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  • 1
    In: JGH Open, Wiley, Vol. 5, No. 9 ( 2021-09), p. 1092-1096
    Abstract: Fine‐needle biopsy (FNB) needles obtain more core samples and support the shift from cytologic to histologic evaluation; however, recent studies have proposed a superior diagnostic potential for liquid‐based cytology (LBC). This study compared the diagnostic ability of endoscopic ultrasound (EUS)‐guided FNB histology with a 22‐gauge Franseen needle (22G‐FNB‐H) and fine‐needle aspiration (FNA) LBC with a conventional 25‐gauge needle (25G‐FNA‐LBC). Methods We analyzed 46 patients who underwent both 22G‐FNB‐H and 25G‐FNA‐LBC in the same lesion during the same endoscopic procedure. This study evaluated the diagnostic ability of each needle, diagnostic concordance between needles, and incremental diagnostic effect of both needles compared to using each needle alone. Results The agreement rate for malignancy between both techniques was 93.5% (kappa value = 0.82). There was no significant difference in the diagnostic ability of both methods. 22G‐FNB‐H and 25G‐FNA‐LBC provided an incremental diagnostic accuracy in two (4.3%) cases and one (2.2%) case, respectively. Conclusion Our study demonstrated that the diagnostic accuracy of 25G‐FNA‐LBC and 22G‐FNA‐H for solid pancreatic lesions were comparable. A conventional 25‐gauge needle that punctures lesions with ease can be used in difficult cases and according to the skill of the endoscopist.
    Type of Medium: Online Resource
    ISSN: 2397-9070 , 2397-9070
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2919809-4
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  • 2
    In: DEN Open, Wiley, Vol. 3, No. 1 ( 2023-04)
    Abstract: Selection criteria for self‐expandable metal stents (SEMSs) with or without cover during palliative treatment of distal malignant biliary obstruction (DMBO) remain unclear. We evaluated factors associated with time to recurrent biliary obstruction (TRBO) in fully covered SEMSs (FCSEMSs) and uncovered SEMSs (UCSEMSs). Methods We retrospectively analyzed consecutive patients with DMBO who received a SEMS. TRBO was determined using the Kaplan–Meier analysis, and complications were compared between the FCSEMS and UCSEMS groups. After TRBO‐associated factors were extracted using multivariate competing‐risks regression (CRR), propensity score‐adjusted CRRs were performed to verify their robustness. Results There were 180 patients (66 FCSEMSs and 114 UCSEMSs) enrolled in this study. There was no significant difference between median TRBO in the FCSEMS and UCSEMS groups (275 vs. 255 days, p = 0.67). Complications were more frequent in the FCSEMS than UCSEMS group (21.2% vs. 8.8%; p = 0.023). Multivariate CRR for TRBO‐associated factors revealed that “pancreatic ductal carcinoma (PDAC) treated with UCSEMS” was the only independent predictor of TRBO ( p = 0.03). Similarly, the propensity score‐adjusted CRRs showed no significant difference in TRBO in “FCSEMS” vs “UCSEMS” ( p = 0.96); however, there was a significant difference in “PDAC using UCSEMS” vs “other” ( p = 0.043). In the palliative care group including any DMBO without chemotherapy, the first quartile of the TRBO of UCSEMS was 100 days. Conclusions UCSEMSs are a possible option for both patients with DMBO arising from PDAC and for patients with any DMBO receiving palliative care who should avoid SEMS‐related complications.
    Type of Medium: Online Resource
    ISSN: 2692-4609 , 2692-4609
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 3045363-X
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  • 3
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2023
    In:  BMC Gastroenterology Vol. 23, No. 1 ( 2023-06-05)
    In: BMC Gastroenterology, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2023-06-05)
    Abstract: Osteosarcopenia, defined as the coexistence of sarcopenia and osteoporosis, is associated with adverse clinical outcomes. The present study investigated the prognostic significance of osteosarcopenia in patients with cirrhosis. Methods This retrospective study evaluated 126 patients with cirrhosis. Participants were classified into three groups based on the presence or absence of (1) sarcopenia and/or osteoporosis; and (2) Child–Pugh (CP) class B/C cirrhosis and/or osteosarcopenia, and the cumulative survival rates were compared between the groups. Cox proportional hazards model was used to identify independent factors associated with mortality. Sarcopenia and osteoporosis were diagnosed according to the Japan Society of Hepatology and the World Health Organization criteria, respectively. Results Among the 126 patients, 24 (19.0%) had osteosarcopenia. Multivariate analysis identified osteosarcopenia as a significant and independent prognostic factor. The cumulative survival rates were significantly lower in patients with osteosarcopenia than in those without (1/3/5-year survival rates = 95.8%/73.7%/68.0% vs. 100%/93.6%/86.5%, respectively; p  = 0.020). Patients with osteosarcopenia, but not sarcopenia or osteoporosis alone, had significantly lower cumulative survival rates than those without both conditions ( p  = 0.019). Furthermore, patients with both CP class B/C and osteosarcopenia had significantly lower cumulative survival rates than those without both ( p   〈  0.001) and with either condition ( p   〈  0.001). Conclusions Osteosarcopenia was significantly associated with mortality in patients with cirrhosis. The cumulative survival rates were lower in patients with osteosarcopenia than in those without both conditions. Additionally, comorbid osteosarcopenia worsened the prognosis of patients with CP class B/C. Therefore, simultaneous evaluation of both sarcopenia and osteoporosis is crucial to better predict the prognosis.
    Type of Medium: Online Resource
    ISSN: 1471-230X
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2041351-8
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  • 4
    In: JGH Open, Wiley, Vol. 5, No. 7 ( 2021-07), p. 763-769
    Abstract: Sarcopenia frequently develops in patient with liver cirrhosis (LC). Ethanol reduces muscle protein synthesis and accelerates proteolysis. However, the relationship between heavy alcohol consumption and sarcopenia remains controversial. This study aimed to investigate the characteristics and prevalence of sarcopenia among patients with alcoholic LC (ALC) in real‐world clinical settings. Methods This cross‐sectional study included 181 patients with LC. Heavy alcohol consumption was defined as 〉 60 g/day. Sarcopenia was diagnosed according to the Japan Society of Hepatology criteria. Results Among the 181 patients, 64 (35.4%) were diagnosed with ALC. Patients with ALC were younger (median, 61.5 vs 72.0 years; P   〈  0.001) and had a lower prevalence of sarcopenia (18.8 vs 32.5%; P  = 0.048) than those with non‐ALC. Conversely, the former had a higher prevalence of Child–Pugh class B/C ( P  = 0.015), higher total bilirubin ( P  = 0.017), and lower prothrombin time ( P   〈  0.001) than the latter. The prevalence of sarcopenia increased alongside advancing age in patients with ALC ( P  = 0.007). Multivariate analysis identified older age (but not disease stage/liver function reserve and alcohol consumption) as an independent factor associated with sarcopenia ( P  = 0.002) in patients with ALC. Conclusion Patients with ALC were younger and had a lower prevalence of sarcopenia, despite advanced disease stage/impaired liver function reserve, compared to those with non‐ALC in real‐world clinical settings. However, older age was strongly associated with sarcopenia, even in patients with ALC. There was no significant influence of heavy alcohol consumption on the development of sarcopenia.
    Type of Medium: Online Resource
    ISSN: 2397-9070 , 2397-9070
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2919809-4
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  • 5
    In: Diagnostics, MDPI AG, Vol. 12, No. 8 ( 2022-08-12), p. 1957-
    Abstract: Insulin-like growth factor 1 (IGF-1) plays an important role in bone growth and maintenance, and its decreased levels are associated with bone disorders. This study aimed to evaluate the association of serum IGF-1 levels with osteoporosis, prevalent fractures and fracture risk based on the Fracture Risk Assessment Tool (FRAX) in patients with primary biliary cholangitis (PBC). This study included 127 consecutive patients with PBC. Based on the baseline serum IGF-1 levels, the participants were classified into the low (L)-, intermediate (I)- and high (H)-IGF-1 groups. According to the FRAX score, high fracture risk was defined as a 10-year major osteoporotic fracture probability (FRAX-MOF) ≥ 20% or a 10-year hip fracture probability (FRAX-HF) ≥ 3%. The serum IGF-1 levels were positively correlated with bone mineral density, and were negatively correlated with the FRAX-MOF/FRAX-HF. The L-IGF-1 group had the highest prevalence of osteoporosis (58.1%), prevalent fracture (48.4%) and high fracture risk (71.0%). Meanwhile, the H-IGF-1 group had the lowest prevalence of osteoporosis (9.7%), prevalent fracture (12.9%) and high fracture risk (9.7%). The prevalence of these events increased stepwise with decreasing serum IGF-1 levels. The cutoff values of IGF-1 for predicting osteoporosis, prevalent fracture and high fracture risk were 61.5 ng/mL (sensitivity/specificity, 0.545/0.894), 69.5 ng/mL (0.633/0.784) and 61.5 ng/mL (0.512/0.929), respectively. Serum IGF-1 levels were associated with bone disorders and the FRAX-derived fracture risk, and may be a useful indicator for initiating therapeutic intervention to prevent the incidence of fracture in patients with PBC.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662336-5
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  • 6
    In: Frontiers in Oncology, Frontiers Media SA, Vol. 9 ( 2019-8-13)
    Type of Medium: Online Resource
    ISSN: 2234-943X
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2019
    detail.hit.zdb_id: 2649216-7
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  • 7
    In: Journal of Breath Research, IOP Publishing, Vol. 15, No. 2 ( 2021-04-01), p. 026010-
    Abstract: We developed a small portable sensor device using a p-type semiconductor cuprous bromide (CuBr) thin film to measure breath ammonia in real time with highsensitivity and selectivity. Breath ammonia is reportedly associated with chronic liver disease (CLD). We aimed to assess the practical utility of the novel CuBr sensor device for exhaled breath ammonia and the correlation between breath and blood ammonia in CLD patients. This was a feasibility and pilot clinical study of 21 CLD patients and 18 healthy volunteers. Breath ammonia was directly and quickly measured using the novel CuBr sensor device and compared with blood ammonia measured at the same time. CLD patients had significantly higher breath ammonia levels than healthy subjects ( p = 1.51 × 10 −3 ), with the level of significance being similar to that for blood ammonia levels ( p = 0.024). Significant differences were found in breath and blood ammonia between the healthy and cirrhosis groups ( p = 2.97 × 10 −3 and 3.76 × 10 −3 , respectively). Significant, positive correlations between breath and blood ammonia were noted in the CLD group ( R = 0.747, p = 1.00 × 10 −4 ), healthy/CLD group ( R = 0.741, p = 6.75 × 10 −8 ), and cirrhosis group ( R = 0.744, p = 9.52 × 10 −4 ). In conclusion, the newly developed, easy-to-use, and small portable CuBr sensor device was able to non-invasively measure breath ammonia in real time. Breath ammonia measured using the device was correlated with blood ammonia and the presence of liver cirrhosis, and might be an alternative surrogate biomarker to blood ammonia.
    Type of Medium: Online Resource
    ISSN: 1752-7155 , 1752-7163
    Language: Unknown
    Publisher: IOP Publishing
    Publication Date: 2021
    detail.hit.zdb_id: 2381007-5
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  • 8
    In: Nutrients, MDPI AG, Vol. 12, No. 12 ( 2020-12-12), p. 3810-
    Abstract: Low vitamin D status is related to frailty and/or sarcopenia in elderly individuals. However, these relationships are unclear in patients with chronic liver disease (CLD). This study aimed at exploring the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and frailty or sarcopenia in 231 patients with CLD. Frailty was determined based on five factors (weight loss, low physical activity, weakness, slowness, and exhaustion). Sarcopenia was diagnosed by applying the Japan Society of Hepatology criteria. The patients were classified into three groups according to baseline 25(OH)D levels: low (L), intermediate (I), and high (H) vitamin D (VD) groups. Of the 231 patients, 70 (30.3%) and 66 (28.6%) had frailty and sarcopenia, respectively. The prevalence rate of frailty and sarcopenia significantly increased stepwise with a decline in the vitamin D status. The L-VD group showed the highest prevalence rates of frailty and sarcopenia (49.1% (28/57), p 〈 0.001 for both), whereas the H-VD group showed the lowest prevalence rates of frailty (15.3% (9/59)) and sarcopenia (18.6% (11/59)) (p 〈 0.001 for both). Multivariate analysis identified serum 25(OH)D levels as a significant independent factor related to frailty and sarcopenia. Serum 25(OH)D levels significantly correlated with handgrip strength, skeletal muscle mass index, and gait speed. In conclusion, low serum vitamin D level, especially severe vitamin D deficient status, is closely related to frailty and sarcopenia in patients with CLD.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2518386-2
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  • 9
    In: World Journal of Hepatology, Baishideng Publishing Group Inc., Vol. 9, No. 1 ( 2017), p. 57-
    Type of Medium: Online Resource
    ISSN: 1948-5182
    Language: English
    Publisher: Baishideng Publishing Group Inc.
    Publication Date: 2017
    detail.hit.zdb_id: 2573703-X
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  • 10
    In: Hepatology Research, Wiley, Vol. 49, No. 6 ( 2019-06), p. 653-662
    Abstract: Primary biliary cholangitis (PBC) is an autoimmune liver disease with unknown pathogenesis. In PBC, activation of T‐cell receptor (TCR) signaling is associated with inflammatory cytokine production through N‐Ras upregulation. Although the CD4 + T cell TCR repertoire could be associated with PBC pathogenesis, it has not been evaluated. Thus, we analyzed the PBC‐CD4 + T cell TCR repertoire using next generation sequencing (NGS). Methods Four PBC patients (one treatment‐naïve and three receiving ursodeoxycholic acid) and three healthy individuals were enrolled. NRAS expression in CD4 + T cells was assessed by quantitative reverse transcription–polymerase chain reaction (qRT‐PCR). N‐Ras dynamics in CD4 + T cells were assessed by qRT‐PCR and GTP‐N‐Ras activation assay. The TCR α‐ (TRA) and β‐chain (TRB) repertoires on CD4 + T cells were analyzed by NGS and profiled using hierarchical analysis. Motif analysis was undertaken to elucidate the structure of PBC‐specific TCRs. Results NRAS was upregulated in PBC relative to control CD4 + T cells ( P   〈  0.05), and N‐Ras enhanced T cell activation in CD4 + T cells. Among 2668 TRAs and 841 TRBs, 20 and 11, respectively, were differentially expressed in PBC compared to that in controls ( P   〈  0.05, fold‐change 〉 2). Among them, TRAV29/J22, TRBV6–5/J2–6, and TRBV10–1/J2–1 were expressed in PBC but the expression was negligible in the controls, with more mature and longer forms observed in PBC‐CD4 + T cells. Conclusions N‐Ras was upregulated in PBC‐CD4 + T cells, and it enhanced TCR activation, indicating that PBC‐CD4 + T cells were activated by N‐Ras upregulation with differentially expressed TCR repertoires on their surfaces.
    Type of Medium: Online Resource
    ISSN: 1386-6346 , 1872-034X
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 2006439-1
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