No abstract

The etiology and prognosis differed in patients with fulminant hepatitis and LOHF depending on the disease types in Japan, and liver transplantation improved the prognosis of the patients irrespective of the disease type and etiology.

No abstract

This multicenter, randomized, open study revealed that combination therapy of bezafibrate and UDCA improved biliary enzymes in non-cirrhotic Japanese patients with PBC refractory to UDCA. Further studies are needed to evaluate whether combination therapy improves histological staging and prognosis.

Although the major histologic type in small gastric cancers, less than 10 mm in diameter, is differentiated-type adenocarcinoma (D.Ca), the incidence of D.Ca and that of undifferentiated-type adenocarcinoma (UD.Ca) is almost the same in all early gastric cancers. Histologic conversion from D.Ca to UD.Ca has been speculated, however, a detailed examination of this phenomenon has not yet been performed. Three-hundred and 51 early gastric cancers (D.Ca, 150 (42.7%) lesions; UD.Ca, 93 (26.4%) lesions; and mixed differentiated and undifferentiated type (D&UD.Ca), 108 (30.8%) lesions; tumor size less than 10 mm in diameter; 64 lesions, more than 10 mm, 287 lesions) were examined histochemically with paradoxical concanavalin A type III and high-iron diamine-Alcian blue (pH 2.5), and immunohistochemically with antigastric mucin antibody. The associations between tumor size, tumor differentiation and phenotypic expression of mucin were examined. Regardless of the tumor size, mucin phenotypic expression in the mucosal lesions examined was preserved. Of 47 cancers with a gastrointestinal mucin phenotype (GIM type) or a gastric mucin phenotype (GM type) measuring less than 10 mm, 35 (74.5%) consisted of D.Ca and 12 (25.5%) of both D&UD.Ca and UD.Ca, while of 224 GIM or GM type cancers measuring more than 10 mm, 64 (28.6%) consisted of D.Ca and 160 (71.4%) of both D&UD.Ca and UD.Ca. Differences between these two groups were statistically significant (P < 0.001). Of 15 cancers with an intestinal mucin phenotype (IM type) measuring less than 10 mm, 12 (80.0%) consisted of D.Ca and three (20.0%) of both D&UD.Ca and UD.Ca, and of 50 IM type cancers measuring more than 10 mm, 35 (70.0%) consisted of D.Ca and 15 (30.0%) of both D&UD.Ca and UD.Ca. Differences between these two groups were not statistically significant. These findings suggest that small D.Ca showing gastric mucin expression may transform into UD.Ca during the progression of early gastric cancer.

No abstract

The liver enzymes, alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH), which are responsible for the oxidative metabolism of ethanol, are polymorphic in humans. Cytochrome P450IIE1, an ethanol-inducible isozyme of liver microsomal P450, is also important in ethanol metabolism. Genetic polymorphisms in the 5'-flanking region of the human cytochrome P450IIE1 gene have recently been reported. We hypothesized that the polymorphisms of ADH, ALDH, and P450IIE1 modify the susceptibility to development of alcoholism. We determined the genotypes of the ADH2, ALDH2, and P450IIE1 loci of 96 Japanese alcoholics and 60 healthy male subjects, using leukocyte DNA by the restriction fragment-length polymorphism by polymerase chain reaction. The alcoholics had significantly higher frequencies of the ADH2(1) and ALDH2(1) alleles than did the healthy subjects. No significant difference in the frequency of the P450IIE1 genotype was observed between the alcoholics and the healthy subjects. In conclusion, genetic polymorphisms of the ADH and ALDH genes, but not of the P450IIE1 gene, influence the risk of developing alcoholism in Japanese.

Mucosal addressin cell adhesion molecule-1 (MAdCAM-1) is selectively expressed in the endothelial cells of intestinal mucosa and gut-associated lymphoid tissue (GALT). Engagement of MAdCAM-1 to its ligand, integrin alpha4beta7, on lymphocytes is associated with the homing of gut-associated lymphocytes to normal gastrointestinal tract and inflammation sites. The present study was designed to elucidate differences between Crohn's disease (CrD) and ulcerative colitis (UC) from the expression patterns of MAdCAM-1. Samples were taken from 40 patients with CrD and 24 patients with UC at surgical resection. Using frozen sections, immunohistochemistry was performed for MAdCAM-1, E-selectin and CD34. MAdCAM-1+ venules were abundant in inflamed mucosa in both UC and CrD. In contrast, clear differences were noted between UC and CrD in the inflammatory area in the ulcer base, that is, MAdCAM-1+ venules were more abundant in CrD than in UC (P < 0.001), while E-selectin was expressed equally in these venules in both diseases. Furthermore, CrD was characterized by the occurrence of MAdCAM-1+ venules in deeper layers of the intestinal tissue, mainly in lymphoid aggregates. Our data indicated more extensive expression of MAdCAM-1 in CrD, which could contribute not only to mucosal inflammation, but also to transmural inflammation in CrD.