Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 49, Issue 6
Displaying 1-8 of 8 articles from this issue
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Original Article
  • Nadir platelet and neutrophil counts during the course of PEG-IFN α-2b plus ribavirin combination therapy can be predicted by the values at week one: Towards achieving better efficacy
    Yoshiyasu Karino, Joji Toyota, Tomohiro Arakawa, Yasuaki Kuwata, Jun A ...
    Article type: Original Article
    2008 Volume 49 Issue 6 Pages 239-247
    Published: 2008
    Released on J-STAGE: June 23, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.239
    JOURNAL FREE ACCESS
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    In the treatment of chronic infection with genotype 1 hepatitis C virus, good compliance to PEG-IFN treatment schedule is extremely important to achieve virological response. With the objective of assuring the administration of adequate doses, we examined whether the dose reduction according to the criteria in the package insert of PEG-IFN α-2b is really needed or not. In the past 10 years after approval in Japan , IFN α-2b has been administered, as a rule, without dose reduction. No significant difference is observed following the administration of 6 MIU of IFN α-2b and 1.5 μg/kg of PEG-IFN α-2b in the change in blood cell parameters. To assure safety when PEG-IFN α-2b is administered without dose reduction, the correlation between nadir values during the treatment period and the weekly or monthly measurement values was examined. The results indicated that it is possible to predict nadir values during the treatment period from measurement value after one week of treatment (Platelet: r'2=0.6011, P<0.0001, Neutrophil: r'2=0.6801, P<0.0001). No safety problems were observed if we did not strictly follow the dose reduction of PEG-IFN α-2b settled in the package insert. To achieve improvement in efficacy with PEG-IFN α-2b plus ribavirin combination treatment, early reduction of the dose of PEG-IFN α-2b should be avoided while conducting periodic monitoring of blood cell parameters.
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Case Reports
  • A case of surgical treatment for hepatocellular carcinoma that developed in a chronic hepatitis C patient who had shown sustained virological response to interferon 11 years before
    Jun Hanaoka, Mitsuo Shimada, Toru Ikegami, Satoru Imura, Yuji Morine, ...
    Article type: Case Report
    2008 Volume 49 Issue 6 Pages 248-254
    Published: 2008
    Released on J-STAGE: June 23, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.248
    JOURNAL FREE ACCESS
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    A 66-year-old male, with a history of treated hepatitis C, was admitted to our hospital for liver tumors. He had undergone interferon treatment 11 years ago with sustained virological response since then. The radiological work-ups revealed that the main tumor with a satellite lesion was located in the anterior segment, with a typical enhancement pattern for hepatocellular carcinoma. All the hepatitis viral markers except anti-HBc and anti-HCV were negative. HCV RNA was also negative. A right lobectomy of the liver was undertaken with uncomplicated post-surgical course. We herein report an interesting case of hepatocellular carcinoma that occurred 11 years after achieving sustained virological response to interferon treatment.
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  • The possible suppressive effect against the recurrence of HCV-related hepatocellular carcinoma by interferon after curative treatments
    Tomoyoshi Ohno, Izumi Hasegawa, Hiroki Koguchi, Aki Miura, Syuya Shimi ...
    Article type: Case Report
    2008 Volume 49 Issue 6 Pages 255-259
    Published: 2008
    Released on J-STAGE: June 23, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.255
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    The recurrence rate of HCV-related hepatocellular carcinoma (HCC) is very high even after potentially curative therapies. Such high recurrence rate has been explained by intrahepatic metastasis or multicentric carcinogenesis. Interferon (IFN) therapy is known to reduce the incidence of HCC and also to be very effective when combined with chemotherapy against advanced HCC. Therefore we evaluated how effective IFN was to prevent the recurrence of HCC in consecutive eight patients who was treated with IFN after curative treatment of HCC. Four patients achieved sustained virological response while the remaining four could not eradicate HCV. Prognosis of the 4 responders was very satisfactory (no recurrence of HCC, or a relapsed HCC could be curatively treated), whereas HCC recurred again and again in all of the non-responders. These data indicated that for the suppression of the recurrence of HCC the eradication of HCV by IFN would be very important.
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  • Three cases of amoebic liver abscess
    Kazufumi Dohmen, Hirofumi Tanaka, Masatora Haruno, Hiroshi Otoba, Shin ...
    Article type: Case Report
    2008 Volume 49 Issue 6 Pages 260-267
    Published: 2008
    Released on J-STAGE: June 23, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.260
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    We experienced three male cases of amoebic liver abscess. Of the three patients, one (23 years old) was revealed to be a homosexual man, one (40 years old) had a history of frequent oro-anal sexual contacts with commercial sex workers, and the third patient (47 years old) had often traveled in endemic areas in the Southeast Asia. These patients were treated with metronidazole and responded well. Generally, revelation of the transmission route of Entamoeba hystolytica possibly inhibits the spread of amoebic infection. However, it has become difficult to do so due to a legislation of personal data protection. Amoebic liver abscess had ever been regarded as a rare disease in Japan, until recent reports indicated an increasing number of the amoebic infection along with a spread of the diversification of sexual behavior involving homosexual ones, and increasing availability of traveling abroad. A lot of carriers of Entamoeba hystolytica may exist unnoticed in our community.
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  • A case of hepatic sclerosed hemangioma with a significant morphological change over a period of 17 years
    Natsumi Tsumaki, Nobuo Waguri, Osamu Yoneyama, Isamu Hama, Junji Kouhi ...
    Article type: Case Report
    2008 Volume 49 Issue 6 Pages 268-274
    Published: 2008
    Released on J-STAGE: June 23, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.268
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    A female in her 70s was admitted for right hypochondralgia and a liver tumor. Plain computed tomography (CT) showed an approximately 4-cm low-density mass in the periphery of Segment 8 that was marginally enhanced on contrast-enhanced dynamic CT. The tumor, a low-intensity mass on T1-weighted magnetic resonance images, showed slightly high intensity on T2. We suspected the tumor was a cholangiocarcinoma, a metastatic liver tumor, or a scirrhous-type hepatocellular carcinoma. Partial hepatectomy was performed and histological examination of a surgically obtained specimen revealed sclerosed hemangioma with marked hyalinization and sparse stromal fibrosis. Interestingly the radiological findings of the tumor obtained 17 years before at a local hospital had shown a typical cavernous hemangioma of the liver. Hepatic sclerosed hemangioma is a rare condition; thus the radiological findings taken from the same patient 17 years apart would be valuable in its implications for the involutional process from cavernous hemangioma to sclerosed hemangioma.
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Short Communications
  • Comparison of the adverse events to interferon therapy in patients with chronic hepatitis C: standard interferon versus pegylated interferon
    Michiyasu Yagura, Akihisa Tanaka, Masanobu Iri, Hiroshi Kamitsukasa
    Article type: Short Communication
    2008 Volume 49 Issue 6 Pages 275-278
    Published: 2008
    Released on J-STAGE: June 23, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.275
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    We compared the adverse events among the same patients with chronic hepatitis C who were treated with standard interferon (IFN) with no response and again treated with pegylated interferon (PEG-IFN) combined with or without ribavirin (RIB), based on a questionnaire and blood count analysis. Patients were divided into four groups; standard IFN group, standard IFN+RIB group, PEG-IFN group, and PEG-IFN+RIB group. As a result, allergic reactions, such as itching, stomatitis, sneezing were much less seen in the standard IFN group, compared to PEG-IFN group. On the other hand, flu-like symptoms were more seen in the former than the latter. Hemoglobin and neutrophilic leukocyte counts significantly decreased until 16 weeks after starting the therapy in the groups with RIB than the groups without it. Platelet level significantly decreased at 2 weeks in the standard IFN+RIB group compared with PEG-IFN+RIB. As a whole, patients were satisfied with PEG-IFN therapy in view of visiting a doctor only once a week and its physical and mental easiness.
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  • A proposal of simple scoring system to differentiate nonalcoholic steatohepatitis from nonalcoholic fatty liver disease: we originally named NAFIC score composed of serum ferritin, fasting insulin, type IV collagen 7S
    Yoshio Sumida, Kazuyuki Kanemasa, Akitoshi Douhara, Takako Wada, Naohi ...
    Article type: Short Communication
    2008 Volume 49 Issue 6 Pages 279-281
    Published: 2008
    Released on J-STAGE: June 23, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.279
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    Noninvasive, simple, reproducible, and reliable biomarkers are greatly needed to differentiate nonalcoholic steatohepatitis (NASH) from nonalcoholic fatty liver disease (NAFLD). One hundred seventeen patients with biopsy-proven NAFLD were involved in this study. We combined 3 clinical variables to generate the NAFIC score originally: ferritin (≥200 (female) or ≥300 (male) ng/ml), fasting insulin (≥10 μU/ml), and type IV collagen 7S (≥5.0 ng/ml). These parameters were selected as independent variables by multivariate analysis using logistic regression analysis. The presence of each variable gives 1 point in the combined score. The NAFIC score of NASH patients (n=65, 1.94±0.85) was significantly higher than that of simple steatosis patients (n=52, 0.58±0.67, p<0.0001). The percentage of NASH in NAFLD in a total score of 0, 1, 2, and 3 was 10.3% (3/29), 41.0% (16/39), 93.3% (28/30), and 94.7% (18/19), respectively. The NAFIC score can become one of noninvasive, simple, and useful biomarkers to differentiate NASH from NAFLD.
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Special Article
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