Bruce A. Runyon – 30 December 2003 – Ascites is the most common of the major complications of cirrhosis. The development of ascites is an important landmark in the natural history of cirrhosis and has been proposed as an indication for liver transplantation. The initial evaluation of a patient with ascites should include a history, physical evaluation, and abdominal paracentesis with ascitic fluid analysis. Treatment should consist of abstinence from alcohol, sodium restricted diet, and diuretics. This regimen is effective in ≈90% of patients.

Stewart Sell – 30 December 2003 – The ultrastructural characteristics of liver progenitor cell types of human atypical ductular reactions seen in chronic cholestasis, in regenerating human liver after submassive necrosis, in alcoholic liver disease, and in focal nodular hyperplasia are compared with liver progenitor cell types seen during experimental cholangiocarcinogenesis in hamsters; during hepatocarcinogenesis in rats; and in response to periportal liver injury induced by allyl alcohol in rats.

Juan Córdoba, Juan Cabrera, Louis Lataif, Plamen Penev, Phyllis Zee, Andrés T. Blei – 30 December 2003 – Sleep disturbance is a classic sign of hepatic encephalopathy. However, there are limited data regarding its prevalence in cirrhotic patients without overt hepatic encephalopathy. We assessed the characteristics of sleep in cirrhosis using a sleep questionnaire (n = 44) and actigraphy (n = 20). The results were compared with those of subjects with chronic renal failure and those of healthy controls.

Sien‐Sing Yang, Chi‐Hwa Wu, Tsuey‐Ru Chiang, Ding‐Shinn Chen – 30 December 2003 – We prospectively studied the role of somatosensory evoked potentials (SEPs) and psychometric tests in the assessment of subclinical portosystemic encephalopathy (PSE) in 61 cirrhotic patients with grade 0 PSE and 20 controls. Six additional uneducated controls underwent only psychometric tests. Median nerve‐evoked cortical responses were recorded for N20‐N65 interpeak latencies (IPLs). Psychometric tests were conducted within 4 hours of SEP testing.

Ewa Ellis, Bryan Goodwin, Anna Abrahamsson, Chris Liddle, Agneta Mode, Mats Rudling, Ingemar Björkhem, Curt Einarsson – 30 December 2003 – The regulation of hepatic bile acid formation is incompletely understood. Primary cultures of mammalian hepatocytes offer an opportunity to examine putative regulatory factors in relative isolation. Using rat and human hepatocytes in primary culture, we examined bile acid composition and the expression of the rate‐limiting enzyme of formation, cholesterol 7α‐hydroxylase.

Tatu E. Miettinen, Tuula Kiviluoto, Matti Taavitsainen, Matti Vuoristo, Tatu A. Miettinen – 30 December 2003 – Effects of long‐term high‐dose ursodeoxycholic acid (UDCA) and simvastatin treatments on cholesterol metabolism and biliary lipid compositions were compared in patients with cholesterol gallstones. Absorption and synthesis of cholesterol, serum and biliary noncholesterol sterols and lipids were determined in 14 patients randomized to UDCA (23‐25 mg/kg/d) or simvastatin (40 mg/d) for 1 year. Simvastatin reduced serum low‐density lipoprotein cholesterol by 55%, and UDCA, by 9%.

Gianluca Svegliati Baroni, Letizia D'Ambrosio, Gianna Ferretti, Alessandro Casini, Antonio Di Sario, Renata Salzano, Francesco Ridolfi, Stefania Saccomanno, Anne Marie Jezequel, Antonio Benedetti – 30 December 2003 – Oxidative stress is associated with liver fibrosis and with hepatic stellate cell (HSC) activation in vivo. However, it remains controversial whether oxidative stress contributes to HSC activation either directly or through a paracrine stimulation by damaged hepatocytes.

Kenji Kaneda, Wichai Ekataksin, Mitsue Sogawa, Akiko Matsumura, Akikuni Cho, Norifumi Kawada – 30 December 2003 – Intraportal infusion of endothelin‐1 (ET‐1), a potent vasoconstrictor, significantly elevates portal venous pressure. To determine the major site of vascular constriction in the intrahepatic porto‐sinusoidal system, we performed an in situ perfusion of rat livers with 1 nmol/L ET‐1 at a flow rate of 20 mL/min. Portal pressure rose from 22 cm H2O to 54 cm H2O within 25 minutes. Specimens were prepared for light‐microscopic serial reconstruction and electron microscopy.

Raymond F. Burk, Dayna S. Early, Kristina E. Hill, Ivan S. Palmer, Martha E. Boeglin – 30 December 2003 – Plasma selenium concentration is decreased in patients with cirrhosis and, based on this finding, it has been suggested that patients with cirrhosis are selenium deficient. We measured plasma selenium concentration and the two plasma selenoproteins, glutathione peroxidase (GSHPx‐3) and selenoprotein P, in the plasma of patients with cirrhosis of Child classes A, B, and C and in control subjects.

Masaki Kaibori, A‐H. Kwon, Michio Oda, Yasuo Kamiyama, Naomi Kitamura, Tadayoshi Okumura – 30 December 2003 – We have reported that infusion of recombinant human hepatocyte growth factor (rhHGF) stimulates liver regeneration after hepatectomy in cirrhotic rats and increases the level of serum lipids and secretion of very‐low density lipoprotein (VLDL). Studies were now performed to determine whether rhHGF directly influences lipid synthesis and its secretion in cultured rat hepatocytes. Isolated cells were cultured in the presence or absence of rhHGF (20 ng/mL) for 2 days.