AIM： To investigate the efficacy of angiotensin Ⅱ receptor antagonist on hepatic stellate cells （HSCs） activation in the patients with non-alcoholic steatohepatitis （NASH）. METHODS： Seven patients with NASH wer...AIM： To investigate the efficacy of angiotensin Ⅱ receptor antagonist on hepatic stellate cells （HSCs） activation in the patients with non-alcoholic steatohepatitis （NASH）. METHODS： Seven patients with NASH were prescribed Iosartan, a selective angiotensin Ⅱ type 1 receptor antagonist （50 mg/d） for 48 wk. Liver biopsies were performed both at the entry and end of the study in all patients. Quiescent and activated HSCs were identified by double immunostaining using anti-p75 and α-smooth muscle actin antibodies, and the number of each phenotype was counted. Similarly, the liver specimens obtained from the eight patients with non-alcoholic fatty liver （NAFL） were also examined as controls. RESULTS： In NASH hepatic tissues, activated HSCs were dominantly distributed as compared with those in NAFL. The 48-wk Iosartan treatment induced a remarkable decrease in activated HSCs and a mild increase in quiescent phenotypes. CONCLUSION： Our data suggest the crucial involvement of HSCs in anti-fibrotic effect of angiotensin Ⅱ receptor antagonist on patients with NASH.展开更多
A primary benign schwannoma of the liver is extremely rare and is difficult to preoperatively discriminate from a malignant tumor.We compared the imaging and pathological findings,and examined the possibility of preop...A primary benign schwannoma of the liver is extremely rare and is difficult to preoperatively discriminate from a malignant tumor.We compared the imaging and pathological findings,and examined the possibility of preoperatively diagnosing a benign liver schwannoma.A 72-year-old woman was admitted to our hospital because of a 4.6-cm mass in the liver.A malignant tumor was suspected,and a right hepatectomy was performed.After this,the diagnosis of a primary benign schwannoma of the liver was made through pathological examination.Contrast-enhanced ultrasonography(CEUS) with Sonazoid showed minute blood flows into the septum and solid areas of the tumor in the vascular phase;most likely due to increased arterial flow associated with infiltration of chronic inflammatory cells.In the postvascular phase,CEUS showed contrast defect of cystic areas and delayed enhancement of solid areas;most likely due to aggregation of siderophores.Because discriminating between a benign and malignant schwannoma of the liver is difficult,surgery is generally recommended.However,the two key findings from CEUS may be useful in discriminating ancient schwannoma by recognizing the hemorrhage involved in the secondary degeneration and aggregation of siderophores.展开更多
基金Supported by a Grant-in-Aid for Scientific Research (C) from the Japan Society for the Promotion of Science, No. 15590613,and a grant for Research on Intractable Disease from the Japanese Ministry of Public Welfare
文摘AIM： To investigate the efficacy of angiotensin Ⅱ receptor antagonist on hepatic stellate cells （HSCs） activation in the patients with non-alcoholic steatohepatitis （NASH）. METHODS： Seven patients with NASH were prescribed Iosartan, a selective angiotensin Ⅱ type 1 receptor antagonist （50 mg/d） for 48 wk. Liver biopsies were performed both at the entry and end of the study in all patients. Quiescent and activated HSCs were identified by double immunostaining using anti-p75 and α-smooth muscle actin antibodies, and the number of each phenotype was counted. Similarly, the liver specimens obtained from the eight patients with non-alcoholic fatty liver （NAFL） were also examined as controls. RESULTS： In NASH hepatic tissues, activated HSCs were dominantly distributed as compared with those in NAFL. The 48-wk Iosartan treatment induced a remarkable decrease in activated HSCs and a mild increase in quiescent phenotypes. CONCLUSION： Our data suggest the crucial involvement of HSCs in anti-fibrotic effect of angiotensin Ⅱ receptor antagonist on patients with NASH.
文摘A primary benign schwannoma of the liver is extremely rare and is difficult to preoperatively discriminate from a malignant tumor.We compared the imaging and pathological findings,and examined the possibility of preoperatively diagnosing a benign liver schwannoma.A 72-year-old woman was admitted to our hospital because of a 4.6-cm mass in the liver.A malignant tumor was suspected,and a right hepatectomy was performed.After this,the diagnosis of a primary benign schwannoma of the liver was made through pathological examination.Contrast-enhanced ultrasonography(CEUS) with Sonazoid showed minute blood flows into the septum and solid areas of the tumor in the vascular phase;most likely due to increased arterial flow associated with infiltration of chronic inflammatory cells.In the postvascular phase,CEUS showed contrast defect of cystic areas and delayed enhancement of solid areas;most likely due to aggregation of siderophores.Because discriminating between a benign and malignant schwannoma of the liver is difficult,surgery is generally recommended.However,the two key findings from CEUS may be useful in discriminating ancient schwannoma by recognizing the hemorrhage involved in the secondary degeneration and aggregation of siderophores.
