Long-term changes in carotid intima-media thickness according to baseline blood pressure level: J-STARS Echo study.

Background And Aims: We aimed to investigate long-term changes in carotid intima-media thickness (IMT) based on baseline blood pressure (BP) levels in non-cardioembolic stroke patients.

Methods: Patients aged 45-80 years with dyslipidemia who were not on statins before enrollment and had experienced a non-cardioembolic stroke were assigned to either the pravastatin group or the control group in a randomized trial. Patients were classified into three groups according to BP levels: normal BP (N-group: systolic BP [sBP] <140 mmHg and diastolic BP [dBP] <90 mmHg), highly elevated BP (G2 group: sBP ≥160 mmHg or dBP ≥100 mmHg), and mildly elevated BP (G1 group: the remaining patients).

[Successful Treatment of Blow-out Type Left Ventricular Free Wall Rupture Using Sutureless Technique].

Blow-out type left ventricular free wall rupture is a serious complication of acute myocardial infarction, that carries high hospital mortality rates and poor surgical outcome. We report the case of an 88-year-old woman who developed cardiac tamponade following percutaneous coronary angioplasty for acute myocardial infarction. She was diagnosed with left ventricular free wall rupture, and rupture type was proved to be blow out after median sternotomy.

Surgical treatment for coarctation of the aorta.

Key Clinical Message: Surgical treatment is a better option for coarctation of the aorta.

Abstract: A 56-year-old man was admitted to the hospital due to chest pain. Computed tomography showed severe coarctation of the aorta distal to the left subclavian artery, with poststenotic dilatation of the descending aorta.

Bimodal artificial intelligence using TabNet for differentiating spinal cord tumors-Integration of patient background information and images.

We proposed a bimodal artificial intelligence that integrates patient information with images to diagnose spinal cord tumors. Our model combines TabNet, a state-of-the-art deep learning model for tabular data for patient information, and a convolutional neural network for images. As training data, we collected 259 spinal tumor patients (158 for schwannoma and 101 for meningioma).

[Acute Empyema During Thoracic Drainage in a Pneumothorax Patient with Atopic Dermatitis:Report of a Case].

A 33-year-old man with atopic dermatitis underwent thoracic drainage was initiated for the right spontaneous pneumothorax. On the third hospital day, he developed acute empyema with pleural fluid opacity and elevated inflammatory reaction on blood test. For prolonged air leakage and acute empyema, thoracoscopic bullectomy and thoracic lavage and curettage were performed on the 6th hospital day.

A case of colonic perforation in collagenous colitis without diarrheal symptoms.: A case report.

Introduction: Collagenous colitis is an inflammatory disease characterized by hyperplasia of the collagen band beneath the colonic mucous membrane. Chronic diarrhea is a characteristic clinical symptom. The disease is often diagnosed accidentally on colonoscopy for chronic diarrhea, and patients without chronic diarrhea have few chances to suspect the disease.

Female "Paradox" in Atrial Fibrillation-Role of Left Truncation Due to Competing Risks.

Female sex in patients with atrial fibrillation (AF) is a controversial and paradoxical risk factor for stroke-controversial because it increases the risk of stroke only among older women of some ethnicities and paradoxical because it appears to contradict male predominance in cardiovascular diseases. However, the underlying mechanism remains unclear. We conducted simulations to examine the hypothesis that this sex difference is generated non-causally through left truncation due to competing risks (CR) such as coronary artery diseases, which occur more frequently among men than among women and share common unobserved causes with stroke.

[A Case of Obstructive Rectal Cancer with Flaccid Constipation Resected One Year and Three Months after SEMS Implantation].

We report a case of rectal cancer that was resected 1 year and 3 months after SEMS implantation. An 89-year-old man was previously diagnosed with sigmoid colon cancer at another hospital but did not undergo surgery. Three years and 7 months after the diagnosis, SEMS was implanted at another hospital.

[Clinical Characteristics, Surgical Outcomes, and Optimal Approach Methods for Transverse Colon Cancers].

Surgery for transverse colon cancer is very difficult because of small number of patients, variations in the vascular system, and complexity of the mobilize hepatic and splenic flexure of colon. We analyzed the clinical characteristics and surgical outcomes in 51 cases who underwent surgery for transverse colon cancer at our hospital between January 2014 and December 2021, and examined the optimal laparoscopic approach method. The surgical procedure was right hemicolectomy in 24 cases, transverse colectomy in 22 cases, and left hemicolectomy in 5 cases, of which 37 cases had laparoscopic surgery.

Diffuse Idiopathic Skeletal Hyperostosis with Severely Displaced Spine Fracture Managed with Posterior Approach Alone: Case Reports and Literature Review.

Diffuse idiopathic skeletal hyperostosis (DISH) is a condition in which minor trauma can cause extremely unstable vertebral fractures. Spinal fractures associated with DISH are prone to instability due to the large moment of lever arm and secondary neurological deterioration; hence, surgical internal fixation is considered necessary. On the other hand, some reports suggest that patients with DISH have a high osteogenic potential.

Atlantoaxial Intradural Synovial Cyst Mimicking an Extradural Lesion Adjacent to a Retro-odontoid Pseudotumor: A Case Report.

Atlantoaxial synovial cysts can very rarely penetrate the dura mater into the thecal sac and cause direct neural compression. Several case reports have been available on "intradural synovial cysts" (IDSCs). In this study, we report on a case with an atlantoaxial IDSC mimicking an extradural lesion.

Case of Syringomyelia Associated with Ossified Yellow Ligament and Arachnoid Web.

Syringomyelia is often associated with Chiari malformation, trauma, infection, and spinal cord tumor. Although they are relatively rare diseases, arachnoid cysts and its related pathology, "arachnoid web" can sometimes lead to syrinx formation at the thoracic vertebral level. However, syrinx formation caused by degenerative spinal disorders, particularly at the thoracic vertebral levels, has rarely been reported.

Combined C1-2 transarticular screw fixation and C1 laminoplasty with interlaminar bone transplant for retro-odontoid pseudotumor: illustrative case.

Background: The surgical treatment for retro-odontoid pseudotumor (ROP) remains controversial. Posterior C1 laminectomy without fixation occasionally leads to postoperative enlargement of ROP. Because its pathogenesis is associated with atlantoaxial instability, atlantoaxial fixation with C1 laminectomy is commonly performed.

Development, implementation, and refinement of a comprehensive postcardiac arrest care training course in Japan.

Aim: In Japan, no training course is dedicated to postcardiac arrest care (PCAC), including venoarterial extracorporeal membrane oxygenation (VA-ECMO); thus, faculty members of the Japanese Circulation Society developed an original, comprehensive PCAC training course. This report reviews the development, implementation, and refinement of this PCAC training course.

Methods: We examined the preserved data from the Japanese Circulation Society PCAC training courses between 2014 and 2020.

Real-world clinical outcomes in Japanese patients with locally advanced squamous cell carcinoma of the head and neck treated with radiotherapy plus cetuximab: a prospective observational study (JROSG12-2).

Background: Radiotherapy plus cetuximab (bioradiotherapy: BRT) is a standard option in the treatment of locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). Published data on its safety and efficacy in real-world settings is limited. Here, we conducted a prospective multi-institutional observational study to evaluate clinical outcomes of BRT in patients with LA-SCCHN.

A surgical treatment for frank rupture of acute type a small intramural hematoma.

A 71-year-old woman was admitted to the hospital due to cardiac tamponade. Computed tomography revealed that the diameter and wall thickness of the ascending aorta were 36 and 9 mm, respectively. An emergent ascending aortic replacement was performed uneventfully.

[Right Anterior Minithoracotomy as an Effective Technique for Minimally Invasive Aortic Valve Replacement in Frail and Elderly Patient:Report of a Case].

Transcatheter aortic valve replacement has increasingly been used as a standard treatment option for patients with aortic valve stenosis, especially in the frail and the elderly. However, it is not recognized as a valid treatment for patients with aortic valve regurgitation. In this study, we report our experience in conducting a right anterior minithoracotomy for a minimally invasive aortic valve replacement in the elderly.

Klebsiella invasive liver abscess syndrome presenting with a central nervous system manifestation secondary to latent cholecystitis: a case report.

Background: Brain abscess is a life-threatening event. Moreover, when Klebsiella pneumoniae is the cause, rapid diagnosis and appropriate treatment are required. Klebsiella invasive liver abscess syndrome, a bloodstream metastatic infection of potentially aggressive nature, has been recognized to cause infection in the central nervous system, and concern for Klebsiella liver abscess syndrome is increasing globally.

Lateral Lumbar Interbody Fusion Using Bone Graft Substitute for Lumbar Vertebral Fracture Associated Radiculopathy.

This study aims to present our surgical technique of lateral lumbar interbody fusion (LLIF) without corpectomy for lumbar vertebral fracture (LVF) associated radiculopathy. This study includes three patients treated with LLIF (mean age of 77.3 years, Group L) and three patients treated with PLIF (mean age of 75.

[A Surgical Technique for Ascending Aorta-bifemoral Bypass and Coronary Artery Bypass Grafting without Aortic Cross-clamp].

A 69-year-old woman presented with symptoms of resting pain in the lower limb bilaterally. A computed tomography( CT) scan revealed occlusion of the infrarenal aorta and bilateral common iliac arteries, indicating Leriche syndrome. A coronary angiogram demonstrated in-stent restenosis in the left anterior descending coronary artery.

Induction of mucosal healing by intensive granulocyte/monocyte adsorptive apheresis (GMA) without use of corticosteroids in patients with ulcerative colitis: long-term remission maintenance after induction by GMA and efficacy of GMA re-treatment upon relapse.

This study examined the long-term maintenance rate after inducing remission by intensive granulocyte/monocyte adsorptive apheresis (GMA) without use of corticosteroids (CS) and GMA re-treatment efficacy in the same patients upon relapse with ulcerative colitis. Patients who achieved clinical remission and mucosal healing (MH) by first-time intensive GMA (first GMA) without CS were enrolled. The cumulative non-relapse survival rate up to week 156 was calculated.

[A Greater Than Four-Year Survival of a Patient with Inoperable Hilar Cholangiocarcinoma following Portal Vein Embolization and Administration of S-1].

We report a patient with inoperable hilar cholangiocarcinoma due to invasion at the umbilical portion who survived more than 4 years after right portal vein embolization and administration of S-1(50 mg/day). A 64-year-old male patient was immediately hospitalized for liver dysfunction and a high level of HbA1c. The disease was diagnosed as hilar cholangiocarcinoma mainly extending along the right hepatic duct.

[Acute Aortic Dissection after Reoperative Aortic Valve Replacement with Early Diagnosis:Report of a Case].

Acute aortic dissection is a rare and potentially catastrophic perioperative complication of cardiac surgery. A 72-year-old woman underwent aortic valve replacement with a bioprosthetic valve for aortic regurgitation seven years earlier. She experienced respiratory distress on exertion and was diagnosed with prosthetic valve dysfunction.