The safety and efficacy of through-and-through wire technique for ureteral Double-J stent placement.

Objective: To evaluate the efficacy and safety of the through-and-through wire (TTW) technique for antegrade ureteral Double-J stent placement after failure of either antegrade or retrograde ureteral stent placement. Method: This retrospective study analyzed the medical records of consecutive patients who underwent Double-J stent placement with the TTW technique at Asan Medical Center and Gil Medical Center between January 2016 and February 2023. Patient histories, reasons for employing the TTW technique, TTW pathways, and complications were reviewed. Eight patients were included in the study. The reasons for using the TTW technique were failure to advance a larger-diameter catheter, balloon catheter, or Double-J stent passing over the guidewire beyond the stricture (6/8, 75.0%); failure to negotiate the stricture with a guidewire (1/8, 12.5%); and guidewire passing through a ureteropelvic junction defect (1/8, 12.5%). Results: TTW was applied either between a percutaneous nephrostomy (PCN) and the urethral orifice (n=4), between a PCN and an ileostomy pouch (n=3), or between a left and right PCN (n = 1). Urologic assistance was required for retrograde ureteral cannulation in one male patient (12.5%). Subsequently, balloon dilation and/or Double-J stent placement were performed in all eight patients, resulting in 100% technical success. No major or minor complications occurred. Conclusions: The TTW technique was safe and effective in the undertaking of PCN and antegrade Double-J stent placement in patients for whom either antegrade or retrograde access had failed.

Percutaneous creation of new bilioenteric anastomosis in a patient with accidentally failed hepaticojejunostomy.

ABSTRACT: If the cause of the bile leakage after hepaticojejunostomy is accidental non-anastomosis of one bile duct, it is unlikely that the leakage will resolve spontaneously, and reoperation may be necessary. However, if the patient has contraindications to surgery, other treatments should be considered. In this case report, we describe a new percutaneous tract creation between the isolated right bile duct and Roux-en-Y afferent jejunal loop in a patient who underwent hepaticojejunostomy, and the right bile duct was accidentally not anastomosed with the jejunal loop.

Estimating postsurgical outcomes of patients with a single hepatocellular carcinoma using gadoxetic acid-enhanced MRI: risk scoring system development and validation.

OBJECTIVES: To develop and validate risk scoring systems using gadoxetic acid-enhanced liver MRI features and clinical factors that predict recurrence-free survival (RFS) of a single hepatocellular carcinoma (HCC). METHODS: Consecutive 295 patients with treatment-naïve single HCC who underwent curative surgery were retrospectively enrolled from two centers. Cox proportional hazard models developed risk scoring systems whose discriminatory powers were validated using external data and compared to the Barcelona Clinic Liver Cancer (BCLC) or American Joint Committee on Cancer (AJCC) staging systems using Harrell's C-index. RESULTS: Independent variables-tumor size (per cm; hazard ratio [HR], 1.07; 95% confidence interval [CI]: 1.02-1.13; p = 0.005), targetoid appearance (HR, 1.74; 95% CI: 1.07-2.83; p = 0.025), radiologic tumor in vein or tumor vascular invasion (HR, 2.59; 95% CI: 1.69-3.97; p < 0.001), the presence of a nonhypervascular hypointense nodule on the hepatobiliary phase (HR, 4.65; 95% CI: 3.03-7.14; p < 0.001), and pathologic macrovascular invasion (HR, 2.60; 95% CI: 1.51-4.48; p = 0.001)-with tumor markers (AFP ≥ 206 ng/mL or PIVKA-II ≥ 419 mAU/mL) derived pre- and postoperative risk scoring systems. The risk scores showed comparably good discriminatory powers in the validation set (C-index, 0.75-0.82) and outperformed the BCLC (C-index, 0.61) and AJCC staging systems (C-index, 0.58; ps < 0.05). The preoperative scoring system stratified the patients into low-, intermediate-, and high-risk for recurrence, whose 2-year recurrence rate was 3.3%, 31.8%, and 85.7%, respectively. CONCLUSION: The developed and validated pre- and postoperative risk scoring systems can estimate RFS after surgery for a single HCC. KEY POINTS: • The risk scoring systems predicted RFS better than the BCLC and AJCC staging systems (C-index, 0.75-0.82 vs. 0.58-0.61; ps < 0.05). • Five variables-tumor size, targetoid appearance, radiologic tumor in vein or vascular invasion, the presence of a nonhypervascular hypointense nodule on the hepatobiliary phase, and pathologic macrovascular invasion-combined with tumor markers derived risk scoring systems predicting postsurgical RFS for a single HCC. • In the risk scoring system using preoperatively-available factors, patients were classified into three distinct risk groups, with 2-year recurrence rates in the low-, intermediate-, and high-risk groups being 3.3%, 31.8%, and 85.7% in the validation set.

IL-17A promotes Helicobacter pylori-induced gastric carcinogenesis via interactions with IL-17RC.

BACKGROUND: Gastric cancer (GC) is a common malignancy worldwide, with a major attribution to Helicobacter pylori. Interleukin (IL)-17A has been reported to be up-regulated in serum and tumor of GC patients, but the precise mechanisms underlying its involvement in gastric tumorigenesis are yet to be established. Here, we investigated the roles of IL-17A in the pathogenesis of H. pylori-induced GC. METHODS: GC was induced in IL-17A knockout (KO) and wild-type (WT) mice via N-methyl-N-nitrosourea (MNU) treatment and H. pylori infection. At 50 weeks after treatment, gastric tissues were examined by histopathology, immunohistochemistry, and immunoblot analyses. In vitro experiments on the human GC cell lines were additionally performed to elucidate the underlying mechanisms. RESULTS: Deletion of IL-17A suppressed MNU and H. pylori-induced gastric tumor development accompanied by a decrease in gastric epithelial cell growth, oxidative stress, and expression of gastric epithelial stem cells markers. In AGS cells, recombinant human IL-17A (rhIL-17A) inhibited apoptosis and G1/S phase transition arrest while promoting reactive oxygen species production, sphere formation ability of cancer stem cells (CSC), and expression of stemness-related genes. In addition, rhIL-17A induced expression of IL-17RC, leading to NF-κB activation and increased NADPH oxidase 1 (NOX1) levels. Inhibition of NOX1 with GKT136901 attenuated rhIL-17A-mediated elevation of GC cell growth, ROS generation, and CSC stemness. Clinically, IL-17RC expressions were significantly upregulated in human GC compared with normal gastric tissues. CONCLUSION: Our results suggest that IL-17A promotes gastric carcinogenesis, in part, by regulating IL-17RC/NF-κB/NOX1 pathway, supporting its potential as a target in human GC therapy.

Diaphragmatic weakness after transcatheter arterial chemoembolization of the right inferior phrenic artery for treatment of hepatocellular carcinoma: a comparison of outcomes after N-butyl cyanoacrylate versus gelatin sponge embolization.

BACKGROUND: The inferior phrenic artery (IPA) is the most common extrahepatic feeder for hepatocellular carcinoma (HCC) during transhepatic arterial chemoembolization (TACE). PURPOSE: To compare the incidence of diaphragmatic weakness in patients with HCC after TACE of the right IPA conducted using either N-butyl cyanoacrylate (NBCA) or gelatin sponge particles. MATERIAL AND METHODS: Medical records of 111 patients who underwent TACE of the right IPA using NBCA were retrospectively reviewed and compared with data from 135 patients with IPA embolization using gelatin sponge particles. RESULTS: The incidence of diaphragmatic weakness after the initial TACE procedure did not significantly differ between the groups (NBCA group 16.2%; gelatin sponge group 20.7%; P = 0.458). Five patients in the NBCA group and 11 in the gelatin sponge group showed spontaneous resolution of diaphragmatic weakness after a mean period of 3.5 months. Diaphragmatic weakness developed after the initial follow-up visit in 17 patients from the gelatin sponge group due to repeated TACE of the right IPA (mean 2.4 sessions; range 2-4 sessions), while it spontaneously developed without additional TACE procedures in one patient from the NBCA group. Permanent diaphragmatic weakness was less common in the NBCA than in the gelatin sponge group (12.6% and 25.2%, respectively; P = 0.017). The complete response rate did not significantly differ between the groups (NBCA group 16.2%; gelatin sponge group 25.9%; P = 0.065). CONCLUSION: Use of NBCA rather than gelatin sponge particles for TACE of the right IPA resulted in a lower incidence of permanent diaphragmatic weakness.

Transcatheter arterial embolization for hemorrhage after gynecologic hysterectomy: a multicenter study.

BACKGROUND: Transcatheter arterial embolization (TAE) is not common for hemorrhagic complications after gynecologic hysterectomy. PURPOSE: To evaluate the effectiveness and safety of TAE for hemorrhage after hysterectomy for gynecologic diseases. MATERIAL AND METHODS: This is a retrospective, multicenter study, which investigated 11 patients (median age = 45 years) who underwent TAE for hemorrhage after gynecologic hysterectomy between 2004 and 2020. RESULTS: The median interval between surgery and angiography was one day (range = 0-82 days). Hemodynamic instability and massive transfusion were present in 6 (54.5%) and 4 (36.4%) patients, respectively. CT scans (n = 7) showed contrast extravasation (n = 5), pseudoaneurysm (n = 1), or both (n = 1). On angiography, the bleeding arteries were the anterior division branches of the internal iliac artery (IIA) (n = 6), posterior division branch (lateral sacral artery, n = 1), and inferior epigastric artery (n = 1) in eight patients with active bleeding. In the remaining three patients, angiographic staining without active bleeding foci was observed at the vaginal stump, and the feeders for staining were all anterior division branches of the IIA. Technical and clinical success rates were 100% and 90.9% (10/11), respectively. In one patient, active bleeding focus was successfully embolized on angiography, but surgical hemostasis was performed for suspected bleeding on exploratory laparotomy. Postembolization syndrome occurred in one patient. CONCLUSIONS: TAE is effective and safe for hemorrhage after hysterectomy for gynecologic diseases. Angiographic findings are primarily active bleeding, but angiographic staining is not uncommon. A bleeding focus is possible in any branch of the IIA, as well as the arteries supplying the abdominal wall.

Arterioureteral fistula: overview of clinical characteristics, endovascular management, and outcomes.

BACKGROUND: Arterioureteral fistula (AUF) is a condition resulting from the pathologic connection between the ureter and the artery. Despite the low incidence, it can lead to devastating clinical consequences due to massive hematuria with a considerable mortality rate. MATERIAL AND METHODS: From January 2009 to December 2018, eight patients with AUF from two tertiary referral centers were included. Clinical data including presenting symptoms, previous pelvic surgery or radiotherapy, indwelling ureteral stents, primary vascular pathology, angiographic findings, type of treatment, survival, and recurrence were analyzed. RESULTS: All eight patients (six women, mean age 62.4 ± 14.5 years) presented with macroscopic hematuria and were successfully treated by endovascular management. One patient developed AUF due to an underlying iliac artery aneurysm, and the rest were due to secondary causes. Six patients had a history of an indwelling ureteral stent for a median of 5.5 months (1-84 months). All of the patients were successfully treated by endovascular management. For the median follow up of 987 days, three patients had recurrence of hematuria in a mean of 6.3 months, two patients were treated by surgery, while one was treated by endovascular treatment. CONCLUSION: AUF should be confirmed through a purposeful iliac angiogram or ureterography when suspected based on a relevant history or CT findings. AUF can be successfully treated by endovascular management. The surgical option should be considered in cases of recurrence. ABBREVIATIONS: AUF: arterioureteral fistula; CIA: common iliac artery; DJ: double J; EIA: external iliac artery; IIA: internal iliac artery; NBCA: N-butyl cyanoacrylate; PCN: percutaneous nephrostomy.

Feasibility and outcomes of bronchial artery embolization in patients with non-massive hemoptysis.

PURPOSE: To evaluate the safety, efficacy, and long-term outcome of bronchial artery embolization (BAE) in the treatment of non-massive hemoptysis and the prognostic factors associated with recurrent bleeding. MATERIALS AND METHODS: From March 2005 to September 2014, BAE was performed in 233 patients with non-massive hemoptysis. All patients had a history of persistent or recurrent hemoptysis despite conservative medical treatment. We assessed the technical and clinical success, recurrence, prognostic factors related to recurrent bleeding, recurrence-free survival rate, additional treatment, and major complications in all the patients. RESULTS: Technical success was achieved in 224 patients (96.1%), and clinical success was obtained in 219 (94.0%) of the 233 patients. In addition, 64 patients (27.5%) presented hemoptysis recurrence with median time of 197 days after embolization. Tuberculosis sequelae and presence of aberrant bronchial artery or non-bronchial systemic collaterals were significantly related to recurrent bleeding (p < 0.05). The use of Histoacryl-based embolic materials significantly reduced the recurrent bleeding rate (p < 0.05). Patient who had a tuberculosis sequelae showed a significantly lower recurrence-free survival rate (p = 0.013). Presence of aberrant bronchial artery or non-bronchial systemic collaterals showed a statistically significant correlation with recurrence-free survival rate (p = 0.021). No patients had major complications during follow-up. CONCLUSIONS: BAE is a safe and effective treatment to manage non-massive hemoptysis. The procedure may offer a better long-term control of recurrent hemoptysis and quality of life than conservative therapy alone.

Interoperable Nanoparticle Sensor Capable of Strain and Vibration Measurement for Rotor Blade Monitoring.

Recent advances in nanomaterials technology create the new possibility to fabricate high performance sensors. However, there has been limitations in terms of multivariate measurable and interoperable sensors. In this study, we fabricated an interoperable silver nanoparticle sensor fabricated by an aerodynamically focused nanomaterial (AFN) printing system which is a direct printing technique for inorganic nanomaterials onto a flexible substrate. The printed sensor exhibited the maximum measurable frequency of 850 Hz, and a gauge factor of 290.62. Using a fabricated sensor, we evaluated the sensing performance and demonstrated the measurement independency of strain and vibration sensing. Furthermore, using the proposed signal separation algorithm based on the Kalman filter, strain and vibration were each measured in real time. Finally, we applied the printed sensor to quadrotor condition monitoring to predict the motion of a quadrotor.

Outcome of Rectal Arterial Embolization for Rectal Bleeding in 34 Patients: A Single-Center Retrospective Study over 20 Years.

PURPOSE: To report the efficacy of rectal artery embolization (RAE) for the treatment of rectal bleeding and the prognostic factors related to recurrent bleeding. MATERIALS AND METHODS: A total of 34 patients in a single center who underwent RAE for treatment of rectal bleeding between September 1998 and December 2018 were retrospectively reviewed. Procedure details including angiographic findings and embolic materials used, technical success rate, bleeding control rate during hospital stay, major adverse event rate, and prognostic factors associated with recurrent bleeding were evaluated. RESULTS: Technical success rate was 97.1% (33 of 34). Bleeding control during hospital stay was achieved in 64.7% of patients (n = 22). The most common bleeding focus was in the superior rectal artery. Recurrent bleeding occurred in 11 patients. Incomplete initial angiography with only an inferior mesenteric or internal iliac angiogram had been performed in 90.9% of patients with recurrent bleeding (10 of 11) and 52.2% of patients with bleeding control (12 of 23; P = .053). The use of N-butyl-2-cyanoacrylate was related to a significantly lower incidence of recurrent bleeding (P = .014), whereas coagulopathy (P = .001) and transfusion of > 10 U of packed red blood cells (PRBCs; P = .003) were related to higher recurrent bleeding rates. One patient had a puncture site-related complication, and no bowel infarction was noted during follow-up. CONCLUSIONS: RAE was feasible and safe. The use of N-butyl-2-cyanoacrylate, presence of coagulopathy, and transfusion of > 10 U of PRBCs were significant factors related to recurrent bleeding. Bilateral inferior mesenteric artery and internal iliac artery angiography is highly recommended in the initial RAE session to achieve a high rate of bleeding control.

Duplication of superficial femoral artery: imaging findings and literature review.

BACKGROUND: Duplication of the superficial femoral artery (SFA) is an extremely rare anatomic variation, with few case studies reported. We report one case of the duplicated SFA, discovered by both ultrasonography (US) and computed tomography angiography (CTA). We also reviewed literatures concerning 6 cases of the duplicated SFA (including our present case), and summarized the clinical and imaging features of the anatomic variation. CASE PRESENTATION: A 55-year-old woman presented to our hospital with an intermittent cramp in the lateral aspect of the right leg. The patient underwent Doppler US examination on bilateral lower extremity arteries and veins to examine potential vascular abnormality. Incidentally, US discovered the duplicated left SFA and CTA of bilateral lower extremities revealed the anatomic orientation, course, length, diameter and distance of the duplicated left SFA. It was revealed to be divided into two trunks with similar luminal diameter and courses parallel. They reunited at distal thigh level. The findings of US and CTA examination did not correspond with the symptom of the patient, and the patient was discharged. CONCLUSION: We report a rare case of the duplicated SFA diagnosed with the combinations of US and CTA examination, which served as valuable imaging methods to detect and diagnose the vascular anatomic variation in lower extremities.

Design and synthesis of amorphous SiOx structures generated by Sn quantum dots: growth mechanism and luminescent origin.

SiOx structures with different diameters of a few hundreds of nanometers and/or a few micrometers are prepared using applied thermal evaporation. Subsequently, Sn quantum dot-based SiOx architectures are synthesized via the continuous steps of the carbothermal reduction of SnO2, substitution of Sn(4+) for In(3+), thermal oxidation of Si, Sn sublimation, interfacial reaction, and diffusion reaction consistent with corresponding phase equilibriums. Several crystalline and spherical-shaped Sn quantum dots with diameters between 2 and 7 nm are observed in the amorphous SiOx structures. The morphological evolution, including hollow Sn (or SnOx) sphere and wire-like, worm-like, tube-like, and flower-like SiOx, occurs stepwise on the Si substrate upon increasing the given process energies. The optical characteristics based on confocal measurements reveal the as-synthesized SiOx structures, irrespective of whether crystallinity is formed, which all have visible-range emissions originating from the numerous different-sized and -shaped Sn quantum dots permeating into the SiOx matrix. In addition, photoluminescence emissions ranging between ultraviolet and red regions are in agreement with confocal measurements. The origins of the morphology- and luminescence-controlled amorphous SiOx with Sn quantum dots are also discussed.

The radio-sensitizing effect of xanthohumol is mediated by STAT3 and EGFR suppression in doxorubicin-resistant MCF-7 human breast cancer cells.

BACKGROUND: Chemotherapeutic drug resistance remains a clinical obstacle in cancer management. Drug-resistant cancer cells usually exhibit cross-resistance to ionizing radiation, which has devastating consequences for patients. With a better understanding of the molecular mechanisms, it will be possible to develop strategies to overcome this cross-resistance and to increase therapeutic sensitivity. METHODS: Natural and synthetic flavonoid compounds including xanthohumol, the principal flavonoid in hops, were investigated for its radio-sensitizing activity on human breast cancer MCF-7 and adriamycin-resistant MCF-7 (MCF-7/ADR) cells. Chemo-sensitizing or radio-sensitizing effect was analyzed by tetrazolium-based colorimetric assay and flow cytometry. Western blot analysis, confocal microscopy, gene silencing with siRNA transfection and luciferase reporter gene assay were performed to examine signaling molecule activation. RESULTS: Among the tested flavonoid compounds, pretreatment of the cells with xanthohumol significantly sensitized MCF-7/ADR cells to the radiation treatment by inducing apoptosis. In MCF-7/ADR cells, treatment with xanthohumol alone or with gamma-rays significantly decreased levels of anti-apoptotic proteins. Multi-drug resistance 1 (MDR1), epidermal growth factor receptor (EGFR) and signal transducer and activator of transcription 3 (STAT3) expression levels in MCF-7/ADR cells were suppressed by xanthohumol treatment. In addition, xanthohumol treatment increased death receptor (DR)-4 and DR5 expression. The xanthohumol-induced changes of these resistance-related molecules in MCF-7/ADR cells were synergistically increased by gamma-ray treatment. CONCLUSIONS: Xanthohumol restored sensitivity of MCF-7/ADR cells to doxorubicin and radiation therapies. GENERAL SIGNIFICANCE: Our results suggest that xanthohumol may be a potent chemo- and radio-sensitizer, and its actions are mediated through STAT3 and EGFR inhibition.

Effects of functionalization of TiO2 nanotube array sensors with Pd nanoparticles on their selectivity.

This study compared the responses of Pd-functionalized and pristine titanate (TiO2) nanotube arrays to ethanol with those to acetone to determine the effects of functionalization of TiO2 nanotubes with Pd nanoparticles on the sensitivity and selectivity. The responses of pristine and Pd-functionalized TiO2 nanotube arrays to ethanol gas at 200 °C were ~2877% and ~21,253%, respectively. On the other hand, the responses of pristine and Pd-functionalized TiO2 nanotube arrays to acetone gas at 250 °C were ~1636% and 8746% respectively. In the case of ethanol sensing, the response and recovery times of Pd-functionalized TiO2 nanotubes (10.2 and 7.1 s) were obviously shorter than those of pristine TiO2 nanotubes (14.3 and 8.8 s), respectively. In contrast, in the case of acetone sensing the response and recovery times of Pd-functionalized TiO2 nanotubes (42.5 and 19.7 s) were almost the same as those of pristine TiO2 nanotubes (47.2 and 17.9 s). TiO2 nanotube arrays showed the strongest response to ethanol and Pd functionalization was the most effective in improving the response of TiO2 nanotubes to ethanol among six different types of gases: ethanol, acetone, CO, H2, NH3 and NO2. The origin of the superior sensing properties of Pd-functionalized TiO2 nanotubes toward ethanol to acetone is also discussed.

Production of recalcitrant organic matter under the influence of elevated carbon dioxide and temperature.

The effects of elevated CO2 and temperature on the quantity and quality of dissolved organic carbon (DOC) of wetland sediments were investigated by measuring organic matter decomposition rates and phenolic compounds as target recalcitrant organic matter. Mean rates of anaerobic microbial metabolism were consistently higher both in vegetated sediments and in elevated CO2 and temperature, although the differences were not statistically significant (P < 0.05). Concentrations of phenolic compounds in sediments with vegetation are significantly different (P < 0.05) from those in sediments without vegetation. Regarding the biodegradability of the phenolic compounds, vegetated sediments showed higher concentrations of 2-chlorophenol and 2,4-dimethylphenol under elevated CO2 and temperature conditions, which means that more refractory material can be produced through enhanced organic matter degradation by elevated CO2 and temperature. The produced phenolic compounds can be transported to the freshwater ecosystem and influence the recalcitrance of DOC.

Multi-approach assessment of groundwater biogeochemistry: Implications for the site characterization of prospective spent nuclear fuel repository sites.

The disposal of spent nuclear fuel in deep subsurface repositories using multi-barrier systems is considered to be the most promising method for preventing radionuclide leakage. However, the stability of the barriers can be affected by the activities of diverse microbes in subsurface environments. Therefore, this study investigated groundwater geochemistry and microbial populations, activities, and community structures at three potential spent nuclear fuel repository construction sites. The microbial analysis involved a multi-approach including both culture-dependent, culture-independent, and sequence-based methods for a comprehensive understanding of groundwater biogeochemistry. The results from all three sites showed that geochemical properties were closely related to microbial population and activities. Total number of cells estimates were strongly correlated to high dissolved organic carbon; while the ratio of adenosine-triphosphate:total number of cells indicated substantial activities of sulfate reducing bacteria. The 16S rRNA gene sequencing revealed that the microbial communities differed across the three sites, with each featuring microbes performing distinctive functions. In addition, our multi-approach provided some intriguing findings: a site with a low relative abundance of sulfate reducing bacteria based on the 16S rRNA gene sequencing showed high populations during most probable number incubation, implying that despite their low abundance, sulfate reducing bacteria still played an important role in sulfate reduction within the groundwater. Moreover, a redundancy analysis indicated a significant correlation between uranium concentrations and microbial community compositions, which suggests a potential impact of uranium on microbial community. These findings together highlight the importance of multi-methodological assessments in better characterizing groundwater biogeochemical properties for the selection of potential spent nuclear fuel disposal sites.

Endovascular Treatment of Iatrogenic Iliac Vein Rupture during Total Hip Arthroplasty: A Case Report.

We present a case of iatrogenic iliac vein rupture with venous thrombosis during total hip arthroplasty that was endovascularly treated with the insertion of covered and uncovered stents, aspiration, and balloon maceration of the thrombus. We describe in detail, with a schematic diagram, an endovascular treatment method that can be performed under local anesthesia alone and explain how to overcome the situation when the diameter of the covered stent is inadequate to cover the iliac vein.

Thyroid Artery Embolization for Tracheostomy Site Bleeding: A Report of Three Cases.

In this case report, the authors present three cases of post-tracheostomy site bleeding successfully treated using embolization, supplemented by CT and angiography images. This report highlights that embolization can be a viable alternative when surgical or endoscopic interventions fail or are not applicable in cases of post-tracheostomy bleeding.

Renal abscess in a Lionhead rabbit due to Encephalitozoon cuniculi and Escherichia coli: A case report.

Background: In rabbits, renal abscesses (pus-filled sores) are rare and diagnosis remains challenging. Therefore, in this study, we aimed to determine the clinical manifestation and diagnostic tests associated with renal abscess identification in rabbits. Case Description: A four-and-a-half-year-old castrated male Lionhead rabbit with a history of poor appetite and abdominal distension was admitted to the animal hospital. Blood analysis, radiography, ultrasonography, and computed tomography scans revealed a kidney abscess found within the renal parenchyma, with severe loss of the cortex and medulla, extending toward the capsule. Consequently, the rabbit underwent nephrectomy. The enlarged right kidney was surgically removed. Histopathological examination of the affected kidney showed severe necrosis and ischemic zones, atrophy of the renal tubules, and prominent heterophils with mixed inflammatory cell infiltrates. Immunohistochemistry and polymerase chain reaction confirmed Encephalitozoon cuniculi and Escherichia coli infections, respectively. Conclusion: This report provides novel insights into the diagnosis of renal abscesses in Lionhead rabbits.

Radiologic Insertion of a Covered Esophageal Stent Using the Rendezvous Technique: A Case Report.

In this report, we present a case of a radiotherapy-induced tracheoesophageal fistula treated with the fluoroscopy-guided insertion of a covered stent through the gastrostomy route using both the antegrade and retrograde approaches. The initial antegrade endoscopic and fluoroscopic stent insertion procedure failed due to severe esophageal stricture. Compared to the endoscopic approaches, fluoroscopy-guided radiologic procedures are generally less invasive and more successful because they allow for a better understanding of the anatomy outside the lumen during the procedure and enable the use of devices with smaller diameters.