Machine learning-based prediction for incidence of endoscopic retrograde cholangiopancreatography after emergency laparoscopic cholecystectomy: A retrospective, multicenter cohort study.

Background: Laparoscopic cholecystectomy is the preferred treatment for symptomatic cholelithiasis and acute cholecystitis, with increasing applications even in severe cases. However, the possibility of postoperative endoscopic retrograde cholangiopancreatography (ERCP) to manage choledocholithiasis or biliary injuries poses significant clinical challenges. This study aimed to develop a predictive model for ERCP incidence following emergency laparoscopic cholecystectomy using advanced machine learning techniques.

Accelerator neutron sources for BNCT: Current status and some pointers for future development.

Recent decades have seen the development of accelerator neutron sources suitable for installation in a hospital setting. Numerous challenges have been faced and solved to deliver technology which continues to transform the field of BNCT. This paper begins by briefly reviewing the technologies which are currently, or soon will be, in clinical use.

Incidence and Prognosis of Prosthesis-Patient Mismatch After Transcatheter Aortic Valve Replacement for Bicuspid Aortic Stenosis.

Background: Evidence regarding the incidence of prosthesis-patient mismatch (PPM) and long-term mortality after transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valve stenosis (AS) is scarce.

Objectives: This study sought to assess the incidence and prognostic impact of PPM after TAVR for bicuspid AS compared with that for tricuspid AS.

Methods: In total, 7,393 patients who underwent TAVR were prospectively enrolled in the OCEAN-TAVI (Optimized Catheter Valvular Intervention Transcatheter Aortic Valve Implantation) registry, an ongoing Japanese, multicenter registry.

Release of apoptosis inhibitor of macrophage (AIM) from pentameric IgM in serum predicts prognosis after hemodialysis initiation.

Background: The optimal timing for initiating dialysis and prognostic markers in chronic kidney disease (CKD) patients are under debate, with mortality and cardiovascular risks varying among patients. This study investigates whether the apoptosis inhibitor of macrophage (AIM), which is mostly bound to pentameric IgM, could serve as an effective indicator.

Methods: We prospectively followed 423 patients at dialysis initiation and 563 at various CKD stages.

Prevalence and Clinical Outcomes of Discordant Lesions Between Fractional Flow Reserve and Nonhyperemic Pressure Ratios in Clinical Practice: The J-PRIDE Registry.

Background: Limited large-scale, real-world data exist on the prevalence and clinical impact of discordance between fractional flow reserve (FFR) and nonhyperemic pressure ratios (NHPRs).

Methods: The J-PRIDE registry (Clinical Outcomes of Japanese Patients With Coronary Artery Disease Assessed by Resting Indices and Fractional Flow Reserve: A Prospective Multicenter Registry) prospectively enrolled 4304 lesions in 3200 patients from 20 Japanese centers. The lesions were classified into FFR+/NHPR-, FFR-/NHPR+, FFR+/NHPR+, or FFR-/NHPR groups according to cutoff values of 0.

Factors Associated With Leaving-Without-Being-Seen in Pediatric Emergency Department Patients.

Aim Preventing leaving-without-being-seen (LWBS) in children is crucial due to their inability to seek medical care independently. Because there are no studies of LWBS in Japan, the extent of this problem in Japan and its impacts on healthcare are uncertain. The present study seeks to fill this gap by investigating LWBS after triage and identifying the associated factors.

Impact of coronary artery tortuosity on outcomes following stenting with newer-generation drug-eluting stents. An analysis of the randomized BIOFLOW trials.

Introduction And Objectives: Patients undergoing percutaneous coronary intervention in vessels with moderate-to-severe tortuosity are at higher risk of adverse outcomes, but data are scarce in the era of newer-generation stents. We compared outcomes following percutaneous coronary intervention in vessels with moderate-to-severe tortuosity using a bioresorbable-polymer sirolimus-eluting stent (BP-SES) vs a durable-polymer everolimus-eluting stent.

Methods: A total of 2350 patients from the BIOFLOW II, IV, and V randomized trials were stratified into 2 groups based on target-vessel tortuosity: none-to-mild and moderate-to-severe.

A Prospective Phase II Trial of First-line Osimertinib for Patients with EGFR Mutation-positive Non-small Cell Lung Cancer and Poor Performance Status (OPEN/TORG2040).

Introduction: Osimertinib is the first-line treatment for patients with non-small cell lung cancer (NSCLC) who have EGFR mutations and favorable performance status (PS). Despite increasing clinical data on osimertinib, evidence in patients with an impaired PS remains limited. Therefore, a multicenter phase II trial (OPEN/TORG2040) was conducted to evaluate the efficacy and safety of first-line osimertinib for patients with EGFR mutation-positive NSCLC and poor PS.

Impact of Sheath Type on Vascular and Bleeding Complications After Transcatheter Aortic Valve Replacement: A Post Hoc Analysis From the MARVEL Registry Study.

Background: Vascular and bleeding complications remain a concern after transfemoral transcatheter aortic valve replacement (TAVR). The impact of the sheath type on these complications remains unclear.

Methods: The prospective MARVEL registry study analyzed enrolled 500 patients undergoing large-bore transfemoral procedures and arteriotomy closure with the MANTA vascular closure device from 10 hospitals in Europe and Canada.

Preliminary evidence of renal function improvement in chronic progressive kidney disease using autologous CD34 cell therapy: A clinical trial.

Background: To date, no specific treatment has been established to reverse progressive chronic kidney disease (CKD).

Aim: To evaluate the safety and efficacy of autologous CD34 cell transplantation in CKD patients who exhibited a progressive decline in renal function.

Methods: The estimated glomerular filtration rate (eGFR) at the beginning of the study was 15.

One-year hemodynamic and clinical outcomes in self-expanding valves: Comparison of ACURATE neo2 versus ACURATE neo.

Background/purpose: Transcatheter aortic valve replacement (TAVR) with ACURATE neo2 showed better hemodynamic outcomes by mitigating paravalvular leakage (PVL) compared with ACURATE neo, and revealed promising one-year outcomes in single-arm studies. However, studies comparing the hemodynamic and clinical outcomes of the two valves are still scarce. Therefore, this study aimed to compare the one-year hemodynamic and clinical outcomes between the neo2 and neo.

Cell therapy in kidney diseases: advancing treatments for renal regeneration.

Kidney diseases, including acute kidney injury (AKI) and chronic kidney disease (CKD), pose a significant global health challenge, with high morbidity and mortality rates driven by rising prevalence of risk factors such as diabetes and hypertension. Current therapeutic strategies are often limited, prompting the exploration of advanced cell therapies as potential solutions. This review provides a comprehensive overview of the state of cell therapies in kidney disease, tracing the progression from preclinical studies to clinical applications.

Successful transcatheter edge-to-edge repair for tricuspid regurgitation in a patient with a double-inlet left ventricle and discordant connections of the great arteries: a case report.

Background: In patients with adult congenital heart disease (ACHD), significant atrioventricular valve regurgitation is an important risk factor for poor outcomes, such as heart failure. However, in many cases, transcatheter intervention may reduce the risk profile to avoid a high surgical risk.

Case Summary: A 44-year-old man with complex ACHD in the form of a double-inlet left ventricle, congenitally corrected transposition of the great arteries, pulmonary atresia, atrial septal defect, and patent ductus arteriosus was referred for the treatment of severe tricuspid regurgitation.

Non-oliguric acute renal failure secondary to a potentially lethal dose of caffeine with acute intoxication: a case report.

Background: Recently, the incidence of caffeine intoxication has been on an upward trend, with severe outcomes. However, acute kidney injury (AKI) resulting from renal pathologies secondary to caffeine intoxication is rare, and the pathophysiological mechanisms underlying AKI are unclear.

Case Presentation: A female patient in her 20s ingested an over-the-counter drug containing caffeine.

Association of Baseline Mitral Valve Area With Procedural and Clinical Outcomes of Mitral Transcatheter Edge-to-Edge Repair: Insights From the OCEAN-Mitral Registry.

Background: A small mitral valve area (MVA) is one of the challenging anatomies for transcatheter edge-to-edge repair (TEER) for mitral regurgitation, but the relationship between baseline MVA and clinical outcomes remains unknown. This study aimed to evaluate the association of baseline MVA with procedural and clinical outcomes in patients undergoing TEER with MitraClip from the OCEAN-Mitral registry (Optimized Catheter Valvular Intervention-Mitral).

Methods: A total of 1768 patients undergoing TEER were divided into 3 groups according to baseline MVA: group 1: <4.

Utility of Orthosis in the Conservative Treatment of Proximal Phalanx Fractures: A Preliminary Study in Healthy Participants.

Background: The standard treatment for the conservative management of a proximal phalanx fracture of the little finger involves immobilizing the fracture site with a cast. However, cast immobilization presents challenges in maintaining hygiene during treatment and restricts the fine motor movements of the fingers. In this study, we developed a removable orthosis that immobilizes only the ring and little fingers.

Public assistance and survival equality in patients with EGFR mutation-positive lung cancer.

Background: Disparities in public assistance or the urbanization level of a residential region can affect cancer treatment outcomes. This study aimed to investigate whether these factors affect the overall survival (OS) of patients with epidermal growth factor receptor (EGFR) mutation-positive non-small cell lung cancer (NSCLC) using Tokushukai REAL World Data.

Methods: We analyzed the clinical data of consecutive patients with NSCLC receiving EGFR-tyrosine kinase inhibitors between April 2010 and March 2020 at 46 Tokushukai Medical Group hospitals in Japan.

Left Ventricular Reverse Remodeling After Successful Living Donor Kidney Transplantation: The VINTAGE Study.

Background: The impact of kidney transplantation (KT) on left ventricular (LV) remodeling remains poorly understood. This study aimed to evaluate the effect of KT on LV reverse remodeling, utilizing echocardiographic LV geometric patterns as a key assessment tool.

Methods: In 100 recipients who underwent living KT between 2012 and 2022, we evaluated changes in the distribution of LV geometric patterns (normal geometry, concentric remodeling, eccentric hypertrophy, and concentric hypertrophy) between baseline and 1 year post-transplantation.

Spatially resolved gene expression profiling of tumor microenvironment reveals key steps of lung adenocarcinoma development.

The interaction of tumor cells and their microenvironment is thought to be a key factor in tumor development. We present spatial RNA profiles obtained from 30 lung adenocarcinoma patients at the non-invasive and later invasive stages. We use spatial transcriptome sequencing data in conjunction with in situ RNA profiling to conduct higher resolution analyses.

Impact of Angiographically Detected Residual Trabeculation After Left Atrial Appendage Closure Using the WATCHMAN Device: Insight From the OCEAN-LAAC Registry.

Background: Research on the impact of angiographically detected residual trabeculation after left atrial appendage closure (LAAC) is limited.

Objectives: To investigate the incidence, characteristics, and clinical implications of angiographically detected residual trabeculation after LAAC using the WATCHMAN device.

Methods: We analyzed 1350 consecutive patients with atrial fibrillation undergoing LAAC using the WATCHMAN device from the OCEAN-LAAC registry, which is a prospective ongoing, multicenter Japanese registry.

Update on Prosthesis-Patient Mismatch Following Transcatheter Aortic Valve Replacement in Asian Patients.

Background: Prosthesis-patient mismatch (PPM) after transcatheter aortic valve replacement (TAVR) is of greater concern in Asians, considering their relatively smaller annular sizes compared with Westerners. However, the prognostic significance of PPM in Asian populations has not been demonstrated.

Objectives: This study aimed to elucidate the prognostic value of PPM after TAVR in Asian patients.