Publications by authors named "Ryu Sasaki"

Background: This study aimed to investigate the changes in oncological resection status in patients with unresectable hepatocellular carcinoma (u-HCC) receiving atezolizumab plus bevacizumab (Atez/Bev) and the impact of conversion therapy following Atez/Bev treatment.

Methods: This cohort included 631 patients with u-HCC treated with Atez/Bev. Tumors were assessed using oncological resectability criteria and categorized as borderline resectable 1 (BR1, n=166) or borderline resectable 2 (BR2, n=465).

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: Covert hepatic encephalopathy (CHE) is associated with decreased quality of life. Detection of Child-Pugh class A is necessary for its early diagnosis. This study aimed to establish a simple diagnostic method of CHE in patients with Child-Pugh class A.

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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.
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  • 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™.
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  • 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.*
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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.
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In aqueous binary solvents with fluorinated alcohols, 2,2,2-trifluoroethanol (TFE) and 1,1,1,3,3,3-hexafluoroisopropanol (HFIP), and aliphatic alcohols, ethanol (EtOH) and 2-propanol (2-PrOH), the denaturation of hen egg white lysozyme (HEWL) with increasing alcohol mole fraction has been investigated in a wide view from the molecular vibration to the secondary and ternary structures. Circular dichroism (CD) measurement showed that the secondary structure of α-helix content of HEWL increases on adding a small amount of the fluorinated alcohol to the aqueous solution, while the β-sheet content decreases. On the contrary, the secondary structure does not significantly change by the addition of the aliphatic alcohols.

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  • 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.
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  • 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.
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  • 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.
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  • 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.
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Rationale: Kounis syndrome is a rare but life-threatening anaphylactic reaction that can lead to acute coronary syndrome and cardiac arrest, and requires prompt diagnosis. Adrenaline, which is used to treat anaphylaxis, may cause coronary vasoconstriction and worsen ischemia, whereas coronary vasodilators may dilate systemic vessels and exacerbate hypotension. Delayed diagnosis of Kounis syndrome and inadequate therapeutic intervention may thus lead to a poor outcome.

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Aim: We aimed to verify the therapeutic efficacy and safety of stereotactic body radiotherapy (SBRT) for previously untreated initial small hepatocellular carcinoma (HCC) in a multicenter, retrospective study.

Methods: Patients who underwent SBRT for HCC at the Japanese Society of Clinical Oncology (JCOG) member hospitals in Japan between July 2013 and December 2017 and met the following eligibility criteria were included: (1) initial HCC; (2) ≤3 nodules, ≤5 cm in diameter; (3) Child-Pugh score of A or B; and (4) unsuitability for or refusal of standard treatment. We analyzed the overall survival, recurrence-free survival, and cumulative incidence of local recurrence rate, and adverse events directly related to SBRT.

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  • 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.
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Right aortic arch is caused by a malformation of the aorta while Kommerell's diverticulum is a saccular aneurysm arising at the origin of the subclavian artery. Both diseases are caused by malformations during embryonic development and can subsequently cause compression of the esophagus and trachea due to abnormal arterial migration. Here, we report five cases of esophageal stenosis due to aortic angiogenesis anomalies.

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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.

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Introduction: Adjusting immunosuppression to minimal levels post-adult liver transplantation (LT) is critical; however, graft rejection has been reported in LT recipients with normal liver function evaluated by liver biopsy (LBx). Continual protocol liver biopsy (PLB) is performed regularly in LT recipients with normal liver function in some centers; however, its usefulness remains inadequately evaluated. This study aimed to assess retrospectively the usefulness of late PLB after adult LT.

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  • This study compares the effectiveness and safety of Atezolizumab plus Bevacizumab (ATEZO/BEVA) versus Lenvatinib (LEN) as first-line treatments for hepatocellular carcinoma (HCC).
  • A total of 810 patients were analyzed, and after matching for comparable characteristics, the results showed no significant difference in objective response rates (44.8% for ATEZO/BEVA vs. 46.7% for LEN), but ATEZO/BEVA had better progression-free survival and overall survival rates.
  • ATEZO/BEVA also had lower rates of severe side effects like appetite loss and fatigue, but a higher rate of severe bleeding, and showed a better conversion
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  • The study aimed to assess the survival outcomes and identify risk factors for patients with hepatocellular carcinoma (HCC) treated using stereotactic body radiotherapy (SBRT).
  • A total of 73 patients were analyzed, revealing high local control rates and 1, 3, and 5-year survival rates of 94.5%, 63.9%, and 45.5%, respectively.
  • Key factors affecting prognosis included baseline modified albumin-bilirubin grades and BCLC stages, indicating that patients with better mALBI grades had a more favorable prognosis.
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Objective The course of cryptogenic cirrhosis (CC) after liver transplantation (LT) is unknown. We therefore clarified the natural course post-LT for CC and investigated the etiology of CC. Methods Eighteen patients who underwent LT for CC were included.

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Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is an aggressive malignant digestive system lymphoma. We report the case of a 68-year-old Asian woman who was diagnosed with MEITL of the duodenum and small intestine due to intestinal obstruction. MEITL is mainly located in the small intestine, and duodenal lesions are rare.

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Background: The efficacy of molecular-targeted agents (MTAs) has been demonstrated in recent years. However, the results of multidisciplinary treatment including hepatic resection are still unclear. The present study evaluated the outcomes of MTA treatment for advanced, unresectable hepatocellular carcinoma (HCC), with the goal of achieving liver resection, in our department.

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Anti-VEGF drugs, such as tyrosine kinase inhibitors, play an important role in systemic therapy for unresectable hepatocellular carcinoma (uHCC). We examined the effects of sorafenib and lenvatinib on proteinuria and renal function.Patients who were administered sorafenib (n = 85) or lenvatinib (n = 52) as first line treatment for uHCC from July 2009 to October 2020, were enrolled in this retrospective observational study.

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  • Fibrosis is a key factor in predicting Hepatocellular carcinoma (HCC), but its occurrence in patients with non-alcoholic fatty liver disease (NAFLD) is relatively low; this study aimed to differentiate HCC from non-HCC in cirrhotic livers using histological features.
  • Seventeen NAFLD patients undergoing liver transplantation were analyzed, utilizing FibroNest to quantify various histological traits of fibrosis and develop a Phenotypic Composite Fibrosis Score (Ph-CFS) that helps differentiate HCC from non-HCC.
  • Results showed significant differences in Ph-CFS scores between HCC and non-HCC cases (4.6 vs. 5.9), with the Ph-CFS providing
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Synopsis of recent research by authors named "Ryu Sasaki"

  • - Ryu Sasaki's recent research primarily focuses on liver diseases, exploring various markers and diagnostic tools to improve the understanding and management of conditions such as cirrhosis, fatty liver disease, and the impact of alcohol on liver health.
  • - Key findings from his studies include the potential of intestinal fatty acid-binding protein (I-FABP) levels as markers for liver complications, the effectiveness of digital pathology combined with AI in analyzing liver fibrosis, and identifying total bile acid levels as a tool for screening portopulmonary hypertension in patients with decompensated cirrhosis.
  • - Additionally, his work also examines the genetic implications of steatohepatitis post-pancreaticoduodenectomy and utilizes innovative methodologies such as whole-slide imaging and deep learning models to enhance diagnostic accuracy and treatment efficacy for liver-related conditions.

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