Comparison of Endoscopic Ultrasound-Guided Tissue Acquisition Using a 20-Gauge Menghini Needle with a Lateral Forward Bevel and a 22-Gauge Franseen Needle: A Single-Center Large Cohort Study

Background/Aims Several fine-needle biopsy (FNB) needles are available for endoscopic ultrasound (EUS)-guided tissue acquisition. However, there is disagreement on which type of needle has the best diagnostic yield. The aim of this study was to compare the performance and safety of two commonly used EUS-FNB needles. Methods We retrospectively analyzed consecutive patients who underwent EUS-FNB between June 2016 and March 2020 in our hospital. Two types of needles were evaluated: a 20-gauge Menghini needle with a lateral forward bevel and a 22-gauge Franseen needle. Rapid on-site evaluation was performed in all the cases. A multivariate analysis was performed to clarify the negative predictive factors for obtaining a histological diagnosis. Propensity score matching was performed to compare the diagnostic yields of these two needles. Results We analyzed 666 patients and 690 lesions. The overall diagnostic rate of histology alone was 88.8%, and the overall adverse event rate was 1.5%. Transduodenal access and small lesions (≤2 cm) were identified as negative predictive factors for obtaining a histological diagnosis. After propensity score matching, 482 lesions were analyzed. The diagnostic accuracy rates of histology in the M and F needle groups were 89.2% and 88.8%, respectively (p=1.00). Conclusions Both the needles showed high diagnostic yield, and no significant difference in performance was observed between the two

A case of methamphetamine use disorder presenting a condition of ultra-rapid cycler bipolar disorder

Methamphetamine, a potent psychostimulant, may cause a condition of mood disorder among users. However, arguments concerning methamphetamine-induced mood disorder remain insufficient. This case study describes a male with methamphetamine-induced bipolar disorder not accompanied by psychotic symptoms, who twice in an 11-year treatment period, manifested an ultra-rapid cycler condition alternating between manic and depressive mood states with 3- to 7-day durations for each. The conditions ensued after a bout of high-dose methamphetamine use and shifted to a moderately depressive condition within 1 month after the use under a treatment regimen of aripiprazole and mood stabilizers. The cycler condition may be characteristic of a type of the bipolar disorder and a sign usable for characterization. Further efforts are needed to seek distinctive features and to improve diagnostic assessment of methamphetamine-induced mood disorders

Comparison of Capability of Abdominal 320-Detector Row CT and of 16-Detector Row CT for Small Vasculature Assessment

The purpose of our study was to compare the capability of the 320-detector row CT (area-detector CT: ADCT) using the step-and-shoot scan protocol for small abdominal vasculature assessment with that of the 16-detector row CT using the helical scan protocol. Contrast-enhanced abdominal CT for preoperative assessment was administered to 25 patients, 18 of whom, suspected of having lung cancer, underwent ADCT using the step-and-shoot scan protocol, while the remaining 7, suspected of having renal cell carcinoma, underwent 16-MDCT using the helical scan protocol. Two experienced abdominal radiologists independently assessed renal interlobar and arcuate as well as mesenteric marginal (Griffith point) arteries by means of a 5-point visual scoring systems. Kappa analysis was used for evaluation of interobserver agreement. To compare the visualization capability of the two systems, the scores for each of the arteries were compared by using the Mann-Whitney U-test. Overall interobserver agreements for both systems were almost perfect (κ>0.78). Visualization scores for renal interlobar and arcuate, (p<0.0001) and mesenteric marginal (Griffith point) arteries (p<0.05) were significantly higher for ADCT than for 16-detector row CT. ADCT using the step-and-shoot scan protocol for small abdominal vasculature assessment can be considered superior to 16-detector row CT using the helical scan protocol

Mitochondrial Dynamics Regulation in Skin Fibroblasts from Mitochondrial Disease Patients

Mitochondria are highly dynamic organelles that constantly fuse, divide, and move, and their function is regulated and maintained by their morphologic changes. Mitochondrial disease (MD) comprises a group of disorders involving mitochondrial dysfunction. However, it is not clear whether changes in mitochondrial morphology are related to MD. In this study, we examined mitochondrial morphology in fibroblasts from patients with MD (mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) and Leigh syndrome). We observed that MD fibroblasts exhibited significant mitochondrial fragmentation by upregulation of Drp1, which is responsible for mitochondrial fission. Interestingly, the inhibition of mitochondrial fragmentation by Drp1 knockdown enhanced cellular toxicity and led to cell death in MD fibroblasts. These results suggest that mitochondrial fission plays a critical role in the attenuation of mitochondrial damage in MD fibroblasts