A 75-year-old man, who had undergone aortic valve and ascending aorta replacement at the age of 73 years, was admitted to our hospital with one week of fever. Blood culture showed growth of Streptococcus bovis and echocardiography showed vegetation on the prosthetic valve. Although antibiotic treatment was commenced, he complained of abdominal pain, and computed tomography showed a superior mesenteric artery embolism. The abdominal pain improved with fasting, but echocardiography showed another vegetation, and re-aortic valve replacement was performed to prevent embolism recurrence. When he resumed eating postoperatively, he again complained of abdominal pain and computed tomography showed mesenteric ischemia. The necrotic intestine was extensively resected and he recovered successfully. A superior mesenteric artery should be revascularized to 2/11 prevent perioperative mesenteric ischemia when cardiac surgery complicated by acute superior mesenteric artery embolism is performed.

Kobe City has developed a new “Healthcare Data Integration System” that links and anonymizes health care data such as medical and nursing care claims data and medical checkup data, and started its operationin November 2020. Kobe City aims to improve healthcare services through the promotion of data-driven evidence-based policymaking using the same system. This system contains consolidated data on an individual basis for about 600,000 citizens, such as medical claims data, nursing care claims data, health checkup data, nursing care certification records, and immunization data. These consolidated data can be used free of charge for research purposes, but only by academic institutions. The use of the data must be approved by the Institutional Review Board of Kobe City. The minimum necessary data set is created according to the content of the research and is anonymized so that individuals cannot be identified. Kobe City uses the data stored in the “Healthcare Data Integration System” for two purposes： first, to understand and keep track of the health status and health issues of citizens, and second, to accelerate the use of data for research purposes. When the research of high public value is conducted based on Kobe City's data, new findings from the results can be reflected in health services by the government. Byaccelerating the use of the “Healthcare Data Integration System”, Kobe City is expecting to further improve health services for all citizens.

Background/Aims: Recently, a three-plane symmetric nee-dle with Franseen geometry was developed for endoscopic ultrasound-guided fine needle biopsy (EUS-FNB). In this ret-rospective study, tissue acquisition per pass was compared between 22-gauge Franseen FNB and standard fine needle aspiration (FNA) needles in patients with solid pancreatic le-sions. Methods: Consecutive patients who underwent EUSFNA or EUS-FNB for solid pancreatic lesions between Octo-ber 2014 and March 2018 were retrospectively studied. The tissue acquisition rate and the diagnostic performance per session, per pass, and at first pass were compared. Results: A total of 663 passes (300 by the FNB needle and 363 by the standard FNA needle) were performed in 154 patients (71 FNB and 83 FNA). The tissue acquisition rate per session and at first pass in the FNB and FNA groups was 100% and 95% (p=0.13) and 87% and 69% (p=0.007), respectively. The multivariate analysis revealed that among the patients, EUS-FNB (odds ratio, 3.07; p=0.01) was associated with a higher first-pass tissue acquisition rate. While the tissue ac-quisition rate reached a plateau after the 4th pass with FNA, it reached a plateau after the 2nd pass with FNB. Among the 129 malignant cases, the histological tissue acquisition rate per session was similar (100% and 94%), but the sensitivity by histology alone per session was higher for FNB than for FNA (93% and 73%, p<0.01). Conclusions The results of our retrospective analysis indicated that compared with a standard FNA needle, a 22-gauge Franseen FNB needle was associated with a higher first-pass tissue acquisition rate.