Successful Fistula Closure After Treatment with Colostomy and Infliximab in a Patient with Ulcerative Colitis Complicated by Rectovaginal Fistula.

The patient was a 50-year-old Japanese woman who was diagnosed with total-colitis-type ulcerative colitis (UC) at the age of 26 years. She was treated with mesalazine and azathioprine, and her disease activity was well controlled. At the age of 50 years, the patient was experiencing fever, abdominal pain, diarrhea, bloody stool, and anal pain, which led to a diagnosis of a relapse of UC. Although steroid therapy was administered and tended to improve her symptoms, fecaloid vaginal discharge occurred, and rectovaginal fistula (RVF) was confirmed. Colostomy was performed, and infliximab was initiated as maintenance therapy for UC. All symptoms improved, and RVF closure was confirmed 6 months after the initiation of infliximab. To date, she has been free from relapse of UC. There have been only a few reports of UC complicated by RVF, and this condition is often difficult to treat. To the best of our knowledge, no other case of UC complicated by RVF in which the fistula was closed after treatment with colostomy and infliximab has been previously reported; thus, our report of the present case is valuable to the literature.

Primary Bile Duct Diffuse Large B-cell Lymphoma Diagnosed by Repeated Endoscopic Ultrasound-guided Fine-needle Aspiration and Endoscopic Retrograde Cholangiopancreatography.

A 54-year-old man was admitted with obstructive jaundice. Computed tomography showed common bile duct stricture and a tumor around the celiac artery. Repeated endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and endoscopic retrograde cholangiopancreatography (ERCP) as well as a laparotomic biopsy around the celiac artery were diagnostically unsuccessful. Since the bile duct stricture progressed, EUS-FNA and ERCP were performed a third time, finally leading to the diagnosis of diffuse large B-cell lymphoma. The treatment plan and prognosis of obstructive jaundice differ greatly depending on the disease. It is important to conduct careful follow-up and repeated histological examinations with appropriate modifications until a diagnosis is made.

Late-onset Wilson Disease in a Patient Followed-up for Nonalcoholic Fatty Liver Disease.

A 73-year-old woman was referred to our hospital for persistent liver dysfunction. When the patient was 45 years old, her youngest sister had been diagnosed with Wilson disease (WD). The patient therefore underwent several family screening tests, all of which were unremarkable. She had an annual medical checkup and was diagnosed with liver dysfunction and fatty liver at 68 years old. A liver biopsy and genetic testing were performed, and she was diagnosed with WD; chelation therapy was then initiated. In patients with hepatic disorders and a family history of WD, multiple medical examinations should be conducted, as the development of WD is possible regardless of age.

Adult-onset Still's Disease Diagnosed during Puerperium with Liver Dysfunction in Pregnancy and Liver Failure of the Infant.

Most cases of liver dysfunction in pregnancy are pregnancy-related, but the onset of systemic autoimmune diseases is also differentiated. A 24-year-old woman presented with liver dysfunction at 28 weeks' gestation with suspected autoimmune hepatitis and started taking ursodeoxycholic acid. She gave birth prematurely at 35 weeks' gestation, and the infant presented with pancytopenia and liver failure but survived because of liver transplantation. Since the patient had major symptoms during the puerperium, she was diagnosed with adult-onset Still's disease. When encountering a patient with liver dysfunction during pregnancy, we should also consider the onset of autoimmune diseases.

A retrospective multicenter study comparing the punctures to B2 and B3 in endoscopic ultrasound-guided hepaticogastrostomy.

Objectives: In recent years, endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) has been performed as an important salvage option for failed endoscopic retrograde cholangiopancreatography for biliary drainage. However, technical issues, such as puncture site (bile duct of segment 3 [B3] or bile duct of segment 2 [B2]), dilation method, stent selection, and procedural safety, need to be resolved for the optimization of EUS-HGS. The present study was to compare the safety, difficulty, and technical and functional success between biliary access via B2 and B3 during EUS-HGS. Methods: We conducted a retrospective investigation of 161 consecutive EUS-HGS cases across a total of 6 facilities, including those at our hospital. The patients were divided into two groups according to the successful drainage route: the puncture to B2 (P-B2) or the puncture to B3 (P-B3). We compared the technical and functional success rates, technical difficulty, and adverse events between the two groups. We also conducted a subgroup analysis to show the factors related to the procedure time. Results: There were 92 cases in the P-B2 group and 69 cases in the P-B3 group. There were no significant differences in the technical success, functional success, or adverse events between the groups; however, the procedure time was significantly shorter in P-B2 cases than in P-B3 cases. The multivariate analysis showed that the puncture site was the only factor related to the procedure time. Conclusions: Based on these findings, P-B2 appears useful and safe. P-B2 is as effective as P-B3 and was able to be performed in a shorter period of time. The B2 approach can be considered a useful option for EUS-HGS.

A new species of Ecitonides Wasmann, 1894 (Coleoptera: Staphylinidae: Paederinae) from Peru and phylogenetic placement of the genus based on molecular data.

Ecitonides constanceae sp. nov., a new species of the myrmecophilous genus Ecitonides Wasmann, 1894, which is associated with army ants (Hymenoptera: Formicidae: Ecitoninae), is described from Peru. The holotype, which is the only known specimen, was collected at light at Los Amigos Biological Station, Madre de Dios department, Peru. The army ant host species is unknown. The new species is distinguished from congeners and an updated key of the species, as well as a checklist of Ecitonides and their associated host ants are provided. Based on the holotype we non-destructively extracted DNA and sequenced two genes which were incorportated into an existing molecular phylogenetic dataset and analysed using Bayesian Inference. Ecitonides is recovered as sister to recently described thermitophilous genus Ruptor ya et al. 2022 and placed in the so-called Medonina and allied taxa clade. Beyond Bayesian Inference phylogenetic analysis and their associated nodal support methods, we also explored the position of the Ecitonides within the posterior sample of trees produced in the Bayesian analyses, which further supported its placement.

Left thoracoscopic surgery in the prone position for a bronchogenic cyst localized to the lower thoracic esophagus: A case report.

A 60-year-old woman with an abnormality discovered during a chest X-ray was referred to the authors' hospital for diagnosis and treatment. Upon enhanced computed tomography (CT), endoscopic ultrasonography, and magnetic resonance imaging, a tumor on the left side of the lower thoracic esophagus was detected. We diagnosed mediastinum cyst. One year after the first visit, a CT examination confirmed an increase in lesion size. Therefore, surgery was performed using a left thoracoscopic approach in the prone position. Before surgery, 3D models were used for simulation. Excision was performed without leakage of the contents. The histopathological diagnosis was a bronchogenic cyst. The left thoracoscopic surgery in the prone position is an uncommon approach but is useful for resecting tumors in the left side of the lower mediastinum. The authors were well-prepared and able to perform safe and reliable surgery.

Pseudocirrhosis after chemotherapy for gastric cancer with diffuse liver metastases: A case report.

Pseudocirrhosis is a rare but important complication of metastatic cancer. We herein present the case of a patient with pseudocirrhosis occurring after a complete response to chemotherapy for metastatic gastric cancer was achieved. A 72-year-old man was diagnosed with gastric adenocarcinoma with multiple liver metastases. The patient's general condition was good, with an Eastern Cooperative Oncology Group performance status of 1. Chemotherapy with oxaliplatin and S-1 was initiated and, after four cycles, the patient noticed sudden abdominal distension. Despite the marked regression of the liver metastases, massive ascites, segmental atrophy and esophageal varices developed, findings consistent with pseudocirrhosis. The patient achieved complete response for the primary and metastatic lesions. Following endoscopic ligation of the varices, he underwent subsequent chemotherapy with S-1 only and management of his ascites for 6 months. At 12 months after initial chemotherapy, the patient appeared to be disease-free. In conclusion, clinicians should be aware of the possibility of pseudocirrhosis in cases of cancer metastasis to the liver, including metastatic gastric cancer.

A new species of Endustomus Brme, 1842 and new records of Afrotropical Cossyphini Latreille, 1802 (Coleoptera: Tenebrionidae).

Endustomus sanjensis sp. nov. is described from Tanzania. First records of Endustomus nimbaensis Ardoin, 1963 and Cossyphus (Cossyphus) moniliferus moniliferus Chevrolat, 1829 are given for Sierra Leone. New faunistic data are provided for E. parallelogrammus parallelogrammus Fairmaire, 1888, E. senegalensis Laporte de Castelnau, 1833, and E. magnicollis Fairmaire, 1887.

New species, new records and notes of Afrotropical Chaetophora Kirby amp; Spence, 1817 (Coleoptera: Byrrhidae: Syncalptinae).

Three new species of Chaetophora Kirby Spence, 1817 (Coleoptera: Byrrhidae: Syncalptinae) are described: C. morettoi sp. nov., C. milesi sp. nov. C. smithi sp. nov. from Cte dIvoire, Sierra Leone and Zambia respectively. C. medleri Johnson 1978 is redescribed with additional faunistic records. Morphological features of C. russelli (Fiori, 1978) are also discussed. A diagnostic key to currently known species of Afrotropical Chaetophora is provided.

Investigation of the Indications for Endoscopic Papillectomy and Transduodenal Ampullectomy for Ampullary Tumors.

OBJECTIVE: The standard treatment for ampullary tumors is pancreaticoduodenectomy. However, minimally invasive procedures such as endoscopic papillectomy (EP) and transduodenal ampullectomy (TDA) have recently gained popularity. Therefore, we aimed to evaluate the effectiveness of these minimally invasive procedures for ampullary tumors. METHODS: We conducted a retrospective study of 42 patients who underwent either EP or TDA for ampullary tumors between June 2011 and November 2020. RESULTS: We found that in patients with significantly larger tumors, TDA was often selected. Patients who underwent EP had significantly shorter hospital stays. No significant differences were observed regarding procedural accidents, tumor size, and recurrence. CONCLUSION: No differences were observed regarding the treatment outcomes of EP and TDA except hospital stay. EP is less invasive and can be the initial choice of procedure. TDA is performed when EP is not technically feasible. No significant relationship was noted between tumor size and recurrence, and careful observation of the patient's postoperative course is required.

New species and records of Angolan Limnichidae (Coleoptera: Byrrhoidea).

Two new species of Limnichidae, Simplocarina angolensis Matsumoto sp. nov. and Byrrhinus angolensis Matsumoto sp. nov. are described. Simplocarina curticollis Pic, 1922 is reported as a new genus and species for the fauna of Angola.

Types of the New World Stigmoderini (Coleoptera: Buprestidae) deposited in Natural History Museum, London Buprestidae: Buprestinae: Stigmoderini.

The type specimens of the New World Stigmoderini deposited in the Natural History Museum in London are catalogued and illustrated. Twenty-eight lectotypes are designated, one of which is a new lectotype, since the previous one is considered invalid under the article 74.2. (ICZN 1999). Holotype and in some cases, paratypes, are recognized for the following taxa: Conognatha nanula Hoscheck, 1934, Conognatha blairi Hoscheck, 1934, Hiperantha decorata var. insignata Hoscheck, 1928 and Hiperantha saundersi Théry, 1928. In addition, Lasionota oberthuri (Kerremans, 1897) rev. stat. is reinstated as a valid species, having been considered to be a junior synonym of Lasionota tetrazonus (Chevrolat, 1838) since 1997. The comparison of the reinstated species, with the recently described species Lasionota inca Moore Diéguez, 2019 showed that both are conspecific and hence L. inca syn. nov. is proposed as a junior synonym of L. oberthuri.

Pruritus is common in patients with chronic liver disease and is improved by nalfurafine hydrochloride.

Pruritus is known to be a common complication in hepatitis patients, but the exact frequency and degree are not fully elucidated. Thus, we evaluated pruritus of 450 patients with chronic liver disease at our hospital. Pruritus was observed in 240 (53%) of the patients. Pruritus was significantly associated with males (OR = 1.51, P = 0.038) and patients with alkaline phosphatase (ALP) ≥ 200 U/L (OR = 1.56, P = 0.0495) and was significantly less in HBsAg-positive patients (OR = 0.449, P = 0.004). Seasonally, there was no difference in the frequency of pruritus between summer and winter. Of the 24 refractory pruritus patients treated with nalfurafine, 17 (71%) indicated improvement of itch, which is defined as a decrease in the visual analog scale score ≥ 30 mm. Pruritus was improved by nalfurafine both during daytime and nighttime in the Kawashima's scores evaluation. All patients who received nalfurafine exhibited improved Kawashima's scores ≥ 1 point during the daytime or nighttime. In conclusion, pruritus occurred in > 50% of patients with chronic liver disease, and predictors of pruritus were males and ALP ≥ 200 U/L. Nalfurafine may be useful for pruritus, regardless of whether daytime or nighttime.