Background : Hepatocytes (Hep) contributes to a maintenance of “quiescent” phenotype of hepatic stellate cells (HSC) in co-culture system. We hypothesized that a direct binding to the hepatocyte membrane is essential for the maintenance of “quiescent” phenotype of HSCs and that there may be hepatocyte membrane factors that are involved in HSC deactivation. Methods : Cell membranes were isolated from wild-type mHep. Primary mHSC and human hepatic stellate cells (HHSteC) were cultured with the hepatocyte-membranes and subjected to the morphological observation using time-lapse imaging and gene expression analysis. Results : mHSCs cultured on hepatocyte membranes showed dendrite-rich morphology, a “quiescent” phenotype, and expressions of HSC-activation markers, Acta2 and Col1a1 were suppressed in these cells compared to those in mHSCs following normal plate cultures. In HHSteC with hepatocyte membranes, ACTA2 and COL1A1 expressions were suppressed, while the HSC-quiescent marker, MMP1 mRNA expression increased in dose-dependent manners. Conclusion : This study suggests the presence of hepatocyte membrane factors that are involved in maintaining the ‘quiescent’ phenotype of HSCs. We further investigate the pathophysiological role of hepatocyte membranes.

Ectopic varices have been increasing in recent years due to improvement of outcome of patients with esophageal and gastric varices, in whom endoscopic therapies and/or interventional radiology treatment were done. However, the treatment strategy for ectopic varices has not yet been established. In this study, we evaluated the outcome of 22 patients with ruptured ectopic varices receiving therapies for a total of 41 variceal lesions in our hospital; 6 lesions in the duodenum, 5 lesions in the postoperative anastomosis, 6 lesions in the rectum, 2 lesions in the small intestine, 1 lesion in the ascending colon, and 2 lesions in the stoma. Initial hemostasis was obtained in all the patients, while rebleeding occurred frequently in patients with varices in the anastomosis, rectum, and stoma. Recently, endoscopic sclerotherapy using cyanoacrylate (HA-EIS) has been done for patients with bleeding varices. In our hospital, 16 patients received HA-EIS. And the patient with varices in the duodenum and ascending colon, the feeding veins were successfully embolized in 5 patients. Thus, endoscopic therapies should be done in patients with ruptured ectopic varices to obtain initial hemostasis, and HA-EIS merits consideration in a part of patients to obtain a favorable outcome in whom adequate embolization of the feeding veins was achieved.