Purpose: The outcome predictors of Kasai portoenterostomy (KPE) for biliary atresia (BA) are controversial. This study aimed to identify possible short-term outcome predictors of KPE for BA in infants. Methods: This retrospective study included infants with BA who underwent KPE between January 2015 and December 2017 and were followed up for at least 6 months after surgery at the Pediatric Hepatology Unit, Cairo University Pediatric Hospital, Egypt. The short-term outcome was jaundice clearance within 6 months following surgery. All data were compared between the jaundice free group and those with persistent jaundice to identify the predictors of jaundice clearance. Results: The study included 75 infants. The mean age at the time of surgery was 82.43±22.77 days (range, 37–150 days), and 28 (37.3%) infants cleared their jaundice within 6 months postoperative. Age at surgery did not significantly affect the outcome (p=0.518). Infants with persistent jaundice had significantly higher pre-operative levels of aspartate aminotransferase (AST) than those who were jaundice free (p=0.041). Receiver operating characteristic curve analysis showed that preoperative AST ≤180 IU/L was predictive of a successful KPE, with sensitivity 74.5% and specificity 60.7%. Infants with bile plugs in liver biopsy had a 6-fold higher risk of persistent jaundice than those without bile plugs (95% confidence interval: 1.59–20.75, p=0.008). Conclusion Jaundice clearance after KPE for BA can be predicted using preoperative AST and presence of bile plugs in liver biopsy.

Bleomycin (BLM) is one of anti-cancerous drugs. One of its limitation is the development of pulmonary fibrosis during therapy So, we proposed to examine the outcome of BLM take on the light and electron microscopic design of rat lung. Along with, assessment the probable protecting role of ginsenoside on BLM induced pulmonary changes. In this study, thirty adult male albino rats were comprised and were classified to four clusters; Negative & positive control group, BLM treated group and BLM& ginsenoside treated group. The lung was treated for histological and immunohistochemical (anti-p65) studies. Light microscopic examination of H&E stained sections of BLM treated group showed huge distortion of the lung building. Mallory trichrome stain of this group showed evident deposition of collagen fibers in the markedly thickened interalveolar septa and around intrapulmonary bronchi, bronchioles and blood vessels. Moreover, strong positive staining for nuclear factor (NF)-κB in the wall of bronchiole as well as the thickened interalveolar septa were observed. Ultrastructural inspection of lung of this group revealed muddled lung planning. Marked improvement of the lung structure and marked reduction in NF-κB immunoexpression was appeared in BLM and ginsenoside treated group. So, we concluded that coadministration of ginsenoside with BLM significantly enhanced the histological and morphometric image of the lung.

Background/Aims: Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) using oblique-view EUS in patients with a surgically altered anatomy (SAA) of the upper gastrointestinal tract is limited because of difficult scope insertion due to the disturbed anatomy. This study aimed to investigate the efficiency of forward-view (FV)-EUS in performing FNA in patients with a SAA. Methods: We retrospectively investigated 32 patients with a SAA of the upper gastrointestinal tract who visited Aichi Cancer Center Hospital in Nagoya, Japan, between January 2014 and December 2020. We performed-upper gastrointestinal EUS-FNA using FV-EUS combined with fluoroscopic imaging to confirm tumor recurrence or to make a decision before chemotherapy or after a failure of diagnosis by radiology. Results: We successfully performed EUS-FNA in all studied patients (100% technical success), with the specificity, sensitivity, and accuracy of 100%, 87.5%, and 87.8%, respectively, with no complications. Conclusions EUS-FNA using FV-EUS combined with fluoroscopic imaging is an effective and safe technique for tissue acquisition in patients with a SAA.