Hepatol Res
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Clinicopathological significance of oxidative cellular damage in non-alcoholic fatty liver diseases.
Oxidative stress may play an important role in the progression of simple steatosis to non-alcoholic steatohepatitis (NASH). Oxidative stress is generated through multiple sources, including oxidation of free fatty acids, cytochrome P4502E1, iron overload, and necro-inflammatory cytokines including tumor necrosis factor-alpha. Oxidative stress may trigger damage to cellular membranes and nuclear DNA, which results in lipid peroxidation and oxidative DNA damage, respectively. ⋯ With respect to 8-OHdG, although no 8-OHdG expression was observed in normal liver and only a few in non-alcoholic simple fatty liver, 11 of 17 patients with NASH (65%) exhibited nuclear expression of 8-OHdG in hepatocytes and sinusoidal cells in areas of active inflammation. The 8-OHdG index significantly correlated with the grade of necro-inflammation, but not with the stage of fibrosis. Our observations suggest that oxidative cellular damage occurs frequently in livers with NAFLD and may be associated with some clinico-pathological features of NAFLD including liver fibrosis and possibly, hepatocarcinogenesis.
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The Japanese staging system that is generally used for hepatocellular carcinoma (HCC) (3rd edition) was considerably revised recently, especially T category. No study, however, has revealed how well the new classification (4th edition) works to stratify HCC patients at a pre-intervention stage. The purpose of this study is to assess the discriminatory value and predictive power of the 4th edition, and to compare its utility with the clinical utilities of the 3rd edition and the cancer of the liver Italian program (CLIP) score, as determined from 662 Japanese patients. ⋯ These findings indicate that the 4th edition has a higher stratification value than the 3rd edition. However, this benefit is due to the non-surgical patients, rather than to the surgical patients. If the 4th edition had an additional scoring system based on its original tumor staging and liver damage, it might be highly beneficial, although relative risk ratios of those should be analyzed.
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Guillain-Barré syndrome is characterized by acute paralysis and ascending neuropathy due to an inflammatory attack on the myelin of peripheral nerves. About 2/3 of patients with Guillain-Barré syndrome have an infection 1-3 weeks before the onset of the symptoms. Guillain-Barré syndrome has rarely been reported after solid organ transplantation (18 cases with three cases after liver transplantation), and these cases are mostly related to a CMV infection. ⋯ Although the patient received tacrolimus as immunosuppressant agent and is hepatitis C positive, we can conclude that the Campylobacter infection was probably the primary trigger for the development of Guillain-Barré syndrome. As T-cell response is depressed in our patient and cross-reactive antibodies (anti-ganglioside GM-1) exists after Campylobacter infection, we suppose that a humorally mediated attack is responsible for Guillain-Barré syndrome after solid organ transplantation. A review of the literature is performed.
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We conducted a randomized controlled trial to assess the efficacy of twice-a-day administration of natural interferon beta (IFNbeta) as an induction of IFN therapy for chronic hepatitis C. Seventy-one patients with chronic hepatitis C were enrolled into the trial and randomly assigned into three treatment groups. Six million units (MU) of IFNbeta were administered once-a-day for the first 4 weeks, and then thrice weekly for 12 weeks in 20 patients (once-a-day group). ⋯ Four patients in once-a-day group (20%), 9 in twice-a-day+beta group (39%), and 12 in twice-a-day+alpha group (43%) obtained sustained response. Sustained response rate in twice-a-day groups was higher than in once-a-day group, although there was no statistical significance. The present study suggested the possible superiority of twice-a-day administration of IFNbeta as an induction therapy to once-a-day administration, but further studies are needed to confirm this regimen.