AIM: To characterize and evaluate the therapeuti efficacy of bioartificial liver (BAL) as compared to tha of continuous hemodiafiltration (CHDF) with plasma exchange (PE), which is the current standard therapy fo fulm...AIM: To characterize and evaluate the therapeuti efficacy of bioartificial liver (BAL) as compared to tha of continuous hemodiafiltration (CHDF) with plasma exchange (PE), which is the current standard therapy fo fulminant hepatic failure (FHF) in Japan. METHODS: Pigs with hepatic devascularization were divided into three groups: (1) a non-treatment group (NT; n = 4); (2) a BAL treatment group (BAL; n = 4) (3) a PE + CHDF treatment group using 1.5 L of norma porcine plasma with CHDF (PE + CHDF, n = 4). Our BA system consisted of a hollow fiber module with 0.2 μm pores and 1 x 1010 of microcarrier-attached hepatocyte inoculated into the extra-fiber space. Each treatment wa initiated 4 h after hepatic devascularization. RESULTS: The pigs in the BAL and the PE + CHD groups survived longer than those in the NT group. The elimination capacity of blood ammonia by both BAL and PE + CHDF was significantly higher than that in NT Aromatic amino acids (AAA) were selectively eliminated by BAL, whereas both AAA and branched chain amino acids, which are beneficial for life, were eliminated by PE + CHDF. Electrolytes maintenance and acid-base balance were better in the CPE + CHDF group than that in the BAL group. CONCLUSION: Our results suggest that PE + CHDF eliminate all factors regardless of benefits, wherea BAL selectively metabolizes toxic factors such as AAA However since PE + CHDF maintain electrolytes and acid-base balance, a combination therapy of BAL plu CPE + CHDF might be more effective for FHF.展开更多
Interferon (IFN) therapy is the only treatment strategy for hepatitis C virus (HCV) infection after liver transplantation (LT), but prophylactic and treatable IFN therapy after LT has been shown to be insufficient due...Interferon (IFN) therapy is the only treatment strategy for hepatitis C virus (HCV) infection after liver transplantation (LT), but prophylactic and treatable IFN therapy after LT has been shown to be insufficient due to the adverse effects of IFN and rivabirin. In this paper, we describe the disappearance of HCV after LT without IFN therapy in the presence of residual viremia on the day of LT. We herein report our findings since this is considered an important case for the anti-HCV strategy of post LT. A 60-year old woman with LC and HCC was referred to Nagasaki University Hospital in August 2004. After she underwent LT on February 18, 2005, we injected peg- IFN-α-2a the 11th time at 18 wk and HCV-RNA was still positive in the serum at LT. The serum HCV-RNA was negative one month after operation and subsequently dissolved 15 mo after operation without IFN therapy. As a result, we speculate that if HCV-RNA is positive while HCV core antigen is negative before LT, then it may lead to clearance of HCV after LT. Therefore long acting peg-IFN- α-2a is thus considered a potentially effective agent for the treatment of HCV-related cirrhosis before LT.展开更多
AIM: To elucidate the metabolism and the effect of the cyclosporin A (CyA) as a representative immuno-suppressive drug used in transplantation in a partially hepatectomized rat model. METHODS: CyA was administered to ...AIM: To elucidate the metabolism and the effect of the cyclosporin A (CyA) as a representative immuno-suppressive drug used in transplantation in a partially hepatectomized rat model. METHODS: CyA was administered to rats that under- went a 70% hepatectomy. These rats were randomly assigned into three groups according to the dose of CyA administration as follows; (group 1) water, (group 2) 5 mg/kg CyA, (group 3) 10 mg/kg CyA. On post- operative days-1, 3, 7 and 14, the rats were killed to analyze the serum concentration of CyA, the liver re- generation ratio, biochemical or histological markers, and mRNA expression using reverse transcriptase-poly- merase chain reaction method to determine albumin and cytochrome p450 expression. RESULTS: The serum concentration of CyA in group 3 was significantly higher than group 2 during liver regeneration. CyA enhanced the liver regeneration in a dose dependent manner. The mRNA expression associ- ated with CyA metabolism was signifi cantly decreased on day 14, while preserving the albumin producing activity. CONCLUSION: These data indicate that the p-450 ac-tivity required to metabolize the CyA may be reduced during regeneration of the remnant liver after a hepa- tectomy, which may, therefore, be linked to diffi culty in controlling the optimal dose of CyA during early period of LDLT.展开更多
We report a patient with hyperplastic polyposis who had two asynchronous colon cancers, a combined adenoma-hyperplastic polyp, a serrated adenoma, and tubular adenomas. Hyperplastic polyposis is thought to be a precan...We report a patient with hyperplastic polyposis who had two asynchronous colon cancers, a combined adenoma-hyperplastic polyp, a serrated adenoma, and tubular adenomas. Hyperplastic polyposis is thought to be a precancerous lesion; and adenocarcinoma arises from hyperplastic polyposis through the hyperplastic polyp-adenoma-carcinoma sequence. Most polyps in patients with hyperplastic polyposis present as bland- looking hyperplastic polyps, which are regarded as non- neoplastic lesions; however, the risk of malignancy should not be underestimated. In patients with multiple hyperplastic polyps, hyperplastic polyposis should be identified and followed up carefully in order to detect malignant transformation in the early stage.展开更多
文摘AIM: To characterize and evaluate the therapeuti efficacy of bioartificial liver (BAL) as compared to tha of continuous hemodiafiltration (CHDF) with plasma exchange (PE), which is the current standard therapy fo fulminant hepatic failure (FHF) in Japan. METHODS: Pigs with hepatic devascularization were divided into three groups: (1) a non-treatment group (NT; n = 4); (2) a BAL treatment group (BAL; n = 4) (3) a PE + CHDF treatment group using 1.5 L of norma porcine plasma with CHDF (PE + CHDF, n = 4). Our BA system consisted of a hollow fiber module with 0.2 μm pores and 1 x 1010 of microcarrier-attached hepatocyte inoculated into the extra-fiber space. Each treatment wa initiated 4 h after hepatic devascularization. RESULTS: The pigs in the BAL and the PE + CHD groups survived longer than those in the NT group. The elimination capacity of blood ammonia by both BAL and PE + CHDF was significantly higher than that in NT Aromatic amino acids (AAA) were selectively eliminated by BAL, whereas both AAA and branched chain amino acids, which are beneficial for life, were eliminated by PE + CHDF. Electrolytes maintenance and acid-base balance were better in the CPE + CHDF group than that in the BAL group. CONCLUSION: Our results suggest that PE + CHDF eliminate all factors regardless of benefits, wherea BAL selectively metabolizes toxic factors such as AAA However since PE + CHDF maintain electrolytes and acid-base balance, a combination therapy of BAL plu CPE + CHDF might be more effective for FHF.
文摘Interferon (IFN) therapy is the only treatment strategy for hepatitis C virus (HCV) infection after liver transplantation (LT), but prophylactic and treatable IFN therapy after LT has been shown to be insufficient due to the adverse effects of IFN and rivabirin. In this paper, we describe the disappearance of HCV after LT without IFN therapy in the presence of residual viremia on the day of LT. We herein report our findings since this is considered an important case for the anti-HCV strategy of post LT. A 60-year old woman with LC and HCC was referred to Nagasaki University Hospital in August 2004. After she underwent LT on February 18, 2005, we injected peg- IFN-α-2a the 11th time at 18 wk and HCV-RNA was still positive in the serum at LT. The serum HCV-RNA was negative one month after operation and subsequently dissolved 15 mo after operation without IFN therapy. As a result, we speculate that if HCV-RNA is positive while HCV core antigen is negative before LT, then it may lead to clearance of HCV after LT. Therefore long acting peg-IFN- α-2a is thus considered a potentially effective agent for the treatment of HCV-related cirrhosis before LT.
文摘AIM: To elucidate the metabolism and the effect of the cyclosporin A (CyA) as a representative immuno-suppressive drug used in transplantation in a partially hepatectomized rat model. METHODS: CyA was administered to rats that under- went a 70% hepatectomy. These rats were randomly assigned into three groups according to the dose of CyA administration as follows; (group 1) water, (group 2) 5 mg/kg CyA, (group 3) 10 mg/kg CyA. On post- operative days-1, 3, 7 and 14, the rats were killed to analyze the serum concentration of CyA, the liver re- generation ratio, biochemical or histological markers, and mRNA expression using reverse transcriptase-poly- merase chain reaction method to determine albumin and cytochrome p450 expression. RESULTS: The serum concentration of CyA in group 3 was significantly higher than group 2 during liver regeneration. CyA enhanced the liver regeneration in a dose dependent manner. The mRNA expression associ- ated with CyA metabolism was signifi cantly decreased on day 14, while preserving the albumin producing activity. CONCLUSION: These data indicate that the p-450 ac-tivity required to metabolize the CyA may be reduced during regeneration of the remnant liver after a hepa- tectomy, which may, therefore, be linked to diffi culty in controlling the optimal dose of CyA during early period of LDLT.
文摘We report a patient with hyperplastic polyposis who had two asynchronous colon cancers, a combined adenoma-hyperplastic polyp, a serrated adenoma, and tubular adenomas. Hyperplastic polyposis is thought to be a precancerous lesion; and adenocarcinoma arises from hyperplastic polyposis through the hyperplastic polyp-adenoma-carcinoma sequence. Most polyps in patients with hyperplastic polyposis present as bland- looking hyperplastic polyps, which are regarded as non- neoplastic lesions; however, the risk of malignancy should not be underestimated. In patients with multiple hyperplastic polyps, hyperplastic polyposis should be identified and followed up carefully in order to detect malignant transformation in the early stage.
