Comparative evaluation of the sleep quality metrics between a cardboard bed and a camp cot: a randomized controlled crossover study.

Background: Health-beneficial emergency bedding has become increasingly important for dealing with natural disasters such as the anticipated Nankai Trough earthquake in Japan. When the Great East Japan Earthquake occurred, cardboard beds were provided to evacuees. However, there were concerns about lower back pain and sleep disturbances, as cardboard beds offer insufficient pressure distribution. This study aimed to compare the effects of cardboard beds with those of foldable camp cots on sleep quality. Methods: A randomized controlled crossover study involving 20 healthy participants aged 18-45 years was conducted between June 2022 and January 2023. Participants were asked to sleep for one night on a camp cot and for another night on a cardboard bed, with a minimum three-day washout period between the two nights. Body pressure distribution and sleep metrics obtained from polysomnography (PSG) and questionnaires were compared between the two-bed types (P < 0.05). Results: The camp cot exhibited better body pressure distribution than a cardboard bed, leading to improved sleep satisfaction, bedding comfort, and reduced morning sleepiness. Nevertheless, polysomnography revealed no notable differences in sleep metrics or sleep architecture between the two types of beds. Conclusions: Our findings indicate that cardboard beds have lower pressure dispersion capabilities than camp cots, leading to an increased number of position changes during sleep. Additionally, subjective sleep quality, such as alertness on waking, sleep comfort, and sleep satisfaction, was lower for cardboard beds, suggesting that camp cots might offer a more comfortable bedding option for evacuees. However, there were no discernible differences between the two-bed types in terms of objective sleep metrics derived from PSG. The potential for sleep disturbances caused by lower back pain from a hard mattress has been noted, and it is possible that a single night's experience in healthy individuals might not be enough for sleep issues to manifest.

Primary renal peripheral T-cell lymphoma, not otherwise specified, treated with partial nephrectomy.

Introduction: Renal involvement by non-Hodgkin's lymphoma is very rare, and the kidney as the primary site of this lymphoma is much more uncommon. We report a case of primary renal peripheral T-cell lymphoma, not otherwise specified, treated with partial nephrectomy. Case presentation: A 63-year-old man was hospitalized with coronavirus infectious disease, emerged in 2019 in the emergency department. Computed tomography examination showed a 2-cm renal mass in the right kidney. Abdominal enhanced computed tomography examination revealed that the noted mass showed good enhancement in the corticomedullary phase and washout in the nephrogenic phase. No metastatic lesions were found. He was diagnosed as having cT1aN0M0 renal cell carcinoma, and robotic-assisted partial nephrectomy was carried out. The pathological diagnosis was peripheral T-cell lymphoma, not otherwise specified. He has been followed for 20 months after robotic-assisted partial nephrectomy without additional treatment and recurrence. Conclusion: We experienced a primary renal peripheral T-cell lymphoma, not otherwise specified that was followed up without treatment after surgery.

A case of robot-assisted laparoscopic partial nephrectomy during pregnancy.

Introduction: Malignancy during pregnancy requires consideration of both the mother and fetus. We report a patient with renal cell carcinoma during pregnancy who was treated with robot-assisted partial nephrectomy. Case presentation: The patient was incidentally found to have a renal mass on abdominal ultrasonography. Definitive diagnosis of cT1aN0M0 RCC was made by enhanced computed tomography. Subsequently, pregnancy was discovered. RAPN was performed without complications. Pathologic examination revealed clear cell RCC. There were no postoperative complications, and the baby was born safely. Conclusion: RAPN can be safe and effective even during pregnancy. Every pregnant patient requires individualized treatment involving the timing of surgery, the procedure used, and management based on the condition of the mother and fetus, tumor stage, and the experience of the surgical team.

A case of abiraterone acetate withdrawal syndrome after initiation of upfront abiraterone therapy for high-risk prostate cancer.

Introduction: Transient decrease in serum prostate-specific antigen level can occur after abiraterone acetate withdrawal in male patient with metastatic castration-resistant prostate cancer. Here, we report a case of abiraterone acetate withdrawal syndrome with transient prostate-specific antigen decrease after progression to castration-resistant disease while using upfront abiraterone therapy for high-risk prostate cancer. Case presentation: A 73-year-old man with hormone-sensitive high-risk prostate cancer with multiple bone metastases (prostate-specific antigen level, 294.109 ng/mL) received upfront abiraterone/prednisolone combination and androgen deprivation therapy. One year later, prostate-specific antigen level decreased to 0.017 ng/mL (nadir) but it gradually rose by 15 months after treatment initiation. He was diagnosed as castration-resistant and new bone metastases appeared. After abiraterone was discontinued, prostate-specific antigen level decreased and stabilized at a low level for 5 months. Conclusion: Abiraterone acetate withdrawal syndrome was observed when hormone-sensitive prostate cancer with upfront abiraterone therapy progressed to castration-resistant prostate cancer.

Upside-Down Kidney Transplantation in a Recipient with Severe Arteriosclerosis: A Case Report.

Recently, the number of patients with significant arteriosclerosis has been increasing owing to the aging of kidney transplant patients, an increase in the number of patients with kidney failure with diabetes as the primary disease, and an increase in the number of patients undergoing long-term dialysis. Severe atherosclerosis in kidney transplant recipients makes it difficult to determine the site of vascular anastomosis and increases the technical difficulty of the surgical procedure. This study presents a case of upside-down kidney transplantation in a recipient with severe arteriosclerosis. The patient was a 58-year-old male with diabetic nephropathy. He received an ABO-compatible living donor kidney transplant from his wife. Preoperative computed tomography revealed a mild calcification of the external iliac artery. However, during surgery, more than half of the external iliac artery was found to be calcified, making vascular anastomosis difficult. The peripheral side of the external iliac artery showed mild atherosclerosis. Therefore, the vessel could be anastomosed to the peripheral side of the external iliac artery by turning the kidney graft upside-down for use as the anastomosis site. The postoperative course was uneventful, and the kidney function was good at the last follow-up. Upside-down kidney transplantation is safe in patients with severe arteriosclerosis.

[A Case of Metanephric Adenoma Treated with Robotic-Assisted Laparoscopic Partial Nephrectomy].

A 53-year-old female patient was diagnosed with a left renal mass incidentally detected on an abdominal computed tomography (CT) scan. Further examination revealed a slightly contrast-enhancing mass 2.0 cm in diameter, in the left kidney on a contrast-enhanced CT scan. A diagnosis of left renal cell carcinoma (cT1aN0M0) was made and a robotic-assisted laparoscopic partial nephrectomy was performed. The excised tissue specimen exhibited a clearly circumscribed tumor. On hematoxylin eosin staining, the small uniform tumor cells appeared organized in glandular luminal arrangements, with lacking nuclear atypia and any malignant features. Immunostaining confirmed the diagnosis as metanephric adenoma, as indicated by positive results for WT1 and negative results for alpha-methylacyl-CoA race mase. Metanephric adenoma is an uncommon benign epithelial tumor of the kidney, which frequently poses a challenge in differential diagnosis with renal carcinoma on preoperative imaging. Pathologically, it can be challenging to differentiate from papillary renal cell carcinoma, and immunostaining can be used to effectively differentiate between the two entities.