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Topic Review
Cholangiocarcinoma Detection and Staging of Extrahepatic Cholangiocarcinom
Extrahepatic cholangiocarcinoma (CCA) is a rare and aggressive type of cancer, presenting as a mass or as a biliary stricture. Depending on their localization, CCAs are classified into intrahepatic, perihilar, and distal. The EUS detection rate for distal CCAs is higher than that for the proximal CCAs. The accuracy of T staging varies between 60 and 80%, and vascular involvement is correctly assessed by conventional EUS.
  • 407
  • 12 Apr 2023
Topic Review
Colonoscopy in Intestinal Diseases
Colonoscopy is an examination of the colorectum and terminal ileum undertaken by inserting a scope with a camera device and flexible light source through the anus. In cases of infectious diseases, colonoscopy is helpful in making the differential diagnosis, revealing endoscopic gross findings, and obtaining the specimens for pathology. Additionally, colonoscopy provides clues for distinguishing between infectious disease and inflammatory bowel disease (IBD), and aids in the post-treatment monitoring of IBD.
  • 404
  • 17 Apr 2023
Topic Review
Cytokines in Spondyloarthritis and Inflammatory Bowel Diseases
Spondyloarthritis and inflammatory bowel diseases are chronic immune disorders of the joints and the gut that often coexist in the same patient, increasing the burden of each disorder, worsening patients’ quality of life, and influencing therapeutic strategies. Genetic predisposition, environmental triggers, microbiome features, immune cell trafficking, and soluble factors such as cytokines contribute to the pathogenesis of both articular and intestinal inflammation. Cytokines have a central role in immune disorders and seem to be involved at different levels in the pathogenesis of articular and intestinal IMID, leading to the activation and perpetuation of proinflammatory pathways with consequent tissue damage.
  • 403
  • 28 Feb 2023
Topic Review
Pathological Conditions with Excessive Hepatic Glycogen Accumulation
The liver is a major store of glycogen and is essential in maintaining systemic glucose homeostasis. In healthy individuals, glycogen synthesis and breakdown in the liver are tightly regulated. Abnormal glycogen metabolism results in prominent pathological changes in the liver, often manifesting as hepatic glycogenosis or glycogen inclusions. This can occur in genetic glycogen storage disease or acquired conditions with insulin dysregulation such as diabetes mellitus and non-alcoholic fatty liver disease or medication effects. Excessive glycogen accumulation within hepatocytes occurs in diseases caused or accompanied by the dysregulation of carbohydrate metabolism, as well as in conditions not primarily driven by altered carbohydrate metabolism. In these pathological conditions, the excess glycogen is distinctly visible on H&E; the hepatocytes usually exhibit cytoplasmic pallor and rarefaction or may show cytoplasmic-glycogen-filled inclusion bodies. Some hepatocytes may also demonstrate glycogen-filled nuclear vacuoles without a delimiting membrane (“glycogenated nuclei”); these are frequently seen in patients with diabetes and obesity, although they can also be seen in other liver conditions such as Wilson’s disease.
  • 403
  • 06 Apr 2023
Topic Review
Therapeutic Quiver of Non-Alcoholic Fatty Liver Disease
The therapeutic quiver of nonalcoholic fatty liver disease (NAFLD) consists of several levels, of which lifestyle, pharmaceutical, and surgical approaches are the main treatments. A multimodal intervention with multiple aspects, such as lifestyle modification, weight loss, specific diets, and medication, is the most appropriate and holistic approach for most people with NAFLD.
  • 402
  • 27 Apr 2023
Topic Review
Liver Tissue Engineering
The liver is the largest gland in the human body, mediating essential functions in homeostasis, metabolism, serum protein production, storage of glycogen, drug detoxification, immune system, and production and secretion of bile acids. The ultimate goal of liver tissue engineering (LTE)  is to restore partial or total function of the liver during liver failure. A fully functional liver is the ultimate aim of LTE, and functional liver tissue can be used for drug testing. Moreover, LTE has the potential to develop an extracorporeal liver support (ECLS) system performing the essential functions of the liver to reduce mortality or to bridge a patient to a liver transplant. With recent advances in the field of regenerative medicine, tissue engineering holds high potential to progress as an alternative or supplement to LT. A major advance in the LTE area was published by Chhabra and colleagues, reporting the development of a vascularized liver model to understand liver regeneration.
  • 402
  • 05 Jan 2024
Topic Review
Contribution of Leukocytes in Non-Alcoholic Fatty Liver Disease
Non-alcoholic fatty liver disease (NAFLD) is currently the most prevalent chronic liver disease in Western countries, affecting approximately 25% of the adult population. This condition encompasses a spectrum of liver diseases characterized by abnormal accumulation of fat in liver tissue (non-alcoholic fatty liver, NAFL) that can progress to non-alcoholic steatohepatitis (NASH), characterized by the presence of liver inflammation and damage. Lymphocytes are certainly the most relevant leukocytes of the adaptive immune system. 
  • 401
  • 20 Feb 2023
Topic Review
Pathogenesis of Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is a very complex world health problem. Approximately 905,677 new cases and 830,180 HCC-related deaths were reported in 2020. The estimation of more than 1 million deaths caused by HCC by 2030 has been predicted. The pathogenesis of hepatocellular carcinoma (HCC) is a multifactorial process that has not yet been fully investigated.
  • 400
  • 08 May 2023
Topic Review
Single-Cell RNA Sequencing for Crohn’s Disease Fibrosis Mechanisms
Crohn’s disease (CD) is a chronic inflammatory bowel disease with a high prevalence throughout the world. The development of Crohn’s-related fibrosis, which leads to strictures in the gastrointestinal tract, presents a particular challenge and is associated with significant morbidity. There are no specific anti-fibrotic therapies available, and so treatment is aimed at managing the stricturing complications of fibrosis once it is established. This often requires invasive and repeated endoscopic or surgical intervention. 
  • 399
  • 25 Jun 2023
Topic Review
Gastric Outlet Obstruction Management
Gastric outlet obstruction (GOO) poses a common and challenging clinical scenario, characterized by mechanical blockage in the pylorus, distal stomach, or duodenum, resulting in symptoms such as nausea, vomiting, abdominal pain, and early satiety. Its diverse etiology encompasses both benign and malignant disorders. The spectrum of treatment modalities extends from conservative approaches to more invasive interventions, incorporating procedures like surgical gastroenterostomy (SGE), self-expandable metallic stents (SEMSs) placement, and the advanced technique of endoscopic ultrasound-guided gastroenterostomy (EUS-GE). While surgery is favored for longer life expectancy, stents are preferred in malignant gastric outlet stenosis. The novel EUS-GE technique, employing a lumen-apposing self-expandable metal stent (LAMS), combines the immediate efficacy of stents with the enduring benefits of gastroenterostomy. 
  • 398
  • 17 Feb 2024
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