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Is YouTube an adequate patient useful resource about orthodontic maintenance? The cross-sectional investigation of content material and also quality.
A 38-year-old man visited our hospital with a complaint of diarrhea and abdominal pain. Contrast-enhanced computed tomography showed that the ileocecal site was intussuscepted to the transverse colon without ischemia. After we reduced intussusception with an enema using a water-soluble contrast agent, his abdominal pain disappeared. Colonoscopy was performed immediately after reduction and showed erosion and edema at the ileocecal site without tumor. The stool culture at admission revealed verotoxin 1 producing Escherichia coli O-26;therefore, we established a diagnosis of intussusception associated with Escherichia coli enterocolitis. Bacterial enteritis should be considered as a potential cause in adult patients with intussusception.In a 67-year-old man, colonoscopy confirmed the presence of a 5-6mm submucosal tumor in the upper rectum (Ra);the tumor showed a tendency to grow with the size appearing to be 9-10mm at re-examination that was performed 1 year thereafter. No findings on computed tomography indicated metastasis. A neuroendocrine tumor (NET) was suspected, and endoscopic submucosal dissection was performed. The patient was pathologically diagnosed with coexistence of NETG1 and a well-differentiated adenocarcinoma. Few reports have described the coexistence of relatively low-grade NETG1 and an adenocarcinoma in the Ra, and such an occurrence is considered rare. The patient has shown no recurrence at 3 years and 2 months postoperatively.A 17-year-old young man visited our hospital because of severe upper abdominal pain and was diagnosed with acute peritonitis caused by gastrointestinal perforation. Emergent surgical treatment was performed, and the perforated lesion of the stomach was repaired. He recovered and was discharged without any complication at 14 days postoperatively. However, he had intermittent fever 2 days after discharge and visited our hospital again. He was diagnosed with infectious mononucleosis (IM), derived from Epstein-Barr virus (EBV) initial infection, on biochemical examination that was positive for anti-EBV VCA-IgG and negative for EBV nuclear antigen, although he was ameliorated conservatively. This pathophysiology raised a possibility that EBV infection had induced acute gastritis or gastric ulcer leading to the penetration of the stomach. Six weeks postoperatively, esophagogastroduodenoscopy showed a gastric ulcer in the vestibular part of the stomach. Pathologic examination of the stomach revealed mucosal erosion with B-cell infiltration into the lamina propria;however, Epstein-Barr viral infection was unclear by EBV-encoded small RNA in situ hybridization. Here, we report a rare case of gastric perforation that occurred during the incubation period of IM with a review of the relevant literature.We determined whether PODXL and SCGB1D2 expressions in whole blood could be useful as diagnostic biomarkers to determine the presence of intraductal papillary mucinous neoplasm (IPMN), as compared to serum CA19-9. A discovery-stage clinical study was performed on 12 patients with IPMN, including 6 intraductal papillary mucinous adenoma (IPMA) patients and 6 intraductal papillary mucinous carcinoma (IPMC) patients who had undergone treatment at the Department of Surgery at Kochi Health Sciences Center and the Department of Gastroenterology and Hepatology at Kochi Medical School Hospital from April 2015 to January 2016;13 controls who did not have pancreatic disease were also enrolled. Serum PODXL and SCGB1D2 levels were measured using ELISA. We found that the area under the receiver-operating characteristic curve (AUC) for IPMN (IPMA+IPMC) diagnosis in IPMN patients and control individuals was 0.89 (95% CI0.76-1) for PODXL, 0.50 (95% CI0.25-0.74) for SCGB1D2, and 0.81 (95% CI0.62-1) for CA19-9. Multivariable logistic regression analysis showed that PODXL was independently able to distinguish IPMN patients from controls. PODXL may be a novel, non-invasive diagnostic biomarker for the detection of IPMN. learn more The AUC for distinguishing IPMC patients from IPMA patients was 0.78 (95% CI0.47-1) for PODXL, 0.83 (95% CI0.58-1) for SCGB1D2, and 0.58 (95% CI0.22-0.95) for CA19-9. Although it was quantitatively demonstrated that the detection of PODXL and SCGB1D2 in the serum may provide a novel, non-invasive approach for distinguishing IPMC patients from IPMA patients, the present findings are preliminary until more elaborate studies are able to clarify whether PODXL and SCGB1D2 are useful as diagnostic markers for IPMC detection.
Catheter ablation (CA) is effective for recurrent episodes of ventricular fibrillation (VF) in Brugada syndrome (BrS). VF development in BrS is associated with several electrocardiogram (ECG) abnormalities. This study investigated changes in ECG parameters in high-risk BrS patients who underwent epicardial CA.Methods and ResultsIn all, 27 BrS patients were implanted with an implantable cardioverter-defibrillator (ICD). Patients were divided into 2 groups (1) an ablation group (n=11) that underwent epicardial CA because of VF recurrence; and (2) a primary prevention (PP) group (n=16) with ICD implantation only. ECG parameters were evaluated before and 12 months after CA and compared with ECG parameters in the PP group. The T wave peak-to-end interval was significantly longer and the number of abnormal spikes in leads V1-V3 at the second, third, and fourth intercostal spaces was greater in the ablation than PP group. After ablation, ST levels and the sum of abnormal spikes in leads V1-V3 were significantly decreased. The mean (±SD) number of ICD shocks decreased markedly during a mean follow-up period of 42.0 months (from 3.8±3.7 to 0.2±0.4/year). Four patients had an ICD shock following the ablation procedure. Greater reductions in ST-segment elevation and abnormal spikes were observed in the group without than with VF recurrence.

Improvements in surface ECG parameters appear to be associated with successful ablation in high-risk BrS patients.
Improvements in surface ECG parameters appear to be associated with successful ablation in high-risk BrS patients.
Because anticoagulant drugs for ambulatory patients with cancer-associated venous thromboembolism (CAT) are limited to warfarin and direct oral anticoagulants (DOACs) in Japan, it is important to assess the outcomes of both drugs.Methods and ResultsWe retrospectively assessed the outcomes of CAT patients who were treated with warfarin or edoxaban between 2011 and 2017. The assessment was limited to the duration of anticoagulant administration. CAT patients who did not receive anticoagulation therapy were also compared with the warfarin and edoxaban groups. We enrolled 111 CAT patients treated with warfarin (n=58, mean age 62.6 years, mean time in therapeutic range [TTR] % 61.1) or edoxaban (n=53, mean age 64.6 years). Although venous thromboembolism (VTE) recurred in 2 warfarin-treated patients, the 2 treatment groups were not significantly different (P=0.18). Bleeding during anticoagulation therapy occurred in 6 warfarin-treated patients (2 with major bleeding) and in 5 edoxaban-treated patients (no major bleeding) (P=1.
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