Cooling-induced brushite crystallization in urine as a predictive risk marker for calcium kidney stone recurrence.

Kidney stones have a high recurrence rate-10% within 5 years and 50% within 10. Crystalluria reflects the urinary physicochemical environment and may serve as a recurrence marker, but key crystals like brushite are rarely detected under ambient conditions. This study aimed to identify novel recurrence markers by inducing crystallization through urine cooling and analyzing crystal composition.

Index Transcatheter Aortic Valve Expansion After TAV-in-TAV Using a One-Size-Smaller SAPIEN Valve.

Background: Index transcatheter aortic valve (TAV) expansion during TAV-in-TAV is crucial as it changes the valve-to-aorta distances and may increase the intraprocedural risk.

Case Summary: A TAV-in-TAV procedure was planned for a 90-year-old woman with prior TAV replacement (23-mm SAPIEN XT) who presented with prosthetic valve stenosis. Second TAV sizing was assessed by averaging the stent areas of the index TAV and by drawing a virtual circle on preprocedural computed tomography (CT).

Gut Microbiota-Derived butyric acid attenuates kidney stone formation in humans and mice.

Metabolic syndromes, particularly obesity, are associated with kidney stone formation (KSF). The gut microbiota and its metabolites, including butyrate, play critical roles in regulating inflammation and obesity-related disorders. In this study, using human tissue samples and in vivo mice experiments, we examined the effects of butyrate on KSF.

Evaluating the learning curve of robot-assisted partial nephrectomy with the cumulative sum method.

Robot-assisted partial nephrectomy (RAPN) has become the standard treatment for small renal tumors, offering better perioperative outcomes than open surgery. However, objective evaluations of the RAPN learning curve are limited. While the Trifecta criteria-comprising negative surgical margins, no perioperative complications, and warm ischemia time (WIT) ≤ 25 min-are commonly used to assess surgical outcomes, they are inadequate for continuous proficiency assessment.

Effect of Pembrolizumab on Lymph Node Dissection in Patients Who Experienced Bladder Cancer Recurrence Following Radical Cystectomy.

Background/aim: Pelvic lymph node dissection is recommended to improve the prognosis in patients with bladder cancer undergoing radical cystectomy. Although several studies have reported an association between lymph node dissection and the efficacy of immune checkpoint inhibitors, evidence specific to bladder cancer remains lacking. This study aimed to investigate the effect of pembrolizumab on lymph node dissection during radical cystectomy in patients with bladder cancer.

Sinus Sequestration After TAV-in-SAV: Optimizing CT Planning and Procedure.

Background: Sinus sequestration, well discussed in transcatheter aortic valve (TAV)-in-TAV, may also occur in TAV-in-surgical aortic valve (SAV), and its risk may be underrecognized if not assessed properly. We report an optimized TAV-in-SAV procedure in a patient at risk for sinus sequestration who was successfully treated after detailed computed tomography (CT) planning.

Case Summary: An 85-year-old woman who underwent previous surgical aortic valve replacement (Magna #19 valve, Edwards Lifesciences) presented with severe bioprosthetic stenosis.

Effectiveness of the Ureteral Illuminating Catheter in Securing Adhesive Ureters in Robot-Assisted Ureteral Reconstruction.

Objective: Ureteral strictures, a common complication of ureteral stone treatment, pose substantial challenges. These conditions often necessitate robot-assisted ureteral reconstruction (RUR), a procedure complicated by difficulty in identifying and mobilizing adhesive ureters. This study evaluated the effectiveness of a ureteral illuminating catheter (IRIS U-kit) in enhancing visualization and securing adhesive ureters during RUR.

Feasibility of Computed Tomography as a Gatekeeper for Invasive Angiography Before TAVR: A Pragmatic Real-World Experience.

Background: Although pretranscatheter aortic valve replacement-computed tomography angiography (TAVR-CTA) has shown a good correlation with invasive coronary angiography (ICA) for ruling out obstructive coronary artery disease (CAD), its clinical effectiveness and safety as a gatekeeper for ICA pre-transcatheter aortic valve replacement (pre-TAVR) remain unclear. This study aims to determine whether routine TAVR-CTA, without premedication, could safely defer and guide the need for ICA pre-TAVR.

Methods: Patients who underwent TAVR evaluation with either TAVR-CTA or ICA to determine CAD between 2017 and 2022 were included.

Extended Follow-Up of Robot-Assisted Partial Nephrectomy for Renal Hilar Tumor: A Prospective Multi-Institutional Study (ROBOHIT Trial).

Objectives: We aimed to evaluate the long-term oncological and functional outcomes after robot-assisted partial nephrectomy (RAPN) for renal hilar tumors.

Methods: A total of 22 academic hospitals in Japan participated in a prospective, multicenter, single-arm, open-label trial with a 2-year enrollment period. After undergoing RAPN, 105 patients with clinical T1 renal hilar tumors were followed up for 5 years and evaluated.

Risk of Coronary Obstruction in Redo-Transcatheter Aortic Valve Replacement Between Bicuspid and Tricuspid Aortic Valves.

Background: Transcatheter aortic valve replacement (TAVR) is approved across all risk profiles, including patients with bicuspid aortic valves. These patients are generally younger, with a higher chance of reintervention.

Objectives: The aim of this study was to compare the feasibility of redo transcatheter aortic valve (TAV) between bicuspid and tricuspid aortic valves.

Effect of Using Automated Irrigation Systems on the Risk of Infectious Complications after Endoscopic Combined Intrarenal Surgery: A Retrospective Cohort Study.

Endoscopic combined intrarenal surgery (ECIRS) is a treatment option for kidney stones comparable with other standard methods. One reported complication of ECIRS is infection associated with high intrarenal pressure (IRP), and the irrigation system is an important factor affecting the IRP. Therefore, this study aimed to compare the operative outcomes and infectious complications between manual and gravity irrigation and automated irrigation systems for ECIRS.

Ureteral stent biomaterial encrustation after endoscopic lithotripsy: a randomized, single-blind study.

This study evaluated the adherence of bacteria, calcium, and magnesium to three different ureteral stents after endoscopic surgery for urinary calculi. We randomly assigned 61 patients requiring the insertion of ureteral stents after urinary calculi treatment into three groups: Percuflex with a coating composition of Hydroplus (n = 21); Tria with a coating composition of Percushied (n = 22); and InLay Optima, which had a proprietary pHreeCoat coating (n = 18). All stents were removed and evaluated 1 month after treatment.

The role of osteopontin in modulating macrophage phagocytosis of calcium oxalate crystals.

In inflammation, osteopontin (OPN) acts as both a stone matrix component for calcium oxalate (CaOx) crystal formation and an inflammatory mediator. While previous studies have demonstrated the individual roles of OPN and macrophages (Mφ) in renal CaOx stone formation during inflammation, their interaction remains poorly understood. This study aimed to elucidate the role of OPN in modulating Mφ function during crystal formation, using an ex vivo model.

Validation of Guideline Recommendation on Sudden Cardiac Death Prevention in Hypertrophic Cardiomyopathy.

Background: To prevent sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy (HCM), the HCM Risk-SCD calculator and guideline recommendations are used to aid decision making for implantable cardioverter-defibrillator placement.

Objectives: The aim of this study was to assess the clinical profiles and occurrence of SCD by phenotypes of HCM and validate the performance of the current guidelines from a large-scale Japanese multicenter registry.

Methods: This was a retrospective, multicenter, observational, longitudinal cohort study that enrolled 3,611 consecutive patients with HCM.

Best Practices for Imaging of Transcatheter Valve Failure: An Update From the Heart Valve Collaboratory.

This updated Heart Valve Collaboratory framework addresses the growing concern for transcatheter valve failure (TVF) following transcatheter aortic valve replacement (TAVR). With the increasing volume of redo-TAV and surgical TAV explantation, there is a critical need for standardized pathways and protocols for evaluating TVF using echocardiography and cardiac computed tomography (CT) angiography. This document clarifies prior definitions of bioprosthetic valve deterioration and bioprosthetic valve failure in a practical, imaging directed context for TAVR.

A case of Page kidney due to an encapsulated perirenal hematoma improved by capsulectomy.

Introduction: Page kidney causes secondary hypertension due to external compression of the renal parenchyma and renal hypoperfusion.

Case Presentation: A 21-year-old healthy man was diagnosed with hypertension during a medical examination 3 months after he had gotten a bruise at the right lumbar region. The patient's blood pressure was 176/120 mmHg.

Electron microscopic findings predict clinical outcomes in patients with non-ischaemic cardiomyopathy.

Aims: Electron microscopy reveals microstructural alterations in cardiomyocyte nuclei and myofilaments in non-ischaemic cardiomyopathy (NICM), particularly in dilated cardiomyopathy (DCM). Nevertheless, the correlation between such observations and clinical outcomes, including prognosis and left ventricular reverse remodelling (LVRR), remains unclear. This study aimed to examine the association between electron microscopic findings and outcomes in patients with NICM.

Reduced Pulmonary Artery Compliance in a Conscious State Predicts Cardiac Event After Transcatheter Edge-to-Edge Repair in Patients With Ventricular Secondary Mitral Regurgitation.

Background: Right ventricular (RV) dysfunction negatively affects mitral valve transcatheter edge-to-edge repair (M-TEER) outcomes in patients with ventricular secondary mitral regurgitation (vSMR). However, RV dysfunction occurs in the late phase of heart failure, when it may not respond to interventions. The pulsatile component of RV afterload, pulmonary artery (PA) compliance, is a sensitive parameter that decreases before RV dysfunction occurs.

Eosinophil is a predictor of severe immune-related adverse events induced by ipilimumab plus nivolumab therapy in patients with renal cell carcinoma: a retrospective multicenter cohort study.

Introduction: Immune-related adverse events (irAEs) induced by immune checkpoint inhibitors are difficult to predict and can lead to severe events. Although it is important to develop strategies for the early detection of severe irAEs, there is a lack of evidence on irAEs associated with ipilimumab plus nivolumab therapy for metastatic renal cell carcinoma (RCC). Therefore, this study aimed to investigate the association between eosinophil and severe irAEs in patients receiving ipilimumab plus nivolumab therapy for RCC.

Prolyl hydroxylase domain inhibitors prevent kidney crystal formation by suppressing inflammation.

The early stages of kidney crystal formation involve inflammation and hypoxia-induced cell injury; however, the role of the hypoxic response in kidney crystal formation remains unclear. This study investigated the effects of a prolyl hydroxylase domain inhibitor (roxadustat) on renal calcium oxalate (CaOx) crystal formation through in vitro and in vivo approaches. In the in vitro experiment, murine renal tubular cells (RTCs) were exposed to varying roxadustat concentrations and CaOx crystals.

Peri-procedural outcome according to VARC-3 criteria and hemodynamic mid-term follow-up after Valve-in-valve transcatheter aortic valve replacement for failed aortic bioprosthesis.

Despite the widespread adoption of valve-in-valve transcatheter aortic valve replacement (VIV-TAVR) for patients with failed aortic bioprosthesis, the effectiveness of this treatment for Japanese patients frequently associated with small aortic annuli remains unclear. From December-2011 to October-2022, 41 consecutive patients undergoing VIV-TAVR were enrolled in this study. The endpoints were technical success, device success, early safety, and two-year mortality according to implanted surgical valve size (small valves: 19-mm and 21-mm, n = 23; large valves: 23-mm and 25-mm, n = 18).

Evaluation of thermal effects of surgical energy devices: ex vivo study.

This study evaluated the direct and indirect thermal effects of various surgical energy devices using an ex-vivo model. Two types of three devices were evaluated: ENSEAL™ X1 Curved Jaw Tissue Sealer (X1) and ENSEAL™ G2 Curved Tissue Sealer (G2) as vessel sealing systems (VSSs), and HARMONIC HD1000i Shears (HA) as an ultrasonic activating device (USAD). Each device was activated once under DRY or WET conditions.

Learning curve of multiple surgeons for robot-assisted radical prostatectomy using the cumulative sum method: a retrospective single-institution study.

Prostate cancer (PC) is common among men and has become a significant societal issue. Localized PC has a good prognosis with appropriate treatment. Prostatectomy, particularly robot-assisted radical prostatectomy (RARP), has become a common treatment since the da Vinci prostatectomy was approved by the FDA in 2001.