Publications by authors named "Hirohito Minami"

Article Synopsis
  • Replacing a lumen-apposing metal stent (LAMS) with a double-pigtail plastic stent (DPS) is effective for preventing recurrence of walled-off necrosis, but traditional success rates are low; so a new technique was developed.
  • In the new method, a 7-F DPS is placed inside the LAMS to facilitate its removal while allowing granulation to occur, which stabilizes the DPS; out of 18 patients, 17 had successful replacements with no recurrences observed over 385 days.
  • Prior to this technique, replacing LAMS with DPS had a low success rate (61.8%), and recurrence of pancreatic fluid collection was noted in 15.3% of patients who could
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  • A 54-year-old woman experienced persistent fatigue and high fever, leading to the discovery of central pontine myelinolysis (CPM) on brain scans, even though she had no neurological symptoms.
  • Investigation revealed she had primary splenic diffuse large B-cell lymphoma (PS-DLBCL), with her low serum sodium being a contributing factor.
  • The CPM condition was treated successfully through splenectomy and immunochemotherapy, marking the first documented case of CPM linked to PS-DLBCL with pathology confirmation and improvements noted in brainstem auditory-evoked potentials.
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Crossover designation factors such as COSA-1 are concentrated at the specific DNA double-strand break (DSB) sites to promote crossover formation. mutants, which show defects in the homologous chromosome pairing of chromosomes II and III, increase the COSA-1 foci/normal bivalent state compared to the expected value. The excess designation was suppressed by an additional mutation in in mutants.

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  • * The procedure took an average of 27.3 minutes, with significant improvement in GOO symptoms over time, achieving an overall survival rate of about 194 days post-procedure.
  • * While EPASS had a 16.2% rate of mild adverse events, it maintained 100% stent patency, emphasizing its safety and reliability for managing malignant GOO cases.
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Introduction: In median arcuate ligament syndrome (MALS), the celiac artery is compressed, causing an arcade to develop in the pancreatic head, leading to ischemic symptoms and aneurysms.

Patient Concerns: The patient was diagnosed with borderline resectable pancreatic cancer (PC) and MALS. Endoscopic biliary drainage with a covered metal stent (CMS) was performed for the obstructive jaundice.

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Objectives: Endoscopic transpapillary gallbladder drainage (ETGBD) is a highly technical procedure, but few studies have evaluated factors that predict its technical success. Therefore, in this study, we sought to identify predictors of technically successful ETGBD.

Methods: One hundred and eighty-two patients who underwent ETGBD for acute cholecystitis at our hospital were retrospectively investigated.

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Article Synopsis
  • - Tonozuka and colleagues highlight a new ultra-thin peroral cholangioscope designed for challenging biliary stricture cases, featuring a tip diameter of just 2.3 mm.
  • - This innovative cholangioscope simplifies the insertion process compared to conventional scopes, easing accessibility for medical professionals.
  • - It's also cost-effective and versatile, making it a valuable tool in the field of biliary procedures.
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Transpapillary endoscopic biliary drainage is the gold standard for resolving malignant biliary obstruction. Stent migration occasionally occurs and is troublesome to retrieve. Yamamoto and colleagues report with accompanying video on the successful retrieval of a proximally migrated stent using biopsy forceps through a guiding sheath cannula.

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Article Synopsis
  • Afferent loop syndrome (ALS) is a rare complication after gastrointestinal surgery that requires prompt treatment, with various endoscopic interventions being explored for its management.
  • A study analyzed nine patients with malignant ALS who were treated using endoscopic methods like EMSP, EUS-EE, and EUS-HGS, focusing on success rates and patient outcomes.
  • Results indicated that all interventions were technically successful with no immediate adverse events, but stent dysfunction occurred in some cases, and most patients eventually died from their primary diseases.
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Background And Aims: Bilioenteric anastomotic stricture (BES) is a well-known adverse event after bilioenterostomy. Recently, EUS-guided antegrade intervention (EUS-AI) has been developed for cases that are difficult to treat by balloon enteroscopy-assisted ERCP. However, no data are available on the long-term outcomes after EUS-AI.

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  • This study investigates how different needle types and the angle of the echoendoscope affect the ease (puncturability) of inserting needles for diagnosing gastrointestinal lesions using EUS-guided techniques.
  • Researchers compared several 22-gauge fine-needle aspiration (FNA) and biopsy (FNB) needles to measure their resistance when being advanced through tissue.
  • Results showed that FNB needles had higher resistance compared to FNA needles, with SharkCore exhibiting the lowest resistance, making it the best option when a tight angle is needed during insertion.
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A 78-year-old man with prostate squamous cell carcinoma recurrence in his pelvis was admitted to our hospital. Rectal obstruction led to creation of an artificial anus on the transverse colon. Then, docetaxel and radiation therapies were started.

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PuraStat is a newly developed self-assembling hemostatic gel which is expected to be applied to bleeding from various lesions of the gastrointestinal tract. Yamamoto and colleagues describe the practical use of this hemostatic gel for delayed bleeding after endoscopic papillectomy, with accompanying video.

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  • - The traditional view of hematopoiesis as a stepwise process has shifted to a continuous one due to advancements in single-cell RNA sequencing, which revealed complexities in the differentiation process that weren’t previously acknowledged.
  • - This study focuses on the B-plasmacytoid dendritic cell (pDC) pathway, identifying significant fluctuations in transcriptome dynamics in the B/NK progenitor region using novel computational methods that model splicing kinetics.
  • - The findings illustrate that these fluctuations are critical for differentiation, demonstrating a model that reconciles continuous and discrete processes, with implications for understanding other developmental systems.
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Background/purpose: A peroral cholangioscope (POCS) can allow direct visualization of the biliary mucosa and its use is becoming more widespread due to improvements in functionality, image quality, and operability, as well as the development of related devices. Recently, a novel mother-baby peroral cholangioscope (nMB-POCS) with a large (2-mm) accessory channel has been developed. In this study, we evaluated the feasibility of this novel POCS in a dry simulation and animal model.

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High-intensity focused ultrasound (HIFU) is a novel advanced therapy for unresectable pancreatic cancer (PC). HIFU therapy with chemotherapy is being promoted as a novel method to control local advancement by tumor ablation. We evaluated the therapeutic effects of HIFU therapy in locally advanced and metastatic PC.

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We herein report two cases of hemorrhagic ampullary lesions in which endoscopic papillotomy was performed to control bleeding and resulted in successful treatment. Both patients were pathologically diagnosed with an underlying pathology characterized by inflammatory cell infiltration and capillary proliferation. They also had disposing factors for bleeding, such as antithrombotic therapy and idiopathic thrombocytopenic purpura.

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Highlight Tsuchiya and colleagues developed a scope holder to maintain good scope positioning during interventional endoscopic ultrasound. The scope holder not only reduces the burden on the endoscopist but also reduces the radiation exposure of the caregiver. This is the first report on a scope holder for flexible endoscopes.

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Pancreatic duct stenting is a well-established method for reducing post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. However, there is no consensus on the optimal type of plastic stent. This study aimed to evaluate the feasibility and safety of a new 4-Fr plastic stent for pancreatic duct stenting.

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Although Spy DS (SpyGlass DS Direct Visualization System) is considered to be useful for the diagnosis of bile duct strictures and the treatment of bile duct stones, there is limited data to date validating its efficacy. We hence retrospectively evaluated the clinical outcomes of the use of Spy DS in a large number of patients. A total of 183 patients who underwent Spy DS-guided procedures for indeterminate bile duct strictures ( = 93) and bile duct stones ( = 90) were analyzed retrospectively.

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Background And Objectives: EUS-guided biliary drainage (EUS-BD) has been reported as an effective alternative drainage technique. However, clinical data on EUS-BD for patients with acute cholangitis (AC) are limited. The aim of this study was to analyze the clinical outcomes of EUS-BD in patients with AC.

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Objective This study aims to elucidate the association between the clinical characteristics of post-colonoscopy colorectal cancer (PCCRC) and quality indicators (QIs) of colonoscopy. Methods Patients with PCCRC who underwent total colonoscopy (TCS) and were histologically diagnosed with adenocarcinoma within six months to five years of the last examination were included in this study. PCCRC and normally detected cancer (NDC) identified within the same period were compared in terms of their clinicopathological characteristics.

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