Hepatology Research最新文献

{"title":"Cisterna Chyli Dilation Is a Risk Factor for Liver Nodules and Hepatocellular Carcinoma in Fontan-Associated Liver Disease: Pathophysiological Role of Lymphatic Dysfunction.","authors":"Koji Imoto, Masatake Tanaka, Takeshi Goya, Yuuki Azuma, Tomonobu Hioki, Yusuke Morita, Keisuke Sakaguchi, Nobuhiro Fujita, Takamori Kakino, Ayako Ishikita, Kenichiro Yamamura, Ichiro Sakamoto, Kousei Ishigami, Kohtaro Abe, Yoshihiro Ogawa","doi":"10.1111/hepr.70268","DOIUrl":"https://doi.org/10.1111/hepr.70268","url":null,"abstract":"<p><strong>Aim: </strong>In Fontan-associated liver disease (FALD), chronic congestion often confounds conventional fibrosis markers, complicating surveillance for hepatocellular carcinoma (HCC). Although lymphatic dysfunction is fundamental to Fontan physiology, its contribution to hepatocarcinogenesis remains unclear. We aimed to investigate how lymphatic congestion, quantified by cisterna chyli (CC) dilation, is associated with liver nodules and HCC.</p><p><strong>Methods: </strong>We retrospectively analyzed 77 patients with FALD who underwent cardiac catheterization and contrast-enhanced computed tomography or magnetic resonance imaging. Clinical, hemodynamic, and lymphatic parameters were evaluated to identify factors independently associated with liver nodules. HCC-related analyses were carried out exploratorily because of the limited number of HCC cases.</p><p><strong>Results: </strong>Liver nodules were identified in 43 patients (55.8%), including six patients with HCC. CC diameter was 3.2 mm, 4.1 mm, and 6.6 mm in the non-nodule, nodule without HCC, and HCC groups, respectively (p < 0.0001). In multivariable analysis, larger CC diameter and higher total bile acid (TBA) levels were independently associated with liver nodules, whereas anticoagulant therapy showed an inverse trend. Exploratory analyses suggested an association between larger CC diameter and HCC. CC diameter showed positive correlations with central venous pressure indices and TBA, suggesting a relationship between CC enlargement and the hemodynamic and hepatic abnormalities of FALD.</p><p><strong>Conclusion: </strong>CC dilation was associated with liver nodules in FALD and may reflect lymphatic and hemodynamic burden related to chronic venous congestion. Its potential association with HCC requires validation in larger prospective cohorts.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Leucine-Rich α2-Glycoprotein 1 Identifies Cachexia in Patients With Liver Cirrhosis and/or Hepatocellular Carcinoma Having Low C-Reactive Protein Levels.","authors":"Takatsugu Tanaka, Goki Suda, Masatsugu Ohara, Osamu Maehara, Tomoka Yoda, Qingjie Fu, Zijian Yang, Daisuke Yokoyama, Naohiro Yasuura, Akimitsu Meno, Risako Kohya, Takashi Kitagataya, Naoki Kawagishi, Masato Nakai, Takuya Sho, Shunsuke Ohnishi, Naoya Sakamoto","doi":"10.1111/hepr.70270","DOIUrl":"https://doi.org/10.1111/hepr.70270","url":null,"abstract":"<p><strong>Aim: </strong>Cachexia in liver cirrhosis (LC) and hepatocellular carcinoma (HCC) is associated with poor outcomes. Although C-reactive protein (CRP) is used for diagnosis, its limited specificity may hinder detection of cachexia without systemic inflammation. Leucine-rich α2-glycoprotein 1 (LRG1) may identify cachexia when CRP is low; however, its significance in LC and HCC remains unclear.</p><p><strong>Methods: </strong>We retrospectively enrolled 243 patients with LC and/or HCC. Cachexia was defined according to the Asian Working Group for Cachexia criteria. Serum LRG1 levels were measured, and associations with cachexia, CRP, and survival were analyzed. Receiver operating characteristic curve analysis determined the optimal LRG1 cutoff.</p><p><strong>Results: </strong>Cachexia, observed in 65 patients (26.7%), was independently associated with shorter survival. Serum LRG1 levels were higher in patients with cachexia than in those without (median, 16.70 vs. 11.55 μg/mL; p < 0.001). Although LRG1 correlated with CRP, high LRG1 was observed in some patients with low CRP. In multivariable analysis, LRG1 remained independently associated with cachexia (odds ratio, 1.060; 95% confidence interval, 1.000-1.130; p = 0.045). The optimal LRG1 cutoff was 15.2 μg/mL; cachexia was more frequent in patients with high LRG1 than in those without (48.75% vs. 15.95%, p < 0.001). Among patients with cachexia having low CRP, 37.5% had high LRG1. In the low-CRP subgroup, LRG1 remained independently associated with cachexia.</p><p><strong>Conclusions: </strong>Serum LRG1 is associated with cachexia in LC and/or HCC and may provide clinically relevant information not captured by CRP. LRG1 assessment may improve recognition and stratification of cachexia, even in patients with low CRP levels.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid Intrasegmental Progression After Percutaneous Radiofrequency Ablation for Hepatocellular Carcinoma: Incidence, Imaging Features, and Clinical Outcomes.","authors":"Takuma Kaneko, Takuma Nakatsuka, Ryosuke Tateishi, Keisuke Mabuchi, Yuki Matsushita, Tomoharu Yamada, Tatsuya Minami, Masaya Sato, Mitsuhiro Fujishiro","doi":"10.1111/hepr.70267","DOIUrl":"https://doi.org/10.1111/hepr.70267","url":null,"abstract":"<p><strong>Aim: </strong>Radiofrequency ablation (RFA) is curative therapy for early-stage hepatocellular carcinoma (HCC), but a rare subset of patients develop aggressive intrasegmental recurrence shortly after complete ablation. We characterized the incidence, risk factors, and absolute risk.</p><p><strong>Methods: </strong>This single-center retrospective study included consecutive patients with HCC treated with RFA from August 2002 to December 2024. Rapid progression was defined as recurrence at the ablation margin within 6 months that precluded further locoregional therapy. Cases were matched 1 to 4 with controls based on treatment era, prior RFA sessions, tumor diameter, and tumor number. Preablation imaging and tumor marker dynamics were compared, and absolute risk was estimated.</p><p><strong>Results: </strong>Among 3163 patients who underwent 10,240 RFA treatments, 20 (0.20%) met criteria for rapid progression. Aggressive imaging features including nonsmooth margins (OR 5.87, 95% CI 1.80-19.12) and multinodular confluent growth (OR 3.84, 95% CI 1.30-11.36) were significantly more common in the rapid progression group, though positive predictive values remained below 1%. Irregular rim-like hyperenhancement was present in 15% of rapid progression cases but was absent in all controls. Periportal location accounted for half of the rapid progression cases (OR 2.84, 95% CI 0.97-8.29). Tumor markers including alpha-fetoprotein and des-gamma-carboxy prothrombin declined after RFA in controls but not in the rapid progression group.</p><p><strong>Conclusions: </strong>Aggressive imaging features and insufficient post-ablation tumor marker decline were associated with rapid progression, though individual predictive value was low. Tumor marker trends may help guide surveillance and earlier transition to systemic therapy.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on“Anti-MRPS27 Antibody: A Novel Diagnostic Biomarker for Autoimmune Hepatitis Identified via a Human Proteome Microarray”","authors":"Wei Ouyang,&nbsp;Miaofeng Wang,&nbsp;Yu Zhang","doi":"10.1111/hepr.70199","DOIUrl":"10.1111/hepr.70199","url":null,"abstract":"","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"56 9","pages":"1438-1439"},"PeriodicalIF":3.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Mac-2 Binding Protein Glycan Isomer and Cerebral White Matter Injury in Older Adults: A Hepatic–Cerebral Link","authors":"Maiko Nagaoka,&nbsp;Katsuya Nagaoka,&nbsp;Naoto Kajitani,&nbsp;Yoko Yoshimaru,&nbsp;Takehisa Watanabe,&nbsp;Hiroko Setoyama,&nbsp;Hirofumi Soejima,&nbsp;Noboru Fujise,&nbsp;Minoru Takebayashi,&nbsp;Manabu Makinodan,&nbsp;Yasuhito Tanaka","doi":"10.1111/hepr.70209","DOIUrl":"10.1111/hepr.70209","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Metabolic dysfunction–associated steatotic liver disease (MASLD) is increasingly recognized as a systemic condition with extrahepatic complications; however, its impact on cerebral microvascular pathology remains poorly understood. This study aimed to examine the association between serum Mac-2 binding protein glycan isomer (M2BPGi), a validated biomarker of liver fibrosis, and cerebral small vessel disease (CSVD), as reflected by T1-weighted white matter hypointensity volume (WM hypointensity).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional analysis of 1577 community-dwelling older adults enrolled in the Arao cohort, of whom 602 participants met the inclusion criteria and were included in the final analysis. MASLD was defined using the fatty liver index (FLI) ≥ 30 in combination with metabolic criteria. WM hypointensity volume was quantified using MRI and analyzed with FreeSurfer software. Multivariable linear regression analyses were performed to identify factors associated with WM hypointensity, adjusting for age, sex, and established vascular risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Higher serum M2BPGi levels were independently associated with increased WM hypointensity (<i>β</i> = 1190.39, 95% CI 149.15–2231.63; <i>p</i> = 0.025) after adjustment for age, sex, hypertension, diabetes mellitus, hyperlipidemia, and high-sensitivity C-reactive protein. The association between M2BPGi and WM hypointensity was consistent regardless of MASLD status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Serum M2BPGi levels are independently associated with greater WM hypointensity burden in older adults, irrespective of MASLD status or systemic inflammation. These findings support the presence of a hepatic–cerebral axis and suggest that liver fibrosis biomarkers may help identify individuals at increased risk of cerebral microvascular injury.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"56 9","pages":"1392-1401"},"PeriodicalIF":3.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Stereotactic Body Radiation Therapy in Patients With Hepatocellular Carcinoma in the Caudate Lobe: A Comparative Study With Radiofrequency Ablation","authors":"Yuki Tamura,&nbsp;Hirotaka Arai,&nbsp;Hiroki Kiyohara,&nbsp;Yukihiko Yoshimatsu,&nbsp;Satoru Kakizaki,&nbsp;Yuki Kanayama,&nbsp;Takeshi Hatanaka,&nbsp;Atsushi Naganuma,&nbsp;Takashi Ueno,&nbsp;Satoshi Takakusagi,&nbsp;Toru Fukuchi,&nbsp;Hiroki Tojima,&nbsp;Yuichi Yamazaki,&nbsp;Kei Shibuya,&nbsp;Tatsuya Ohno,&nbsp;Toshio Uraoka","doi":"10.1111/hepr.70197","DOIUrl":"10.1111/hepr.70197","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study compared the efficacy and safety of stereotactic body radiation therapy (SBRT) and radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) located in the caudate lobe.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 57 patients with caudate lobe HCC who underwent either RFA (<i>n</i> = 39) or SBRT (<i>n</i> = 18) at seven institutions in Japan between January 2016 and August 2025. Local tumor progression (LTP), distant recurrence, overall survival (OS), and changes in albumin–bilirubin (ALBI) scores were analyzed. Propensity score matching (PSM) was performed to minimize baseline imbalances between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median age was 74 years, and most patients were male. No significant difference was observed in LTP or distant recurrence between the two groups in the crude cohort (<i>p</i> = 0.856 and 0.622), the PSM cohort (<i>p</i> = 0.286 and 0.907), or the curative-intent subgroup (patients with no more than three lesions, each 3 cm or less) (<i>p</i> = 0.827 and 0.533). Although OS did not differ in the crude cohort (<i>p</i> = 0.090) or the curative-intent subgroup (<i>p</i> = 0.060), OS was better in the RFA group than in the SBRT group in the PSM cohort (<i>p</i> = 0.031). No grade ≥ 3 adverse events occurred in either group. However, ALBI scores worsened significantly in the SBRT group compared with the RFA group (<i>p</i> = 0.012).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SBRT achieved favorable local control with an acceptable safety profile. It may represent a valuable alternative for patients in whom RFA is technically challenging.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"56 9","pages":"1354-1365"},"PeriodicalIF":3.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compensatory Hepatic Hypertrophy After Carbon Ion Radiotherapy for Hepatocellular Carcinoma: Factors Associated With Its Development and Relationship With Prognosis","authors":"Tatsuma Murakami,&nbsp;Takeshi Hatanaka,&nbsp;Yumeo Tateyama,&nbsp;Hiroki Tojima,&nbsp;Yuichi Yamazaki,&nbsp;Yuhei Miyasaka,&nbsp;Kei Shibuya,&nbsp;Atsushi Naganuma,&nbsp;Satoru Kakizaki,&nbsp;Tatsuya Ohno,&nbsp;Toshio Uraoka","doi":"10.1111/hepr.70206","DOIUrl":"10.1111/hepr.70206","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to investigate predictors of compensatory hepatic hypertrophy and their association with prognosis in patients undergoing carbon ion radiotherapy (CIRT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this retrospective analysis, we included 94 patients with hepatocellular carcinoma (HCC) who received CIRT at Gunma University between November 2010 and June 2020. Significant compensatory hypertrophy was defined as an increase of more than 50 cm³ in the hepatic lateral segment volume at 3 months after CIRT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median age of the patients was 76.5 years (IQR, 69.0–83.0), and 63 (67.0%) were male. The median volume of the lateral segment was 254 cm³ (IQR, 183–354), and the median clinical target volume (CTV) was 72.52 cm³ (IQR, 33.69–148.75). Compared with pretreatment values, an increase in volume was observed in 74 (78.7%) patients, whereas a decrease was noted in 20 (21.3%). Significant compensatory hypertrophy was observed in 27 (28.7%) patients. Patients with significant compensatory hypertrophy had larger tumor diameters and CTV values than those without hypertrophy (<i>p</i> = 0.03 and <i>p</i> = 0.01, respectively). The median overall survival was 87.3 months in patients with significant compensatory hypertrophy and 88.8 months in those without, with no significant difference between the groups (<i>p</i> = 0.5). In contrast, patients without worsening ALBI scores had significantly better survival than those with worsening ALBI scores (<i>p</i> = 0.004).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Compensatory hypertrophy was frequently observed after CIRT in HCC patients but was not associated with prognosis. Preservation of liver function appears to be important for achieving a favorable prognosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"56 9","pages":"1382-1391"},"PeriodicalIF":3.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147987234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ALDH2 Polymorphism in Alcohol-Related Cirrhosis Requiring Liver Transplantation: A Recipient–Donor Analysis","authors":"Noriyo Yamashiki,&nbsp;Yoshihide Ueda,&nbsp;Takashi Ito,&nbsp;Etsuro Hatano","doi":"10.1111/hepr.70200","DOIUrl":"10.1111/hepr.70200","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Genetic polymorphisms of alcohol-metabolizing enzymes influence drinking behavior and susceptibility to alcohol-related liver disease (ALD). This study aimed to clarify the distribution of ALDH2 and ADH1B genotypes in liver transplant recipients with ALD, and to explore associations with post-transplant drinking behavior using a recipient–donor paired design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-four living donor liver transplant (LDLT) recipients with ALD, their corresponding living donors, and 50 healthy controls were analyzed. Single nucleotide polymorphisms of ALDH2 (rs671) and ADH1B (rs1229984) were determined by the Cycleave PCR method. Drinking behavior before and after transplantation was assessed by self-report and electronic health records. Post-transplant alcohol use was classified as habitual (≥ once per week) or occasional (&lt; once per week).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ALDH2 genotype distribution differed among three groups (<i>p</i> = 0.002), with enrichment of the ALDH2*1/*1 genotype in ALD recipients (92%). ADH1B genotype distribution also differed among groups (<i>p</i> = 0.041), although the effect size was modest. During a median follow-up of 5.3 years (range, 0.3–15.9 years), 11 recipients (45%) reported post-transplant alcohol use, including 5 habitual drinkers (20%). In an exploratory analysis, a non-significant trend toward higher rates of habitual drinking was observed among recipients who received grafts from donors with the ALDH2*1/*1 genotype compared with other genotypes (40% vs. 7%, <i>p</i> = 0.12).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The ALDH2*1/*1 genotype was more prevalent among liver transplant recipients with alcohol-related cirrhosis than among donors or healthy controls, supporting a role of alcohol tolerance–related genetic background in progression to end-stage liver disease. Donor ALDH2 genotypes may also influence post-transplant drinking behavior in an exploratory manner.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"56 9","pages":"1419-1425"},"PeriodicalIF":3.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hepr.70200","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nationwide Engagement in an Interdisciplinary eLearning Program on Alcohol Dependence in Japan","authors":"Akihiko Shibamoto,&nbsp;Tadashi Namisaki,&nbsp;Ryuhei So,&nbsp;Taro Takami,&nbsp;Yasunari Nakamoto,&nbsp;Shuji Terai,&nbsp;Tetsuo Takehara,&nbsp;Yoshinori Horie,&nbsp;Toshikazu Saito,&nbsp;Susumu Higuchi,&nbsp;Hitoshi Yoshiji","doi":"10.1111/hepr.70196","DOIUrl":"10.1111/hepr.70196","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>eLearning has become an essential platform for continuing medical education in Japan, but engagement trends across regions and specialties remain poorly defined. Therefore, this study analyzed participation patterns in an eLearning program jointly organized by the Japanese Society of Alcohol-Related Problems and Addiction Medicine and the Japan Society of Hepatology in an effort to improve clinical skills in alcohol dependence management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Aggregate data from a nationwide eLearning platform as of June 2025 were analyzed, focusing on prefectural, specialty, and academic society distributions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 3860 course completions were analyzed. Participation rose continuously from 2022 to 2025. Tokyo had the highest number of participants (<i>n</i> = 511), followed by Osaka (<i>n</i> = 269) and Kanagawa (<i>n</i> = 257). When adjusted for population, Nara Prefecture ranked first in participation (7.70 per 100,000), followed by Wakayama Prefecture (6.94) and Shimane Prefecture (6.24). Psychiatry accounted for 52.0% of participants (mean age, 44.7 years), whereas internal medicine accounted for 39.3% (mean age, 48.7 years). The Japanese Society of Psychiatry and Neurology contributed 44.3% of participants, whereas the Japan Society of Hepatology contributed 20.5%. More than half of the participants worked in hospitals (53.5%). Meanwhile, 60% of the participants completed courses during holidays or outside standard working hours.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This large-scale eLearning initiative achieved nationwide adoption with distinctive regional and specialty disparities. The observed sustained participation in this initiative underscores the value of interdisciplinary collaboration and growing importance of digital education in alcohol-related medicine.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"56 9","pages":"1342-1353"},"PeriodicalIF":3.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variability in Liver Disease Progression and Outcomes in Glycogen Storage Disease Type IV","authors":"Rebecca L. Koch,&nbsp;William R. Jeck,&nbsp;Priya S. Kishnani","doi":"10.1111/hepr.70201","DOIUrl":"10.1111/hepr.70201","url":null,"abstract":"","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"56 9","pages":"1440-1442"},"PeriodicalIF":3.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}