Patients were operated on by the same surgeon and were managed by the same haemophilia treatment centre. Forty procedures (25 minor and 15 major) were conducted in 18 patients. Twenty-one minor

cases were covered using rFVIIa, three with pd-PCC, and one with pd-APCC; all major cases were covered using rFVIIa. Bleeding was no greater than expected compared with a non-haemophilic population in all 25 minor procedures. In the major procedure group, there was no excessive bleeding in 40% of cases (6/15) and bleeding completely stopped in response to rFVIIa. For the remaining nine cases, bleeding response to rFVIIa was described as ‘markedly decreased’ or ‘decreased’ in 4/15 cases and ‘unchanged’ in 5/15 cases. Overall, efficacy of rFVIIa, based on final patient outcome, was 85%. One death occurred as a result of sepsis secondary http://www.selleckchem.com/products/ulixertinib-bvd-523-vrt752271.html to necrotizing fasciitis. Good control of haemostasis can be achieved with bypassing

agents in haemophilia patients with inhibitors undergoing minor EOS; rFVIIa was used as an effective bypassing agent, enabling EOS in patients undergoing minor and major procedures. “
“Summary.  Haemophilia has been recognized as the most severe among the inherited disorders of blood coagulation since the beginning of the first millennium. Joint damage is the hallmark selleckchem of the disease. Despite its frequency and severity, the pathobiology of blood-induced joint disease remains obscure. Although bleeding into the joint is the ultimate provocation, the stimulus within the blood inciting the process and the mechanisms by which bleeding into a joint results in synovial inflammation (synovitis) and cartilage and bone destruction (arthropathy) is unknown. Clues

from careful observation of patient material, supplemented with data from animal models of joint disease provide some MCE clues as to the pathogenesis of the process. Among the questions that remain to be answered are the following: (i) What underlies the phenotypic variability in bleeding patterns of patients with severe disease and the development of arthropathy in some but not all patients with joint bleeding? (ii) What is the molecular basis underlying the variability? (iii) Are there strategies that can be developed to counter the deleterious effects of joint bleeding and prevent blood-induced joint disease? Understanding the key elements, genetic and/or environmental, that are necessary for the development of synovitis and arthropathy may lead to rational design of therapy for the targeted prevention and treatment of blood-induced joint disease. “
“Summary.  Chronic HCV infection continues to be of significant clinical importance in patients with hereditary bleeding disorders. This guideline provides information on the recent advances in the investigation and treatment of HCV infection and gives GRADE system based recommendations on the management of the infection in this patient group.

Patch, James O’Beirne, Douglas Thorburn, Tu Vinh Luong, Amar P. Dhillon, Andrew K. Burroughs BACKGROUND: Type 2 hepatorenal syndrome

(HRS2) is a form of functional renal impairment complicating end-stage liver disease. While generally felt selleck inhibitor to be reversible after liver transplantation, long-term outcomes after transplantation in HRS2 patients remains ill-defined. METHODS: Retrospective, matched case-control (1:2) study of all adult HRS2 patients transplanted in our institution between 2000 and 2012. HRS2 patients were identified from our electronic transplant database, and matched with controls for the following variables: age, gender, etiology, diabetes mellitus and year of transplant.

RESULTS: Forty-two HRS2 patients were compared to 83 controls. At the time of transplant, HRS2 patients had an estimated glomerular filtration rate (eGFR) of 41 ±1ml/min/1.73m2 (vs. 96±4ml/min/1.73m2 among controls, p<0.0001). HRS2 patients required more intra-operative packed red blood cell transfusion (p=0.002), and had a longer intensive care unit (p=0.01) and total hospital length of stay (p=0.03). Reversal of HRS2 occurred in 88.1% patients, on average 5.7±0.5 days post-transplantation. Although HRS2 patients had lower initial exposure to calcineurin NVP-LDE225 cost inhibitor, a greater proportion of HRS2 patients had renal dysfunction, as defined by eGFR <60ml/min/1.73m2, at three (53.8% vs. 28.4%, p=0.007) and 12 months (59.5% vs. 38.2%, p=0.03) post-transplantation compared

to controls (Figure 2). One-year survival was similar between the two groups (log-rank p=0.82). On multivariate analysis, pre-transplant HRS2 was associated with persistent renal dysfunction at three (OR 3.73, [95% CI 1.54-9.03], p=0.004) and 12 months (OR 3.23 [95% CI 1.37-7.64], p=0.007) post-transplant. CONCLUSION: Liver transplantation reverses HRS2 in the majority of patients with survival outcomes comparable to matched controls. However, pre-transplant HRS2 is associated with persistently impaired renal dysfunction post-transplant, MCE despite calcineurin inhibitor minimization. Disclosures: Florence Wong – Consulting: Gore Inc; Grant/Research Support: Grifols Eberhard L. Renner – Advisory Committees or Review Panels: Vertex Canada, Novartis, Astellas Canada, Roche Canada, Gambro, AbbVIe, BMS; Grant/ Research Support: Novartis Canada, Gilead; Speaking and Teaching: Novartis, Astellas Canada, Roche Canada The following people have nothing to disclose: Hiang K. Tan, Max Marquez Background: Radioembolization using Yttrium-90 is increasingly being used as locoregional Rx in the US to treat HCC. We report the use of SIRT by itself or associated with TACE to improve outcome of our OLT-uHCC population.

Patch, James O’Beirne, Douglas Thorburn, Tu Vinh Luong, Amar P. Dhillon, Andrew K. Burroughs BACKGROUND: Type 2 hepatorenal syndrome

(HRS2) is a form of functional renal impairment complicating end-stage liver disease. While generally felt Copanlisib in vitro to be reversible after liver transplantation, long-term outcomes after transplantation in HRS2 patients remains ill-defined. METHODS: Retrospective, matched case-control (1:2) study of all adult HRS2 patients transplanted in our institution between 2000 and 2012. HRS2 patients were identified from our electronic transplant database, and matched with controls for the following variables: age, gender, etiology, diabetes mellitus and year of transplant.

RESULTS: Forty-two HRS2 patients were compared to 83 controls. At the time of transplant, HRS2 patients had an estimated glomerular filtration rate (eGFR) of 41 ±1ml/min/1.73m2 (vs. 96±4ml/min/1.73m2 among controls, p<0.0001). HRS2 patients required more intra-operative packed red blood cell transfusion (p=0.002), and had a longer intensive care unit (p=0.01) and total hospital length of stay (p=0.03). Reversal of HRS2 occurred in 88.1% patients, on average 5.7±0.5 days post-transplantation. Although HRS2 patients had lower initial exposure to calcineurin Selleck Caspase inhibitor inhibitor, a greater proportion of HRS2 patients had renal dysfunction, as defined by eGFR <60ml/min/1.73m2, at three (53.8% vs. 28.4%, p=0.007) and 12 months (59.5% vs. 38.2%, p=0.03) post-transplantation compared

to controls (Figure 2). One-year survival was similar between the two groups (log-rank p=0.82). On multivariate analysis, pre-transplant HRS2 was associated with persistent renal dysfunction at three (OR 3.73, [95% CI 1.54-9.03], p=0.004) and 12 months (OR 3.23 [95% CI 1.37-7.64], p=0.007) post-transplant. CONCLUSION: Liver transplantation reverses HRS2 in the majority of patients with survival outcomes comparable to matched controls. However, pre-transplant HRS2 is associated with persistently impaired renal dysfunction post-transplant, medchemexpress despite calcineurin inhibitor minimization. Disclosures: Florence Wong – Consulting: Gore Inc; Grant/Research Support: Grifols Eberhard L. Renner – Advisory Committees or Review Panels: Vertex Canada, Novartis, Astellas Canada, Roche Canada, Gambro, AbbVIe, BMS; Grant/ Research Support: Novartis Canada, Gilead; Speaking and Teaching: Novartis, Astellas Canada, Roche Canada The following people have nothing to disclose: Hiang K. Tan, Max Marquez Background: Radioembolization using Yttrium-90 is increasingly being used as locoregional Rx in the US to treat HCC. We report the use of SIRT by itself or associated with TACE to improve outcome of our OLT-uHCC population.

Among the 130 HCC samples used (Supporting Table 2), matched peritumoral liver tissues from the same patient were available for 12 HCC samples. Consistent with previous reports,17, 18 clinical HCC tissues exhibited

more elevated RACK1 expression than matched peritumoral liver tissues (Fig. 2A; drug discovery Supporting Table 3). Levels of RACK1 protein in the 130 HCC tissues were well associated with the clinical stage (Supporting Table 4). In addition, even not statistically significant, RACK1 expression in HCC tissues showed a tendency to be correlated with tumor size (Supporting Table 4). Now that RACK1 could engage in a direct interaction with MKK7 in human HCC cells, it is possible that accumulated RACK1 protein contributes to elevated JNK activity in HCC. In this scenario, levels of P-JNK were

also analyzed. As expected, clinical HCC tissues exhibited more elevated P-JNK expression than matched peritumoral liver tissues (Fig. 2A; Supporting Table 5). Levels of P-JNK in the 130 HCC tissues were associated with tumor size and pathological grade (Supporting Table 6). More www.selleckchem.com/products/icg-001.html important, levels of RACK1 protein in clinical HCC tissues were positively correlated with those of P-JNK (Fig. 2A,B). Furthermore, immunoblotting (IB) analysis revealed that 10 (Huh7, SK-Hep-1, Hep3B, BEL-7404, PLC/PRF/5, HepG2, Li-7, SMMC7721, BEL-7402, and MHCC-97H) of the 12 human HCC cell lines examined exhibited elevated RACK1 expression, albeit to varied extent, as compared

with immortalized healthy human hepatocyte line HL-7702 (Fig. 2C). All cell lines with elevated RACK1 expression, except MHCC-97H, showed up-regulated levels of P-JNK, as compared with HL-7702 (Fig. 2C). These data further indicate a correlation between levels of RACK1 protein and JNK activity in human HCC cells. Interestingly, levels of MKK7 phosphorylation (P-MKK7) at Ser271 and Thr275, which is required for MKK7 activity,2-5 were also up-regulated in Huh7, SK-Hep-1, BEL-7404, PLC/PRF/5, HepG2, SMMC-7721, and BEL-7402 cells (Fig. 2C), suggesting that MKK7 is implicated in the regulation of JNK activity by RACK1. JNK activity has been suggested to 上海皓元医药股份有限公司 contribute not only to the proliferation of liver cancer cells, but also that of healthy hepatocytes.19 It is possible that increased RACK1 levels can simply be the consequence of an increased proliferative activity of hepatocytes. In this scenario, two-thirds partial hepatectomy (PH) was performed to explore the levels of RACK1 protein during liver regeneration. IB analysis revealed a marginal increase in RACK1 protein levels under the conditions that PH triggered robust proliferation of healthy hepatocytes (Supporting Fig. 1). Thus, elevated RACK1 expression does not simply result from an increased proliferative activity of hepatocytes. Collectively, our data suggest a critical role of RACK1 in HCC development.

When administering ART, we should take into consideration the potential for anti-HIV agents to cause drug-induced liver injury. Before commencing ART involving anti-HBV agents, it is important to check for a history of treatment with anti-HBV agents. Before commencing ART involving anti-HBV agents, it is important to evaluate functional hepatic reserve. The ART regimen should consist

of a backbone of either tenofovir (TDF) with emtricitabine (FTC), MI-503 order or tenofovir (TDF) with lamivudine (3TC), together with a key drug (integrase inhibitor, non-nucleoside reverse transcriptase inhibitor or protease inhibitor). If it is necessary to cease administration of an anti-HIV drug with anti-HBV activity due to adverse reactions associated with ART, there is a danger of recurrence or aggravation of hepatitis. Where possible, two anti-HBV agents should be administered instead. Consideration should be given to entecavir+adefovir combination therapy. The members of Drafting Committee for Hepatitis Management Guidelines have received Pexidartinib cost consultant fees from GlaxoSmithKline, royalty from SRL, lecture fees from Ajinomoto Pharmaceuticals, MSD, Daiichi-Sankyo, Dainippon-Sumitomo Pharma, Mitsubishi Tanabe Pharma, Chugai Pharmaceutical, Bristol-Myers-Squibb, and research support from Eisai, MSD, Kan Research Institute, GlaxoSmithKline, Chugai Pharmaceutical,

Bristol-Myers-Squibb, Daiichi-Sankyo, Mitsubishi Tanabe Pharma, Dainippon-Sumitomo Pharma, Toray, Minophagen Pharmaceutical. “
“Insulin’s metabolic effects in the liver are widely appreciated, but insulin’s ability to act as a hepatic mitogen is less well understood. Because the insulin receptor (IR) can traffic to the nucleus, and Ca2+ signals within the nucleus regulate cell proliferation,

we investigated whether insulin’s mitogenic effects result from activation of Ca2+-signaling pathways by IRs within the nucleus. Insulin-induced increases in Ca2+ and cell proliferation depended upon clathrin- and caveolin-dependent translocation of the IR to the nucleus, as well as upon formation of inositol 上海皓元医药股份有限公司 1,4,5,-trisphosphate (InsP3) in the nucleus, whereas insulin’s metabolic effects did not depend on either of these events. Moreover, liver regeneration after partial hepatectomy also depended upon the formation of InsP3 in the nucleus, but not the cytosol, whereas hepatic glucose metabolism was not affected by buffering InsP3 in the nucleus. Conclusion: These findings provide evidence that insulin’s mitogenic effects are mediated by a subpopulation of IRs that traffic to the nucleus to locally activate InsP3-dependent Ca2+-signaling pathways. The steps along this signaling pathway reveal a number of potential targets for therapeutic modulation of liver growth in health and disease.

When administering ART, we should take into consideration the potential for anti-HIV agents to cause drug-induced liver injury. Before commencing ART involving anti-HBV agents, it is important to check for a history of treatment with anti-HBV agents. Before commencing ART involving anti-HBV agents, it is important to evaluate functional hepatic reserve. The ART regimen should consist

of a backbone of either tenofovir (TDF) with emtricitabine (FTC), check details or tenofovir (TDF) with lamivudine (3TC), together with a key drug (integrase inhibitor, non-nucleoside reverse transcriptase inhibitor or protease inhibitor). If it is necessary to cease administration of an anti-HIV drug with anti-HBV activity due to adverse reactions associated with ART, there is a danger of recurrence or aggravation of hepatitis. Where possible, two anti-HBV agents should be administered instead. Consideration should be given to entecavir+adefovir combination therapy. The members of Drafting Committee for Hepatitis Management Guidelines have received find more consultant fees from GlaxoSmithKline, royalty from SRL, lecture fees from Ajinomoto Pharmaceuticals, MSD, Daiichi-Sankyo, Dainippon-Sumitomo Pharma, Mitsubishi Tanabe Pharma, Chugai Pharmaceutical, Bristol-Myers-Squibb, and research support from Eisai, MSD, Kan Research Institute, GlaxoSmithKline, Chugai Pharmaceutical,

Bristol-Myers-Squibb, Daiichi-Sankyo, Mitsubishi Tanabe Pharma, Dainippon-Sumitomo Pharma, Toray, Minophagen Pharmaceutical. “
“Insulin’s metabolic effects in the liver are widely appreciated, but insulin’s ability to act as a hepatic mitogen is less well understood. Because the insulin receptor (IR) can traffic to the nucleus, and Ca2+ signals within the nucleus regulate cell proliferation,

we investigated whether insulin’s mitogenic effects result from activation of Ca2+-signaling pathways by IRs within the nucleus. Insulin-induced increases in Ca2+ and cell proliferation depended upon clathrin- and caveolin-dependent translocation of the IR to the nucleus, as well as upon formation of inositol MCE公司 1,4,5,-trisphosphate (InsP3) in the nucleus, whereas insulin’s metabolic effects did not depend on either of these events. Moreover, liver regeneration after partial hepatectomy also depended upon the formation of InsP3 in the nucleus, but not the cytosol, whereas hepatic glucose metabolism was not affected by buffering InsP3 in the nucleus. Conclusion: These findings provide evidence that insulin’s mitogenic effects are mediated by a subpopulation of IRs that traffic to the nucleus to locally activate InsP3-dependent Ca2+-signaling pathways. The steps along this signaling pathway reveal a number of potential targets for therapeutic modulation of liver growth in health and disease.

e. plasmid and cellular DNA and proteins. Using such a system, we produce approximately 1 × 105–5 × 105 vg transfected cell−1, with 1010 cells Epacadostat manufacturer grown per week [24]. This process can be further scaled by moving from adherent cells to suspension culture for transfection; even allowing for some fall-off in vector productivity per cell on scale up, one can reach vector yields of 5 × 1012 to 1 × 1014 purified vg per litre of batch culture. An alternative production process relies on

introduction of the required DNA components (same as above) into an insect cell line using expression vectors that are generated from baculovirus, a double-stranded DNA virus that naturally infects butterflies and moths. The baculovirus expression system has been reported to result in yields in the range of 7 × 1013 purified vg per litre of batch culture

[25]. The products administered to subjects in the haemophilia trials to date have all been manufactured using the transient transfection mammalian cell culture systems. The sole licensed AAV product, Glybera for the treatment of lipoprotein lipase deficiency, was generated using a baculovirus system, and was administered by intramuscular injection. The concerns around the mammalian expression system include risks associated with residual plasmid or mammalian DNA impurities, and around the baculovirus system, the risks associated with residual xenogeneic (insect cell or baculoviral) DNA. The baculoviral production this website method has also been characterized by the generation of defective particles, which, if present, would increase the total capsid dose that must be delivered to achieve a set level of expression. At this point, there are three trials open and recruiting subjects for gene therapy for haemophilia B [26-28]. Moreover, two other groups have declared their intention of starting trials in haemophilia B [29, 30]. Thus, opportunities to

participate in trials would seem to be plentiful. Yet the pace of accrual to the ongoing studies seems slow. There are several reasons medchemexpress for this. First, most trials have mandatory pauses between subjects, to allow time to observe any adverse events before enrolment of the next set of subjects. Second, many interested participants at this point are still turned away, because they fail to meet the eligibility criteria of low or absent neutralizing antibodies to AAV (vide supra). Manufacturing considerations are theoretically a limitation, although not until participation becomes more robust than currently. An additional factor, clearly though, is patient uncertainty about gene therapy. Gene therapy has had a chequered history, and in the view of the lay public may still be regarded as highly experimental.

Of these, however, only vascular invasion was considered to be associated with survival prognosis throughout the entire postoperative period (LF007772 level 2b). Factors for early recurrence, namely, in less than 2 years after surgery, are non-systematic anatomical resection, selleck chemicals with pathological vascular invasion and AFP of 32 ng/mL or more (LF114293 level 2b). Tumor diameter is also reported to affect

prognosis in some articles (LF006234 level 2b, LF008535 level 4); there is no consensus on this issue. For tumors of 2 cm or less in diameter, the survival rate for patients with early hepatocellular carcinoma is good (LF003786 level 2a). For patients with hepatocellular carcinoma resection accompanied by a tumor thrombosis in the main trunk of the portal vein or the primary branch, prognosis is good for those without ascites, prothrombin activity of 75% or more, and a tumor size of 5 cm or less in diameter (LF106197 level 2b). Of 1481 English original articles (1980–2007) identified using “hepatocellular carcinoma” and “surgery” as key words, 364 concerned prognostic factors. Of these, we reviewed 37 articles

with high reliability. Vascular invasion was most frequently (68%) considered useful, followed by BYL719 purchase liver function (46%), number of tumors (35%), stage classification (19%) and tumor diameter (19%). For liver function, the Child classification and serum albumin levels were often found to be useful. For tumor diameter, 23% of the articles reported that it did not affect prognosis; there is no consensus on this point. Of the stage classes, medchemexpress the survival rate in patients with early hepatocellular carcinoma graded as stage 0 was good; thus, early hepatocellular carcinoma can be defined as a prognostic factor. In addition, some articles reported that presence/absence of capsule, satellite nodule, systematic anatomical resection and AFP level were also significant prognosis factors. In contrast, many articles

stated that presence of cirrhosis and width of the surgical margin were not significant. CQ21 Does width of the surgical margin contribute to prognosis? A minimum surgical margin is sufficient for hepatectomy. (grade B) There was no significant difference in the postoperative recurrence rate between groups with a liver surgical margins of 1 cm or more versus less than 1 cm (LF001281 level 2a, LF007772 level 2b). Comparisons between liver surgical margins of 5 mm or more and less than 5 mm also showed no significant difference in postoperative recurrence rates (LF006233 level 2b, LF007284 level 2b). In addition, a report comparing wide resection (at least lobectomy) and minor resection also showed no significant difference in survival rates (LF000335 level 2b).

The operation also led to a marked decrease in type IV collagen 7s domain and des-y-carboxy prothrombin. In addition, B-RTO significantly decreased homeostasis model assessment (HOMA) of IR without a statistical decline of HOMA of p-cell function, suggesting a pronounced recovery from IR. The 75g oral glucose tolerance test (75-OGTT) revealed that occlusion of PSS reduced both fasting immunoreactive insulin (IRI) levels and the area under the curve for IRI, suggesting amelioration

of hyperinsulinemia in the fasting state selleck chemicals llc and attenuation of the excessive insulin response to a glucose load. However, no significant change in preprandial or postprandial plasma glucose levels was observed. Furthermore, according to the criteria of the American Diabetes Association, B-RTO improved a 75-OGTT profile in 58.3% of patients who had impaired glucose tolerance or diabetes mellitus before the procedure. Preoperative factors statistically associated with an improvement in H〇MA-IR by B-RTO were sex=male, age<70 years, body

mass index<25, etiology=HCV, C-P class=A, and feeding vein of GV=Ieft gastric vein. Conclusions: Shunt occlusion attenuates IRrelated hyperinsulinemia through increased portal venous flow, promoted liver function, and conseguent augmented hepatic insulin clearance in cirrhotic patients with PH. Excessive insulin response and sustained hyperglycemia after meals are reportedly risk factors for both hepatic fibrosis and hepatocarcinogenesis, and thus B-RTO may be beneficial

for therapeutic management of patients with LC. Disclosures: The following people have nothing to disclose: NVP-BGJ398 concentration Tsuyoshi Ishikawa, Takashi Matsuda, Takuya Iwamoto, Shuji Terai, Isao Sakaida [Background and Aim] Spleen stiffness (SS) can be easily measured using virtual touch guantification (VTQ), and it is expected to be important in identifying cirrhotic patients with esophageal varices (EVs). Portosystemic shunts (PSSs), which were developed to treat portal hypertension, can influence SS. However, the significance of SS for the prediction of EVs considering PSSs has not been well documented. medchemexpress The aim of the present study was to determine the predictive value of SS for the presence and severity of EVs. [Patients and Methods] Between June 2008 and May 2013, 981 patients underwent liver stiffness measurement, and data on SS, EVs, and PSSs were available for 143 patients with chronic liver disease (hepatitis C virus, 86; hepatitis B virus, 19; alcoholic liver disease, 14; autoimmune hepatitis, 9; nonalcoholic steatohepatitis, 6; unknown, 9). VTQ was performed using a Siemens Acuson S2000. EVs evaluated using upper endoscopy were classified into the following 3 grades: F1, small, straight, disappearing on insufflation; F2, moderately sized, tortuous, occupying less than one-third of the lumen; and F3, large, coiled, occupying more than one-third of the lumen.

The operation also led to a marked decrease in type IV collagen 7s domain and des-y-carboxy prothrombin. In addition, B-RTO significantly decreased homeostasis model assessment (HOMA) of IR without a statistical decline of HOMA of p-cell function, suggesting a pronounced recovery from IR. The 75g oral glucose tolerance test (75-OGTT) revealed that occlusion of PSS reduced both fasting immunoreactive insulin (IRI) levels and the area under the curve for IRI, suggesting amelioration

of hyperinsulinemia in the fasting state Carfilzomib mw and attenuation of the excessive insulin response to a glucose load. However, no significant change in preprandial or postprandial plasma glucose levels was observed. Furthermore, according to the criteria of the American Diabetes Association, B-RTO improved a 75-OGTT profile in 58.3% of patients who had impaired glucose tolerance or diabetes mellitus before the procedure. Preoperative factors statistically associated with an improvement in H〇MA-IR by B-RTO were sex=male, age<70 years, body

mass index<25, etiology=HCV, C-P class=A, and feeding vein of GV=Ieft gastric vein. Conclusions: Shunt occlusion attenuates IRrelated hyperinsulinemia through increased portal venous flow, promoted liver function, and conseguent augmented hepatic insulin clearance in cirrhotic patients with PH. Excessive insulin response and sustained hyperglycemia after meals are reportedly risk factors for both hepatic fibrosis and hepatocarcinogenesis, and thus B-RTO may be beneficial

for therapeutic management of patients with LC. Disclosures: The following people have nothing to disclose: learn more Tsuyoshi Ishikawa, Takashi Matsuda, Takuya Iwamoto, Shuji Terai, Isao Sakaida [Background and Aim] Spleen stiffness (SS) can be easily measured using virtual touch guantification (VTQ), and it is expected to be important in identifying cirrhotic patients with esophageal varices (EVs). Portosystemic shunts (PSSs), which were developed to treat portal hypertension, can influence SS. However, the significance of SS for the prediction of EVs considering PSSs has not been well documented. MCE公司 The aim of the present study was to determine the predictive value of SS for the presence and severity of EVs. [Patients and Methods] Between June 2008 and May 2013, 981 patients underwent liver stiffness measurement, and data on SS, EVs, and PSSs were available for 143 patients with chronic liver disease (hepatitis C virus, 86; hepatitis B virus, 19; alcoholic liver disease, 14; autoimmune hepatitis, 9; nonalcoholic steatohepatitis, 6; unknown, 9). VTQ was performed using a Siemens Acuson S2000. EVs evaluated using upper endoscopy were classified into the following 3 grades: F1, small, straight, disappearing on insufflation; F2, moderately sized, tortuous, occupying less than one-third of the lumen; and F3, large, coiled, occupying more than one-third of the lumen.