Innovative use of a 3-Fr microcatheter for precision guidewire placement with digital single-operator cholangioscopy for pancreaticobiliary drainage (with video).

Biliary and pancreatic tract stenosis are hallmark symptoms in pancreaticobiliary diseases, transcending malignancy. Endoscopic techniques are pivotal for biliary/pancreatic drainage; however, challenging scenarios arise when attempting to pass a guidewire (GW) through obstruction. Cholangioscopy-assisted GW placement has proven valuable, but challenges persist in its execution, particularly in maneuvering the GW through cholangioscopy.

Correction: Feasibility of newly designed rotatable sphincterotome for endoscopic sphincterotomy (with video).

[This corrects the article DOI: 10.1055/a-2422-2425.].

Feasibility of newly designed rotatable sphincterotome for endoscopic sphincterotomy (with video).

Endoscopic sphincterotomy can be challenging especially in patients with surgically altered anatomy. Although a rotatable sphincterotome (r-sphincterotome) may be useful, its rotational function is often inadequate. We evaluated the feasibility of a newly designed r-sphincterotome equipped with a well-conceived cutting wire.

Fast computational approach with prior dimension reduction for three-dimensional chemical component analysis using CT data of spectral imaging.

Spectral image (SI) measurement techniques, such as X-ray absorption fine structure (XAFS) imaging and scanning transmission electron microscopy (STEM) with energy-dispersive X-ray spectroscopy (EDS) or electron energy loss spectroscopy (EELS), are useful for identifying chemical structures in composite materials. Machine-learning techniques have been developed for automatic analysis of SI data and their usefulness has been proven. Recently, an extended measurement technique combining SI with a computed tomography (CT) technique (CT-SI), such as CT-XAFS and STEM-EDS/EELS tomography, was developed to identify the three-dimensional (3D) structures of chemical components.

Prognostic Nutritional Index after Introduction of Atezolizumab with Bevacizumab Predicts Prognosis in Advanced Hepatocellular Carcinoma: A Multicenter Study.

Introduction: Atezolizumab plus bevacizumab (Atez/Bev) is the preferred treatment for advanced hepatocellular carcinoma (HCC). However, biomarkers of therapeutic efficacy have remained unclear. We took a retrospective approach to explore the role of prognostic nutritional index (PNI) for predicting the outcomes of Atez/Bev treatment.

Serum CXCL10 levels at the start of the second course of atezolizumab plus bevacizumab therapy predict therapeutic efficacy in patients with advanced BCLC stage C hepatocellular carcinoma: A multicenter analysis.

Background & Aims: Relationships of serum C-C motif chemokine ligand 5 (CCL5) and C-X-C motif chemokine ligand 10 (CXCL10) levels with hot immune features have been reported in patients with hepatocellular carcinoma (HCC). Therefore, we examined the utility of their levels for predicting the efficacy of atezolizumab plus bevacizumab (Atez/Bev) in patients with HCC.

Design: In total, 98 patients with HCC treated with Atez/Bev were enrolled, and their initial responses were evaluated at least once via dynamic computed tomography or magnetic resonance imaging.

The novel technique of drainage stenting using a tapered sheath dilator in endoscopic ultrasound-guided biliary drainage.

During endoscopic ultrasound-guided biliary drainage (EUS-BD), there is a risk for bile leakage until stent deployment, which can result in severe peritonitis, particularly when passing a drainage stent becomes challenging despite tract dilation. There is no established method or dedicated device to optimize EUS-BD. Therefore, we have developed a novel stent deployment technique using the tapered sheath dilator.

Kinetics of HBcrAg and HBsAg using highly sensitive iTACT assays in chronic hepatitis B patients with HBsAg seroclearance.

Two novel assays have been developed, iTACT-hepatitis B core-related antigen (iTACT-HBcrAg) and iTACT-hepatitis B surface antigen (iTACT-HBsAg) assays. We investigated the longitudinal profiles of iTACT-HBcrAg- and -HBsAg in patients with HBsAg seroclearance (SC) (<0.05 IU/mL).

Serum inducible protein 10 kDa/C-X-C motif chemokine 10 levels predict regression of M2BPGi-based liver fibrosis after hepatitis C virus eradication by direct-acting antiviral agents.

Aim: It is desirable to identify predictors of regression of liver fibrosis after achieving sustained virological response by anti-hepatitis C virus (anti-HCV) therapy. We retrospectively investigated the serum interferon-γ inducible protein 10 kDa (IP-10) level as a predictive indicator of regression of liver fibrosis after successful hepatitis C virus eradication by direct-acting antiviral agents (DAAs) therapy.

Methods: The study participants were recruited from a historical cohort of 116 chronically hepatitis C virus-infected patients who had achieved sustained virological response by DAAs therapy and whose serum Mac-2 binding protein glycosylation isomer (M2BPGi) levels at baseline (before DAAs therapy) were ≥2.

Adult-onset Type II Citrullinemia Developed under Dietary Restrictions during Imprisonment.

A 29-year-old man presented with liver damage, and a liver biopsy was performed, but the cause was unclear. Thereafter, he was referred to our hospital. We found that he had been unable to consume carbohydrates in his diet and preferred fried chicken since childhood.

Magnetic resonance imaging of endolymphatic hydrops: a comparison of methods with and without gadolinium-based contrast agent administration.

In the evaluation of endolymphatic hydrops (EH) using magnetic resonance (MR) imaging, hybrid of reversed image of positive endolymph signal and native image of perilymph signal multiplied with heavily T2-weighted MR cisternography (HYDROPS-Mi2) imaging with the intravenous administration of a gadolinium-based contrast agent (IV-GBCA) has been utilized. Recently, MR cisternography (MRC) without GBCA has been proposed as a potential alternative method. However, the feasibility of EH evaluation by MRC without GBCA has not been established.

Theoretical step approach with 'Three-pillar' device assistance for successful endoscopic transpapillary gallbladder drainage.

Background: Endoscopic transpapillary gallbladder drainage (ETGBD) has been reported as an alternative procedure for acute cholecystitis but remains a challenging procedure.

Aims: To elucidate the efficacy of a strategic approach for ETGBD that utilizes a four-step classification system and the optional use of 'Three-pillar' assistance with the following devices: cholangioscopy (SpyGlass DS, SG), a flex-type guidewire (Flex-GW), and a 3-Fr microcatheter (3-Fr Micro).

Methods: A total of 115 patients undergoing ETGBD were studied retrospectively.

The neutrophil-to-lymphocyte ratio at the start of the second course during atezolizumab plus bevacizumab therapy predicts therapeutic efficacy in patients with advanced hepatocellular carcinoma: A multicenter analysis.

Aim: Atezolizumab plus bevacizumab (Atez/Bev) therapy is expected to have good therapeutic efficacy for patients with advanced hepatocellular carcinoma (HCC). However, the clinical indicators that predict therapeutic efficacy have not been established. We retrospectively investigated whether the neutrophil-to-lymphocyte ratio (NLR) during Atez/Bev therapy could predict therapeutic efficacy.

Finger Tapping Test for Assessing the Risk of Mild Cognitive Impairment.

Aim: A testing method for early diagnosis of Mild cognitive dementia (MCI) that can be easily applied in clinical practice was investigated in this study. We examined whether MCI risk can be determined through finger movements.

Methods: Between 2013 and 2020, 1097 individuals were screened.

Relationship between finger movement characteristics and brain voxel-based morphometry.

Background: Aging is the most significant risk factor for dementia. Alzheimer's disease (AD) accounts for approximately 60-80% of all dementia cases in older adults. This study aimed to examine the relationship between finger movements and brain volume in AD patients using a voxel-based reginal analysis system for Alzheimer's disease (VSRAD) software.

Clinical impact of bile-derived exosomal microRNAs as novel diagnostic and prognostic biomarkers for biliary tract cancers.

Sampling of bile juice during endoscopic retrograde cholangiopancreatography (ERCP) has potential benefit of being amenable to the identification of novel biomarkers in liquid biopsy. This study reports the results of a global investigation of exosomal microRNAs (miRNAs) in bile to identify potential biomarkers for biliary tract cancers (BTCs). Eighty-eight bile samples collected during ERCP (45 BTC and 43 noncancer control samples) were enrolled in this study.

Use of Endoscopic Scraper and Cell Block Technique as a Replacement for Conventional Brush for Diagnosing Malignant Biliary Strictures.

Histological evidence is essential for diagnosing malignant biliary strictures. However, conventional brush cytology remains the primary method used worldwide, despite its low diagnostic sensitivity and accuracy, as it is technically easy, rapid, and cost-effective. The aim of this study was to evaluate the diagnostic performance of a recently introduced endoscopic scraper, the simplicity of which is comparable to that of a conventional brush, by comparing diagnostic yields and the number of collected cells.

Impact of Cafeteria Service Discontinuation at a Dialysis Facility on Medium-Term Nutritional Status of Elderly Patients Undergoing Hemodialysis.

Despite evident lifestyle changes due to measures against the coronavirus disease 2019 (COVID-19) outbreak, few reports focus on the effects of eating-behavior changes on the nutritional status of elderly patients undergoing hemodialysis (HD). Thus, we examined dry-weight reduction, the simplest indicator of malnutrition among patients undergoing dialysis, and its association with the discontinuation of cafeteria services at a dialysis facility as per COVID-19 measures. This retrospective study included elderly patients (aged ≥ 65 years) undergoing HD at the Nagasaki Renal Center between December 2020 and October 2021.

Assessment of finger motor function that reflects the severity of cognitive function.

Objectives: We conducted a finger tapping movement test using a finger tapping device with magnetic sensors (UB-2) and performed multiple regression analyses using a number of finger movements parameters to estimate the severity of cognitive impairment.

Methods: The subjects of this study were 64 patients, including 44 diagnosed with Alzheimer's disease (AD) (mean age: 73.8±7.

Age-related changes in the distribution of intravenously administered gadolinium-based contrast agents leaked into the cerebrospinal fluid in patients with suspected endolymphatic hydrops.

Purpose: The purpose of this retrospective study was to investigate the relationship between age and leakage of intravenously administered gadolinium-based contrast agents (GBCAs) into the cerebrospinal fluid (CSF) by volumetric segmentation of the whole-cranium CSF.

Materials And Methods: In 30 patients clinically diagnosed with suspected endolymphatic hydrops, the three-dimensional real inversion recovery (3D-real IR) images were obtained at pre- and 4 h post-intravenous administration of a single dose of GBCA. The volume of interest was set on the whole-cranium CSF in the 3D-real IR image.

Distribution of Gadolinium-based Contrast Agent after Leaking into the Cerebrospinal Fluid: Comparison between the Cerebral Cisterns and the Lateral Ventricles.

Purpose: Leakage of a small amount of intravenously administered gadolinium-based contrast agents (GBCAs) into the cerebrospinal fluid (CSF) space has been reported, even in healthy subjects without blood-brain barrier disruption. Several candidates including the choroid plexus and cortical veins have been proposed as the source of the leakage. The purpose of this study was to evaluate the distribution of intravenously administered GBCA leakage into the CSF by comparing the contrast enhancement of the cerebral cisterns to the lateral ventricles (LVs).