Portal vein preparation for inflow anastomosis is a critical step in liver transplantation. Although portal vein thrombosis is well documented and classified according to Yerdel grading, calcification or sclerosis of the portal vein is rarely reported. Segmental or diffuse calcification of portal vein compromises its structural integrity and may even result in flow obstruction, rendering it unsuitable for reconstruction and necessitating alternative inflow strategies. This case report describes a patient with portal vein tearing around chronic calcification who underwent successful living donor liver transplantation using a cryopreserved iliac vein graft anastomosed to gastric varices.

Background: Liver transplantation (LT) is the standard treatment for end-stage liver disease; however, it can lead to biliary strictures in 25%–30% of cases. We aimed to develop a biodegradable stent loaded with paclitaxel that could be inserted during surgery without requiring removal. We evaluated the safety and efficacy of this stent using a porcine model. Methods: Fourteen pigs underwent simulated ischemic injury during LT, and a biodegradable paclitaxel-eluting stent was inserted after duct-to-duct anastomosis.Pigs were divided into four groups: no stent (n=3), bare stent (n=3), 300 µg paclitaxel stent (n=4), and 900 µg paclitaxel stent (n=4). After 3 months of follow-up, autopsies were conducted to obtain common bile duct tissue samples, and inflammation and fibrosis thicknesses were assessed under a microscope. Results: Most tissues had resolved the inflammatory reactions by the 3-month mark. The thinnest fibrosis thickness was observed in the 900 µg group (359.08±167.23 µm); however, no statistical significance was observed. Conclusion This study demonstrated the safety of paclitaxel-eluting biodegradable biliary stents and their positive effects on fibrosis in an ischemic bile duct porcine model. This biodegradable stent represents a potential approach for overcoming the complications associated with biliary strictures after LT.

Objectives: ：This study aimed to explore the association between depression and perceived stress, viral anxiety, reassurance-seeking behavior, and poor sleep quality among the general population in Bangladesh, withself-efficacy as a possible mediator. Methods: ：Data on stress and anxiety during the pandemic in Bangladesh were collected through an online survey from September 16, 2021 to October 4, 2021. Viral anxiety and depression were measured using the Bangla version of Stress and Anxiety to Viral Epidemic-6 (SAVE-6) and Patient Health Questionnaire-9 (PHQ-9), re-spectively. Self-efficacy was measured by the General Self-efficacy (GSE) scale. Reassurance-seeking behavior related to the coronavirus disease 2019 infection was measured by the Coronavirus Reassurance-Seeking Behav-iors Scale (CRBS). Results: ：The CRBS showed a significant correlation with SAVE-6 (r=0.281, p<0.001) and PHQ-9 (r=0.227, p<0.001). People with higher anxiety, reassurance-seeking behavior, and poor sleep quality had lower self-effi-cacy, which led to depression. In contrast, perceived stress increased self-efficacy. The psychological factors im-pacted depression directly as well as indirectly, and self-efficacy mediated the association. Conclusions ：Viral anxiety, reassurance-seeking behavior, perceived stress, and poor sleep quality have a close correlation with depression both directly and indirectly. Self-efficacy can be a mediating factor in the asso-ciation between psychological distress and depression. Viral anxiety, reassurance-seeking behavior, and poorsleep quality reduce self-efficacy. On the other hand, perceived stress can strengthen self-efficacy.

Objectives: ：This study aimed to explore the association between depression and perceived stress, viral anxiety, reassurance-seeking behavior, and poor sleep quality among the general population in Bangladesh, withself-efficacy as a possible mediator. Methods: ：Data on stress and anxiety during the pandemic in Bangladesh were collected through an online survey from September 16, 2021 to October 4, 2021. Viral anxiety and depression were measured using the Bangla version of Stress and Anxiety to Viral Epidemic-6 (SAVE-6) and Patient Health Questionnaire-9 (PHQ-9), re-spectively. Self-efficacy was measured by the General Self-efficacy (GSE) scale. Reassurance-seeking behavior related to the coronavirus disease 2019 infection was measured by the Coronavirus Reassurance-Seeking Behav-iors Scale (CRBS). Results: ：The CRBS showed a significant correlation with SAVE-6 (r=0.281, p<0.001) and PHQ-9 (r=0.227, p<0.001). People with higher anxiety, reassurance-seeking behavior, and poor sleep quality had lower self-effi-cacy, which led to depression. In contrast, perceived stress increased self-efficacy. The psychological factors im-pacted depression directly as well as indirectly, and self-efficacy mediated the association. Conclusions ：Viral anxiety, reassurance-seeking behavior, perceived stress, and poor sleep quality have a close correlation with depression both directly and indirectly. Self-efficacy can be a mediating factor in the asso-ciation between psychological distress and depression. Viral anxiety, reassurance-seeking behavior, and poorsleep quality reduce self-efficacy. On the other hand, perceived stress can strengthen self-efficacy.

Primary malignant fibrous histiocytoma (MFH) is a malignant tumor of mesenchymal origin that rarely occurs in the urinary tract, particularly in the urinary bladder. Unlike urothelial carcinoma, which accounts for most bladder cancers, it occurs in the submucosal portion of the bladder wall and consists of the lamina propria, muscularis propria, and adventitia.It is presumed to originate from poorly differentiated pluripotent mesenchymal cells in which fibroblasts and histiocytes are partially differentiated. Radiologically, it is known as the “non-papillary tumor” and is commonly diagnosed as a large mass without necrosis, which shows invasion beyond the muscularis propia. Although the prognosis of this rare malignancy depends on pathological parameters, it generally has a poor prognosis with high local tumor recurrence. Here, we present a case of primary MFH in the urinary bladder with clinical symptoms of lower abdominal pain without gross hematuria that recurred rapidly and showed an aggressive disease course.

Objectives: South Korea has the highest suicide rate among Organisation for Economic Co-operation and Development countries; there is an increasing trend in suicide attempts among middle and high school students. Various factors contribute to the risk of suicide among adolescents, and the perception of suicide prevention has emerged as a significant factor. This study aimed to investigate the association between emotional and behavioral difficulties among middle and high school students and their perceptions of suicide prevention and to explore differences in suicide perception according to age. Methods: A survey was conducted among community middle and high school students, including 530 participants, between 2020 and 2021. Emotional and behavioral difficulties were assessed using the Strengths and Difficulties Questionnaire-Korean version, and participants were asked to complete a questionnaire on the importance and possibility of suicide prevention. A correlation test and analysis of variance were used to examine the relationships between the variables, and suicide awareness was compared according to age. Results: The participants who displayed higher strength or lower difficulty were more likely to respond positively to suicide prevention measures. They also exhibited high strength and low difficulty levels, thus agreeing with the importance of suicide prevention. Regarding age-related perceptions of suicide, adults aged 20–29 years reported the lowest probability of suicide prevention. Conclusion Suicide perceptions influence the incidence of suicide. Therefore, active societal engagement through suicide prevention campaigns and related education is essential to improve such perceptions. Continuous attention and support are required to address this issue.

Primary malignant fibrous histiocytoma (MFH) is a malignant tumor of mesenchymal origin that rarely occurs in the urinary tract, particularly in the urinary bladder. Unlike urothelial carcinoma, which accounts for most bladder cancers, it occurs in the submucosal portion of the bladder wall and consists of the lamina propria, muscularis propria, and adventitia.It is presumed to originate from poorly differentiated pluripotent mesenchymal cells in which fibroblasts and histiocytes are partially differentiated. Radiologically, it is known as the “non-papillary tumor” and is commonly diagnosed as a large mass without necrosis, which shows invasion beyond the muscularis propia. Although the prognosis of this rare malignancy depends on pathological parameters, it generally has a poor prognosis with high local tumor recurrence. Here, we present a case of primary MFH in the urinary bladder with clinical symptoms of lower abdominal pain without gross hematuria that recurred rapidly and showed an aggressive disease course.