This study was performed to investigate the preliminary outcomes and complications of patients with glaucoma who underwent cataract surgery with iStent inject^® W implantation. The study involved 32 eyes of 27 patients (mean age, 69.2 ± 10.0 years) who underwent cataract surgery with an iStent inject^® W from November 2020 to June 2021 at Kyorin University Hospital and were followed up for at least 3 months. Intraocular pressure (IOP), mean number of medications, and postoperative complications were retrospectively reviewed from the medical records. The mean number of medications was represented by a score of 1 point for a single eye drop for glaucoma and 2 points for a combination drug. Thirty-one eyes had primary open-angle glaucoma and one had exfoliation glaucoma. The preoperative and 1-month postoperative IOP was 17.1 ± 3.0 and 16.4 ± 2.6 mmHg, respectively, with no significant difference (p = 0.6183). Three months postoperatively, however, the IOP significantly decreased to 14.7 ± 2.4 mmHg (p = 0.0020). The mean number of medications preoperatively and 1 and 3 months postoperatively was 3.4 ± 1.1, 1.8 ± 1.0, and 2.1 ± 1.2, respectively, showing a significant decrease after 1 and 3 months (p < 0.0001 for both). Postoperative complications included stent occlusion by the iris in two eyes, anterior chamber hemorrhage in one eye, and temporary IOP elevation in two eyes. Temporary IOP elevation and anterior chamber hemorrhage resolved within approximately one week of postoperative follow-up. Cataract surgery with the iStent inject^® W showed no serious intraoperative or postoperative complications. It is useful for lowering the IOP and reducing the number of medications in patients with glaucoma.

Reading fatigue in radiologists while assessing diagnostic images reduces their performance and increases errors in image interpretation. Such errors impact patient morbidity and mortality rates as diagnostic imaging plays a crucial role in patient management. We conducted functional magnetic resonance imaging (fMRI) scans of experienced and less-experienced radiologists reading images, both before and after fatigue induction, and assessed their brain activity in both states. Computed tomography (CT) images were presented to seven experienced and six less-experienced radiologists. Pre-fatigue, the radiologists underwent fMRI while reading head CT images; subsequently, they interpreted different CT images for 1 hour outside the MRI suite. Then, in the fatigued state, all 13 radiologists underwent fMRI scanning again while reading a different set of images. During the pre-fatigue reading of head CT images, the bilateral lingual gyri and posterior lobes of the cerebellum were activated in the experienced radiologists but not significantly activated in the less-experienced radiologists. No region was significantly activated in either group of fatigued radiologists. We concluded that the bilateral lingual gyri and posterior lobes of the cerebellum have important roles in image-reading tasks, suggesting the possibility of identifying brain regions involved in specific professional skills. The results indicated that fatigue resulted in reduced brain activation, underscoring the serious effect of excessive work on the brain activation of diagnostic radiologists.

Background: Postoperative atrial fibrillation (AF) is a common complication of cardiac surgery that has negative implications on patient outcomes. This study aimed to evaluate the effect of abdominal aortic calcification, measured using the Agatston Score, on patients undergoing aortic valve replacement for aortic valve stenosis. Methods and Results: This study included 183 patients who underwent aortic valve replacement. Preoperative characteristics and Agatston scores for abdominal aortic calcification were compared between patients with (n = 108) and without (n = 75) postoperative atrial fibrillation. Multivariate analysis showed that a high Agatston Score (derived by a cutoff point of 2767.65; odds ratio, 2.314; 95% confidence intervals (CI) , 1.063–5.041; P = 0.035), left atrial volumes (LAV) (derived by a cutoff point of 69.95; odds ratio, 3.176; 95% CI, 1.459–6.914; P = 0.004), and age (derived by a cutoff point of 75.5 years old, odds ratio, 3.465; 95% CI, 1.588–7.557; P = 0.003) were significant predictors of postoperative atrial fibrillation in the second week after surgery. Conclusions: Age and left atrial volume could be independent predictors of postoperative atrial fibrillation in patients with aortic valve stenosis, while the severity of abdominal aortic calcification, as measured using the Agatston Score, independently predicted postoperative atrial fibrillation during the second week following aortic valve stenosis. Patients with an Agatston Score exceeding 2767.65 should be considered at high risk and should receive appropriate management to improve outcomes.

Vascular resection including portal vein resection and/or hepatic artery resection has rarely been reported in distal cholangiocarcinoma. This review aimed to elucidate the safety and oncological outcomes of surgery with vascular resection in patients with distal cholangiocarcinoma. The following data were extracted from the identified studies: type of vascular resection, surgical outcome, pathological findings, recurrence-free survival (RFS), and overall survival (OS). Six studies were identified, and patients were classified into the vascular resection (VR) group and non-VR group according to the presence or absence of vascular resection in each study. The vascular resection ratios ranged from 6.8% to 20.0% in the surgical cases. The most frequent tumor location in the VR group was the extrapancreatic common bile duct and the most frequent sites of vascular resection were portal vein and right hepatic artery. The ratios of T3 or T4 tumor were significantly higher in the VR group. The ratios of severe complications and postoperative mortality were not significantly different between the VR and non-VR groups. The median RFS time and OS time in the VR group were shorter than 1 year and 2 years, respectively, in all studies. In conclusion, the patients with distal cholangiocarcinoma in the VR group tended to show early recurrence and shorter survival, although vascular resection could be performed safely.