Ruptured AAA: bridging the gap between international guidelines and local clinical realities.

Background: Treatment of asymptomatic Abdominal Aortic Aneurysms (AAA) presents a clinical challenge, requiring a delicate balance between rupture risk, patient comorbidities, and intervention-related complications. International guidelines recommend intervention for specific AAA size thresholds, but these are based on historical trials with limited female representation. We aimed to analyse disease characteristics, AAA size at rupture, and intervention outcomes in patients with ruptured AAA from 2009 to 2023 to investigate the gap between guidelines and local realities.

Endovascular repair for arterio-venous fistula treatment: a case report.

Background: Arterio-venous fistula is a rare clinical entity that occurs as a result of a ruptured abdominal aortic aneurysm into the inferior vena cava or iliac vein. Open surgery has been considered the treatment of choice for this condition; however, endovascular repair has become an evolving therapeutic option over the past 20 years. The endovascular treatment has contributed to a decrease in the perioperative mortality; nevertheless, some endovascular repair specific concern for residual fistula still remains.

Hyperuricemia exacerbates abdominal aortic aneurysm formation through the URAT1/ERK/MMP-9 signaling pathway.

Objective: Previous studies have revealed associations between hyperuricemia and microvascular diseases, but the association between hyperuricemia and abdominal aortic aneurysm (AAA) remains unclear. The aim of this study was to elucidate the pathogenesis and prove the relationship between AAA and hyperuricemia.

Methods: A retrospective study was performed to validate the growth rates of AAA in humans with different serum uric acid levels.

A case of pyloric gland adenoma with high-grade dysplasia in the duodenum arising from heterotopic gastric mucosa observed over 5 years.

Pyloric gland adenoma (PGA) in the duodenum is a rare gastric phenotype duodenal neoplasm. Although heterotopic gastric mucosa in the duodenum has been recognized as a benign lesion, it is a potential precursor of PGA and gastric phenotype adenocarcinoma. Herein, we present a case follow-up of endoscopic and histological changes in the PGA in the duodenum from low-grade to high-grade dysplasia.

Larger sagittal inter-screw distance/tibial width ratio reduces delayed union or non-union after arthroscopic ankle arthrodesis.

Background: Arthroscopic ankle arthrodesis (AAA) has risks of complications, such as delayed union and non-union. The number and direction of the inserted screws have been reported as important factors affecting the time to union of AAA. However, the ratio of inter-screw distance (ISD) to tibial width (TW) in different planes has not been investigated.

Failure properties of abdominal aortic aneurysm tissue are orientation dependent.

Introduction: Biomechanical rupture risk assessment of abdominal aortic aneurysm (AAA) requires information about failure properties of aneurysmal tissue. There are large differences between reported values. Among others, studies vary in using either axially or circumferentially oriented samples.

A case of esophageal squamous cell carcinoma with neuroendocrine, basaloid, and ciliated glandular differentiation.

Esophageal carcinomas have multidirectional differentiation abilities and different histological components have been reported. Herein, we report a case of esophageal carcinoma with four different differentiations. A 64-year-old man was referred to our hospital for treatment of an esophageal tumor detected during an esophagogastroduodenoscopy, which revealed an elevated lesion accompanied by a slightly depressed lesion in the middle of the esophagus.

Dosimetric comparison of analytic anisotropic algorithm and Acuros XB algorithm in VMAT plans for high-grade glioma.

Purpose: To investigate the dosimetric impact between the anisotropic analytical algorithm (AAA) and the Acuros XB (AXB) algorithm in volumetric-modulated arc therapy (VMAT) plans for high-grade glioma (HGG).

Methods: We used a heterogeneous phantom to quantify the agreement between the measured and calculated doses from the AAA and from the AXB. We then analyzed 14 patients with HGG treated by VMAT, using the AAA.

Metformin represses the pathophysiology of AAA by suppressing the activation of PI3K/AKT/mTOR/autophagy pathway in ApoE mice.

Background: The protective effect of metformin (MET) on abdominal aortic aneurysm (AAA) has been reported. However, the related mechanism is still poor understood. In this study, we deeply investigated the role of metformin in AAA pathophysiology.

Withdrawal of thiopurines in Crohn's disease treated with scheduled adalimumab maintenance: a prospective randomised clinical trial (DIAMOND2).

Background: The risk:benefit ratio of concomitant use of thiopurines with scheduled adalimumab (ADA) maintenance therapy for Crohn's disease is controversial. The aim of this study is to identify the influence of withdrawal of thiopurines in patients in remission with combination therapy in an open-label, randomised, controlled trial (DIAMOND2; UMIN000009596).

Methods: Patients in corticosteroid-free clinical remission (CFCR) for ≥ 6 months with ADA (40 mg, s.

Grading system to categorize breast MRI using BI-RADS 5th edition: a statistical study of non-mass enhancement descriptors in terms of probability of malignancy.

Purpose: To analyze the association of breast non-mass enhancement descriptors in the BI-RADS 5th edition with malignancy, and to establish a grading system and categorization of descriptors.

Materials And Methods: This study was approved by our institutional review board. A total of 213 patients were enrolled.

Early Experience With Endovascular Aneurysm Sealing in Combination With Parallel Grafts for the Treatment of Complex Abdominal Aneurysms: The ASCEND Registry.

Purpose: To report the results of the ASCEND Registry of cases involving endovascular aneurysm sealing (EVAS) in combination with chimney grafts (chEVAS) for the treatment of para- and juxtarenal aortic aneurysms (AAA).

Methods: A retrospective, multicenter registry established in 8 vascular centers between 2013 and 2016 recorded the treatment results and follow-up of chEVAS procedures for nonruptured AAAs; data were analyzed using standardized outcome measures. In the observation period, 154 patients (mean age 72.

Endovascular Aneurysm Repair with Balloon Thrombectomy for Acute Thrombosis of Abdominal Aortic Aneurysm.

Acute occlusion of abdominal aortic aneurysm (AAA) is a rare complication and is usually treated with surgical reconstruction. We present a case of acute AAA occlusion that was successfully treated by endovascular aneurysm repair (EVAR) with Fogarty balloon thrombectomy. A 77-year-old man with a history of acute myocardial ischemia presented with limb weakness and coldness.

Lipoprotein(a) Levels in Patients With Abdominal Aortic Aneurysm.

Circulating markers relevant to the development of abdominal aortic aneurysm (AAA) are currently required. Lipoprotein(a), Lp(a), is considered a candidate marker associated with the presence of AAA. The present meta-analysis aimed to evaluate the association between circulating Lp(a) levels and the presence of AAA.

Successful treatment of duodenal adenocarcinoma with multiple liver metastases by S-1 + irinotecan (CPT-11).

Unresectable duodenal adenocarcinoma excluding the ampullary region is rare, and no standard chemotherapy has been defined for this disease. Although S-1-based chemotherapy is widely administered for advanced gastric cancer, few reports have described advanced duodenal cancer treated with S-1-based chemotherapy. We present herein a case of duodenal adenocarcinoma with liver metastases.

A case of isolated granulomatous gastritis that spontaneously resolved without Helicobacter pylori eradication.

Isolated or idiopathic granulomatous gastritis (IGG) is a rare disease and its etiology remains unclear. Some recent papers have reported that IGG is caused by Helicobacter pylori. We present herein a case of IGG that resolved spontaneously without H.