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.

Clinical symptoms and quality of life (QOL) were evaluated for 24 months in both patients. In patient 1, although energy expenditure had deteriorated somewhat after 3 months of the regular meal LES, it had greatly improved at 9 months after she had changed to the enteral nutrition product LES. In patient 2, energy expenditure gradually improved until 12 months with the enteral nutrition product LES (Fig. 1a). The frequency of muscle cramps decreased in both patients and the cramps disappeared after 16 and 18 months, respectively. Insomnia and early morning fatigue also improved in patient 2. According to subscale analysis of the SF-36, for the evaluation of QOL,4 the mental component summary (MCS) score gradually improved until 24 months in both patients, but there were no changes in the physical component summary (PCS) score (Fig. 1b). The alleviation of the muscle cramps may have been an effect on the skeletal muscle conferred by improved protein synthesis and reduced protein catabolism related to the alleviation of nocturnal starvation by the LES.5 The analysis of MCS and PCS (each of which consists of four subscales) can comprehensively evaluate mental and physical aspects of QOL in a quantitative fashion. An average healthy individual has a summary score of 50,4 and both patients showed an improvement in the mental aspects of QOL, which was probably the effect of the LES. In conclusion, long-term administration of a LES supplemented with BCAA to cirrhotic patients improved not only their energy expenditure but also their clinical symptoms and mental Letter to the editor

Long-term nutritional assessment and quality of life in patients with cirrhosis taking a late evening snack.

A 26-year-old woman, who had had Turner syndrome from age 10 years old, had diarrhea, fever, joint pain, and erythema in the lower left leg. She was given a diagnosis of Crohn's disease, erythema nodosum, and Hashimoto disease. Systemic steroid therapy was very effective for both intestinal and skin lesions. It has been reported that half of inflammatory bowel disease patients with Turner syndrome have 46XiX (q) type chromosome abnormality, and this case also has this type of abnormality.

[A case of Turner syndrome complicated with Crohn's disease, erythema nodosum and Hashimoto disease].

Summary We studied the effect in anesthetized rats of a new cholecystokinin (CCK) receptor antagonist developed in Japan, KSG-504, administered intraduodenally, on pancreatic exocrine secretion stimulated by exogenous CCK and intraduodenal casein Intraduodenal administration of KSG-504 in graded doses of 25-50 mg/kg/h produced dose-dependent inhibition of pancreatic juice volume and amylase output stimulated by intravenous infusion of CCK-8 in a dose of 006 μg/kg/h The ID, (half-maximal inhibition dose) of KSG-504 for CCK-8-stimulated amylase secretion was 34 mg/kg/h Moreover, intraduodenal KSG-504 (5 and 25 mg/kg/h) dose dependently suppressed pancreatic juice volume, and amylase output increased with intraduodenal infusion of casein (400 mg/h) It is concluded that KSG-504 administered intraduodenally has a significant, potent inhibitory action on the exocrine pancreas stimulated by exogenous CCK and intraduodenal casein

A new CCK-A antagonist, KSG-504, administered intraduodenally, inhibits pancreatic secretion in rats.

We have investigated the role of intestinal fat digestion in fat-induced suppression of gastric acid secretion and gastrin release in the rat. Intraduodenal administration of oleic acid (10%, pH 6.5) and triglyceride (10%, pH 6.5) at a rate of 2 ml/hr resulted in significant suppression of gastric acid secretion and gastrin release stimulated by intragastric perfusion of peptone (0.5%). Diversion of pancreatic juice from the duodenum completely abolished triglyceride-induced inhibition of peptone-stimulated gastric acid secretion and plasma gastrin release, but oleic acid-suppressed gastric acid secretion and gastrin release were unaffected by pancreatic juice diversion. Intraduodenal administration of digested triglyceride, prepared by preincubation with lipase, caused significant suppression of the peptone-induced gastric acid secretion and rise in plasma gastrin levels, even though pancreatic juice was excluded. The results of this study indicate that digestive products of triglyceride by pancreatic juice, especially by lipase, are responsible for the intestinal fat-induced inhibition of gastric acid secretion and gastrin release and that intestinal fat digestion plays a significant role in the mechanism.

Intestinal fat digestion plays a significant role in fat-induced suppression of gastric acid secretion and gastrin release in the rat

To compare sonazoid-enhanced ultrasound (SEUS) and contrast-enhanced computed tomography (CECT) enhancement and washout patterns in hepatic lesions. Enhancement and washout patterns on SEUS were compared with those on CECT for 61 lesions. There were 36 hepatocellular carcinomas, three intrahepatic cholangiocarcinomas, three metastatic lesions, eight focal nodular hyperplasias, two angiomyolipomas, and nine undetermined benign lesions. Diagnosis was based on histopathology, or CECT and tumor markers, or findings on 2-year follow-up. All 61 lesions (100%) showed arterial enhancement on both SEUS and CECT. The “washout/no washout” agreement between SEUS and CECT for the 61 lesions was 93.4% (κ coefficient: 0.816). Of the 42 malignant lesions, 38 lesions (90.5%) showed washout on both SEUS and CECT. The remaining four malignant lesions, of which three lesions contained fibrosis (two intrahepatic cholangiocarcinomas and one scirrhous hepatocellular carcinoma), showed washout on SEUS but not on CECT. For the 19 benign lesions, agreement between SEUS and CECT was 100% (κ coefficient: 1), with seven lesions showing washout with both methods and 12 lesions showing no washout with both methods. The overall concordance rate between SEUS and CECT was good, but some differences were seen in the washout patterns of malignant lesions.

Keiko Shiratori

Papers

Long-term nutritional assessment and quality of life in patients with cirrhosis taking a late evening snack.

[A case of Turner syndrome complicated with Crohn's disease, erythema nodosum and Hashimoto disease].

A new CCK-A antagonist, KSG-504, administered intraduodenally, inhibits pancreatic secretion in rats.

Intestinal fat digestion plays a significant role in fat-induced suppression of gastric acid secretion and gastrin release in the rat

Comparing enhancement and washout patterns of hepatic lesions between sonazoid-enhanced ultrasound and contrast-enhanced computed tomography