This study aimed to show the changes in health-related quality of life (HRQoL) after a sustained virological response (SVR) to hepatitis C treatment. A retrospective study was conducted among 1,546 patients with SVR to interferon-based (IFN-based) or direct-acting antiviral (DAA) anti hepatitis C virus treatments from January 1990 to March 2017 in five hospitals. The survey was conducted between November 2017 and October 2018. A questionnaire including the Japanese version of the EQ-5D-3L before and after SVR by IFN-based or DAA treatment was used to assess changes in HRQoL retrospectively. Of the 1,546 patients who achieved SVR, 580 achieved SVR with IFN-based treatment (SVR-IFN) and 966 achieved SVR with DAA treatment (SVR-DAA). Comparison of HRQoL before and after treatment revealed a significant increase in SVR-IFN (0.9078 vs. 0.9278, p = 0.0406). For SVR-IFN, patients in their 60s and 70s showed a significant increase in HRQoL after treatment. In contrast, changes in HRQoL in SVR-DAA were not statistically significant (0.9018 vs. 0.9063, p = 0.3908). For SVR-DAA, HRQoL significantly improved for patients in their 50s and 60s. The results of this study showed a trend toward improvement or unchanged HRQoL in patients who achieved SVR, despite advanced age. The results of this study can serve as a basis for follow-up after SVR and cost-effectiveness analyses.

It has been suggested that certain nonsurgical abilities can be used to predict laparoscopic surgical skills. This study aimed to conclusively determine whether these nonsurgical proficiencies are associated with laparoscopic surgical skills both before and after surgical training. We recruited 58 medical students for this study and assessed their laparoscopic surgical skills using the Surgical Assessment Device (HUESAD). The participants performed ten runs of HUESAD tasks before training. After they underwent box training and VR simulator training once a week for two weeks, they performed ten additional runs of the tasks. Finally, the participants responded to a questionnaire about their involvement in nonsurgical skills, including playing computer games, typing, sewing, playing musical instruments, and using chopsticks. Pearson’s correlation coefficients were calculated. No significant correlation was found between any of the nonsurgical skills and initial laparoscopic surgical skills. However, a significant correlation was observed between the participants’ ability to use chopsticks and scissors, ride a bicycle, and post-training laparoscopic surgical skills (p < 0.05). Several nonsurgical abilities investigated in this study did not correlate with pre- and post-training laparoscopic surgical skills, demonstrating that certain nonsurgical skills predict laparoscopic surgical skills not before but after training. This approach can be useful in predicting improvement in laparoscopic surgical skills. The ability to predict laparoscopic surgical skills is important for designing custom training programs to ensure safety and high-quality operations in laparoscopic surgery.

The principal route of the coronavirus disease 2019 (COVID-19) infection is through the inhalation of respiratory droplets and aerosols. To date, there are no reports on the control of aerosol-mediated infections during vaginal delivery. This study aimed to visualize the airflow in a delivery room and use this information to develop infection control measures. A tracheal intubation practice manikin was used for the experiment. Smoke was generated using fog liquid and a fog machine. Smoke was collected in a plastic bag connected to the lower pharynx of the manikin via a conduit. Exhaled airflow was visualized by irradiating exhaled smoke with a laser beam. We visualized the aerosol flow from the mouth and nose of the manikin by compressing a plastic bag filled with smoke. We performed a smoke test to check the expiratory flow and accordingly modified the delivery room in two ways: the head side of the delivery table was surrounded with a plastic sheet, and the exhaust pipe was passed through the vinyl sheet to the exhaust port. After these modifications, we managed 18 vaginal deliveries in parturient women with COVID-19, with no related infections among the babies or staff. With emerging infectious diseases, such as COVID-19, the route of infection may be unclear and determining appropriate infection control measures can be difficult. By considering the characteristics of the virus and implementing appropriate infection control measures, we can safely manage high-risk vaginal deliveries.

Cases in which malignant lymphoma (ML) is detected in urine cytology are rare; to the best of our knowledge, only eight cases of non-Hodgkin lymphoma that were detected on urine cytology have been reported. Herein, we report a case of diffuse large B-cell lymphoma (DLBCL) that was detected on urine cytology, focusing on the cytological findings. A 75-year-old man was referred to our hospital because of fever. Computed tomography showed a dense soft tissue lesion in the right lower ureter. Right hydronephrosis, a thickened bladder wall, and enlargement of the para-aortic, right external iliac, and inguinal lymph nodes were also observed. Clinically, upper tract or bladder urothelial carcinoma was suspected and urine cytology was performed. A small number of isolated atypical cells were detected, which showed high nuclear–cytoplasmic ratios, nuclear membrane irregularities, fine chromatin, and enlarged prominent nucleoli with scant clear cytoplasm. Liquid-based cytology with immunocytochemistry revealed that the atypical cells were positive for LCA and negative for CK AE1/AE3, suggesting the possibility of ML. In addition to urine cytology, atypical cells were observed in the urine sediment test. Bladder and inguinal lymph node biopsies were performed and a histological diagnosis of DLBCL (NOS, activated B-cell subtype) was made. Familiarity with and recognition of the characteristic cytopathological findings of ML on urine cytology are important for making a correct diagnosis.