https://aasldpubs.onlinelibrary.wiley.com/doi/epdf/10.1002/hep.25762

The diagnosis and management of non-alcoholic fatty liver disease: practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association

SUMMARY Background Non-alcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease, and its worldwide prevalence continues to increase with the growing obesity epidemic. This study assesses the epidemiology of NAFLD in adults based on clinical literature published over the past 30 years. Aim To review epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults based on clinical literature published over the past 30 years. Methods An in-depth search of PubMed (1980–2010) was based on five search terms: ‘nonalcoholic fatty liver disease’ OR ‘non-alcoholic steatohepatitis’ OR ‘fatty liver’ OR ‘steatosis’ AND ‘incidence’ [MeSH Terms] OR ‘prevalence’ [MeSH Terms] OR ‘natural history’. Studies of paediatric cohorts were excluded. Articles were categorised by topic and summarised, noting generalisations concerning their content.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2036.2011.04724.x

Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults.

Background Sclerosing pancreatitis is a unique form of pancreatitis that is characterized by irregular narrowing of the main pancreatic duct, lymphoplasmacytic inflammation of the pancreas, and hypergammaglobulinemia and that responds to glucocorticoid treatment. Preliminary studies suggested that serum IgG4 concentrations are elevated in this disease but not in other diseases of the pancreas or biliary tract. Methods We measured serum IgG4 concentrations using single radial immunodiffusion and an enzyme-linked immunosorbent assay in 20 patients with sclerosing pancreatitis, 20 age- and sex-matched normal subjects, and 154 patients with pancreatic cancer, ordinary chronic pancreatitis, primary biliary cirrhosis, primary sclerosing cholangitis, or Sjogren's syndrome. Serum concentrations of immune complexes and the IgG4 subclass of immune complexes were determined by means of an enzyme-linked immunosorbent assay with monoclonal rheumatoid factor. Results The median serum IgG4 concentration in the patients ...

https://www.nejm.org/doi/pdf/10.1056/NEJM200103083441005

High serum IgG4 concentrations in patients with sclerosing pancreatitis.

https://aasldpubs.onlinelibrary.wiley.com/doi/epdf/10.1002/hep.20973

Nonalcoholic fatty liver disease: From steatosis to cirrhosis

/pdf/nccn-clinical-practice-guidelines-in-oncology-hepatobiliary-1kpacqqvi8.pdf

NCCN clinical practice guidelines in oncology: hepatobiliary cancers.

Aims: The aim of this study was to determine the clinicopathological features and surgical management of solid pseudopapillary neoplasms (SPNs) of the pancreas at

Clinical and Pathological Features of Solid Pseudopapillary Neoplasms of the Pancreas at a Single Institution

Background: Gastric antral vascular ectasia (GAVE) is characterized by diffuse vasodilation mainly affecting the antrum and causes gastrointestinal hemorrhage. Argon plasma coagulation (APC) provides rapid coagulation of a wide region, and thus appears to be more useful than conventional methods for the treatment of extensive lesions with superficial oozing bleeding, such as GAVE. In this study, we evaluated the use of APC for GAVE.



Methods:  The study subjects were 22 patients with GAVE (10 men and 12 women, mean age 65.8 years, diffuse type (n = 19) and watermelon type (n = 3)) who developed gastrointestinal hemorrhage (melena, fall in hemoglobin (Hb, by ≥ 2.0 g/dL), or endoscopy-confirmed bleeding) and treated with APC. Endoscopic treatment was applied weekly, and considered successful if all detectable GAVE lesions were eradicated and the Hb stabilized without further transfusion. Clinical outcome was assessed.



Results:  The median total number of treatment sessions was four (range: 2–9 times), and the median observation period was 23.5 months. The cumulative recurrence-free rate was 49.7% after 1 year, 35.5% after 2 years, and 35.5% after 3 years. The survival rates after treatment were 94.4, 75.8 and 64.9% at 1, 2, and 3 years, respectively. No complications of APC were observed.



Conclusion:  APC appears to be effective for temporary control of hemorrhage and anemia due to GAVE, but is not always effective over the long term. For proper management of GAVE, drug therapy, blood transfusion and control of the underlying disease are necessary in addition to achieving hemostasis temporarily by APC.

Long‐term follow up of gastric antral vascular ectasia treated by argon plasma coagulation

BACKGROUND AND AIM Host genetic factors have been reported as influencing the progress to fulminant hepatitis (FH). Our previous data showed the serum level of tumor necrosis factor (TNF)-alpha influenced by gene polymorphisms to be markedly increased. It was investigated whether polymorphisms in the IL-10 gene, in addition to TNF-alpha and -beta gene polymorphisms, might contribute to the pathogenesis of FH. METHODS We analyzed 42 patients with FH, 78 patients with acute hepatitis (AH), and 149 healthy subjects (control). IL-10 polymorphism sites at promoter regions -1028, -819, -592; TNF-alpha polymorphism sites at promoter regions -1031, -863, -857, -308, -238; and TNF-beta first intron Nco1 sites were studied. IL-10 gene polymorphisms were classified into three groups: low IL-10-producing haplotypes (ATA/ATA), intermediate haplotypes (ATA or CCA/CCA), and high haplotypes (ATA/ATG or CCG). RESULTS The allelic frequency of B2 in the TNF-beta gene was significantly higher in FH patients compared with the control group. The three groups showed no differences in polymorphisms of positions -1031, -863, -857, -308 and -238 in the TNF-alpha gene. The frequency of low IL-10-producing haplotypes tended to be higher in FH patients compared with control and that of high IL-10-producing haplotype tended to be lower in FH patients compared with control. The carrier rate with both the IL-10 haplotype and the TNF-beta gene B2/B2 was significantly higher than control. CONCLUSION Variations of cytokine polymorphisms including IL-10 and TNF-beta genes may be attributable to the pathogenesis of FH.

Possible involvement of cytokine gene polymorphisms in fulminant hepatitis.

ObjectivesIn addition to surgery, procedures for patients with pancreatolithiasis are developing; therefore, establishing practical guidelines for the management of pancreatolithiasis is required.MethodsThree committees (the professional committee for asking clinical questions (CQs) and statements b

Japanese Clinical Guidelines for Endoscopic Treatment of Pancreatolithiasis.

Background: Soluble tumor necrosis factor receptor (sTNFR) is reported to be a good indicator of TNF production and severity in inflammatory diseases. To investigate the clinical significance of sTNFR in non-alcoholic steatohepatitis (NASH), we measured the serum levels of soluble TNF receptor-1 and -2. Patients and Methods: We analyzed 82 NASH patients and 15 healthy subjects (control). The grades of fibrosis, inflammation and fatty deposit were evaluated on liver biopsy. The serum levels of sTNFR-1 and were measured by ELISA. Results: There was significant correlation between platelet count and sTNFRs. The titers of sTNFR-2 in NASH patients with diabetes mellitus (DM) were higher than in those without DM. The serum levels of sTNFRs in NASH patients with advanced fibrosis were increased compared with those of control and NASH patients with low-grade fibrosis. Soluble TNFRs in patients with moderate inflammation were increased compared to those of control and patients with mild inflammation. There was no significant association between fatty deposit grade and sTNFRs. Conclusion: Soluble TNFRs have a sienificant correlation with fibrosis in NASH.

Keiko Shiratori

Papers

Clinical and Pathological Features of Solid Pseudopapillary Neoplasms of the Pancreas at a Single Institution

Long‐term follow up of gastric antral vascular ectasia treated by argon plasma coagulation

Possible involvement of cytokine gene polymorphisms in fulminant hepatitis.

Japanese Clinical Guidelines for Endoscopic Treatment of Pancreatolithiasis.

Clinical significance of soluble TNF receptor in Japanese patients with non-alcoholic steatohepatitis.