Pancreatic Ductal Adenocarcinoma with Autoimmune Pancreatitis: A Case Report and Literature Review.

A 50-year-old man was diagnosed with type 1 autoimmune pancreatitis (AIP) following endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and a histopathological examination. After six months of untreated follow-up, the serum IgG4 level decreased, and the diffuse pancreatic enlargement improved; however, a pancreatic head mass became apparent. EUS-FNA of this mass revealed pancreatic ductal adenocarcinoma (PDAC) with IgG4-positive plasma cells.

Plant-plant communication in Camellia japonica and C. rusticana via volatiles.

Plants emit volatile compounds when they are subjected to herbivorous, pathogenic, or artificial damages. Both the damaged plant and the neighboring intact plants induce resistance when they receive these volatiles, a phenomenon known as plant-plant communication. However, field observations of this phenomenon are limited.

Flow characteristics of in-situ internal thoracic artery graft with competitive flow.

Unlabelled: We report flow characteristics of an in-situ internal thoracic artery (LITA) graft with angiographically competitive flow to the left anterior descending artery (LAD), based upon intraoperative transit-time flow measurement (TTFM) during coronary artery bypass grafting with aortic valve replacement (AVR) and during re-AVR seven years later. Although intraoperative TTFM of the graft showed lower mean flow and higher pulsatility index, suggesting inadequate anastomosis, fast Fourier transform (FFT) analysis of TTFM waveforms presented gradual waning of the amplitude, as shown in patent grafts. FFT analysis of the TTFM waveforms is helpful to judge the patency of LITA to LAD, even with competitive flow.

The exposure of field-grown maize seedlings to weed volatiles affects their growth and seed quality.

Plants exposed to volatiles emitted from artificially damaged conspecific or heterospecific plants exhibit increased resistance to herbivorous insects. Here, we examined whether volatiles from artificially damaged weeds affect maize growth and reproduction. Seven days after germination, maize seedlings were exposed to volatiles emitted by artificially damaged mugwort ( var.

Effects of Fractional Flow Reserve on Coronary Artery Bypass Graft Flow to Left Anterior Descending Artery.

Background: The relationships between preoperative fractional flow reserve (FFR) values of the left anterior descending artery (LAD), FFR, and intraoperative transit time flow measurement (TTFM) variables in coronary artery bypass grafting (CABG) remain unclear.

Methods and results: We retrospectively collected data for 74 in situ left internal thoracic artery (LITA) grafts and 27 saphenous vein grafts (SVGs) to the LAD that were shown to be patent on postoperative angiography. Spearman correlation coefficients were determined between FFRand TTFM parameters of the LITA graft, as follows: maximum flow (Q), -0.

Perceived Difficulties and Learning Needs Among Acute Care Ward Nurses Providing End-of-Life Care During the COVID-19 Pandemic: Comparison by Years of Clinical Experience.

Background: In the daily routine of acute care wards, where priority is given to patients with severe illnesses and those who require urgent care, working with and supporting the decision making of terminally ill patients can be challenging.

Methods: This study aimed to clarify the perceived difficulties of and learning needs among acute care ward nurses providing end-of-life care during the COVID-19 pandemic. In order to perform analyses by years of clinical experience, we conducted semi-structured interviews with both novice and experienced nurses.

Fecal Occult Blood Screening before Cardiac Surgery.

Background: Concerns of gastrointestinal (GI) bleeding after cardiac surgery are increasing with increased use of antiplatelets and anticoagulants. We investigated the roles of preoperative screening for fecal occult blood by fecal immunochemical test (FIT) widely used to detect GI bleeding and cancer.

Methods: A retrospective review was done in 1,663 consecutive patients undergoing FIT before cardiac surgery between years 2012 and 2020.

Mid-term results of distal anastomosis to the true lumen for chronic type B aortic dissection.

We investigated whether distal anastomosis to the true lumen in open surgical repair of descending aorta for chronic type B aortic dissection improved the long-term outcomes with aortic remodeling. We retrospectively reviewed 71 patients with chronic type B aortic dissection, excluding those with connective tissue disorder, from October 2001 to June 2021. The patients who underwent distal true lumen anastomosis (group T, n = 36) were compared to those with both lumens' anastomosis (group B, n = 35), regarding survival, overall and distal aortic events.

Foreign early career academics' well-being profiles at workplaces in Japan: a person-oriented approach.

The well-being of foreign early career academics (FECAs) has been the subject of research attention in relation to present demanding academic milieux in general and to those unfamiliar workplace settings in particular. A traditional variable-oriented approach that focuses on mean scores can easily gloss over the diverse nature of the group under study. Our study, conducted in Japan, took a person-oriented approach and identified FECAs' distinct well-being profiles and the associations of their personal attributes with the profiles.

Validation of pencil beam scanning proton therapy with multi-leaf collimator calculated by a commercial Monte Carlo dose engine.

This study aimed to evaluate the clinical beam commissioning results and lateral penumbra characteristics of our new pencil beam scanning (PBS) proton therapy using a multi-leaf collimator (MLC) calculated by use of a commercial Monte Carlo dose engine. Eighteen collimated uniform dose plans for cubic targets were optimized by the RayStation 9A treatment planning system (TPS), varying scan area, modulation widths, measurement depths, and collimator angles. To test the patient-specific measurements, we also created and verified five clinically realistic PBS plans with the MLC, such as the liver, prostate, base-of-skull, C-shape, and head-and-neck.

Early Sternal Bone Healing after Thermoreactive Nitinol Flexigrip Sternal Closure.

Purpose: Thermoreactive nitinol Flexigrip has been developed to ensure better fixation than conventional wire closure. To verify the advantage of Flexigrip over the conventional wiring, we compared early sternal bone healing on computed tomography (CT).

Methods: A prospective cohort study enrolled the first consecutive 80 patients with wiring and the second consecutive 44 patients undergoing Flexigrip sternal closure.

Impact of preoperative nasopharyngeal cultures on surgical site infection after open heart surgery.

Objectives: Despite advances in surgical techniques and management, surgical site infection (SSI) is still important after cardiovascular surgery. We investigated to determine whether or not preoperative nasopharyngeal cultures (NCx) can predict SSI and its microbial spectrum.

Methods: A retrospective review was done in 1226 consecutive patients undergoing NCx and cardiac and thoracic aortic surgery via median sternotomy who were cared for with the standard SSI bundle between 2013 and 2018.

Thrombosed stuck mitral valve during advanced mechanical circulatory support for post-cardiotomy shock.

We report a case of mechanical prosthetic mitral valve thrombosis in a 52-year-old woman with previous diagnosis of dilated cardiomyopathy, who was supported with advanced mechanical circulatory support after urgent mechanical mitral valve replacement (MVR) and tricuspid annuloplasty. Difficult weaning from cardiopulmonary bypass needed support with veno-arterial extracorporeal membranous oxygenation and Impella (Abiomed Inc, Danvers, MA, USA), so-called ECPELLA. Temporary discontinuation of heparin and massive blood transfusion were necessary due to four times of reoperation for bleeding during ECPELLA support.

Effects of cardiopulmonary bypass on immunoglobulin G antibody titres after SARS-CoV2 vaccination.

Objectives: Patients with cardiovascular disease are vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection. Although SARS-CoV2 vaccination may be effective, its impact on surgical patients is not well studied. We investigated the effects of cardiovascular surgery, especially under cardiopulmonary bypass (CPB), on the antibody titres after SARS-CoV2 vaccination.

A case of renal cell carcinoma with late recurrence in the bilateral hilar lymph nodes twenty years after surgery.

Renal cell carcinoma (RCC) is a common malignancy with a high recurrence rate. However, brain and bilateral hilar lymph node (BHL) relapse is rare. A 65-year-old man with a chief complaint of hemosputum visited the primary care clinic.

A case of squamous cell lung cancer treated with anamorelin in combination with a multidisciplinary collaborative approach for treating cancer cachexia.

Anamorelin (ANA) is approved for treating cancer cachexia (CCX) in Japan. We report the case of a 69-year-old man with stage IVB squamous cell lung cancer complicated by CCX, having a 13.6% weight loss in 6 months.

Hybrid repair for Kommerell's diverticulum and right aortic arch with aberrant right vertebral artery.

Kommerell's diverticulum (KD) is a rare aneurysm of the origin of an aberrant subclavian artery. Hybrid aortic arch repair for KD is being performed more often. We report hybrid arch repair for KD in a 63-year-old man with a right aortic arch and aberrant right vertebral artery, an extremely rare variant.

Acromegaly Initially Presenting with Severe Infectious Diseases: A Case Report.

A 39-year-old man presented with worsening fever, cough, and fatigue. He was immediately admitted to the intensive care unit (ICU) and was found to have sepsis, septic pulmonary embolism, right empyema, liver abscess, pyelonephritis, and a prostate abscess, with background diabetes mellitus. While receiving treatment, an ICU nurse noticed that the patient's toe tips were too large to fit the clamp device of pulse oximeters.

Retrieving a lost needle in the descending aorta during hemi-arch replacement.

A 73-year-old man diagnosed with moderate aortic insufficiency and dilatation of the aortic root and ascending aorta underwent a modified Bentall procedure and hemi-arch aortic replacement. During open distal anastomosis of the ascending aorta, the surgical needle was lost. Because of circulatory arrest, the operation was continued; before closing the chest, radiography and a transesophageal echo were located in the needle in the descending aorta.

[Mitral Valve Surgery for a Patient with Mediastinal Shift after Left Pneumonectomy:Report of a Case].

A 70-year-old patient who survived about 40 years after left pneumonectomy for tuberculosis visited emergency hospital, because of dyspnea. She received suitable medical therapy for atirial fibrillation and severe mitral regurgitation and hesitated heart surgery because of anxiety for surgical risk. The computed-tomography showed mediastinal shift to left and right lung compensatory expansion.

Two-staged surgical treatment for Kommerell diverticulum with a right aortic arch and an aberrant left subclavian artery.

Kommerell diverticulum (KD) is an aneurysm of the orifice of an aberrant subclavian artery (SCA) from the descending aorta or aortic arch. We have performed two-staged surgical strategy for the treatment of KD with right aortic arch. The first step was the bypass grafting between the left common carotid artery and the aberrant left SCA with occlusion of the distal side of KD with the plug.

Selective blockade of transient receptor potential vanilloid 4 reduces cyclophosphamide-induced bladder pain in mice.

Transient receptor potential vanilloid 4 (TRPV4) is a non-selective cation channel activated by various physical stimuli such as cell swelling and shear stress. TRPV4 is expressed in bladder sensory nerves and epithelium, and its activation produces urinary dysfunction in rodents. However, there have been few reports regarding its involvement in bladder pain.

Relationship between fractional flow reserve and graft patency after coronary artery bypass grafting.

Background: Bypass for moderately stenosed coronary arteries may cause graft failure (string phenomenon or occlusion). We examined the effects of fractional flow reserve (FFR) on the efficacy of coronary artery bypass grafting (CABG) in preventing graft failure.

Methods: Between January 2013 and December 2017, 48 patients underwent CABG after FFR was measured.