Publications by authors named "Yoshihiro Furuichi"

Since the Asian Pacific Association for the Study of the Liver (APASL) published guidelines on non-cirrhotic portal fibrosis/idiopathic portal hypertension in 2007, there has been a surge in new information, especially with the introduction of the term porto-sinusoidal vascular disorder (PSVD). Non-cirrhotic intra-hepatic causes of portal hypertension include disorders with a clearly identifiable etiology, such as schistosomiasis, as well as disorders with an unclear etiology such as non-cirrhotic portal fibrosis (NCPF), also termed idiopathic portal hypertension (IPH). This entity is being increasingly recognized as being associated with systemic disease and drug therapy, especially cancer therapy.

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Article Synopsis
  • The text provides an English version of the 2018 guidelines for diagnosing and treating idiopathic portal hypertension, extrahepatic portal obstruction, and Budd-Chiari syndrome.
  • These guidelines were developed by the Aberrant Portal Hemodynamics Study Group and are overseen by Japan's Ministry of Health, Labor, and Welfare.
  • The full guidelines contain 86 clinical questions and explanations, spanning 183 pages in Japanese.
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  • The study analyzed 107 patients undergoing balloon-occluded retrograde transvenous obliteration (BRTO) due to uncontrollable hepatic encephalopathy (HE) and assessed the impact of esophageal varices (EVs) on outcomes.
  • Patients were divided into two groups based on the presence of EVs, and results showed that those with EVs had significantly shorter event-free survival and overall survival compared to those without EVs.
  • The findings suggest that having EVs may indicate a higher risk of complications and mortality following the BRTO procedure in HE patients.
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Background: Alcoholic steatohepatitis and nonalcoholic steatohepatitis-related liver cirrhosis (ASH/NASH-LC) are major causes of esophageal varices (EVs). However, the association between high visceral fat and exacerbation of EVs remains unclear. The aim of this study was to clarify the association of visceral fat and recurrence rate of EVs in ASH/NASH-LC and to identify independent predictors associated with recurrence.

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Background: The incidence of alcoholic liver cirrhosis (ALC) is increasing. However, few reports have focused on ALC-derived esophageal varices (EV). We retrospectively examined differences in overall survival (OS) and EV recurrence rate in patients after endoscopic injection sclerotherapy (EIS) for ALC and hepatic B/C virus liver cirrhosis (B/C-LC).

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Objective Direct-acting antiviral agents (DAAs) can eliminate hepatitis C virus at a high rate, although the long-term incidence of portal hypertension and hepatocellular carcinoma (HCC) has not yet been elucidated. In this observational study, we clarified the predictors associated with the incidence of esophageal varices (EVs) and HCC after DAAs treatment based on ultrasound findings and blood examinations. Methods A total of 78 patients treated with DAAs were enrolled in this study.

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Article Synopsis
  • Tricuspid regurgitation pressure gradient (TRPG) measurement via echocardiography is critical for diagnosing portopulmonary hypertension (PoPH) in cirrhotic patients, and this study focuses on identifying factors linked to high TRPG levels.
  • Among 486 patients analyzed, 10.5% had TRPG values of 35 mmHg or higher, with factors such as being female, experiencing shortness of breath, and higher levels of brain natriuretic peptide (BNP) being significant indicators.
  • A scoring model was developed to predict high TRPG risk, demonstrating good accuracy and could help select patients who would benefit from further echocardiography investigations.
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Aim: The association between thrombolytic therapy and the outcome in patients with portal vein thrombosis (PVT) remains controversial. This study aimed to evaluate the outcome in patients with PVT who received antithrombin III-based therapy.

Methods: This study was a retrospective, multicenter study to investigate the liver-related events and the survival rates in 240 patients with PVT who received the therapy.

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Background: Balloon-occluded retrograde transvenous obliteration (BRTO) is an effective treatment for gastric varices, but predictors associated with overall survival rate (OS) and occurrence of esophagogastric varices (EGV) have not yet been clarified. In this study, we clarified these predictors by performing ultrasound elastography and blood tests at various time points.

Methods: A total of 34 patients were enrolled.

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Video 1Endoscopic submucosal dissection using traction by a spring-and-loop with clip for a laterally spreading tumor in the inferior aspect of the cecum: a nonreferral center experience.

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Background/purpose: Although the lumen-apposing metal stent (LAMS) is useful for interventional endoscopic ultrasound (EUS) procedures, there has been some concern about the potential for stent-induced adverse events because of the high lumen-apposing force. A newly designed LAMS with less lumen-apposing force has been developed for use with a physician-controlled electrocautery-enhanced delivery system. The aim of this animal study was to evaluate the feasibility of performing interventional EUS using this newly designed LAMS system.

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Background: Lusutrombopag effectively increases platelet count in patients with severe thrombocytopenia. However, no multicenter studies analyzing the effects of Lusutrombopag on patients with mild thrombocytopenia (platelet count > 50 000/µL) have been performed. In this study, we aimed to clarify the efficacy of Lusutrombopag on these patients by unifying background factors by propensity score matching.

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Article Synopsis
  • A 67-year-old man had problems with blood vessels in his stomach and esophagus that were treated before.
  • He was found to have new issues in his small intestine during a check-up.
  • The doctors used a special type of treatment called endoscopic injection sclerotherapy, which worked well, and there have been no new problems since!
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Background: Data regarding the influence of patatin-like phospholipase domain-containing 3 (PNPLA3) polymorphism for patients with liver cirrhosis (LC) are scarce.

Objective: This study assesses the role of the PNPLA3 polymorphism for the development of LC and its complications by the findings of genetic examinations.

Methods: Patients with LC caused by virus (n = 157), alcohol (n = 104), nonalcoholic fatty liver disease (NAFLD) (n = 106), or autoimmune disease (n = 33) and without LC (n = 128) were enrolled.

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Background: Peri-esophageal collateral veins have been reported to be associated with the recurrence of esophageal varices (EVs). In this study, we retrospectively analyzed whether endoscopic ultrasonography (EUS) findings obtained just before endoscopic injection sclerotherapy (EIS) are associated with the success rate of intravariceal injection, recurrence rate of EVs, and overall survival rate (OS) of patients. Furthermore, we investigated the independent predictors associated with these factors by multivariate analysis.

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Purpose: Measurement of spleen stiffness (SS) using ultrasound (US) elastography is useful for predicting portal hypertension. However, the mechanism leading to increased SS remains unclear. We jointly developed a new US elastography system (Aplio i-series, Canon Medical Systems) that can easily measure organ viscosity (dispersion slope: DS).

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Background/purpose: We developed EUS-guided double-balloon occluded gastrojejunostomy (EPASS) for gastric drainage tract obstruction. The success of EPASS depends on the proximity of the stomach and the gastrointestinal (GI) tract near the ligament of Treitz. The aim of this study is to clarify the GI anatomy near the ligament of Treitz.

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