Safety and Efficacy of a 6-Month Placement of a Fully Covered Self-Expanding Metallic Stent for Refractory Benign Biliary Stricture: A Multicenter Prospective Study.

Background And Aim: Managing benign biliary stricture endoscopically is complicated and challenging. This study aimed to evaluate the safety and efficacy of a 6-month placement of a fully covered self-expanding metallic stent for refractory benign biliary stricture.

Methods: Twenty-two patients with refractory benign biliary stricture (13 with chronic pancreatitis and 9 without) were recruited from five higher tertiary care centers.

Prognostic Significance of S100A4 in Ovarian Clear Cell Carcinoma: Its Relation to Tumor Progression and Chemoresistance.

Background/objectives: S100A4, a small calcium-binding protein, promotes metastasis in a variety of human malignancies, but little is known about its involvement in ovarian clear cell carcinoma (OCCC). Herein, we characterized the functional role of S100A4 in this tumor type.

Methods: We analyzed immunohistochemical sections from 120 OCCC patients.

Comparisons in Postoperative Endoscopic Findings and Postoperative Weight Change Between Delta-Shaped Anastomosis and Circular-Stapled Anastomosis in Laparoscopy-Assisted Distal Gastrectomy With B-I Reconstruction.

Background: Laparoscopy-assisted distal gastrectomy (LADG) with Billroth I (B-I) reconstruction is frequently performed for gastric cancer. However, the difference between the circular stapler technique (CS) and delta-shaped anastomosis (DA) remains unclear, especially regarding the postoperative endoscopic physiological findings.

Methods: Three hundred and one patients including 150 CS patients and 151 DA patients during LADG with B-I reconstruction between 2013 and 2019 at Saitama Medical University International Medical Center were chosen as study subjects.

Effects of Acute Phase Intensive Exercise Training in Patients With Acute Decompensated Heart Failure.

Background: Acute decompensated heart failure (ADHF) leads to hospitalizations and functional decline in older adults. Although cardiac rehabilitation (CR) is effective for stable heart failure, its impact on ADHF patients, particularly those without frailty, is unclear.

Objectives: The goal of this study was to evaluate the efficacy and safety of early in-hospital CR for patients hospitalized with ADHF who are not frail.

Comparative Study of Remimazolam and Midazolam During Sedated Upper Gastrointestinal Endoscopy: A Propensity Score Matching Analysis.

Aim: This study aimed to compare the use of remimazolam and midazolam in upper gastrointestinal endoscopy in Japan as a sub-analysis of data from an investigator-initiated clinical trial of remimazolam.

Methods And Results: Patients in two groups were matched using propensity score matching. We evaluated the time from the end of the gastrointestinal endoscopy until discharge, the time from the end of the procedure until awakening, and adverse events.

Association between adverse childhood experiences and menstruation-related symptoms among Japanese female workers: A cross-sectional study.

Backgrounds: Menstruation-related symptoms are a common and serious health problem even without a specific diagnosis such as premenstrual dysphoric mood disorder (PMDD) or dysmenorrhea. Various adverse childhood experiences (ACEs) might be associated with menstruation-related symptoms, not only traditional traumatic events such as abuse, but also expanded ACEs such as childhood poverty, school bullying, or natural disasters.

Objective: This study examined the association between expanded ACEs (ACEs for Japanese) and menstruation-related symptoms among Japanese working women.

Usefulness and safety of remimazolam in upper gastrointestinal endoscopy: A comparative study between elderly and non-elderly patients.

Objectives: In gastroenterology, sedation demand is increasing, although elderly patients are more prone to experiencing adverse events. Remimazolam, a novel ultra-short-acting benzodiazepine, may reduce recovery time after endoscopic procedures.

Methods: This study was a secondary analysis of the investigator-initiated trial, which investigated the efficacy and safety of remimazolam in gastrointestinal endoscopy (REM-IICT JP01).

Factors affecting 1-year persistence with vedolizumab for ulcerative colitis: a multicenter, retrospective real-world study.

Background/aims: The objectives of this real-world study were to determine 1-year persistence with vedolizumab in patients with ulcerative colitis and to evaluate factors contributing to loss of response.

Methods: In this multicenter, retrospective, observational chart review, patients with moderately to severely active ulcerative colitis who received ≥ 1 dose of vedolizumab in clinical practice at 16 tertiary hospitals in Japan (from December 2018 through February 2020) were enrolled.

Results: Persistence with vedolizumab was 64.

Association between ventricular arrhythmia (premature ventricular contractions burden and nonsustained ventricular tachycardia) and cardiovascular events in patients without structural heart disease.

Background: Premature ventricular contractions (PVCs) and nonsustained ventricular tachycardia (NSVT) are common arrhythmias in cardiovascular clinical settings. However, the clinical significance of PVCs and NSVT in the absence of structural heart disease has not yet been fully elucidated. This study aimed to evaluate the association between PVCs, NSVT, and clinical outcomes.

Differential response to right ventricular extrastimuli from the base and apex during long RP' supraventricular tachycardia.

We report a case of long RP' tachycardia diagnosed as fast-slow atrioventricular nodal reentrant tachycardia (AVNRT) with a bystander nodoventricular pathway (NVP). Differential responses to right ventricular extrastimuli from the base and apex highlighted the anatomical proximity of the NVP attachment, contributing to the diagnosis.

Different effects of catheter ablation on exercise tolerance, leg strength, and quality of life in paroxysmal versus persistent atrial fibrillation.

Background: Catheter ablation (CA) can improve exercise tolerance and quality of life (QOL) in patients with atrial fibrillation (AF). However, its differential effects on muscle strength between paroxysmal AF (PAF) and nonparoxysmal AF (Non-PAF) remain unclear.

Methods: We evaluated 94 patients (67.

Streptococcus pyogenes M1UK Variant-Associated Sartorius Muscle Necrotizing Soft Tissue Infection: A Case Report and Literature Review.

Necrotizing soft tissue infections (NTSIs) represent a concept of necrotizing infections involving the skin, subcutaneous tissue, fascia, and muscle, and it is a potentially fatal disease. Early exploratory incision is strongly recommended for both the diagnosis and treatment of necrotizing soft tissue infections. Treatment of necrotizing soft tissue infections requires the administration of appropriate antimicrobial agents and adequate surgical debridement.

Diversity of TCR repertoire predicts recurrence after CRT followed by durvalumab in patients with NSCLC.

Chemoradiotherapy (CRT) followed by durvalumab is standard for unresectable locally advanced non-small-cell lung cancer (LA-NSCLC). This study assesses how CRT alters the T-cell receptor (TCR) repertoire in CD8 + PD-1 + T-cells and its impact on clinical outcomes. This prospective study, conducted from November 2019 to May 2021 at three institutions in Japan, evaluated the diversity of TCR repertoire (DE50) in PD-1 + CD8 + T-cells and CD8 + T-cell phenotypes in peripheral blood before and after CRT.

Scoping review of initiation criteria for inhaled nitric oxide in preterm infants (born <34 weeks) after 7 days of age.

Objectives: Inhaled nitric oxide (iNO) is a known treatment for pulmonary hypertension (PH) associated with bronchopulmonary dysplasia in preterm infants after 7 days of age (postacute phase). However, a consensus regarding the optimal criteria for initiating iNO therapy in this population in the postacute phase is currently lacking. This study, therefore, aimed to identify the criteria for initiating iNO therapy, alongside the associated clinical and echocardiographic findings, in this population.

Corticosteroid therapy and long-term outcomes in patients with cardiac sarcoidosis stratified by left ventricular ejection fraction.

Aims: This study aimed to investigate the relationship between corticosteroid therapy and long-term outcomes in patients with cardiac sarcoidosis, stratified by left ventricular ejection fraction (LVEF) at diagnosis.

Methods And Results: This study conducted a analysis of the ILLUstration of the Management and prognosIs of JapaNese PATiEnts with Cardiac Sarcoidosis, a retrospective multicentre registry. Cardiac sarcoidosis was diagnosed based on the 2016 Japanese Circulation Society and 2014 Heart Rhythm Society criteria.

Approaches for difficult-to-induce-seizures electroconvulsive therapy cases (DEC): a Japanese expert consensus.

Background: Seizure threshold increases with age and the frequency of electroconvulsive therapy (ECT). Therefore, therapeutic seizures can be difficult to induce, even at maximum stimulus charge with available ECT devices. Such cases are known as difficult-to-induce-seizures electroconvulsive therapy cases (DECs).

Clinical Effect of Ventricular Entry During Resection of Isocitrate Dehydrogenase-Wildtype Glioblastoma: A Multi-Institutional Analysis.

Objective: Glioblastomas contacting the subventricular zone (SVZ) are associated with poor prognosis, and the impact of ventricular entry (VE) during resection remains controversial. Since glioblastomas with SVZ involvement often require VE, both SVZ involvement and VE are confounding factors. This study aimed to evaluate the effect of VE during glioblastoma resection by comparing patients with and without SVZ involvement.

Radiologic Parameters Predicting the Histologic Invasiveness of Pure Ground-Glass Nodules.

Background: This study aimed to investigate the diagnostic performance of combined computed tomography (CT) and fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) for predicting histologic invasiveness of pure ground-glass nodules (pGGNs).

Methods: The study analyzed 91 patients who underwent resection of pGGNs and examined the correlation of pathologic invasiveness with preoperative CT and FDG PET findings.

Results: Overall, 24, 36, and 31 patients had adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), and invasive adenocarcinoma (IAD), respectively.

Detection of Eimeria oocysts in chicken feces using flotation recovery with sucrose or saturated saline solution.

Purpose: Flotation methods are widely used to detect oocysts/cysts of protozoans and eggs of helminths, except trematodes. However, details regarding the concentration and recovery rates of these parasites are poorly understood.

Methods: Using Eimeria tenella oocysts as a model parasite, the present study evaluated three check points: (1) the proportion of parasites that remain floating in flotation solution (sucrose or saturated saline) during centrifugation, (2) the proportion of oocysts that naturally float after addition of flotation solution after centrifugation, and (3) the rate of recovery on cover slips after completion of the flotation protocol.

Advance Care Planning Initiatives in Critical Care Centers in Japan: A Case Report.

This report examines the promotion of advance care planning (ACP) for patients admitted to critical care centers and discharged to home. Emergency transport experience allows patients and their families to realistically discuss her ACP.

Hypertriglyceridemia and younger age are associated with effectiveness of growth hormone therapy on hepatic steatosis.

Adult growth hormone deficiency (AGHD) is often accompanied with metabolic dysfunction-associated steatotic liver disease (MASLD). Although some studies reported that MASLD is ameliorated by growth hormone replacement therapy (GHRT), the characteristics of AGHD that are associated with an improvement of hepatic steatosis by GHRT remain unknown. We aimed to investigate whether GHRT affects hepatic lipid accumulation as well as biochemical parameters, and investigated the association between these parameters (UMIN000044989).

Annual report on National Clinical Database 2021 for gastroenterological surgery in Japan.

Aim: The Japanese National Clinical Database, which covers more than 95% of the surgeries performed in Japan, is the largest nationwide database. This is the 2021 annual report of the Gastroenterological Section of the National Clinical Database, which aims to present the short-term outcomes of cases registered in 2021 and discuss significant changes and insights into gastroenterological surgeries observed over the decade.

Methods: We reviewed the data of patients registered in the National Clinical Database between 2012 and 2021.

Risk factors for local recurrence in patients with clinical stage II/III low rectal cancer: A multicenter retrospective cohort study in Japan.

Background: Identifying risk factors for local recurrence (LR) is pivotal in optimizing rectal cancer treatment. Total mesorectal excision (TME) and lateral lymph node dissection (LLND) are the standard treatment for advanced low rectal cancer in Japan. However, large-scale studies to evaluate risk factors for LR are limited.