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Recurrent aphthous stomatitis leads to ulcers that cause severe pain, which is a substantial burden on patients. Equisetum arvense extract (EA) is a crude drug that promotes wound healing of mucous membranes caused by perineal incision during childbirth and alleviates pain. Here, we elucidated the effects of EA on wound healing and pain in a stomatitis hamster model. After stomatitis induction, two different EA doses were continuously applied to the wound area through the intramucosal injection of acetic acid into the cheek pouch (stomatitis/100*EA group and stomatitis/EA group). The body weight and wound area were measured over time, and histological evaluation was performed after stomatitis induction. The wound area was harvested 10 h after stomatitis induction, and gene expression associated with pain and inflammation was analyzed using qPCR. The dorsal root ganglia of the rat spinal cord were isolated, dispersed, and cultured to examine the inhibitory effect of EA on the K+-evoked release of neurotransmitter substance P. In the stomatitis/100*EA group, a significant reduction in wound size was observed compared with the stomatitis/physiological saline (PS) group, and the weight gain rate was considerably higher. The stomatitis/EA group revealed similar histological changes in the wound and wound size as the stomatitis/PS group; however, the weight gain rate was considerably higher on day 7. The stomatitis/EA group suppressed the expression of inflammatory cytokine mRNA, such as Tnf-α and Il-6, and Cox-2 mRNA in the wound area compared with the stomatitis/PS group. EA treatment reduced the upregulated substance P release from the dorsal root ganglia following high-concentration K+ stimulation. EA alleviates pain in a stomatitis model by suppressing inflammatory cytokine expression in the wound area and substance P release from primary sensory neurons. Therefore, using oral care products containing EA is expected to suppress stomatitis pain., Competing Interests: F.S. and M.M. belonged to a collaborative research laboratory of Earth Corporation (https://corp.earth.jp/en/index.html) and Hiroshima University, which used joint research funds to conduct this study. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2024 Shiba et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The new sizing options of the MitraClip system (Abbott Vascular, Abbott Park, IL, USA) with extended clip arms were recently developed. Its applicability and effectiveness for ventricular functional mitral regurgitation (VFMR) are yet to be investigated., Methods: We retrospectively reviewed consecutive patients with symptomatic VFMR who underwent transcatheter edge-to-edge repair between 2018 and 2022 at the Sakakibara Heart Institute. Pre- and post-procedural mitral valve morphologies were assessed using three-dimensional transesophageal echocardiography., Results: In a total of 104 VFMR patients, the posterior mitral leaflet length was 12.8 ± 2.8 mm and 92 % was indicative of the extended arm (≥9 mm). Although baseline VFMR was more severe in the patients treated with the extended arms (n = 35, XT group) than the patients treated with the standard arms (n = 69, NT group), the decrease in VFMR was greater in the XT group (delta three-dimensional vena contracta area - 43 ± 33 mm 2 vs. -31 ± 22 mm 2 , p = 0.030) and residual VFMR was similar between the groups, with a significantly greater reduction in the mitral annulus anterior-posterior diameter (-4.9 ± 2.2 mm vs -3.1 ± 2.1 mm, p < 0.001) and mitral annulus area in the XT group. The use of extended arms was independently associated with shorter procedure time (81 ± 26 min vs 108 ± 41 min) after adjustment for device generation and the number of clips (p = 0.017)., Conclusions: Most VFMR patients had enough leaflet lengths for transcatheter edge-to-edge repair using the MitraClip with the extended arms, which was associated with shorter procedure time and a greater decrease in the mitral annular size., Competing Interests: Declaration of competing interest Drs Izumi, Saji, and Takamisawa are consultants of Abbott Medical Japan LLC and receive an honorarium. Dr. Kagiyama is affiliated with a department funded by Philips Japan, InterReha, Toho Holdings, and ASAHI Kasei, and receives research grants from EchoNous Inc. and AMI Inc. The other authors have nothing to declare., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Platypnea-orthodeoxia syndrome (POS) is a rare disease characterized by dyspnea and hypoxemia in orthostatism that improves in the recumbent position. We herein report an 81-year-old woman with dyspnea in the upright position following thoracic vertebral compression fractures. After the patient's daughter brought a recording showing decreasing SpO 2 (peripheral capillary oxygen saturation) in the upright position as measured by a portable pulse oximeter outside the hospital, a small atrial septal defect (ASD) was detected. A contrast echocardiogram and four-dimensional flow magnetic resonance imaging demonstrated a right-to-left shunt. The patient's symptoms dramatically improved after percutaneous ASD closure. In conclusion, such new technologies are useful for diagnosing POS.

Venous thromboembolism (VTE) is a common comorbidity of cancer, often referred to as cancer-associated thrombosis (CAT). Even though its prevalence has been increasing, its clinical picture has not been thoroughly investigated. In this single-center retrospective observational study, 259 patients who were treated for pulmonary embolism (PE) between January 2015 and December 2020 were available for analysis. The patients were divided by the presence or absence of concomitant malignancy, and those with malignancy (N = 120, 46%) were further classified into active (N = 40, 15%) and inactive groups according to the treatment status of malignancy. In patients with malignancy, PE was more often diagnosed incidentally by computed tomography or D-dimer testing, and the proportion of massive PE was lower. Although D-dimer levels overall decreased after the initiation of anticoagulation therapy, concomitant malignancy was independently associated with higher D-dimer at discharge despite the lower severity of PE at onset. The patients with malignancy had a poor prognosis during post-discharge follow-up. Active malignancy was independently associated with major adverse cardiovascular events (MACE) and major bleeding. D-dimer at discharge was an independent predictor of mortality even after adjustment for malignancy. This study's findings suggest that CAT-PE patients might have hypercoagulable states, which can potentially lead to a poorer prognosis.