Seigo Takamatsu

Bezafibrate may attenuate biliary damage associated with chronic liver diseases accompanied by high serum biliary enzyme levels.

BackgroundBezafibrate is a commonly used medicine for hyperlipidemia, and recently several reports have suggested the efficacy of bezafibrate for the treatment of primary biliary cirrhosis (PBC). To assess its efficacy for other liver diseases, we administered bezafibrate to patients with various categories of hepatobiliary impairment.MethodsBezafibrate (400 mg/day) was orally administered to 67 patients with chronic liver disease [22 with PBC, six with primary sclerosing cholangitis (PSC), 20 with chronic liver disease associated with hepatitis C virus (HCV) infection (CLD-C), seven with auto immune hepatitis (AIH), ten with alcoholic liver injury, and two with drug-induced liver injury].ResultsThe levels of biliary enzymes, such as alkaline phosphatase and γ-glutamyltranspeptidase, decreased promptly and dramatically. The abnormally high level of alanine aminotransferase also showed a gradual decrease over 6 months in five of the eight PBC patients, all three PSC patients, eight of the 17 CLD-C patients, and all seven alcoholic liver injury patients. The level of immunoglobulin M showed a gradual decrease in 17 of the 22 PBC patients.ConclusionsBezafibrate significantly reduced the level of biliary enzymes in various chronic liver diseases and may be useful for the treatment of certain liver disease subsets.

Noninvasive determination of liver collagen content in chronic hepatitis. Multivariate regression modeling with blood chemical parameters as variables

To evaluate the diagnostic utility of blood biochemical parameters in assessing degree of hepatic fibrosis, serum levels of aminoterminal type III procollagen peptide (P III P), type IV collagen (IV-collagen), 7S domain of type IV collagen (7S-collagen), and hyaluronan (HA) were measured in 54 patients with chronic viral liver disease. Liver collagen content was quantified by a computer-assisted image analysis method. Significant correlations were found between the amount of collagen in the liver and serum levels of P III P (r=0.482;P<0.02), IV-collagen (r=0.705;P<0.001), 7S-collagen (r=0.771;P<0.001), and HA (r=0.595;P<0.001). To optimize diagnostic efficacy, we applied multivariate regression analysis to to the combined results obtained for these blood biochemical parameters and some additional laboratory tests. The correlation coefficient obtained from the application of this model was 0.809. To measure the predictive value of the proposed model, we used it to estimate collagen content in an additional 16 patients with chronic liver disease and compared the estimated to the actual amount of collagen determined by direct measurement. The correlation coefficient was 0.937. These results suggest that application of the model would be useful for the assessment of collagen content of fibrotic liver.

Beneficial effect of bezafibrate on primary sclerosing cholangitis (three case reports).

noted between collagenous colitis and either hepatitis C or dermatomyositis. This is the first known report of a patient with hepatitis C, collagenous colitis, and dermatomyositis. We know that all three of these conditions appear to be related to alterations of the immune system. Thus it is possible that this is more than coincidence that these three diseases occurred together. As we gain more information about the specific etiologies of these diseases, we may find better ways to diagnose and treat these conditions.

Collagen content of liver biopsy specimens in patients with chronic hepatitis

Abstract Collagen content of liver biopsy specimens was determined in 65 patients with chronic hepatitis. The amount of collagen was quantified by computer-assisted image analysis using Sirius-red stained liver sections. The degree of fibrosis was categorized into 5 patterns according to Knodells criterion with slight modification. In comparison with normal liver, no significant increase in collagen content was detected in the fibrotic liver with portal fibrosis or invasion of fibrosis into the parenchyma associated with portal fibrosis with or without a fibrous septal bridge. The liver with more than two septal bridges or cirrhosis showed significantly higher amounts of collagen in the liver. These findings suggest that fibrous septal formation in the liver may be critical in the progression to cirrhosis.

Application of neural network to the interpretation of laboratory data for the diagnosis of two forms of chronic active hepatitis

Abstract The purpose of this study is to investigate the ability of neural network to discriminate the two subtypes, mild and severe form, of chronic active hepatitis, on the basis of the patterns of the five blood biochemical parameters. Serum levels of cholinesterase, albumin, alkaline phosphatase, type IV collagen and hyaluronate were used as variables. The neural network trained with the data from 31 patients: 11 of mild form and 20 of severe form of chronic active hepatitis. The ability of the network to predict the diagnosis of the patients who were additionally recruited was tested with a separate group (cross-validation group) of 9 patients with chronic active hepatitis. A neural network with 5 input neurons, 10 hidden neurons and 2 output neurons correctly classified all 31 patients. This network correctly predicted the diagnoses for 78% of the cross-validation group. These results suggested that neural network are useful for the differentiation of two forms of chronic active hepatitis by a less invasive blood biochemical analysis.

A case of hepatocellular carcinoma with HBcAg in carcinoma cells.

肝細胞癌102例(うち血中HBs抗原陽性36例)の肝組織内B型ウイルス関連抗原にいて,酵素抗体法(PAP法)を用いて検討した.このうち1例の肝癌細胞核内に,HBc抗原を認めた.症例は37歳男性.右背部痛を主訴として入院.各種画像診断,血管造影等によりmassivetypeの肝細胞癌と診断した.血中のHBs抗原,HBe抗原はともに陽性であった.AFPは陰性であった.約5カ月後に死亡し,死後肝穿刺により組織を得た.組織学的検索では,EdmondsonII～III型の肝細胞癌であった.HBc抗原は,癌部の比較的分化度の高い癌細胞核内に陽性であった.一方,HBs抗原は癌部では細胞質にびまん型に陽性を示し,非癌部では封入体型に陽性で,染色性の違いを認めた.癌細胞内HBc抗原の存在は,同部でのB型肝炎ウイルスの存在を示唆し,興味深い.