Background: This study aimed to demonstrate the effectiveness of a percutaneous method for treating intra-abdominal abscesses caused by gastrointestinal anastomotic leakage using tandem catheter placement for simultaneous drainage. Methods: This retrospective study involved 12 patients with intra-abdominal abscesses from anastomotic leakage who underwent image-guided percutaneous drainage. In the tandem drainage technique, one or more catheters were inserted into the abscess while an additional catheter was advanced into the gastrointestinal tract through the anastomotic dehiscence to decompress the tract and prevent further leakage. The study evaluated the technical and clinical success rates of this approach. Results: Technical success was achieved in nine of 12 patients (75.0%), with clinical success in eight of these nine patients (88.9%). The mean overall drainage duration after tandem placement was 65.0 days (range, 6–154 days), and the mean hospitalization duration for patients with clinical success was 66.7 days (range, 10–156 days). Conclusion Simultaneous tandem drainage is a feasible treatment for intra-abdominal abscesses caused by anastomotic leakage and may be a viable option for patients who are not candidates for surgery.

Objective: This study aimed to elucidate the relationship between daily eating habits and stroke risk factors in O City, Ehime Prefecture, Japan, using stroke registry data collected over a 26-year follow-up period based on standardized national criteria.Materials and Methods: Overall, 1,793 middle-aged Japanese participants (446 men and 1,347 women) who completed a 33-item Food Frequency Questionnaire (FFQ) and had no history of stroke were matched to those from O City in a stroke registry from 1996 to 2022. Stroke diagnosis for each person was used to determine whether this was their first documented stroke, and we classified strokes as either a cerebral infarction (CI) or a hemorrhagic stroke (HS), the latter which included an intracerebral hemorrhage (ICH) or a subarachnoid hemorrhage (SAH). A Cox proportional hazard regression model was used to examine the association between habitual dietary intake and the occurrence of stroke, using the following covariates: age, body mass index, elevated blood pressure/hypertension, dyslipidemia, prediabetes/diabetes, alcohol consumption, and smoking.Results: During the 26 years of follow-up, 45 men (10.1%) and 76 women (5.6%) had stroke. The CI rate was 70.2% (n=85; 38 men, 47 women). The HS rate was 29.8% (n=36; 7 men and 29 women); of these patients, 26 and 10 had ICH and SAH, respectively. In men, orange intake showed a significant inverse correlation with CI. In women, fresh fish intake showed a significant inverse correlation with CI, while yogurt intake showed a significant inverse correlation with HS.Conclusion: Our results indicated that fresh fish intake was significantly associated with the prevention of CI among women in a Japanese cohort survey.

Background: This study aimed to demonstrate the effectiveness of a percutaneous method for treating intra-abdominal abscesses caused by gastrointestinal anastomotic leakage using tandem catheter placement for simultaneous drainage. Methods: This retrospective study involved 12 patients with intra-abdominal abscesses from anastomotic leakage who underwent image-guided percutaneous drainage. In the tandem drainage technique, one or more catheters were inserted into the abscess while an additional catheter was advanced into the gastrointestinal tract through the anastomotic dehiscence to decompress the tract and prevent further leakage. The study evaluated the technical and clinical success rates of this approach. Results: Technical success was achieved in nine of 12 patients (75.0%), with clinical success in eight of these nine patients (88.9%). The mean overall drainage duration after tandem placement was 65.0 days (range, 6–154 days), and the mean hospitalization duration for patients with clinical success was 66.7 days (range, 10–156 days). Conclusion Simultaneous tandem drainage is a feasible treatment for intra-abdominal abscesses caused by anastomotic leakage and may be a viable option for patients who are not candidates for surgery.

Background: This study aimed to demonstrate the effectiveness of a percutaneous method for treating intra-abdominal abscesses caused by gastrointestinal anastomotic leakage using tandem catheter placement for simultaneous drainage. Methods: This retrospective study involved 12 patients with intra-abdominal abscesses from anastomotic leakage who underwent image-guided percutaneous drainage. In the tandem drainage technique, one or more catheters were inserted into the abscess while an additional catheter was advanced into the gastrointestinal tract through the anastomotic dehiscence to decompress the tract and prevent further leakage. The study evaluated the technical and clinical success rates of this approach. Results: Technical success was achieved in nine of 12 patients (75.0%), with clinical success in eight of these nine patients (88.9%). The mean overall drainage duration after tandem placement was 65.0 days (range, 6–154 days), and the mean hospitalization duration for patients with clinical success was 66.7 days (range, 10–156 days). Conclusion Simultaneous tandem drainage is a feasible treatment for intra-abdominal abscesses caused by anastomotic leakage and may be a viable option for patients who are not candidates for surgery.

Objective: There is no consensus on whether platinum doublet chemotherapy or lenvatinib and pembrolizumab (LEN/PEM) is superior for advanced or recurrent endometrial cancer. Thus, this study aimed to compare the prognosis and adverse events in patients with advanced or recurrent endometrial cancer treated with platinum doublet chemotherapy or LEN/PEM. Methods: We retrospectively reviewed the medical records of patients who received platinum doublet chemotherapy or LEN/PEM at our institution for advanced or recurrent endometrial cancer and had a history of platinum-based chemotherapy between January 2013 and August 2023. Results: During the study period, 11 regimens were identified in the platinum doublet chemotherapy group, and 11 regimens were identified in the LEN/PEM group. The objective response rates of the platinum doublet chemotherapy and LEN/ PEM groups were 36.4% and 54.5% (P=0.67), respectively. The 6-month progression-free survival (PFS) rates of the platinum doublet chemotherapy and LEN/PEM groups were 27.3% (95% confidence interval [CI], 13.8%-40.7%) and 70.0% (95% CI, 55.5%-84.5%), respectively. The differences were significant between the two groups. Multivariate analyses of histology, prior lines of chemotherapy, platinum-free intervals, and regimens revealed that the LEN/PEM group had significantly better PFS rates. Conclusion Treatment with LEN/PEM resulted in significantly longer PFS than that of treatment with platinum doublet chemotherapy in patients with advanced and recurrent endometrial cancer. However, further large-scale studies are required to validate these findings.

Background/Aims: Asymptomatic esophageal eosinophilia (aEE) is considered to be a potential precursor of eosinophilic esophagitis (EoE). However, there are few clinical parameters that can be used to evaluate the disease. Therefore, we aimed to clarify the factors involved in the symptoms of EoE by examining the clinicopathological differences between aEE and EoE. Methods: We reviewed 41 patients with esophageal eosinophilia who underwent endoscopic ultrasonography and high-resolution manometry. They were divided into the aEE group (n=16) and the EoE group (n=25) using the Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease score. The patients’ clinicopathological findings were collected and examined. Results: The median Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease score was 3.0 in the aEE group and 10.0 in the EoE group. There was no significant difference in patient characteristics, endoscopic findings and pathological findings. The cutoff value for wall thickening was 3.13 mm for the total esophageal wall thickness and 2.30 mm for the thickness from the surface to the muscular layer (total esophageal wall thickness: 84.0% sensitivity, 75.0% specificity; thickness from the surface to the muscular layer: 84.0% sensitivity, 68.7% specificity).The high-resolution manometry study was abnormal in seven patients (43.8%) in the aEE group and in 12 (48.0%) in the EoE group. The contractile front velocity was slower in the EoE group (p=0.026). Conclusions The esophageal wall thickening in the lower portion of the esophagus is an important clinical factors related to the symptoms in patients with EoE.

A 47-year-old woman was incidentally found to have a thoracic aortic aneurysm by CT scan. There was an aneurysm in the ascending aorta and aortic arch, and the Valsalva sinus was enlarged. Echocardiography showed a severe aortic regurgitation. Valve-sparing aortic root replacement and total arch replacement was performed. The pathology of the ascending aorta was consistent with giant cell arteritis. Her postoperative course was straightforward, and she was discharged 23 days after surgery. In Japan, there are few reports of valve-sparing surgery for patients with giant cell aortitis, and we report our experience of a rare case.