Eosinophilic gastroenteritis (EG) is characterized by infiltration of eosinophils into the wall of the digestive tract, and the clinical spectrum seems to depend on the predominant site of eosinophilic infiltration of the wall.
We experienced four cases of EG, and two of them (Cases, 1 and 2) manifested massive ascites, suggesting the principal lesion is located on the serous coat. Case 3 manifested abdominal pain and vomiting, and muscle layer involvement of the duodenum was detected by ultrasonography and CT scan. In case 4, epigastralgia was a main symptom. An endoscopic examination revealed marked redness and erosion of the gastric mucosa associated with massive infiltration of eosinophils. In this case, mucosal involvement seemed to be the main lesion because hypertrophy of the gut wall thickness was not found by ultrasonography and CT scan.
Although the pathogenesis of this disease is obscure, allergic mechanism may play an important role. Three cases had histories of allergic diseases, and steroid therapy resulted in prompt disappearance of symptoms.

A 65-year-old man had received closure of the entry and false lumen Stanford type B acute aortic dissection via left thoratectomy 23 years previously. The patient underwent emergency graft replacement for a ruptured aneurysm of the thoraco-abdominal aorta 10 years previously. Enhanced computed tomography (ECT) revealed that the residual aortic dissection of the distal arch and the descending aorta were dilated. Reoperation via left thoracotomy usually requires a long cardiopulmonary bypass time and intraoperative bleeding. So we selected to perform open stent-grafting through median sternotomy alone, avoiding a left thoracotomy.

An 82-year-old woman fell into a state of shock during the treatment for a urinary tract infection. Computed tomography and transthoracic echocardiography revealed massive pericardial effusion. Pericardiectomy was performed in the operating room and hemorrhagic effusion was observed. Emergent sternotomy was performed, and the bleeding site was located at the posterior portion of the left ventricular outflow. We diagnosed a rupture of a left ventricular outflow tract pseudoaneurysm after infectious endocarditis. A pericardium patch closure of the pseudoaneurysm and an aortic valve replacement were performed. The patient was discharged 35 days after the operation without recurrence of infection. Left ventricular outflow tract pseudoaneurysms is an uncommon complication following infective endocarditis, aortic valve surgery or chest trauma. Transesophageal echocardiography and multidetector-row computed tomography (MDCT) is useful for identifying such lesions.

The purpose of this study was to investigate the effects of Lactobacillus gasseri OLL2809 (MG2809) intake on salivary secretory immunoglobulin A (SIgA) secretion and incidence of upper-respiratory tract infection (URTI) symptoms among college rugby athletes. Sixty-seven subjects were assigned to a MG2809 group (n = 33) or a placebo group (n = 34) using a double-blind procedure. Each subject took MG2809 or placebo tablets for 9 weeks. Resting saliva samples were collected before (0 week) and after 2, 4, 6, 8, and 9 weeks of the MG2809 intakes. A log of URTI symptoms was kept every day during the study period. Our results showed that salivary SIgA level was significantly increased at 6 weeks in the MG2809 group (p < 0.05), although the placebo group did not show significant change. The duration of URTI symptoms episode in the MG2809 group was significantly shorter than that in the placebo (p < 0.05). These results suggest that regular intake of MG2809 may enhance oral immune function mediated by SIgA and reduce the risk of URTI in athletes.

Exercise training is reported to have beneficial effects on both lipid profile and exercise capacity in patients with coronary artery disease. In this retrospective study, we investigated the association between the effect of phase II cardiac rehabilitation (CR) on lipid profile and that on exercise capacity in patients with acute coronary syndrome (ACS). We analyzed 104 consecutive patients with ACS on statin therapy (age 62 ± 8 years, men 86) who received phase II CR after successful percutaneous coronary intervention (PCI). We examined lipid measurements and cardiopulmonary exercise test results before and after phase II CR. After 4 months of phase II CR, percentage of predicted aerobic threshold (%AT) based on age and gender significantly increased from 67 ± 11% to 76 ± 12% (p＜0.001), high-density lipoprotein cholesterol (HDL-C) significantly increased from 41.5 ± 11.8mg/dL to 51.4 ± 12.6mg/dL (p＜0.001), and ratio of lowdensity lipoprotein cholesterol to HDL-C (LDLC/HDLC) significantly decreased from 2.3 ± 0.8 to 1.8 ± 0.6 (p＜0.001). A positive correlation was found between change in HDLC and change in %AT (r = 0.463), as well as between percent change in HDLC and percent change in %AT (r = 0.485). A negative correlation was found between change in LDLC/HDLC ratio and change in %AT (r =－0.379), as well as between percent change in LDLC/HDLC ratio and percent change in %AT (r =－0.374). Multiple regression analysis showed that change in %AT was the only factor associated with both change in HDLC and change in LDLC/HDLC and that percent change of %AT was the only factor associated with both percent change in HDLC and percent change in LDLC/HDLC ratio. In conclusion, improvement of lipids profile was correlated with improvement of %AT in phase II CR for patients with ACS on statin therapy after successful PCI.

This study investigated the characteristics of emergency patients, including walk-in patients and those brought in by ambulance, who visited Akita Kousei Medical Center in the 6 months from April 2019, and the clinical features of elderly patients with heart failure. Elderly patients above 70 years of age accounted for 38.7% of emergency cases and up to 61.7% of ambulance cases. The most common diseases and disorders were orthopedic, digestive, otorhinolaryngeal, respiratory, neurological, dermatological, and cardiovascular disease, in that order. In total, 56 patients with heart failure were admitted during this period (age 83.5±8.3 years, male: female ratio, 1:1.67). Hospitalization from homes accounted for 66.1% of admissions, with the remainder from nursing homes. After treatment, 35.7% of patients moved to nursing homes and 19.6% died despite in-hospital care. Because heart failure is one of the most common conditions in elderly patients, it is pertinent to recognize the importance of quality of outpatient care to prevent hospitalization and also to preserve quality of life by focusing on alleviating overall pain and discomfort.