Medical Frontiers

Stroke is the world's second-leading cause of death. Survivors may suffer brain damage that causes severe impairments in motor, language or other abilities. Japanese doctors have spent years developing a treatment that regenerates the brain using the patient's own cells. Clinical trials are underway. A participant who had complete paralysis on one side of her body can now walk. The treatment takes stem cells from the patient's bone marrow and injects it directly into the brain.

Cell tubes, made entirely from a patient's own cells, are just as elastic as blood vessels but much stronger. Skin cells cultured into lumps are skewered on needles on a base, similar to a Kenzan, a tool used in Japanese flower arrangements, and formed into a tube. The technique, called the Kenzan Method, was made possible by a 3D bioprinter. A clinical trial is underway in Japan to transplant these tubes into humans in place of blood vessels. Studies are being done to apply them to nerves and organs.

A new radiotherapy using boron and neutrons is now available in Japan for head and neck cancer that has recurred despite all types of conventional treatment. It's being offered at a private medical facility for the first time in the world. A patient who was told removing part of his throat, including his vocal cords, was the only solution had the therapy, and his cancer disappeared a year later. We look at the therapy's mechanism and side effects and compare it with other radiotherapies.

Scientists have known that osteoporosis is caused by the dysfunctioning of cells inside the bones but have never been able to observe the cells in a living state. In a world first, a Japanese researcher successfully captured images of the cells dissolving bones and the different cells communicating with each other. A closer look revealed the culprit behind bone diseases. We also introduce food substances and exercises that can lower the risk of osteoporosis.

A man with pain in his arm had surgery twice, but it worsened to the point where he had to take 50 pills a day. After 6 months of treatment by a Japanese anesthesiologist who is also a chronic-pain expert, his pain almost disappeared, and he no longer needed medication. The doctor says chronic pain is caused by abnormalities in 2 functions of the brain -- the pain-suppressing system and the reward system. We explain the mechanism and the secret to treating the condition.

Sleep is said to be the biggest black box of modern science. The International Institute for Integrative Sleep Medicine in Japan is known for its global contributions to uncovering the mysteries of sleep. It developed a device that can be used at home to easily measure brain waves during sleep and analyze sleep quality. Research has revealed the importance of REM sleep, during which the brain becomes highly active, and found a lack of it is associated with a higher risk of dementia and obesity.

A new technology can capture clear images of tiny blood vessels using light and ultrasound. This will enable better treatments, such as reconstructive surgery for patients who have had a part of their head, neck or breast removed due to cancer. Doctors can safely cut and transplant skin flaps containing blood vessels from a different area of the body, decreasing the burden on patients. The technology can also visualize transparent, thin lymph vessels, and improve the treatment of lymphedema.

Parkinson's disease is a progressive neurological disorder for which there is no cure. We focus on a hospital that controls its symptoms to raise patients' quality of life. It is developing a system to remotely diagnose patients who find it difficult to visit the hospital because of their symptoms. The plan is to collect 3D data on patients' movements to aid AI in diagnosing the disorder. The hospital has also developed a way to diagnose Parkinson's disease by analyzing sebum.

Kampo is a Japanese traditional medicine that is based on information contained in an ancient Chinese classic. A Kampo formulation has numerous medicinal properties and is effective for many symptoms. This makes Kampo suitable for treating long COVID, which has various symptoms. We look at how Kampo formulations are prescribed, through 1 patient who was cured. We also introduce the latest scientific findings on how Kampo can prevent depressive symptoms, and how it can prevent coronavirus infection itself.

It is impossible even for surgeons to see the inside of the beating heart in detail with the naked eye. Japanese doctors, mechanical engineers and mathematicians cooperated to develop the heart simulator to reproduce each patient's heart. The simulator analyzes the movements of the heart's molecules, numbering 1 billion x 1 billion, to visualize the heart in 3D. It can also predict postoperative conditions. Clinical trials started in 2022 to save the lives of infants who have heart defects.

An innovative surgical training model has been developed called the bionic humanoid, containing certain artificial tissues with lifelike textures. The eye surgery model recreates a part of a membrane that's just 3 micrometers thick. Surgeons can practice a difficult surgery that involves peeling it away. The brain surgery model replicates complex structures within the skull to help surgeons practice removing tumors through the nostrils. The models could transform training for novice doctors.

We look at the latest in regenerative medicine for treating knee problems. Osteoarthritis happens when the meniscus and cartilage wear out. Researchers aim to repair meniscal damage with autologous synovial stem cell transplants. Ligament tears, an injury common among athletes, are also usually treated with transplants using the patient's own tendons or artificial ligaments. A bovine tendon has successfully been transplanted into a sheep, and a clinical trial will soon begin for use in humans.

New preventive drugs for migraines were approved in Japan in 2021. The drugs contain antibodies that target a substance that plays a key role in migraines. In a clinical trial, around 70% of patients had a 50% drop in headache frequency. Separately, an item essential to patients called a headache diary has been developed into a smartphone app by a Japanese company. Their entries are shared with their doctors, making consultations smoother and more efficient.

Vitamin C can be made by most animals, but not humans. However, researchers are learning that a lack of the nutrient leads to decreased muscle and bone fractures. Also, it is believed that the higher the vitamin C levels in the blood of the brain, the less likely dementia is to develop, and this year, a Japanese researcher identified a protein that transports vitamin C to the brain. Another experiment has confirmed that a lack of vitamin C leads to inflammation in the liver and other organs.

A virtual reality device developed by a Japanese startup is transforming rehabilitation. Patients wear the device and play games that require them to move their upper bodies. Facilities that have introduced the device have seen significant improvement in stroke and other patients. There have also been reports that say combining VR with therapy has improved symptoms in depression patients. The mechanism behind VR's effects is unknown, but we look at its potential to improve medicine.

A Japanese university developed an image-diagnosis support system using artificial intelligence by giving it 500,000 eye images. The system reduced the time needed for diagnoses to a third and helped with early detection of glaucoma and other diseases that can cause blindness if left untreated. Separately, a hospital that does about 8,000 eye surgeries annually has developed an AI system to prevent errors. We report on how AI is helping amid an increase in eye diseases as the population ages.

A nursing home that has tested 150 types of digital care devices installed a sheet-type sensor that measures residents' state of sleep and allows caregivers to check on them remotely. The sensor has led to fewer nighttime visits by caregivers and better sleep in over half of the residents. Another facility uses a sheet-type odor sensor that detects excretions, enabling immediate diaper-changes. Dramatic improvements were seen in the residents' sleep and appetite and caregivers' workload.