Publications by authors named "Miyaaki H"
Background: Trastuzumab deruxtecan (T-DXd) is an antibody-drug conjugate targeting HER2-positive gastric cancer or gastroesophageal junction cancer (GC/GEJC). Although effective, T-DXd has notable toxicities, including interstitial lung disease (ILD). This study evaluated the efficacy, safety, and prognostic factors associated with T-DXd for GC/GEJC.
View Article and Find Full Text PDFAim: The incidence of and factors involved in gastroesophageal varix-related events in hepatitis C virus-related cirrhosis patients, including decompensated cirrhosis, after direct-acting antiviral therapy are unclear.
Methods: We conducted a multicenter study using prospective data from 478 hepatitis C virus-related cirrhosis patients treated with direct-acting antiviral therapy from February 2019 to December 2021 at 33 Japanese hospitals. Gastroesophageal varices were classified as F1 (small-caliber), F2 (moderately enlarged), or F3 (markedly enlarged) according to the Japanese criteria.
We measured intestinal fatty acid-binding protein (I-FABP) levels, a useful marker of small intestinal mucosal injury, in patients with cirrhosis to determine their relationship with liver function and complications. This cross-sectional study included 71 patients with cirrhosis admitted for treatment of cirrhotic complications or hepatocellular carcinoma (cohort A) and 104 patients with cirrhosis who received direct-acting antiviral therapy for HCV (cohort B). I-FABP levels, measured by ELISA, were evaluated relative to hepatic reserve and compared with non-invasive scoring systems for diagnostic performance in cirrhotic complications.
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- This study focused on differentiating between alcohol-related liver disease (ALD) and metabolic dysfunction-associated steatotic liver disease (MASLD) using advanced whole-slide imaging technology on liver specimens from transplant patients.
- It analyzed samples from 36 ALD patients and 17 MASLD patients, revealing distinct fibrosis patterns where ALD was characterized by thicker collagen and a more uneven distribution compared to the more uniform fibrosis in MASLD.
- The research demonstrated that a digital analysis approach could accurately diagnose ALD and MASLD, achieving 100% sensitivity and specificity, thus highlighting the benefits of digital pathology in improving liver disease diagnostics beyond traditional methods based on alcohol consumption.
Article Synopsis
- The study aimed to evaluate the impact of pemafibrate (PEM) on patients with metabolic dysfunction-associated steatotic liver disease (MASLD) and hyperlipidemia.
- A retrospective analysis of 43 patients was conducted, assessing clinical factors and liver stiffness using FibroScan before and after 0.5 years of PEM treatment.
- Results showed that while liver stiffness (LS) and other key liver function metrics did not decrease overall, improvements were noted in patients with more significant liver stiffness at baseline, suggesting PEM may be a potential treatment option for MASLD.*
The DNA damage response protein p53-binding protein 1 (53BP1) accumulates and forms foci at double-strand DNA breaks, indicating the extent of DNA instability. However, the potential role of 53BP1 as a molecular biomarker for hypopharyngeal squamous cell carcinoma (HPSCC) diagnosis remains unknown. Here, we evaluated the potential of immunofluorescence-based analysis of 53BP1 expression to differentiate the histology of hypopharyngeal neoplasms.
View Article and Find Full Text PDFIntroduction: We prospectively evaluated 3 cases regarding the usefulness of fully-covered self-expandable metal stents (FCSEMSs) for hepaticojejunostomy anastomotic stricture (HAS) after living donor liver transplantation (LDLT), which could not be resolved with conventional treatment using a plastic stent.
Case Report: All patients underwent LDLT with Roux-en-Y reconstruction; therefore, a short-type double-balloon enteroscope was used for the endoscopic procedures. HAS was observed on enteroscopic view of endoscopy in patients 1 and 2, and cholangiography revealed dilatation of the intrahepatic bile duct.
Article Synopsis
- Digital pathology allows for noninvasive measurement of pathological features and, when paired with artificial intelligence, it enhances information analysis and sharing, addressing knowledge gaps.
- Fibrosis, a key indicator of chronic inflammation, is crucial in assessing chronic liver diseases like viral hepatitis and metabolic dysfunction-related liver disease.
- This review explores how digital pathology can evaluate liver fibrosis prognosis, highlighting methods such as fiber quantification, collagen analysis, SHG/TPE microscopy, and Fibronest™.
Article Synopsis
- After pancreaticoduodenectomy, 20-40% of patients experience steatotic liver disease (SLD), but the role of specific gene polymorphisms (PNPLA3 and TM6SF2) in this condition post-surgery is not well understood.
- A study involving 43 pancreatic cancer patients assessed these gene variants and their correlation with SLD and high hepatic fibrosis indexes (HFI) after surgery.
- Results indicated that while PNPLA3 variants showed no significant association, the TM6SF2 minor allele was linked to a higher incidence of steatohepatitis, suggesting its potential impact on liver health after the procedure.*
Aim: It is not uncommon to encounter outpatients in the hepatology department with harmful alcohol habits. When treating such chronic liver disease (CLD) patients, an adequate intervention method for harm reduction of alcohol use, such as brief intervention (BI) or BI and nalmefene, should be considered. This study aimed to elucidate the clinical effectiveness of BI for CLD patients affected by harmful alcohol use.
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- The study aimed to assess whether total bile acid (TBA) levels can help identify patients with decompensated cirrhosis who need echocardiography for diagnosing portopulmonary hypertension.
- Out of 135 patients evaluated, elevated TBA levels and main pulmonary artery diameter were linked to higher tricuspid regurgitation pressure gradient (TRPG), suggesting TBA can indicate TRPG elevation effectively.
- However, for patients taking ursodeoxycholic acid (UDCA), the effectiveness of TBA in diagnosing TRPG elevation was reduced, indicating the need for careful interpretation in such cases.
Article Synopsis
- The study analyzes mortality rates in patients who achieved sustained virological response (SVR) after receiving interferon-free direct-acting antiviral (IFN-free DAA) therapy, emphasizing the significance of non-liver-related deaths.
- Three cohorts were examined: those without advanced fibrosis or prior hepatocellular carcinoma (HCC), those with advanced fibrosis but no prior HCC, and those with a history of HCC after curative treatment.
- Findings indicated that while both non-HCC cohorts had comparable mortality rates to the general population, the cohort with a history of HCC had higher overall mortality, highlighting the need to address non-liver-related health issues in all SVR patients.
Article Synopsis
- Researchers are exploring immune checkpoint inhibitors (ICIs) for treating unresectable hepatocellular carcinoma (HCC) but found varied responses in patients, prompting the development of an AI model to better predict treatment efficacy from pre-treatment CT scans.
- The study involved 43 patients receiving atezolizumab and bevacizumab, using contrast-enhanced CT images for analysis and two AI models—ResNet-18 and YOLO— to evaluate diagnostic performance.
- The YOLOv7 model showed high precision and recall rates for predicting disease progression, while the ResNet-18 model excelled in precision but had issues aligning with actual tumor locations, highlighting the need for more extensive training data for effective predictions in cancer treatment.
Recent Advances in Endoscopic Ultrasound for Gallbladder Disease Diagnosis.
Diagnostics (Basel)
February 2024
Article Synopsis
- Gallbladder disease is categorized mainly into GB wall-thickening and protuberant lesions, which includes conditions like cholecystitis and GB carcinoma.
- Recent advancements in diagnosis focus on techniques such as endoscopic ultrasound (EUS) and contrast-enhanced harmonic EUS (CH-EUS) that effectively assess GB lesions.
- The review also discusses the role of EUS-guided fine-needle aspiration (EUS-FNA) and highlights the growing impact of artificial intelligence in diagnosing gallbladder diseases.
Background: Thyroid storm can be complicated by liver dysfunction, which may occasionally progress to acute liver failure. We herein report a case of acute liver failure following thyroid storm that was treated with living donor liver transplantation after resuscitation from cardiopulmonary arrest.
Case Report: The patient was a woman in her 40 s who had been diagnosed with an abnormal thyroid function.
Article Synopsis
- * There was a notable increase in deceased-donor liver transplants from Era 1 to Era 3, alongside a decrease in virus-related diseases and a rise in alcoholic liver cirrhosis cases in the more recent years.
- * The findings indicate important shifts in liver transplantation practices in Japan, highlighting changes in donor types and patient conditions over the two decades.
Article Synopsis
- This study compares two needle types used in endoscopic ultrasound-assisted tissue acquisition (EUS-TA) for collecting cancer tissue samples: the EZ Shot 3 Plus (EZ3) and the SonoTip TopGain (TopGain).
- Researchers analyzed data from EUS-TA cases between 2010 and 2021, finding that the TopGain needle collected tissue with a surface area of 4 mm or more in a higher percentage of cases (68.6%) compared to the EZ3 needle (42.9%).
- The findings suggest that using the TopGain needle is more effective for obtaining larger tissue samples necessary for accurate cancer gene panel testing, indicating its potential benefits in clinical practice.
Article Synopsis
- Patients with chronic liver disease (CLD) and type 2 diabetes often experience impaired glucose tolerance and fluctuations, which can lead to hypoglycemia.
- This study analyzed data from 72 patients using a flash glucose monitoring (FGM) system to correlate glucose levels and fluctuations with liver-related health events.
- Results showed that hypoglycemia was a significant factor influencing liver event-free survival, indicating that FGM can be a valuable tool in predicting complications in these patients.
Background: Nasal high flow (NHF) may reduce hypoxia and hypercapnia during an endoscopic retrograde cholangiopancreatography (ERCP) procedure under sedation. The authors tested a hypothesis that NHF with room air during ERCP may prevent intraoperative hypercapnia and hypoxemia.
Methods: In the prospective, open-label, single-center, clinical trial, 75 patients undergoing ERCP performed with moderate sedation were randomized to receive NHF with room air (40 to 60 L/min, n = 37) or low-flow O via a nasal cannula (1 to 2 L/min, n = 38) during the procedure.
Objectives: Anastomotic biliary strictures (ABSs) are common complications following living donor liver transplantation (LDLT). We evaluated the feasibility of a novel removable, intraductal, fully covered, self-expandable metallic stent (FCSEMS) for the treatment of ABSs following LDLT.
Methods: Nine patients with duct-to-duct ABSs that developed following LDLT were prospectively enrolled in this study.
Article Synopsis
- Immune checkpoint inhibitors (ICIs) are effective cancer treatments but can cause serious immune-related adverse events (irAEs), making it important to find biomarkers to predict these effects.
- * In a study of 226 ICI patients, researchers examined the relationship between changes in lymphocyte counts and the occurrence and severity of irAEs.
- * The findings indicated that lower lymphocyte counts at the onset of severe irAEs were significant, and while patients with irAEs had longer overall survival, lymphocyte count changes did not correlate with survival outcomes.
An 86-year-old man presented with recurrence of hepatocellular carcinoma (HCC) after surgery. Atezolizumab plus bevacizumab was initiated. After the third course of atezolizumab plus bevacizumab therapy, petechial purpura appeared on the extremities and trunk.
View Article and Find Full Text PDFBackground And Aims: A novel EUS-guided fine-needle biopsy sampling (EUS-FNB) needle enabled physicians to obtain sufficient pathologic samples with fewer to-and-fro movements (TAFs) within the lesion. We compared the diagnostic yields of EUS-FNB with 3 and 12 TAFs at each puncture pass.
Methods: The primary endpoint of this multicenter, noninferiority, crossover, randomized controlled trial involving 6 centers was diagnostic sensitivity.