The effect of weight reduction on ultrasonographic findings of nonalcoholic Fatty liver.

BACKGROUND Non-alcoholic fatty liver (NAFL) includes a spectrum of diseases ranging from simple hepatic steatosis to nonalcoholic steatohepatitis (NASH) and cirrhosis. NAFL is typically seen in association with obesity, diabetes and hypertriglyceridaemia. In order to seek the role of diet therapy in treatment of NAFL, we compared the ultrasonographic findings of patients with fatty liver disease before and after standard diet therapy. METHODS Twenty-three overweight or obese subjects with incidental fatty liver discovered during ultrasonography were included. Subjects underwent 3 months of diet therapy, and anthropometric data including weight, height, BMI, waist circumference, and hip circumference were measured. Ultrasonographic findings were graded from 0 to 3. Changes in ultrasonographic findings and anthropometric data were studied. RESULTS After three months of dieting, the ultrasonographic grade of all patients decreased by one or two grades. Fifteen patients decreased one grade while 8 others decreased by 2 grades. We observed a significant correlation between the decrease in ultrasonographic grade and the decrease in weight and BMI. CONCLUSION Our study indicates that standard diet therapy could be used as an effective treatment for NAFL patients.

Hepatocytes of donor origin in recipient liver after hematopoietic SCT in beta-thalassemia major patients.

BM and circulating cells contain stem cells with the potential to differentiate into mature cells of various organs. We determined whether stem cells transformed into hepatocytes. Biopsy specimens from liver were obtained from 11 patients who had undergone transplantation of hematopoietic stem cells from peripheral blood (eight patients) or BM (three patients). Four female patients had received transplants from a male donor and seven male patients had received transplants from a female donor. All patients had beta-thalassemia major and fibrosis in biopsy specimens from the liver before hematopoietic SCT. Hematopoietic stem cell engraftment was verified by STR analysis. The biopsies were studied for the presence of donor-derived hepatocytes using FISH of interphase nuclei and immunohistochemical staining for CD45 (leukocyte common Ag), and a hepatocyte-specific Ag. All 11 recipients of sex-mismatched transplants showed evidence of complete hematopoietic donor chimerism. XY-positive hepatocytes accounted for 4-6.7% of cells in histological sections of the biopsy specimens of female patients and XX-positive hepatocytes accounted for 3-7% of cells in histological sections of the biopsy specimens of male patients. These cells were detected in liver tissue as early as 1 year and as late as 8.5 years after hematopoietic SCT. BM and circulating stem cells can differentiate into mature hepatocytes in beta-thalassemia major patients who had undergone hematopoietic SCT.

Evaluation of suppressive therapy for cold thyroid nodules with levothyroxine: double-blind placebo-controlled clinical trial.

OBJECTIVE: To study the efficacy of levothyroxine suppressive therapy in the management of benign thyroid nodules. METHODS: We performed a double-blind clinical trial comparing levothyroxine treatment (1.5 to 2.0 mg/kg of body weight daily) (N = 32) with placebo (N = 30) for a 1-year period in patients with a benign, cold thyroid nodule confirmed by biopsy and 99mTc-pertechnetate scanning, who were randomly assigned to the treatment or control group. High-resolution sonography was used to measure the size of the nodules before and after the treatment. Suppression of thyrotropin was evaluated by the administration of thyrotropin-releasing hormone to 10 patients randomly in each group. RESULTS: The mean volume of the thyroid nodules decreased significantly after 6 months in both the levothyroxine group (from 12.8 +/- 11.9 mL to 9.4 +/- 9.8 mL; P = 0.003) and the placebo group (from 13.2 +/- 10.2 mL to 11.5 +/- 8.0 mL; P = 0.003). After 12 months, however, the volume of the nodules had increased. Thus, no significant decrease was found in the mean nodule volume in either study group at 1 year in comparison with the mean volume at baseline (final mean volume: 12.4 +/- 16.7 mL in the levothyroxine group and 11.7 +/- 13.6 mL in the placebo group). CONCLUSION: Suppressive therapy with levothyroxine for a period of 12 months proved to be ineffective in significantly reducing the size of the thyroid nodules in our patients despite effective suppression of the thyrotropin level.