The incidence of hepatocellular carcinoma (HCC) in patients with primary biliary cirrhosis (PBC) is not well known. The aims of this study are to determine HCC incidence and survival, and to identify risk factors associated with these outcomes in patients with PBC. We collected information on 396 patients with PBC at enrollment and followed-up from 6 to 271 months. They were all negative for hepatitis B and C virus markers. HCC was detected by scanning with ultrasonography, computed tomography, or both every 4 to 6 months. Life expectancy (LE) was approximated with the declining exponential approximation of LE. A total of 14 patients developed HCC. The cumulative appearance rate of HCC in patients with advanced-stage PBC (Scheuer's stage III or IV) was significantly higher than that for patients with early-stage (stage I or II) (12.3% and 7.7% by the tenth year, respectively. P ‫؍‬ .021). Proportional hazards analysis showed 3 factors are independently associated with the development of HCC: age at the time of diagnosis, male gender, and history of blood transfusion. Age, male gender, and advanced-stage PBC were associated with survival, but HCC development was not. The disease-specific annual mortality rate was estimated to be 0.008 for women and 0.028 for men with advanced-stage PBC. In conclusion, HCC develops in old patients with advanced-stage PBC, but HCC does not affect the patients' survival. P rimary biliary cirrhosis (PBC) is a chronic liver disease of unknown etiology presenting a variety of disease spectrum from asymptomatic disease state to full-blown cirrhosis. Patients with liver cirrhosis caused by chronic infection of hepatitis C virus (HCV) or hepatitis B virus (HBV) are at high risk of hepatocellular carcinoma (HCC); however, it is not known whether the HCC incidence is high in patients with PBC. Although there are 9 studies about HCC incidence in PBC, the results are not consistent. 1-9 Some studies 3,4 show that patients with PBC have no excess risk of developing HCC and others [5][6][7][8][9] show that the incidence of HCC is high in those patients. An Italian study indicated that HCC has a relatively high prevalence in PBC and HCV superinfection may play an important part in favoring HCC. 7 Even though without HBV or HCV infection, a study conducted in UK showed 5.9% of patients with PBC in precirrhotic or cirrhotic stage had developed HCC. 6 The authors of this large-scale cohort study concluded that men with advanced-stage PBC have a higher risk of developing HCC. A recent retrospective study in the Mayo Clinic also reported that patients with PBC 8 are at high risk of hepatobiliary malignancies but the authors did not mention risk factors for HCC development.The aims of the present study are to analyze the survival of patients with PBC, to quantify the incidence at which they develop HCC, and to identify HCC risk factors. In addition, we determined whether HCC affected the survival of patients with PBC. Therefore, we tested 2 hypotheses: (1) that the patients with advanced-stage PBC sur...

It is known that T cells recognize an antigen via the T-cellThe immunopathogenesis of autoimmune hepatitis receptor (TCR). Antigen-specificity of a T cell depends on the (AIH), and the role of T cells in the onset and mainte-TCR, particularly the nucleotide sequences in the complenance of this disease, are still unclear. Since T cells exmentarity-determining region 3 (CDR3) of the TCR, which is pand clonally after stimulation by an antigen, it is improbably the direct recognition site for the antigen in the portant to analyze the behavior of T cells at a clonal context of major histocompatibility complex molecule. 3-5 Durlevel. We have established recently a novel system, using ing the antigen-specific immune response, T cells that bear reverse transcriptase-polymerase chain reaction (RTthe same sequence in the CDR3 would be selected, stimu-PCR) and subsequent single-strand conformation polylated, and expanded by a specific antigen. Consequently, an morphism (SSCP) that allows the identification of clonal accumulated clone is formed eliciting various immunological accumulation of T cells in a lymphocyte population. Useffects, including cytotoxicity or helper activity, in an antiing this system, we demonstrated that oligoclonal T cells gen-specific manner. Thus, it is crucial to investigate T-cell were accumulated in the liver of patients with AIH, and immunity at a clone level. It is possible at the present time that identical T-cell clonotypes were detected in two difto detect certain T-cell clonotypes within a heterogeneous ferent regions of the liver, although these features were population based on differences in nucleotide sequence of the also observed in cases with viral hepatitis. Only in cases CDR3 of the TCR transcripts. We have recently described with AIH, however, nearly all identical T cells were a novel method of T-cell clonotype analysis to study T-cell found to belong to CD8 / subset and there were very few immunity, using a combination of reverse-transcriptase poly-CD4 / T cells in this population. Our results suggest that merase chain reaction (RT-PCR) with multiple TCR primers common antigens presented to CD8 / T cells in the conand subsequent single-strand conformation polymorphism. 6 text of HLA class I molecule are distributed diffusely inThis method allows us to analyze T-cell populations at a the liver of AIH. These findings also suggest that anticlonal level, and to eliminate the bias associated with gens recognized by CD4 / T cells may be relatively hetartifacts in the process of establishing T-cell clones in vitro. 7-11 erogeneous in the liver with AIH. (HEPATOLOGY 1997;Using this RT-PCR/SSCP system, we investigated T-cell clon-25:1070-1076.) ality in the liver of six patients with AIH. We demonstrated a generalized accumulation of CD8 / T-cell clonotypes in the Autoimmune hepatitis (AIH) is a chronic liver disease char-liver, suggesting a universal distribution of the antigens elicacterized by a persistent inflammatory reaction in the liver. iting T-cell activation in the liver. Howeve...

The present study indicated that fulminant hepatic failure can be predicted, by a simple discrimination equation, at the stage of severe acute hepatitis.

No abstract

This study summarizes up-to-date information about the biopositive effects of low radiation treatment (LRT), radiation hormesis, and our experimental devices. In addition, we present a favorable treatment result in a patient with advanced rectal carcinoma who received LRT at home using a radon gas aspirator. The patient was a 61-year-old man who underwent proctectomy in 2010. During the additional first-line chemotherapy, apparent increases in tumor makers identified multiple remote metastases in the lung, sacrum and liver. Sacrum pain limited his activity of daily living and impeded his coming to our facility for LRT. Then, we decided to provide him home LRT using a radon gas aspirator. He inhaled radon gas for 15 minutes at least 3 times a day at home, resulting in remarkably reduced tumor markers and sacrum pain relief. He could walk, keep sitting up without support and sleep in the spine position again after receiving home LRT. No influence of radon gas inhalation on the second-line chemotherapy was observed. The favorable effects of LRT lead us to believe that the newly-developed devices will provide the clinical significance on malignant diseases. To establish the LRT regimen, further clinical investigation and data accumulation are thus called for.