In conclusion, primary percutaneous RFA followed by HR for cases of initial local treatment failure was nearly identical to HR regarding overall survival of compensated cirrhotic patients with very early stage HCC, even with the best scenario for HR and the worst scenario for RFA. We hope that this study will be helpful for further investigations concerning survival outcomes of early stage HCC. Additional Supporting Information may be found in the online version of this article. “
“The Japanese version of the clinical practice guidelines for primary biliary cirrhosis (PBC) was developed in 2012 by the Intractable Pifithrin�� Hepatobiliary Disease Study Group, with the support of the Ministry of Health, Labour and Welfare of Japan,

for the use of general physicians, gastroenterologists and hepatologists who treat patients with PBC. In preparation for developing the guidelines, the study group reviewed recent studies that provided important evidence or that were published in leading journals with a high impact factor, in addition to considering the formal consensus of experts on PBC or related subjects. Using the core keywords “primary biliary cirrhosis,” a PubMed search was conducted for English-language clinical trials, randomized clinical trials (RCTs) and meta-analyses that were published

from January 1998 to December 2009 and that addressed treatment of PBC and its complications, click here follow-up, indication of and time of consultation for liver transplantation, or time of consultation with specialists. Medical systems and other culture-specific

factors in Japan were also taken into account. Members of the task force exchanged ideas frequently during the drafting process to try and establish a consensus. The final draft was made after collecting comments from the public and all the committee members. The level of evidence (LE; Table 1) and the grade of recommendation (GR; Table 2) were based on the Medical Information Network Distribution Service in Japan (MINDS). After being modified by recent literatures published since 2010, the present English version of the guidelines was developed in order to spread our ideas and exchange opinions with physicians who are involved in the management of PBC patients overseas. These clinical practice guidelines should be revised at appropriate intervals to incorporate PDK4 advances in methodology and treatment. PBC is an autoimmune-mediated, chronic cholestatic liver disease that predominantly affects middle-aged women. The initial symptom is most often pruritus, though the disease generally progresses insidiously without symptoms for many years. Jaundice progresses without improvement once it becomes overt, and portal hypertension occurs at a high rate. Clinically, increased levels of serum biliary enzymes [alkaline phosphatase (ALP) and γ-glutamyl transferase (GGT)] and detection of antimitochondrial antibodies (AMAs) are characteristic.