy and report the prevalence of anatomical forms of the UA in women undergoing uterine artery embolization (UAE).</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Methods: </strong>NCE-MRA images of 110 patients undergoing UAE for the treatment of symptomatic uterine fibroids were retrospectively assessed and the bifurcation patterns of their UAs were bilaterally classified into four types.</p><p><strong>Results: </strong>In our population, 61% of the UAs presented with type I bifurcation, followed by type IV (16%), type III (15%), and type II (8%).</p><p><strong>Conclusion: </strong>Preprocedural NCE-MRA allowed for accurate classification of the bifurcation patterns of UAs.</p>","PeriodicalId":520470,"journal":{"name":"Juntendo medical journal","volume":"72 1","pages":"122-126"},"PeriodicalIF":0.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12997347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}