Tuberculous valvular endocarditis is rare and diagnosis before death is seldom achieved. A case of severe aortic regurgitation due to tuberculous endocarditis in a 56-year-old man is presented. Replacement of the aortic valve in emergency and administration of anti-tuberculuos medication permitted an uneventful recovery. This is a rare case report of successful surgical treatment of tuberculous valvular disorder.

A 77-year-old woman was referred to our hospital because of general malaise and appetite loss for 3 months. Contrast-enhanced computed tomography showed a gallbladder tumor and multiple tumors in the liver. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) was performed for the gallbladder tumor. Histopathologically, the tumor was diagnosed as poorly differentiated adenocarcinoma. There were no complications of EUS-FNA. While waiting for the histopathological results of EUS-FNA, her appetite loss gradually became severe, so she declined systemic chemotherapy. She was discharged from the hospital 15 days after EUS-FNA. EUS-FNA for gallbladder lesions is useful when pathological diagnosis is required.

An 85-year-old man who developed sudden neck pain after ingesting walnuts visited our hospital. Computed tomography showed food impaction in the cervical esophagus. Upper gastrointestinal endoscopy revealed a walnut half that was not chewed at all in the cervical esophagus. The walnut half was pushed into the stomach with the endoscope and removed using a retrieval net. No strictures, neoplastic lesions, or ulcerations were found in the esophagus. The neck pain improved after the procedure.

An 83-year-old woman who vomited blood was taken to our hospital by ambulance. She was taking oral ticlopidine for chronic arterial occlusion of the lower extremities. Emergency upper gastrointestinal endoscopy revealed bleeding from a gastric polyp. Following endoscopic mucosal resection, the clinical course was uneventful and she was discharged 7 days after admission. Histopathology revealed that the resected gastric polyp was a hyperplastic polyp with no malignant findings.

An 86-year-old man was diagnosed with obstructive jaundice due to extrahepatic bile duct tumor. Percutaneous transhepatic biliary drainage (PTBD) was performed following failed transpapillary biliary drainage. The next day, a biliary metal stent was placed by rendezvous endoscopic retrograde cholangiopancreatography (ERCP) and a tube was also placed via the PTBD route. Two days later, a computed tomography scan showed emphysema in the abdominal wall where the PTBD tube was inserted. He was diagnosed with cellulitis. The PTBD tube was removed and incisional drainage was performed. Klebsiella oxytoca was cultured from the pus. He subsequently improved and was discharged 22 days after the rendezvous ERCP.

An 86-year-old man diagnosed with distal cholangiocarcinoma was treated with uncovered biliary metal stent placement. The metal stent was occluded due to growth of the tumor into the stent. Although he underwent placement of two additional plastic stents in the metal stent, the plastic stents were also rapidly occluded. He was admitted and underwent transpapillary exchange of the plastic stents. Five days later, endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) was performed using a plastic stent. The patient had no recurrence of cholangitis thereafter and was discharged 42 days after EUS-HGS.

In our department, we perform CABG operations using arterial grafts as much as possible, and in the present study, we investigated 96 patients who underwent CABG operations using arterial grafts alone during the 4-year period from October 1988 to August 1992. The sex ratio (M/F) was 64/32, and the mean age was 63.2 years. Of those 56 patients underwent bypass surgery for one artery each, using a total of 56 grafts. In 18 cases of bypass surgery for 2 arteries 34 grafts were used for 36 arteries, and in 16 patients who underwent surgery for 3 arteries, 42 grafts were used for 48 arteries. In 6 patients who underwent bypass surgery for 4 arteries, 16 grafts were used for 24 arteries. All 148 arteries harvested from 96 patients were available. Forty-one RITAs were used for 43 arteries, 68 LITAs for 72 arteries and 39 RGEAs for 49 arteries. There were 2 (2.0%) operative deaths. Among 135 grafts for 146 arteries on which arteriography was performed after operation, 133 grafts (98.6%) among 142 arteries (97.3%) were patent. In detail, the patency rate of ITA was 98 of 100 grafts (98.0%) and 102 of 105 arteries (97.1%), that of RGEA was 35 of 35 grafts (100%) and 40 of 41 arteries (97.6%), and therefore, good patency was observed in both ITA and RGEA.

The therapeutic effect of artificial CO₂ pack on pressure sores of five patients with neurological diseases was confirmed using an infrared thermometer.
The artificial CO₂ pack was prepared by dissolving a 5-g KAO-BABU tablet in 250ml of water at 50°C.
It was proven that the pressure sore recovered faster after treatment with artificial CO₂ hot-pack than that with plain water hot-pack.
In addition, the skin temperature in the area around the pressure sore became lower than the temperature just before the treatment presumably because of the steal phenomenon of blood flow under the skin.

A man in his 80’s presented with sudden onset chest pain in the outpatient waiting room at our hospital and was diagnosed with acute myocardial infarction. Emergency coronary angiography was performed, and a drug-eluting stent was placed in the occluded right coronary artery. After the procedure, the patient developed high-grade fever (40°) with chills. Computed tomography revealed retroperitoneal and iliopsoas abscesses. The patient’s condition did not improve with the administration of antibiotics, so a drainage procedure was deemed necessary. Because of the stent, he was prescribed dual antiplatelet therapy (DAPT) with aspirin and prasugrel. Two days after stent placement, percutaneous abscess drainage was performed with the patient continuing DAPT. No bleeding occurred when a drainage tube was placed. The tube was withdrawn 19 days after insertion. He was then discharged 11 days after removal of the tube.

A man in his 50's was referred to our hospital for hematemesis and hematochezia. He had previously presented to another hospital for ulcerative colitis that was in remission with a prescription of 11 mg prednisolone and adalimumab. He also had a history of partial gastrectomy. Although detailed information on the gastrectomy was unavailable upon arrival at our hospital, contrast-enhanced computed tomography scan suggested that he had undergone a distal gastrectomy with Billroth II reconstruction. Emergency upper gastrointestinal endoscopy revealed an ulcer with an exposed blood vessel at the Braun anastomosis; thus, clipping hemostasis was performed. However, hematemesis occurred 3 days later, and another emergency upper gastrointestinal endoscopy revealed that the clips at the Braun anastomosis had deviated from the original position; therefore, clipping hemostasis was repeated to stop the bleeding from the exposed blood vessels. Subsequently, he was provided intravenous hyperalimentation, after which he resumed oral intake 14 days after the second clipping. No bleeding was observed after the second clipping, and he was discharged 22 days after admission.