Association between Sodium-Glucose Co-Transporter-2 Inhibitor Use and Prognosis in Underweight Patients with Diabetes Mellitus and Heart Failure.

Background & Aims: It remains unclear whether sodium-glucose co-transporter-2 (SGLT2) inhibitors are effective for patients with underweight. This study aimed to elucidate the association between SGLT2 inhibitors use and prognosis in underweight patients with diabetes mellitus (DM) and HF.

Methods: This study was a post-hoc analysis of data from the Japanese Registry of Acute Decompensated Heart Failure, a prospective, multicenter, observational, nationwide registry.

Goreisan attenuates cardiac hypertrophy and diastolic dysfunction in heart failure with preserved ejection fraction induced by HFD/L-NAME via regulation of ICAT-β-catenin/ERK axis.

Heart failure with preserved ejection fraction (HFpEF), characterized by cardiac hypertrophy and diastolic dysfunction, is increasing worldwide. Goreisan (GRS) is a traditional herbal formulation; its component attenuates cardiomyocyte hypertrophy. This study aimed to investigate the effect of GRS on the pathophysiology of HFpEF.

Excessive HIF-1α driven by phospholipid metabolism causes septic cardiomyopathy through cytopathic hypoxia.

Septic cardiomyopathy, one manifestation of multiple organ dysfunction syndrome, is a challenging complication in sepsis, and cytopathic hypoxia has been proposed to have a key role in the pathophysiology of multiple organ dysfunction syndrome. However, the underlying mechanisms remain unknown. Here, we show that upregulation of hypoxia-inducible factor-1α (HIF-1α) in cardiomyocytes following lipopolysaccharide (LPS) treatment suppresses mitochondrial respiration via inducible nitric oxide synthase-dependent nitric oxide, leading to cytopathic hypoxia.

Factors for bloodstream infection in totally implantable venous-access ports.

Introduction: Central line-associated bloodstream infection (CLABSI) associated with implanted central venous (CV)-access ports (CV ports) remains one of the most serious complications that can worsen patient outcomes. Despite the importance of this problem, comprehensive reports are limited. Here we report an analysis of CLABSI risk factors in patients with CV ports at our institution.

A Novel Treatment Strategy for Unresectable Locally Recurrent Rectal Cancer-Upfront Carbon-Ion Radiotherapy Followed by Surgical Resection of the Irradiated Intestines.

Carbon-ion radiotherapy (CIRT) is a promising treatment option for unresectable locally recurrent rectal cancer (LRRC). However, CIRT is contraindicated in cases where recurrent tumors are attached to the intestine. To address this limitation, we developed a novel treatment strategy involving curative-dose CIRT to recurrent tumors, including the adjacent intestine, without dose constraints, followed by surgical resection of the irradiated intestine.

Successful Urethrorectal Fistula Repair Using GelPOINT Path Anal Access Sheath in Pelvic Fracture Urethral Injury.

Introduction: We present a case of rectourethral fistula complicating urethral trauma, successfully treated using a transanal exposure device.

Case Presentation: A male in his twenties was referred to us with a pelvic fracture urethral injury. Preoperative imaging revealed an urethrorectal fistula.

Clinical characteristics and outcomes of hospitalized patients with heart failure from the Japanese prospective registry.

Background: Recent studies showed that clinical parameters other than cardiac function, such as physical function, cognitive function, mental status, social status, and quality of life, were associated with heart failure (HF) prognosis. These parameters have not been extensively investigated in large Japanese cohorts. Furthermore, novel biomarkers to predict prognosis or treatment responses are required to provide individualized medicine.

[A Case of MSI-H Sigmoid Colon Cancer with Para-Aortic Lymph Node Metastasis Treated with Pembrolizumab and Radical Resection].

A 60-year-old male was admitted to the hospital with abdominal pain and diagnosed with microsatellite instability-high (MSI-H)sigmoid colon cancer. Computed tomography revealed an obstructive mass in the sigmoid colon along with swelling of the para-aortic lymph nodes. The patient initially underwent loop transverse colostomy, followed by treatment with the immune checkpoint inhibitor(ICI)pembrolizumab.

Impact of Low Ligation on Bowel Perfusion and Anastomotic Leakage in Minimally Invasive Rectal Cancer Surgery: A Post Hoc Analysis of a Randomized Controlled Trial.

Background: Whether the level of the inferior mesenteric artery ligation affects the incidence of anastomotic leakage remains unclear.

Objective: To assess the impact of the level of inferior mesenteric artery ligation on blood flow to the anastomotic site and the incidence of anastomotic leakage using indocyanine green fluorescence imaging.

Design: A post hoc analysis of the EssentiAL trial.

Clinical characteristics and predictive biomarkers of intensive care unit-acquired weakness in patients with cardiogenic shock requiring mechanical circulatory support.

Intensive care unit-acquired weakness (ICU-AW) is recognized as newly-acquired bilateral muscle weakness, which is a complication of critical illness in the ICU; however, there are no reports on the pathogenesis and early predictors of ICU-AW specifically associated with cardiogenic shock (CS). Therefore, this study aimed to investigate the clinical characteristics of ICU-AW in patients with CS requiring mechanical circulatory support (MCS). This study was a single-center, prospective, and observational study.

Deep learning model to diagnose cardiac amyloidosis from haematoxylin/eosin-stained myocardial tissue.

Aims: Amyloid deposition in myocardial tissue is a definitive feature for diagnosing cardiac amyloidosis, though less invasive imaging modalities such as bone tracer cardiac scintigraphy and cardiac magnetic resonance imaging have been established as first steps for its diagnosis. This study aimed to develop a deep learning model to support the diagnosis of cardiac amyloidosis from haematoxylin/eosin (HE)-stained myocardial tissue.

Methods And Results: This single-centre retrospective observational study enrolled 166 patients who underwent myocardial biopsies between 2008 and 2022, including 76 patients diagnosed with cardiac amyloidosis and 90 with other diagnoses.

Status of perioperative venous thromboembolism (VTE) prophylaxis in gastrointestinal surgery based on national clinical database (NCD) data in Japan.

Purpose: To investigate the current status of perioperative venous thromboembolism (VTE) prophylaxis in gastrointestinal surgery in Japan.

Methods: We reviewed data on eight gastroenterological procedures from the Japanese National Clinical Database (NCD), accrued between 2018 and 2020. Patient characteristics, prophylactic methods, postoperative bleeding, cardiac arrest, and postoperative mortality rate within 30 days were retrieved.

Establishment of a HFpEF model using female Dahl salt-sensitive rats: a valuable tool for elucidating the pathophysiology of HFpEF in women.

The pathogenesis of heart failure with preserved ejection fraction (HFpEF) remains unclear, and effective treatments are limited. HFpEF is more prevalent in females, indicating potential gender differences in its pathogenesis. However, no female HFpEF model animals have been established.

Regime shift of skeletal δC after 1997/1998 El Nino event in Porites coral from Green Island, Taiwan.

The 1997/1998 El Niño event caused mass coral bleaching and mortality in many tropical and subtropical regions, including corals on Green Island, Taiwan, in the northwestern Pacific Ocean. This study analyzed coral carbon isotope ratios (δC), oxygen isotope ratios (δO), and Sr/Ca ratios for 29 years, including the 1997/1998 El Niño period, to examine how high water temperature events are recorded in coral geochemical indicators. Sr/Ca ratios in coral skeletons from Green Island show the lowest peak, means the highest temperature during the 1997/1998 El Niño period.

Trial Protocol of a Phase II Study of mFOLFOXIRI after Metastasectomy in Patients with Oligometastatic Colorectal Cancer (FANTASTIC Study).

Background: The survival benefit of adjuvant chemotherapy after surgical resection of oligometastases from colorectal cancer (CRC) remains unclear. The prognostic role of circulating-tumor DNA (ctDNA) was reported recently and a risk stratification strategy based on monitoring minimal/molecular residual disease (MRD) has been proposed, however, which drug regimen is most effective for ctDNA-positive patients is unknown.

Methods/design: Oligometastatic CRC patients planning to undergo surgery were registered in this study.

Monitoring ctDNA RAS Mutational Status in Metastatic Colorectal Cancer: A Trial Protocol of RAS-trace and RAS-trace-2 Studies.

Background: Spatial and temporal heterogeneities of RAS and other molecular genes should be considered in the treatment of metastatic colorectal cancer (mCRC) treated with anti-epidermal growth factor receptor (EGFR) monoclonal antibodies (mAbs); acquired RAS mutation is sometimes observed at disease progression of treatment with the anti-EGFR mAb. At the same time, discrepancy of RAS status from tissues and circulating tumor DNA (ctDNA) in the same patient is sometimes observed. Based on this, we commenced two observational studies to clarify these heterogeneities of RAS and BRAF in mCRC, using next generation sequencing from liquid biopsy.

iMPAQT reveals that adequate mitohormesis from TFAM overexpression leads to life extension in mice.

Mitochondrial transcription factor A, TFAM, is essential for mitochondrial function. We examined the effects of overexpressing the gene in mice. Two types of transgenic mice were created: heterozygous ( Tg) and homozygous ( Tg/Tg) mice.

Delineation of the internal iliac vein using MRI with true FISP sequence in patients with locally recurrent rectal cancer: A pilot study using CT/MRI fusion.

Purpose: This study assessed the feasibility of using three-dimensional (3D) models of intrapelvic vascular patterns constructed using computed tomography (CT) and magnetic resonance imaging (MRI) fusion data for preoperative planning in patients with locally recurrent rectal cancer.

Methods: Eleven patients scheduled for pelvic exenteration were included. The 3D fusion data of the intrapelvic vessels constructed using CT and MRI with true fast imaging with steady-state precession sequence (True FISP) were evaluated preoperatively.