Challenges in Rehabilitation of a Tetanus Patient With Severe Complications.

Tetanus is a rare but life-threatening neurological disorder caused by neurotoxins produced by . Although mortality rates have significantly decreased with modern intensive care, severe cases remain challenging due to prolonged Intensive Care Unit (ICU) stays, complications, and rehabilitation barriers. We report the case of an 81-year-old male with a history of hypertension and femoral neck fracture who developed severe tetanus following a contaminated forehead laceration.

International Validation of a Novel PEACE Scale to Improve the Quality of Upper Gastrointestinal Mucosal Inspection During Endoscopy.

Introduction: The performance of a high quality esophagogastroduodenoscopy (EGD) is dependent on the mucosal cleanliness. Recently, the Polprep: Effective Assessment of Cleanliness in EGD (PEACE) scale was created to assess the degree of mucosal cleanliness during EGD. The aim of this study was to validate this scoring system in a cohort of international endoscopists.

High-Degree Posterior Rotational Osteotomy Provides Post-operative Stability Superior to Anterior Rotational Osteotomy for Non-traumatic Osteonecrosis of the Femoral Head: Evaluation Using Computed Tomography.

Introduction This study evaluated hip joint dynamic instability in patients with non-traumatic osteonecrosis of the femoral head (ONFH) with extensive lesions, who had undergone anterior rotational osteotomy (ARO) and high-degree posterior rotational osteotomy (HDPRO), based on the femoral head translation observed by computed tomography (CT) at 0° and 45° hip flexion. Materials and methods Medical records of patients who had undergone transtrochanteric rotational osteotomy for non-traumatic ONFH were retrospectively reviewed to identify patients who had undergone CT examinations six weeks post-operatively. In all, 64 hips (60 patients; 19 men and 41 women), comprising 36 hips treated with HDPRO and 28 hips treated with ARO, respectively, were included.

Utility of endoscopic pressure study integrated system for gastroesophageal reflux disease after endoscopic antireflux therapy.

Objectives: The endoscopic pressure study integrated system (EPSIS) measures intragastric pressure (IGP) during esophagogastroduodenoscopy. Previous research demonstrated that EPSIS correlates with the 24-h impedance-pH (MII-pH) test and shows lower maximum IGP (IGP-Max) and a flatter waveform gradient in gastroesophageal reflux disease (GERD) patients, attributed to lower esophageal sphincter dysfunction. Although endoscopic antireflux therapy (EARTh) is effective for GERD, the MII-pH monitoring, the gold standard for assessing treatment outcomes, requires hospitalization and can be a burden.

Role of balloon dilation test in identifying suitable candidates for gastric peroral endoscopic myotomy.

Background: Predicting successful outcomes of gastric peroral endoscopic myotomy (G-POEM) is essential for identifying patients who are most likely to benefit from the procedure. This study aimed to evaluate the utility of the balloon dilation test (BDT) in optimizing patient selection for G-POEM.

Methods: A retrospective study was conducted from February 2021 to December 2023, including patients with refractory gastroparesis unresponsive to conventional medical treatments.

Renoprotective effects of coenzyme Q10 supplementation in patients with chronic kidney disease: a protocol for a systematic review.

Introduction: Coenzyme Q10 (CoQ10) is a fat-soluble vitamin-like quinone. The plasma levels of CoQ10 are reduced in patients with chronic kidney disease (CKD). CoQ10 supplementation can improve mitochondrial function and decrease oxidative stress in these patients.

Current Status of Sequential Treatment for Castration-resistant Prostate Cancer: A Retrospective Analysis.

Background/aim: Although multiple treatments are available for metastatic castration-resistant prostate cancer, data to determine the optimal treatment sequence are limited. This study aimed to investigate the current status of drug therapy for castration-resistant prostate cancer and clarify the sequential treatment in actual clinical practice.

Patients And Methods: This retrospective study included 425 patients diagnosed with castration-resistant prostate cancer at Showa University Hospital and affiliated hospitals between January 2014 and December 2021, who were treated with any of the following four drugs: novel androgen receptor signal inhibitors (abiraterone acetate and enzalutamide) and anticancer drugs (docetaxel and cabazitaxel).

Persistent body-weight change on achalasia and peroral endoscopic myotomy: a multicenter cohort study.

Background: The distribution of body weight in patients with achalasia and after peroral endoscopic myotomy (POEM) has not been investigated. The role of body weight assessment after treatment remains unclear.

Methods: Using the multicenter achalasia cohort, the frequency of underweight (body mass index [BMI] < 18.

Position statement of the World Endoscopy Organization: Role of endoscopy in screening, diagnosis, and treatment of esophageal superficial squamous neoplasia.

Esophageal squamous cell carcinoma (ESCC) remains a significant global health challenge, being the sixth leading cause of cancer mortality with pronounced geographic variability. The incidence rates range from 125 per 100,000 in northern China to 1-1.5 per 100,000 in the United States, driven by environmental and lifestyle factors such as tobacco and alcohol use, dietary habits, and pollution.

Factors influencing lateral margin diagnosis challenges in Barrett's esophageal cancer: a bicenter retrospective study in Japan.

Background/aims: We aimed to clarify the clinicopathological characteristics and causes of Barrett's esophageal adenocarcinoma (BEA) with unclear demarcation.

Methods: We reviewed BEA cases between January 2010 and August 2022. The lesions were classified into the following two groups: clear demarcation (CD group) and unclear demarcation (UD group).

Atherogenic Dyslipidemia Is Critically Related to Aortic Complicated Lesions in Cryptogenic Stroke.

Aims: Atherogenic dyslipidemia (AD) is regarded as a residual risk of cardiovascular diseases characterized by low high-density lipoprotein cholesterol (HDL-C) and high triglyceride (TG) levels and related to the intracranial stenosis of atheromatous thrombotic brain infarction (ATBI). Further, atherosclerosis is possibly related to another stroke subtype, including cryptogenic stroke (CS). In particular, an aortic complicated lesion (ACL) is a notable embolic source of CS, since recurrence of aortogenic brain embolism is not rare.

International Validation of a Novel PEACE Scale to Improve the Quality of Upper Gastrointestinal Mucosal Inspection During Endoscopy.

Introduction: The performance of a high quality esophagogastroduodenoscopy (EGD) is dependent on the mucosal cleanliness. Recently, the Polprep: Effective Assessment of Cleanliness in EGD (PEACE) scale was created to assess the degree of mucosal cleanliness during EGD. The aim of this study was to validate this scoring system in a cohort of international endoscopists.

Prospective study of once-daily accelerated partial breast irradiation using 3-dimensional conformal external beam radiotherapy for Japanese women: 12-year outcomes, toxicity, and cosmesis.

Background: To analyze in a prospective study the long-term safety and efficacy of 3-dimensional conformal radiotherapy (3D-CRT) to deliver accelerated partial breast irradiation (APBI) for Japanese women with early breast cancer.

Methods: Breast cancer patients with pathological tumor size ≤ 3 cm, age ≥ 20 years, lumpectomy with at least a 5 mm margin, and ≤ 3 positive axillary nodes were eligible. APBI was delivered by 3D-CRT at a dose of 38.

[Endoscopic Treatment for Esophageal Achalasia:Per-oral Endoscopic Myotomy( POEM)].

Per-oral endoscopic myotomy( POEM) is an endoscopic treatment of achalasia. Since the world's first case was performed in Japan in 2008, over 15 years have passed. More than 3,200 cases have been performed at Showa University alone, and over 6,000 cases have been performed throughout Japan.

Differences in efficacy of biweekly irinotecan plus cisplatin versus irinotecan alone in second-line treatment of advanced gastric cancer with or without prior gastrectomy.

Background: Biweekly irinotecan plus cisplatin combination therapy (BIRIP) and irinotecan monotherapy (IRI) are both expectable second-line chemotherapy (SLC) options for treating advanced gastric cancer (AGC). Although many patients receiving SLC have undergone gastrectomy, the impact of gastrectomy on SLC remains unclear, and the impact of gastrectomy may vary from regimen to regimen.

Patients And Methods: A total of 290 eligible patients registered in two randomized phase III trials evaluating BIRIP (IRI, 60 mg/m; CDDP, 30 mg/m, q2w) or IRI (150 mg/m, q2w) for patients with AGC was classified into the prior gastrectomy subgroup (PGG) or the no gastrectomy subgroup (NGG).

Different Patterns of Platelet Count Fluctuation in Response to Various Anticancer Chemotherapies among Patient with Bladder Cancer.

Introduction: In general, platelet counts fluctuate in cancer patients receiving anticancer therapy. It may include thrombocytopenia caused by bone marrow suppression due to cytotoxic anticancer agents and thrombocytosis due to rebound during recovery. This should not be the case in the case of administration of immune checkpoint inhibitors, given their mechanism of action.