Impact of renal function on the efficacy of low-voltage area ablation after pulmonary vein isolation: A sub-analysis of the SUPPRESS-AF trial.

Background And Aims: The SUPPRESS-AF trial showed that pulmonary vein isolation (PVI) plus low-voltage area (LVA) ablation may reduce atrial fibrillation (AF) recurrence in some subgroups. Renal dysfunction is a cause of LVAs due to atrial cardiomyopathy and is also a risk factor for AF recurrence after catheter ablation. The aim of this study was to investigate the efficacy of LVA ablation after PVI stratified by renal function.

Intravitreal Povidone-Iodine Injection and Low-Dose Antibiotic Irrigation for Infectious Endophthalmitis: A Retrospective Case Series.

Infectious endophthalmitis is a vision-threatening complication of intraocular surgery and intravitreal injections. Standard treatment involves intravitreal antibiotics; however, concerns regarding multidrug resistance and vancomycin-associated hemorrhagic occlusive retinal vasculitis (HORV) highlight the need for alternative antimicrobial strategies. This study aimed to evaluate the clinical efficacy and safety of a protocol combining intravitreal injection of 1.

The Role of Mitochondrial DNA in Modulating Chemoresistance in Esophageal Cancer: Mechanistic Insights and Therapeutic Potential.

Chemotherapy remains a cornerstone in the treatment of esophageal cancer (EC), yet chemoresistance remains a critical challenge, leading to poor outcomes and limited therapeutic success. Mitochondrial DNA (mtDNA) has emerged as a pivotal player in mediating these responses, influencing cellular metabolism, oxidative stress regulation, and apoptotic pathways. This review provides a comprehensive overview of the mechanisms by which mtDNA alterations, including mutations and copy number variations, drive chemoresistance in EC.

Outcome of Conversion Surgery After Induction Therapy for Esophageal Cancer with Synchronous Para-Aortic Lymph Node Metastasis: A Multi-institutional Retrospective Study.

Background: Systemic chemotherapy is the standard treatment for esophageal cancer with synchronous distant metastasis including para-aortic lymph node (PALN) metastasis. The significance of conversion surgery for esophageal cancer with synchronous PALN metastasis remains controversial.

Objective: The current study aimed to investigate the clinical outcome of conversion surgery for esophageal cancer with synchronous PALN metastasis after induction therapy.

Clinical impact of primary and secondary KIT mutations on the efficacy of molecular-targeted therapies in gastrointestinal stromal tumors.

Background: Gastrointestinal stromal tumors (GISTs) are commonly driven by primary mutations in KIT or PDGFRA. Imatinib is the first-line therapy for GISTs. However, secondary mutations frequently emerge during imatinib treatment, contributing to resistance and influencing the efficacy of subsequent tyrosine kinase inhibitors, such as sunitinib and regorafenib.

High expression of the cachexia-related protein Fn14 in esophageal squamous cell carcinoma correlates with poor chemotherapy response and anti-Fn14 therapy decreases chemotherapeutic resistance.

Background: In cancer cachexia, cytokine release by tumours causes weight loss, decreased therapeutic efficacy, and worsened prognosis. Tumour necrosis factor-like weak inducer of apoptosis (TWEAK) and fibroblast inducible factor 14 (Fn14) are cancer cachexia-related proteins; however, their expression in oesophageal squamous cell carcinoma (ESCC) and association with therapeutic resistance remain unclear.

Methods: We evaluated how Fn14 knockdown and overexpression in ESCC lines (TE6 and TE10) contributed to proliferation, migration, and chemotherapy resistance in vitro and in vivo.

Tiny-objective segmentation for spot signs on multi-phase CT angiography via contrastive learning with dynamic-updated positive-negative memory banks.

Background And Objective: Presence of spot sign on CT Angiography (CTA) is associated with hematoma growth in patients with intracerebral hemorrhage. Measuring spot sign volume over time may aid to predict hematoma expansion. Due to the difficulties that imaging characteristics of spot sign are similar with vein and calcification and spot signs are tiny appeared in CTA images to detect, our aim is to develop an automated method to pick up spot signs accurately.

Comprehensive registry of esophageal cancer in Japan, 2016.

Background: The registration committee for esophageal cancer in the Japan Esophageal Society (JES) has collected the characteristics, treatments, and outcomes of patients who underwent any treatment in 2016 in Japan.

Methods: We analyzed data on patients who had visited the participating hospitals in 2016. We collected the data using the National Clinical Database with a web-based data collection system.

Validation of the HERMES-24 Score for Outcome Prediction Post Large Vessel Occlusion Treatment in Later Time Window.

Background And Objectives: The Highly Effective Reperfusion Evaluated in Multiple Endovascular Stroke Trials (HERMES)-24 score is highly predictive of outcomes after anterior circulation large vessel occlusion (LVO) treatment, irrespective of intervention in the early time window. Recent evidence has further broadened the eligibility of endovascular therapy (EVT) to patients with late presentation or unwitnessed onset including those with stroke-on-awakening. We aimed to investigate the prediction ability of the HERMES-24 score in patients with anterior circulation LVO and small ischemic core presenting in the late time window from last seen normal.

Prognostic factors for patients with esophageal cancer who achieve pathological complete response in the primary tumor after upfront chemotherapy or chemoradiotherapy.

Aim: Upfront chemotherapy (uCT) or upfront chemoradiotherapy (uCRT) followed by surgery is generally accepted as the standard treatment for patients with locally advanced esophageal cancer. A substantial proportion of patients achieve a pathological complete response (pCR) of the primary tumor with upfront treatment. This retrospective study aimed to clarify the prognostic factors of patients with esophageal cancer who achieve pCR in the primary tumor after upfront treatment and whether the prognosis of patients with pCR who receive uCT differs from that of patients who receive uCRT.

Long-Term Survival Following Multimodal Therapy with Sunitinib and Surgery for Recurrent Duodenal Gastrointestinal Stromal Tumor.

Introduction: Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors often driven by or mutations. Sunitinib, a second-line tyrosine kinase inhibitor (TKI), is effective in imatinib-resistant cases, particularly those with secondary mutations in the ATP-binding domain. However, resistance to sunitinib poses challenges, and evidence supporting surgery during sunitinib treatment remains limited.

Left-Sided Neurological Symptoms and Negative Diffusion-Weighted MRI in Suspected Minor Stroke Patients.

Background: Historically, it has been proposed that functional neurological symptoms occur more frequently on the left side of the body due to a distinct body representation and emotional processing of the right hemisphere, yet objective imaging data to support this are lacking. We aimed to investigate whether patients with acute left-sided symptoms (right hemisphere) suspected of having a minor stroke are more likely to show negative diffusion-weighted imaging (DWI) compared to those with right-sided symptoms.

Methods: Data are from the SpecTRA (Spectrometry for Transient Ischemic Attack Rapid Assessment) multicenter prospective cohort study conducted between 2013 and 2017.

Modified Scleral Needling Technique to Achieve Scleral Wound Closure in Microincision Vitrectomy Surgery.

Purpose: The study aimed to evaluate the effectiveness of the modified scleral needling (SN) technique for unclosed scleral wounds in 25-gauge vitrectomy.

Methods: This retrospective study examined 50 scleral wounds that failed to self-close at the end of vitrectomy surgery performed by the same surgeon using a three-port 25-gauge vitrectomy system (Constellation® Vision System, Alcon Laboratories, Inc., Fort Worth, TX, USA) at Nihon University Hospital between February and August 2023.

Impact of Initial Extensive Ablation on Left Atrial Gaps During Redo Procedures and Subsequent Outcomes in Persistent Atrial Fibrillation.

Background: The efficacy of extensive linear ablation strategies, in addition to pulmonary vein (PV) isolation, remains controversial in persistent atrial fibrillation (AF) ablation. Gaps in previously ablated lesions can induce arrhythmias and potentially decrease the effectiveness of extensive ablation. This study evaluated the incidence of conduction gaps, gap-related reentry, and subsequent recurrence following redo AF ablation in the EARNEST-PVI trial (Efficacy of Pulmonary Vein Isolation Alone in Patients With Persistent Atrial Fibrillation; REGISTRATION: URL: https://www.

Incidence of recurrence and development of polypoidal lesions following half-dose and two-thirds dose photodynamic therapy for pachychoroid neovasculopathy.

The purpose of this study was to determine the recurrence rate, factors, incidence of polypoidal lesions, and risk factors for developing polypoidal lesions after a reduced dose photodynamic therapy (PDT) for pachychoroid neovasculopathy (PNV) without polypoidal lesions. This study is an observational case-control study. The study included 105 patients (77 men, 28 women; mean age, 61.

Benefits of neoadjuvant chemotherapy: is the prognosis of ypN0 patients after neoadjuvant chemotherapy comparable to that of pN0 patients undergoing surgery alone?

Background: Preoperative treatment has become widely recognized for improving survival in patients with esophageal cancer. The present study aimed to compare the prognosis between patients with pathological node-negative status treated with surgery alone (SA-pN0) and those who were clinically node-positive but converted to ypN0 following neoadjuvant chemotherapy (NAC-ypN0) in cases of advanced thoracic esophageal squamous cell carcinoma (ESCC).

Methods: This retrospective analysis used a multicenter database of 4849 consecutive patients who underwent treatment for esophageal cancer.

Impact of Long-Term CPAP Adherence on Recurrence After Atrial Fibrillation Ablation in Patients With Severe Sleep Apnea.

Background: Obstructive sleep apnea represents an arrhythmia recurrence risk following catheter ablation of atrial fibrillation (AF). Continuous positive airway pressure (CPAP) therapy may reduce recurrence, but individual adherence to CPAP varies, potentially leading to inconsistent results across studies.

Methods And Results: We analyzed the impact of CPAP adherence on AF recurrence after catheter ablation in patients with severe obstructive sleep apnea (apnea-hypopnea index ≥30).

Impact of Epiretinal Membrane on Anatomical and Visual Outcomes in Patients with Full-Thickness Macular Holes.

Purpose: This study aimed to evaluate the impact of an epiretinal membrane (ERM) on the postoperative outcomes of full-thickness macular hole (MH) repair, focusing on anatomical closure rates, postoperative visual acuity (VA), and recovery of the outer retinal layers.

Design: A retrospective cohort study.

Participants: A total of 605 eyes from 594 patients who underwent MH surgery from 2015 to 2023.

Low-voltage-area ablation for persistent atrial fibrillation: a randomized controlled trial.

Low-voltage areas (LVAs) in the left atrium may promote atrial fibrillation (AF), but the efficacy of LVA ablation for preventing arrhythmia has not been determined. In the present study, we carried out a multicenter, randomized controlled trial (SUPPRESS-AF) to investigate the efficacy of LVA ablation in patients with persistent AF who had left atrial LVAs. Patients with persistent AF and left atrial LVAs that covered ≥5 cm of the left atrial surface on a voltage map after pulmonary vein isolation (PVI) were randomized to undergo LVA ablation (PVI + LVA-ABL group) or not (PVI-alone group) in a 1:1 fashion.

Exploring predictive biomarkers of efficacy and survival with nivolumab treatment for unresectable/recurrent esophageal squamous cell carcinoma.

Background: Programmed cell death protein-1 (PD-1) blockade has improved survival for patients with esophageal squamous cell carcinoma (ESCC), but response rates are low. Biomarkers to predict who will benefit from PD-1 blockade are urgently needed.

Methods: This multicenter study involved 250 patients with recurrent/unresectable advanced ESCC receiving nivolumab as second- or later-line therapy.

Evaluating the discrepancies between evidence-based and community standard practices in the endoscopic examination of Barrett's esophagus: a nationwide survey in Japan.

Background: Barrett's esophagus (BE) is a known precursor of esophageal adenocarcinoma (EAC). EAC is comparatively rare in Japan compared to Western countries, where BE management guidelines have been well established based on robust evidence. This study evaluated for gaps between evidence-based medicine (EBM) and real-world clinical practice for BE management in Japan and examined endoscopist adherence to Japanese and Western guidelines.

Choroidal circulation time by wide-field indocyanine green angiography in central serous chorioretinopathy.

Purpose: Asymmetric dilated vortex veins (ADVV) extending continuously to the vortex ampullae seen on Indocyanine green angiography (ICGA) findings, are thought to indicate choroidal venous congestion in central serous chorioretinopathy (CSC). In addition, the sclera is thickened compared to normal eyes, suggesting that obstruction of the scleral passage is the pathophysiological mechanism of CSC. The purpose of this study was to examine the choroidal circulation in and around the vortex vein ampulla.

Spot Sign in Intracerebral Hemorrhage: Critical Reappraisal and Future Clinical Implications.

Hematoma expansion (HE) is a common occurrence affecting around 10% to 30% of patients with acute intracerebral hemorrhage within the initial hours from symptom onset and is the only modifiable factor associated with poor clinical outcomes. The detection of contrast extravasation on computed tomography (CT) angiography, known as the spot sign, was initially embraced as a promising radiological marker for predicting HE that could aid patient selection for acute interventions aimed at minimizing HE. However, the initial enthusiasm waned as clinical studies failed to show clear clinical benefits of hemostatic treatments when patients were selected based on the presence of this imaging marker.