A case of idiopathic superior lumbar hernia repaired using a transabdominal laparoscopic approach.

The patient is a 78-year-old woman who presented to our hospital with left lumbar back pain as her chief complaint. She was diagnosed with superior lumbar hernia. There was no history of abdominal or lumbar surgery, or trauma, so the condition was considered idiopathic.

Tumor microenvironmental 15-PGDH depletion promotes fibrotic tumor formation and angiogenesis in pancreatic cancer.

The arachidonic acid cascade is a major inflammatory pathway that produces prostaglandin E (PGE2). Although inhibition of 15-hydroxyprostaglandin dehydrogenase (15-PGDH) is reported to lead to PGE2 accumulation, the role of 15-PGDH expression in the tumor microenvironment remains unclear. We utilized Panc02 murine pancreatic cancer cells for orthotopic transplantation into wild-type and 15-pgdh mice and found that 15-pgdh depletion in the tumor microenvironment leads to enhanced tumorigenesis accompanied by an increase in cancer-associated fibroblasts (CAFs) and the promotion of fibrosis.

Association between Immunoglobulin G Levels and Adverse Effects Following Vaccination with the BNT162b2 Vaccine among Japanese Healthcare Workers.

The purpose of the study was to assess the association between the amount of immunoglobulin G (IgG) and the duration of adverse effects of COVID-19 vaccinations in the Japanese population. This cross-sectional study was conducted from April 2020 to August 2021 among workers at a community hospital. All participants received two doses of the BNT162b2 vaccine (Pfizer-BioNTech) in March and April 2021.

Comprehensive Care through Family Medicine: Improving the Sustainability of Aging Societies.

Comprehensive care through family medicine can enhance the approach to multimorbidity, interprofessional collaboration, and community care, and make medical care more sustainable for older people. This study investigated the effect of implementing family medicine and the comprehensiveness of medical care in one of the most rural communities. This implementation research used medical care data from April 2015 to March 2020.

Visualization of Toyoura sand-grown plant roots by X-ray computer tomography.

Plants establish their root system as a three-dimensional structure, which is then used to explore the soil to absorb resources and provide mechanical anchorage. Simplified two-dimensional growth systems, such as agar plates, have been used to study various aspects of plant root biology. However, it remains challenging to study the more realistic three-dimensional structure and function of roots hidden in opaque soil.

Strengths and Challenges for Medical Students and Residents in Rural Japan.

Background And Objectives: In Japan, family medicine training is driven by community-based medical education (CBME) and is often provided in rural community hospitals and clinics. Although CBME's positive relationship to family medicine in rural community hospitals is proven, the learning processes of medical students and residents in rural community hospitals needs investigating. The objective of this study was to reveal medical students' and residents' changing motivations and learning behaviors, as well as the factors underpinning their transition between medical schools or tertiary hospitals and rural community hospitals.

Students' perceptions of general medicine following community-based medical education in rural Japan.

Background: Japan's population is rapidly aging, and at the same time, the number of medical students interested in general or family medicine is declining. Community-based medical education (CBME) programs may be used to promote interest and competencies in general medicine among medical students.

Method: This mixed-method study investigated the perceptions of fifth- and sixth year undergraduate medical students who completed a two week CBME course in Unnan, a small city in rural Japan.

Percutaneous sonographically assisted endoscopic gastrostomy for difficult cases with interposed organs.

Objectives: The aim of this retrospective observational study was to clarify the usefulness and safety of percutaneous sonographically assisted endoscopic gastrostomy or duodenostomy (PSEGD) using the introduction method.

Methods: The information for the sequential 22 patients who could not undergo standard percutaneous endoscopic gastrostomy (PEG) and underwent PSEGD for 3 y was extracted and was reviewed. In standard PEG, we performed pushing out of the stomach from the mediastinum and full distention to adhere the gastric wall to the peritoneal wall without interposing of the intraperitoneal tissues by air inflation and a turning-over procedure of the endoscope, four-point square fixation of the stomach to the peritoneal wall by using a Funada-style gastric wall fixation kit under diaphanoscopy, extracorporeal thumb pushing, and in difficult cases extracorporeal ultrasound guidance, and if necessary confirmation of fixation of the gastric wall to the peritoneal wall and placement of the PEG tube without any interposed tissues by using ultrasound.

Epigastric hernia contiguous with the laparoscopic port site after endoscopic robotic total prostatectomy.

Both laparoscopic and endoscopic robotic surgery are widely accepted for many abdominal surgeries. However, the port site for the laparoscope cannot be easily sutured without defect, particularly in the cranial end; this can result in a port-site incisional hernia and trigger the progressive thinning and stretching of the linea alba, leading to epigastric hernia. In the present case, we encountered an epigastric hernia contiguous with an incisional scar at the port site from a previous endoscopic robotic total prostatectomy.

Evaluation of Collateral Source Characteristics With 3-Dimensional Analysis Using Micro-X-Ray Computed Tomography.

Background: Collateral arteries provide an alternative blood supply and protect tissues from ischemic damage in patients with peripheral artery disease. However, the mechanism of collateral artery development is difficult to validate.

Methods And Results: Collateral arteries were visualized using micro-x-ray computed tomography.

Unprotected left main intervention for surgery-ineligible patients with coronary artery disease-Usefulness of micro-CT images for stent.

Background: Percutaneous coronary intervention (PCI) for unprotected left main truncus (LMT) lesions is controversial. Inoperable status with advanced age, renal dysfunction, frailty, or patient request may require an unprotected left main PCI. PCI for LMT is not recommended in the typical clinical situation; however, when it is the only feasible option, the performance is not bad.

Percutaneous transhepatic duodenostomy for a gastrectomy case with CT guidance and real-time visualization by an ultrasound and endoscopy.

After gastrectomy, the remnant stomach, a small stomach behind the lateral segment of the liver, is thought to be a relative contraindication to receiving a percutaneous endoscopy-guided gastrostomy (PEG). We successfully performed a percutaneous duodenostomy in a case with remnant stomach. We used a transhepatic pull method with computed tomography (CT) guidance and real-time visualization by using ultrasound (US) and an endoscopy.

Successful nutritional support for a dysphagic patient with massive cirrhotic ascites and intrathoracic stomach using percutaneous endoscopic gastrostomy (PEG).

Although massive cirrhotic ascites is generally considered a contraindication for the placement of percutaneous endoscopic gastrostomy (PEG), such patients are usually poorly nourished. Preceding paracentesis of ascites is one method for controlling ascites and allowing the safe placement of PEG, but it often results in overuse of albumin. Preceding peritoneal-venous (P-V) shunting can avoid excessive use of albumin, but this introduces the risk of infectious contamination.

Contaminant migration in unsaturated porous media using X-ray computerized tomography (CT).

Landfills are usually located in unsaturated zones. Contaminant leaking can easily infiltrate groundwater through these porous media and contribute to groundwater pollution. The main objective of this work is to study the leachate migration in unsaturated porous media using X-ray computerized tomography (CT) and image-processing software.

Efficacy of half-solid nutrient for the elderly patients with percutaneous endoscopic gastrostomy.

Percutaneous endoscopic gastrostomy tube feeding is widely used for patients with swallowing dysfunction and a history of repeated aspiration pneumonitis. However, liquid nutrient feeding via percutaneous endoscopic gastrostomy is not effective enough to prevent aspiration pneumonitis and related inflammatory responses. We performed this prospective multi-centre study to clarify the efficacy of half-solidification of nutrients to prevent fever possibly caused by aspiration pneumonitis in elderly patients with percutaneous endoscopic gastrostomy.

[A case of malignant lymphoma of the stomach in which preoperative chemotherapy provided a complete response].

We have encountered a case of malignant lymphoma of the stomach in which a complete remission was confirmed in a resected specimen after chemotherapy. A 75-year-old woman complained of vomiting blood. A biopsy from gastric endoscopy indicated malignant lymphoma of diffuse large B-cell type.