JMA journal最新文献

{"title":"Treatment Resistant Patients with Metabolic Dysfunction-associated Steatohepatitis: Long-term Follow-up Prospective Study.","authors":"Masayuki Tsujisaki, Takenori Takamura, Hideyasu Takagi, Seiya Nakahara, Mamiko Suwa, Hideto Itoh, Noriyuki Akutsu, Shigeru Sasaki, Hiroshi Nakase","doi":"10.31662/jmaj.2024-0371","DOIUrl":"10.31662/jmaj.2024-0371","url":null,"abstract":"<p><strong>Introduction: </strong>Many treatments for patients with metabolic dysfunction-associated steatohepatitis (MASH) have been proposed; however, most studies showed the results for a single medication and a short duration of treatment. The long-term outcomes of the multidrug therapies remain indeterminate. We conducted a study to investigate the usefulness of multidrug combination therapy for every kind of MASH patient and the differences between treatment-sensitive and treatment-resistant patients.</p><p><strong>Methods: </strong>Fifty-one patients (middle-aged, in their 40s to 60s, metabolic generation) with MASH-determined fibrosis staging were enrolled. Primary treatment (weight control and medication of vitamin E and sodium-glucose cotransporter 2 inhibitor (SGLT2i)) was done and then pemafibrate treatment was added.</p><p><strong>Results: </strong>Regarding responses to the step-by-step multidrug therapy, patients with MASH were divided into 3 groups, with use of 3 markers-alanine aminotransferase (ALT) (hepatitis), elasticity value (E value, liver stiffness measurement) (hepatitis/fibrosis), and type IV collagen (fibrosis); group 1: sensitive to primary treatment (n = 35), group 2: resistant to primary treatment and sensitive to pemafibrate treatment (n = 11), and group 3: resistant to both treatments (n = 5).To determine the parameters related to treatment resistance, the baseline levels of parameters_-obesity (body mass index), metabolic factor (visceral fat, controlled attenuation parameter), diabetes mellitus (DM) (glycated hemoglobulin (HbA1_c), fasting immunoreactive insulin), lipid metabolism (triglyceride), and hepatitis (ALT)-were compared between treatment-sensitive group 1+group 2 and treatment-resistant group 3. However, none of them had differences statistically. The same analysis showed that type IV collagen, E value, FIB-4 index (age (year) x AST (IU/L)/platelet count (10⁴/L) x ALT (IU/L)^1/2), and MASH fibrosis had differences statistically.</p><p><strong>Conclusions: </strong>The most effective treatment for patients with MASH could not be determined, according to the baseline levels of characteristics; however, weight control and step-by-step multidrug therapies made it possible to stabilize more than 90% of patient conditions and to solve MASH without worsening fibrosis. Since high levels of liver fibrosis-related markers affected the treatment resistance, MASH treatments should be started in an early stage while the levels of each marker are still low; type IV collagen <5.3 ng/mL, E value <13.7 kPa, FIB-4 index <1.89 and MASH fibrosis stage 2 or less.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 2","pages":"540-551"},"PeriodicalIF":1.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144905","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":"Biological and Clinical Relevance of Genetic Alterations in Peripheral T-cell Lymphomas.","authors":"Yuta Ito, Yasunori Kogure, Keisuke Kataoka","doi":"10.31662/jmaj.2024-0405","DOIUrl":"10.31662/jmaj.2024-0405","url":null,"abstract":"<p><p>Peripheral T-cell lymphoma (PTCL) is a heterogeneous group of mature T-cell neoplasms with different clinical, biological, and molecular features. These include PTCL, not otherwise specified, nodal T follicular helper cell lymphomas (nTFHLs), anaplastic large cell lymphoma (ALCL), extranodal natural killer (NK)/T-cell lymphoma (ENKTL), and adult T-cell leukemia/lymphoma (ATLL). Over the past decade, several genetic studies using targeted, whole-exome, and more recently whole-genome sequencing have identified numerous driver alterations in PTCLs. These alterations include mutations, copy number alterations, and structural variations (SVs) involving T-cell receptor/NF-κB (such as <i>PLCG1</i>, <i>VAV1</i>, and <i>CD28</i>) and JAK/STAT (<i>JAK3</i> and <i>STAT3</i>) pathway components, epigenetic regulators (<i>TET2</i>, <i>DNMT3A</i>, and <i>ARID1A</i>), immune-associated molecules (<i>HLA-A/B</i>, <i>CD58</i>, and <i>PD-L1</i>), and tumor suppressors (<i>TP53</i> and <i>CDKN2A</i>), which are shared among various PTCL subtypes. Conversely, subtype-specific alterations, such as <i>RHO</i>A G17V and <i>IDH2</i> R172 mutations in nTFHLs; <i>ALK</i> fusions in ALCL; <i>DDX3X</i> and <i>MSN</i> mutations in ENKTL; and <i>PRKCB</i>, <i>CIC,</i> and <i>CCR4</i> mutations in ATLL. Regarding the clinical relevance of genetic alterations, combining genetic information with clinical factors has been reported to improve prognostic stratification in several subtypes of PTCLs, such as ENKTL and ATLL. Additionally, several genetic alterations may have the potential to predict a response to a specific molecularly targeted agent, such as <i>ALK</i> fusions for ALK inhibitors, <i>PD-L1</i> SVs for immune checkpoint inhibitors (including anti-PD-1 antibodies), and mutations in epigenetic regulators for histone deacetylase inhibitors and hypomethylating agents. In this study, we summarize the current understanding of somatic alterations in various subtypes of PTCLs and highlight their clinical utility.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 2","pages":"345-353"},"PeriodicalIF":1.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144365","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 Sarcopenic Obesity and Changes in Skeletal Muscle Mass and Quality in Patients with Stroke Who Undergo Convalescent Rehabilitation.","authors":"Ryo Shiraishi, Nami Shiraishi, Haruhiko Sato, Takuya Tanaka, Keita Shimizu, Kota Okumura, Kou Suzuki, Takahiro Ogawa","doi":"10.31662/jmaj.2024-0370","DOIUrl":"10.31662/jmaj.2024-0370","url":null,"abstract":"<p><strong>Introduction: </strong>Sarcopenic obesity substantially affects the recovery of physical function in patients with stroke. However, few studies have investigated the relationship between changes in skeletal muscle mass (SMM) and skeletal muscle quality (SMQ) and sarcopenic obesity diagnosed using the Japanese Working Group on Sarcopenic Obesity (JWGS) diagnostic criteria in patients with stroke who undergo rehabilitation. Therefore, this study aimed to investigate the relationship between sarcopenic obesity and changes in SMM and SMQ in patients with stroke who undergo rehabilitation.</p><p><strong>Methods: </strong>Patients with stroke admitted to a rehabilitation ward in a single center in Japan were enrolled in this retrospective cohort study. The inclusion criteria were age 40-75 years and hospitalization for rehabilitation therapy due to stroke. The exclusion criteria were length of hospital stay <14 days and missing clinical data. Data were collected from medical records. Classification of sarcopenic obesity was based on the JWGS diagnostic criteria. The outcomes were the change in SMM and phase angle (PhA) from admission to discharge. Multiple regression analysis was used to investigate the relationship between sarcopenic obesity and changes in SMM and PhA after adjustment for confounding factors.</p><p><strong>Results: </strong>A total of 173 patients were analyzed. 8 patients (3 male and 5 female) were diagnosed with sarcopenic obesity using the JWGS criteria. Multiple regression analysis revealed that sarcopenic obesity was negatively associated with changes in SMM (β: -0.281, 95% confidence interval [CI]: -0.449 to -0.113, p < 0.001) and PhA (β: -0.189, 95% CI: -0.367 to -0.010, p = 0.038).</p><p><strong>Conclusions: </strong>Sarcopenic obesity is negatively associated with changes in SMM and SMQ in patients with stroke who undergo rehabilitation, highlighting the importance of evaluating sarcopenic obesity in patients with stroke from an early stage.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 2","pages":"517-525"},"PeriodicalIF":1.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144760","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":"Forearm Magnetic Resonance Imaging Findings in Epidemic Myalgia.","authors":"Remon Sato, Naohiro Uchio, Hirotaka Takagi, Hideyuki Matsumoto","doi":"10.31662/jmaj.2024-0425","DOIUrl":"10.31662/jmaj.2024-0425","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 2","pages":"624-626"},"PeriodicalIF":1.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144784","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":"Funding Trends in Japan Agency for Medical Research and Development (AMED): Focus on Psychiatry.","authors":"Yuji Yamada, Megumi Haga, Yutaka Matsuoka","doi":"10.31662/jmaj.2024-0391","DOIUrl":"10.31662/jmaj.2024-0391","url":null,"abstract":"<p><p>The Japan Agency for Medical Research and Development (AMED) was established in April 2015 as a funding agency for medical research and development. AMED has been striving to ensure the provision of state-of-the-art medical services and the advancement of a society characterized by health and longevity. Furthermore, AMED facilitates the seamless integration of research projects, spanning the spectrum from basic to applied research and practical applications. The current article presents an overview of the trends observed in awarded projects related to psychiatric disorders. Consequently, there was a considerable rise in the number of projects pertaining to medical devices, particularly within the domain of digital mental health. It is anticipated that an increased number of social implementation studies will obtain regulatory approval under the Pharmaceutical and Medical Device Act.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 2","pages":"385-394"},"PeriodicalIF":1.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144789","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":"Assessing the Association of Physician and Specialist Maldistribution with Out-of-hospital Cardiac Arrest Outcomes: Implications for Regulatory Policy.","authors":"Atsushi Takayama, Hemant Poudyal","doi":"10.31662/jmaj.2024-0241","DOIUrl":"10.31662/jmaj.2024-0241","url":null,"abstract":"<p><strong>Introduction: </strong>Because regional physician maldistribution is considered a potential contributor to disparities in healthcare outcomes, several countries regulate the number of physicians and specialists per region to ameliorate health disparities. However, the association between regional physician maldistribution and specific outcomes, such as out-of-hospital cardiac arrest (OHCA) at the regional level, remains unclear. This study aims to evaluate the association between regional physician and specialist maldistribution and OHCA outcomes.</p><p><strong>Methods: </strong>This ecological study used 12 years of longitudinal public open datasets in Japan. We examined the disparity trends of indices of physician and specialist (emergency physicians, cardiologists, and cardiac surgeons) distribution using the Gini index. We also examined the physician uneven distribution index, a newly introduced policy index incorporating local demand and supply of medical services. Next, we analyzed the association between these distributions and OHCA-related outcomes (30-day survival rate and 30-day favorable neurological outcome).</p><p><strong>Results: </strong>The overall number of physicians and each specialist steadily increased throughout all regions and the observation period, but the trends in the regional distribution of specialists for each region were not always synchronized with the distribution of overall physicians. Although the disparity within each index has gradually decreased, the disparity of specialists remained high compared with overall physicians. Moreover, regional physician distributions, which showed the lowest level of disparity across regions, were consistently associated with OHCA-related outcomes, whereas the regional disparity of specialists, which consistently exhibited a higher level of disparity, was not associated with the outcomes.</p><p><strong>Conclusions: </strong>Paradoxically, the unevenly distributed specialist distribution indices did not reflect their relevant outcomes, despite their direct involvement in the specific outcomes. Therefore, our findings call into question the validity of policies aimed at correcting the total number of physicians without considering the impact of specialists on healthcare outcomes.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 2","pages":"506-516"},"PeriodicalIF":1.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144825","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":"Successful Transplantation of Multiple Organs from Donor after Helium Asphyxiation: First Case Report in Japan.","authors":"Shunta Jinno, Takashi Hongo, Takafumi Obara, Tsuyoshi Nojima, Kohei Tsukahara, Tetsuya Yumoto, Hiromichi Naito, Atsunori Nakao","doi":"10.31662/jmaj.2024-0395","DOIUrl":"10.31662/jmaj.2024-0395","url":null,"abstract":"<p><p>Helium inhalation has increased, but most cases are either minor injuries or deaths; there have not yet been any reported cases of brain death leading to organ donation. We report a patient who attempted helium inhalation and was declared brain dead and became an organ donor without complications. To the best of our knowledge, this is the first reported case of deceased organ donation following helium asphyxiation in Japan. The patient in cardiac arrest was found with a helium-filled vinyl bag sealed around the neck. During emergency medical transport to the hospital, a spontaneous return of circulation was obtained after 31 minutes of cardiopulmonary resuscitation. Upon hospital arrival, the physical examination revealed dilated pupils with no response to light. Electrocardiography showed widespread ST-segment depression and ST-segment elevation in augmented Vector Right, as well as elevated cardiac enzymes and decreased myocardial contractility. Head computed tomography revealed diffuse cerebral edema and loss of the gray-white matter boundary without signs of air embolism in the cerebral and coronary arteries. Despite comprehensive post-cardiac arrest care with recovery of organ function, brain death was confirmed on day 4 after hospitalization. The family consented to organ donation on the 11th day of hospitalization. The heart, lungs, liver, and two kidneys were successfully transplanted and all organs functioned. All organ grafts were functioning well at the 3-month follow-up. Our case demonstrates that brain death caused by helium inhalation is not a contraindication to organ donation.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 2","pages":"650-653"},"PeriodicalIF":1.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144834","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":"Saturated Fat Restriction for Cardiovascular Disease Prevention: A Systematic Review and Meta-analysis of Randomized Controlled Trials.","authors":"Satoru Yamada, Tomomi Shirai, Sakiko Inaba, Gaku Inoue, Minami Torigoe, Naoto Fukuyama","doi":"10.31662/jmaj.2024-0324","DOIUrl":"10.31662/jmaj.2024-0324","url":null,"abstract":"<p><strong>Background: </strong>The recommendation to limit dietary saturated fat intake is primarily drawn from observational studies rather than randomized controlled trials of cardiovascular disease prevention. Thus, we aimed to investigate the efficacy of saturated fat reduction in preventing mortality and cardiovascular diseases.</p><p><strong>Methods: </strong>In this systematic review and meta-analysis of randomized controlled trials, Cochrane CENTRAL, PubMed, and Ichu-shi databases were searched for articles up to April 2023. Randomized controlled trials on saturated fat reduction to prevent cardiovascular diseases were selected. Cardiovascular and all-cause mortality and cardiovascular outcomes were evaluated. Changes in electrocardiography or coronary angiography findings were excluded because they could be evaluated arbitrarily. Two or more reviewers independently extracted and assessed the data. A random-effects meta-analysis was performed.</p><p><strong>Results: </strong>Nine eligible trials with 13,532 participants were identified (2 were primary and 7 were secondary prevention studies). No significant differences in cardiovascular mortality (relative risk [RR] = 0.94, 95% confidence interval [CI]: 0.75-1.19), all-cause mortality (RR = 1.01, 95% CI: 0.89-1.14), myocardial infarction (RR = 0.85, 95% CI: 0.71-1.02), and coronary artery events (RR = 0.85, 95% CI: 0.65-1.11) were observed between the intervention and control groups. However, owing to limited reported cases, the impact of stroke could not be evaluated.</p><p><strong>Conclusions: </strong>The findings indicate that a reduction in saturated fats cannot be recommended at present to prevent cardiovascular diseases and mortality. Clinical trials are needed to evaluate the effects of saturated fat reduction under the best possible medical care, including statin administration.</p><p><strong>Systematic review registration number: </strong>This systematic review and meta-analysis was registered with the International Prospective Register of Systematic Reviews (CRD42023428498).</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 2","pages":"395-407"},"PeriodicalIF":1.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144885","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":"Retraction: Chronic Epipharyngitis Treated with Epipharyngeal Abrasion Therapy: Symptoms, Diagnosis, Pathogenesis, and Treatment Outcomes.","authors":"Yasuaki Harabuchi, Takumi Kumai, Kensuke Nishi, Ayaki Tanaka, Osamu Hotta, Hitoshi Hagino, Toshiyuki Kusuyama, Manabu Mogitate, Yoshihiro Ohno, Akira Sakakibara, Satsuki Araki, Yoshinao Nishida, Tomoko Shintani, Hiroyuki Takezawa, Hirofumi Ito, Daigo Komazawa, Noriko Nishiwaki, Ryuzo Toritani, Koichi Hirahata, Satoshi Marumo","doi":"10.31662/jmaj.R-0001","DOIUrl":"10.31662/jmaj.R-0001","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.31662/jmaj.2024-0437.].</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 2","pages":"671"},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144882","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":"Retracted: Chronic Epipharyngitis Treated with Epipharyngeal Abrasion Therapy: Symptoms, Diagnosis, Pathogenesis, and Treatment Outcomes.","authors":"Yasuaki Harabuchi, Takumi Kumai, Kensuke Nishi, Ayaki Tanaka, Osamu Hotta, Hitoshi Hagino, Toshiyuki Kusuyama, Manabu Mogitate, Yoshihiro Ohno, Akira Sakakibara, Satsuki Araki, Yoshinao Nishida, Tomoko Shintani, Hiroyuki Takezawa, Hirofumi Ito, Daigo Komazawa, Noriko Nishiwaki, Ryuzo Toritani, Koichi Hirahata, Satoshi Marumo","doi":"10.31662/jmaj.2024-0437","DOIUrl":"10.31662/jmaj.2024-0437","url":null,"abstract":"<p><p>Chronic epipharyngitis is associated with a wide variety of symptoms, including local symptoms such as postnasal drip, sore throat, lump sensation of the pharynx, headache, chronic cough, nasal obstruction, tinnitus/ear fullness, chronic phlegm and dysphonia due to inflammation of the epipharynx, functional somatic symptoms such as chronic fatigue, dizziness, insomnia, brain fog, abdominal discomfort, and depression caused by dysfunction of the hypothalamus-limbic system via disturbances of vagal response and cerebrospinal fluid outflow, and distant organ symptoms such as immunoglobulin A nephropathy and palmoplantar pustulosis caused by the epipharyngeal lymphoid tissue as an etiologic organ. In the past, chronic inflammation in the epipharynx was difficult to prove by gross findings, now, direct observation of the epipharyngeal inflammation by endoscopy has become easier for the diagnosis. For the treatment of chronic epipharyngitis, epipharyngeal abrasive therapy (EAT), epipharyngeal application of a 1% zinc chloride solution intranasally or orally was popular since the 1960s, recently, endoscopic EAT (E-EAT), in which epipharynx is safely and accurately observed and abraded under clear vision using an endoscope, has been developed. The mechanisms of EAT effects can be classified into anti-inflammatory/antiviral effect, bloodletting effect, and vagus nerve stimulation effect. Recently, the effectiveness of EAT for post-acute sequelae of coronavirus disease 2019 (COVID-19), known as long COVID, has come into the limelight, and the number of patients for whom EAT is expected to increase. In 2019, the Japan Society of Stomato-pharyngology established the EAT Review Committee to accumulate evidence on the efficacy of EAT and to establish indications and techniques for its use. In this article, the EAT Review Committee outlines its symptoms, pathogenesis, and diagnosis of chronic epipharyngitis, technique of E-EAT, mechanisms of EAT effects, past reports for the efficacy of EAT, and a multicenter prospective study.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 2","pages":"371-384"},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144880","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}