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With the advent of new drugs, the treatment outcome of multiple myeloma (MM) has dramatically improved. However, cure for MM has been difficult to attain, and the prognosis of cases resistant to various treatments remains extremely poor. In March 2021, the United States Food and Drug Administration approved idecabtagene vicleucel (Ide-cel) -a B-cell maturation antigen-targeted chimeric antigen receptor (CAR) T-cell therapy -for the treatment of patients with relapsed/refractory MM. The Japanese Ministry of Health, Labor and Welfare approved Ide-cel in December 2021, and CAR T-cell therapy for MM will soon be available for clinical use. This review highlights the latest evidence regarding CAR T-cell therapy for MM.

Introduction: The Japanese Respiratory Society Guidelines for the Management of Community-Acquired Pneumonia (CAP) in Adults (JRS 2005) were published to revise the Basic Concept for the Management of CAP in Adults (JRS 2000). Revisions in JRS 2005 mainly focused on the criteria for the assessment of pneumonia severity and the differentiation between bacterial pneumonia and atypical pneumonia. To evaluate the JRS 2005 criteria for the assessment of pneumonia severity, we conducted a prospective survey., Subjects and Methods: The survey was conducted from July 2006 to March 2007 as a nationwide joint study by 200 institutions. The study subjects included patients aged ≥16 years of age who had CAP. The severity at initial consultation was determined using the criteria established by JRS 2005, JRS 2000, and Infectious Diseases Society of America Guidelines (IDSA-GLs). The survival outcome 30 days after the start of the initial antimicrobial agent treatment was confirmed., Results: A total of 1875 patients were analyzed. The numbers of cases of pneumonia assessed as being moderate and severe were significantly lower when the JRS 2005 criteria were used than when the JRS 2000 criteria were used. Thus, the severity of pneumonia could be determined more appropriately using the JRS 2005 criteria. Furthermore, the severity-dependent prediction of fatal outcomes or mortality according to these criteria was similar to that determined using the IDSA-GLs., Conclusions: Determining severity on the basis of JRS 2005 can resolve nearly all the problems encountered with JRS 2000; these criteria were found to be useful and rapidly and easily applicable in clinical practice., (Copyright © 2012 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.)

We designed a nonroller extra-corporeal circulation system (NRECC) to minimize space requirements and to improve the safety and ease of cardiopulmonary bypass. The NRECC includes a circuit, a centrifugal pump, and a vacuum regulator. The vacuum regulator has five channels, each of which can control negative pressure independently. Negative pressure is applied to suctions, a vent, and a venous reservoir. Auto Vent-SV and one-way valves were placed between the suctions/vent and the reservoir. The total space required for the NRECC with a heat exchanger was 0.49 m2, which is much smaller than that of our current roller pump system. The maximum volume through the suction/vent was 2.5 L/min at -100 mmHg measured in a simulated system. We used the NRECC for six CABG cases and compared results with those of five CABG cases managed by traditional roller pump extra-corporeal circulation (RECC). The two systems were compared in terms of set-up time and stability/accuracy of the suction/vent. The set-up time of the NRECC (5.3 +/- 1.9 min) was significantly shorter than that of RECC (29 +/- 3.4 min) (p < .01). Stable and accurate blood flow were achieved with the NRECC operating between -15 mmHg and -25 mmHg. In conclusion, NRECC can run a bypass easily and safely and has the benefit of reducing space requirements and shortening set-up time.