Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 51, Issue 10
Displaying 1-9 of 9 articles from this issue
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Case Reports
  • Successful cyclosporine treatment for a case with acute-onset autoimmune hepatitis presenting as severe type
    Takuya Kuwashiro, Yasunori Kawaguchi, Satoshi Oeda, Noriko Oza, Hiroka ...
    Article type: Case Report
    2010 Volume 51 Issue 10 Pages 549-556
    Published: 2010
    Released on J-STAGE: November 05, 2010
    DOIhttps://doi.org/10.2957/kanzo.51.549
    JOURNAL FREE ACCESS
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    A 42-year-old woman was admitted to our hospital because of acute hepatitis severe type. She had no history of disease except for thyroid dysfunction, and serological tests for viral hepatitis were all negative. Anti-nuclear antibody (×40) and HLA DR4 were positive, and IgG was 2,220 mg/dl. Although we suspected autoimmune hepatitis (AIH) because of an AIH score 13 points and conducted corticosteroid pulse therapy followed by prednisolone at a dose of 60 mg/day, her symptoms and laboratory data did not improve. Moreover, computed tomography showed marked liver atrophy and ascites. Therefore, we administered cyclosporine in combination with prednisolone. After starting combination therapy, her liver function improved gradually. Consequently, her AIH score reached 18 points and she was diagnosed with AIH. Currently, she is in remission and receiving prednisolone alone at a dose of 8 mg/day. This case suggests that cyclosporine is effective in preventing acute-onset AIH from progressing to fulminant hepatitis.
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  • A case of resection of hepatocellular carcinoma associated with primary biliary cirrhosis (PBC) who had prior infection with HBV
    Hidetaka Takashima, Yoshiki Murakami, Kanako Imaeda, Naoya Kida, Takes ...
    Article type: Case Report
    2010 Volume 51 Issue 10 Pages 557-564
    Published: 2010
    Released on J-STAGE: November 05, 2010
    DOIhttps://doi.org/10.2957/kanzo.51.557
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    A 78-year-old man who had been treated for primary biliary cirrhosis (PBC) for approximately 10 years developed hepatocellular carcinoma (HCC). Serological findings suggested that he had a prior infection with HBV. The patient underwent resection of the S4 segment. Resected tumor tissue showed poorly differentiated HCC, and the adjacent liver tissue showed consistent with liver cirrhosis of PBC (Scheuer IV). To clarify the relation of prior infection with HBV, we performed Alu-PCR to detect viral- host junction, but we couldn't detect it. Since 1990, only 11 patients with HCC based on PBC underwent liver resection and this is the first case report investigating whether HBV-DNA integration occurs in HCC from PBC.
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  • A case of esophageal variceal bleeding induced by portal vein tumor thrombus of hepatocellular carcinoma, effectively treated with combined intra-arterial 5-fluorouracil and pegylated interferon-α therapy
    Yutaka Yata, Daisuke Kanda, Takeshi Hatanaka, Keigo Iesaki, Teruo Yosh ...
    Article type: Case Report
    2010 Volume 51 Issue 10 Pages 565-571
    Published: 2010
    Released on J-STAGE: November 05, 2010
    DOIhttps://doi.org/10.2957/kanzo.51.565
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    A 66-year-old Japanese man was admitted to our hospital because of hematemesis with esophageal variceal hemorrhage induced by portal vein tumor thrombus (PVTT) with advanced hepatocellular carcinoma (HCC). He had been treated with RFA to HCC in hepatic S6 that related HCV liver cirrhosis before this admission. He also had been treated with hepatic arterial infusion chemotherapy (3days FPL therapy) prior to this admission. Despite of these treatments, his HCC had progressed and abdominal CT revealed the advanced diffused type HCCs located in hepatic S6, 7 and the obstruction of right portal vein branch due to tumor invasion. Since the ascites and frequent hemorrhage from esophageal varices were observed, we had treated this patient with pegylated interferon-α (PEG-IFN) with 5FU (Peg-IFN/5FU). After 1 course administration, esophageal varices disappeared and the obstructed right portal vein branch have recanalized. Although the advanced HCC with PVTT and esophageal varices were potentially fatal, Peg-IFN/5FU was effective and contributed to improve the prognosis of HCC patient. This case suggests that Peg-IFN/5FU was useful and should be considered to the other chemotherapeutic-agents resistant HCC.
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  • Four cases of hepatic angiomyolipoma with early draining vein
    Takahisa Maruno, Hiroyuki Kokuryu, Kazuyoshi Matsumura, Masao Yoshida, ...
    Article type: Case Report
    2010 Volume 51 Issue 10 Pages 572-578
    Published: 2010
    Released on J-STAGE: November 05, 2010
    DOIhttps://doi.org/10.2957/kanzo.51.572
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    Case1 was a 66 year-old woman with liver tumor in left lobe. Dynamic CT scan revealed fat components and blood vessels within the tumor. In early phase, the left hepatic vein was shown as a draining vein. Case 2 was a 32 year-old woman with liver tumor in S7. Dynamic CT scan revealed fat-deficient hypervascular tumor. In early phase, accessory hepatic veins were shown as draining veins. Case 3 was a 59 year-old woman with liver tumor in S2. Dynamic CT scan revealed fat-deficient hypervascular tumor. In early phase, the left hepatic vein was shown as draining vein. Case 4 was a 72 year-old man with liver tumor in S1. Dynamic CT scan revealed fat-deficient hypervascular tumor. The CT during hepatic arteriography showed the accessory hepatic vein as draining vein. All of four tumors were diagnosed as hepatic angiomyolipoma (HAML) by biopsy. The presence of early draining vein suggested the diagnosis of HAML strongly.
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Short Communications
  • A case of domestic hepatitis E living in Ibaraki Prefecture who was suspected to contract infection of a new Sapporo HEV strain while traveling in Hokkaido
    Tatsuya Aikawa, Kazuto Ikezawa, Takashi Mamiya, Chisato Ueno, Yumiko W ...
    Article type: Short Communication
    2010 Volume 51 Issue 10 Pages 579-581
    Published: 2010
    Released on J-STAGE: November 05, 2010
    DOIhttps://doi.org/10.2957/kanzo.51.579
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    We encountered a 34-year-old man who developed domestic infection of genotype 4 hepatitis E virus (HEV) in January 2010 two weeks after traveling to Hokkaido, where a series of sporadic cases of hepatitis E (n=8) had been noted between September and October in 2009 (Kanzo 51: 51-53, 2010). The HEV isolate recovered from our patient segregated into a cluster of new Sapporo strains consisting of those recovered from the 8 reported patients, with up to 100% identity, suggesting the wider and continuing spread of the particular strain in Hokkaido. In addition to routine test for hepatitis E, detailed interview and phylogentic analysis of HEV strains should be considered for identifying sources of infection and modes of infection transmission.
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  • Application of New "Criteria of guideline for liver transplantation in patients with fulminant hepatic failure" to children
    Tsuyoshi Sogo, Eitaro Hiejima, Hidenori Sugawara, Tomoyuki Tsunoda, Ha ...
    Article type: Short Communication
    2010 Volume 51 Issue 10 Pages 582-585
    Published: 2010
    Released on J-STAGE: November 05, 2010
    DOIhttps://doi.org/10.2957/kanzo.51.582
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    We investigated whether we could applied the new "criteria of guideline for liver transplantation in patients with fulminant hepatic failure (FHF)" to children. Eight children with FHF were evaluated by new criteria at the onset of hepatic encephalopathy (day 0) and 5 days after encephalopathy (day 5), retrospectively. At day 0, only a patient who was received liver transplantation was predicted as dead accurately. At day 5, 4 patients alive without liver transplantation were judged as alive, and 3 patients received liver transplantation were judged as dead, accurately. New criteria permit accurate prognosis for children with FHF as well as adults. However, scoring according to new criteria should be evaluated sequentially, not only at day 0 in children.
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  • Clinical usefulness of glucose tolerance test in nonalcoholic fatty liver disease patients without overt diabetes mellitus
    Yuki Kimura, Hideyuki Hyogo, Tomokazu Ishitobi, Yoshitaka Nabeshima, K ...
    Article type: Short Communication
    2010 Volume 51 Issue 10 Pages 586-588
    Published: 2010
    Released on J-STAGE: November 05, 2010
    DOIhttps://doi.org/10.2957/kanzo.51.586
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    The glucose tolerance was evaluated in 136 nonalcoholic fatty liver disease (NAFLD) patients without overt diabetes mellitus. All patients underwent liver biopsies and 75-g oral glucose tolerance tests. Plasma glucose and insulin levels were analyzed periodically for 3 h after oral glucose loading. Irrespective of the hemoglobin A1c levels, impaired glucose tolerance, including diabetes mellitus, was detected in 61% of the NAFLD patients. While the secretion pattern of glucose after glucose loading was similar among the NAFLD patients, postprandial insulin levels increased in parallel with the aggravation of histological findings (fibrosis stages and NAFLD activity scores). In conclusion, the present data shows the importance of performing the glucose tolerance test in NAFLD patients without overt diabetes mellitus.
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Rapid Communication
  • Efficacy of 60 weeks treatment of pegylated interferon plus ribavirin in patients whose HCV RNA tuned negative by real-time PCR assay at 12 weeks
    Hiroki Ikeda, Michihiro Suzuki, Norie Yamada, Masaru Okamoto, Minoru K ...
    Article type: Rapid Communication
    2010 Volume 51 Issue 10 Pages 589-590
    Published: 2010
    Released on J-STAGE: November 05, 2010
    DOIhttps://doi.org/10.2957/kanzo.51.589
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    Pegylated interferon combined with ribavirin treatment for 48 weeks is commonly used for chronic hepatitis C patients with genotype 1 and high viral load. Additionally, the 2010 guideline by the Study Group for the Standardization of Treatment of Viral Hepatitis Including Cirrhosis, under the auspice of the Ministry of Health Labor and Welfare of Japan newly recommends 72 weeks treatment for elder female or advanced stage patients, whose HCV RNA turned negative at between 9 and 36 weeks by real-time PCR. In this study, we investigated the efficacy of 60 weeks treatment in patients, whose HCV RNA turned negative at 12 weeks. SVR was achieved in 29 out of 30 cases. Among those cases, 8 females were over 50 years old, and 6 cases were advanced stage. Sixty weeks treatment is considered satisfactory for patients whose HCV RNA turned negative at 12 weeks.
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Special Article
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