Validation of British Society of Gastroenterology guidelines for acute lower gastrointestinal bleeding from 8,956 cases in Japan.

Background And Aims: We sought to validate the British Society of Gastroenterology (BSG) guidelines for acute lower gastrointestinal bleeding (ALGIB).

Methods: We analyzed 8,956 patients with ALGIB in CODE BLUE-J study and categorized them into four groups based on BSG guidelines. Outcomes included 30-day rebleeding, 30-day mortality, blood transfusion, therapeutic intervention, and severe bleeding.

Mesenchymal stem cell origin contributes to the antitumor effect of oncolytic virus carriers.

Oncolytic virotherapy shows promise as a cancer treatment approach; however, its systemic application is hindered by antibody neutralization. This issue can be overcome by using mesenchymal stem cells (MSCs) as carrier cells for oncolytic viruses (OVs). However, it remains elusive whether MSC source influences the antitumor effect.

A Phase II study of avenciguat, a novel soluble guanylate cyclase activator, in patients with systemic sclerosis: Study design and rationale of the VITALISScE™ study.

Introduction: Systemic sclerosis is a rare autoimmune connective tissue disease characterised by (1) microvasculopathy; (2) immune dysregulation; and (3) progressive fibrosis of the skin and internal organs. Soluble guanylate cyclase plays an important role in maintaining vascular and immunological homeostasis and preventing organ fibrosis. Pharmacological modulation of soluble guanylate cyclase with soluble guanylate cyclase stimulators has shown anti-inflammatory and antifibrotic effects in animal models of systemic sclerosis, with a trend towards clinical efficacy in a Phase II study (RISE-SSc).

Determining optimal pretreatment in cardiac surgery: an experimental study.

Objectives: Heart failure patients with reduced ejection fraction are currently treated with four drug combinations: angiotensin receptor/neprilysin inhibitors, beta-blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter 2 inhibitors, resulting in improved survival outcomes. Herein, we examined whether myocardial protection by esaxerenone or sacubitril/valsartan may present a counter-effect to the harm caused by cardioplegic arrest.

Methods: Male Wistar rats fed a normal diet were orally administered esaxerenone (3 mg/kg; Esax) or sacubitril/valsartan (68 mg/kg; SaV) once a day for 2 weeks from 6 weeks of age.

[Allergy and immunotoxicology in preventive and clinical medicine from theory to practice: Environmental factors in bronchial asthma].

Background: According to the gene-environment interactions concept, the mechanism of health impairment can be explained by genetic factors, environmental factors, or their interaction. Physical and mental health effects resulting from environmental exposure may be classified either as toxicity, immune response, and allergic reaction. Moreover, despite the already established therapeutic approaches to bronchial asthma and decreasing mortality due to bronchial asthma, patients with difficult and severe asthma are increasing in number.

Combination of artificial intelligence endoscopic diagnosis and Kimura-Takemoto classification determined by endoscopic experts may effectively evaluate the stratification of gastric atrophy in post-eradication status.

Background: Since it is difficult for expert endoscopists to diagnose early gastric cancer in post-eradication status, it may be critical to evaluate the stratification of high-risk groups using the advance of gastric atrophy or intestinal metaplasia. We tried to determine whether the combination of endoscopic artificial intelligence (AI) diagnosis for the evaluation of gastric atrophy could be a useful tool in both pre- and post-eradication status.

Methods: 270 -positive outpatients (Study I) were enrolled and Study II was planned to compare patients ( = 72) with pre-eradication therapy with post-eradication therapy.

Multilayered Silver-containing Polyurethane-foam (Mepilex Ag) for Tie-over Bolster Fixation of a Skin Graft.

Tie-over bolster fixation is the most common method of securing a skin graft. The bolster material can consist of various materials, including sterilized polyurethane foam. Mepilex Ag is a silver-containing polyurethane-foam wound-dressing material that has a broad-spectrum antibiotic effect.

Wrapping method for better fat handling in endoscopic trans-sphenoidal surgery.

Background: Fat is commonly used for preventing cerebrospinal fluid (CSF) leakage during endoscopic transsphenoidal surgery (ETSS). However, fat is soft, slippery, and sometimes not easy to handle. The present study aimed to examine the efficacy of our Surgicel wrapping method, which allows for better fat handling, in preventing the occurrence of CSF leakage among patients undergoing ETSS.

An experimental study on the diagnostic advantage of dual-energy computed tomography over single-energy scan to evaluate the treatment effect following transcatheter arterial chemoembolization.

Objectives: We assessed the diagnostic advantage of dual-energy computed tomography (DECT) over single-energy computed tomography (SECT) to evaluate lipiodol accumulation in target lesions following transcatheter arterial chemoembolization (TACE).

Methods: TACE was performed in 10 rabbits in whom the VX2 tumor was implanted in their left liver lobes. The miriplatin-lipiodol mixture was injected into the common hepatic artery.

Efficacy of durvalumab plus tremelimumab treatment for unresectable hepatocellular carcinoma in immunotherapy era clinical practice.

Aim: Since the development of tremelimumab plus durvalumab (Dur/Tre) for unresectable hepatocellular carcinoma (uHCC), it has been used as not only an initial but also later line treatment in clinical practice. This study aimed to elucidate clinical prognostic factors for progression-free survival (PFS) in Dur/Tre treatment cases.

Methods: Enrolled were 183 uHCC patients treated with Dur/Tre from 2023 to May 2024 (median age, 74 years; male patients, 152; Child-Pugh class A:B, 150:33; Barcelona Clinic Liver Cancer stage B:C, 59:124; initial line use, 64).

Prognostic Awareness and Knowledge of Acute Exacerbation in Patients Dying with Interstitial Lung Disease: A Nationwide Survey.

Rationale: Accurate prognostic awareness (PA) and knowledge of the disease are critical for decision-making regarding treatment options, advance care planning, and end-of-life care. However, they have not been investigated in patients with interstitial lung disease (ILD).

Objectives: To determine the prevalence of patients with ILD who have accurate PA and/or knowledge of acute exacerbation.

Association Between Direct Oral Anticoagulant Score and Bleeding Events in Patients With Atrial Fibrillation Following Transcatheter Aortic Valve Replacement: A Retrospective Multicenter Cohort Study.

Background: The Direct Oral Anticoagulant (DOAC) Score can predict bleeding risk in patients with atrial fibrillation taking DOACs; however, it lacks external validation. Therefore, this study aimed to assess the association between the DOAC Score and bleeding events in patients with atrial fibrillation who underwent transcatheter aortic valve replacement.

Methods And Results: This retrospective multicenter cohort study included patients with atrial fibrillation who underwent transcatheter aortic valve replacement, as registered in a Japanese multicenter registry.

Artery of Percheron Infarction with Bilateral Thalamic Lesions in a 14-Year-Old Girl: A Case Report.

The artery of Percheron (AOP), a common anatomic vascular variation of the P1 segment of the posterior cerebral artery, provides arterial blood supply to the paramedian thalami and rostral midbrain. Occlusion of the AOP can lead to infarction of the bilateral paramedian thalamus, with or without midbrain involvement, but is rare in children. Here, we describe a case involving a 14-year-old girl with sudden onset of disturbance of consciousness, hypersomnia, and global aphasia.