Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 49, Issue 9
Displaying 1-6 of 6 articles from this issue
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Original Article
  • The prognostic factors of sustained virologic response among patients of chronic hepatitis C treated with peg-interferon alpha 2a monotherapy
    Takashi Tanaka, Satoshi Shakado, Daisuke Morihara, Shinya Nishizawa, K ...
    Article type: Original Article
    2008 Volume 49 Issue 9 Pages 417-425
    Published: 2008
    Released on J-STAGE: October 14, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.417
    JOURNAL FREE ACCESS
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    A combination of peginterferon plus ribavirin is recommended therapy for patients with chronic hepatitis C. However, this treatment may influence the occurrence of adverse events induced by ribavirin including anemia or birth defects. This study aimed to reveal the outcome and prognostic factors of peginterferon alpha-2a (PEG-IFN) monotherapy in patients with chronic hepatitis C in Japan. The study included eighty-four patients who were treated with PEG-IFN monotherapy. Fifty-six patients (66.7%) achieved sustained virological response (SVR) in the ITT analysis. When comparing SVR and non-SVR groups, SVR predictable parameters included treatment at a younger age (p=0.0464) and early staging of fibrosis (p=0.0002). In addition, the most predictable parameter of SVR was serum HCV RNA levels undetectable within 4 weeks after the beginning of the treatment in the multivariate analysis (OR:17.2, 95%CI:4.38-84.5, p=0.0001). We suggested that PEG-IFN monotherapy is beneficial for patients who are younger, have mild fibrosis, and lower HCV RNA levels before treatment (<400 KIU/ml in serotype 1, <500 KIU/ml in serotype 2), and who achieve serum HCV RNA undetectable within 4 weeks from beginning the PEG-IFN monotherapy.
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Case Reports
  • A case of liver cirrhosis with refractory ascites treated by peritoneovenous shunt and entecavir
    Akihisa Ishikawa, Nobushige Kakinoki, Yosuke Kishimoto, Toshirou Kamos ...
    Article type: Case Report
    2008 Volume 49 Issue 9 Pages 426-429
    Published: 2008
    Released on J-STAGE: October 14, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.426
    JOURNAL FREE ACCESS
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    A 65 years old man with liver cirrhosis was admitted to our hospital for the treatment of refractory ascites. He received sodium restriction, diuretics therapy and paracentesis, but had severe hyponatremia. We diagnosed diuretic-intractable ascites. First we inserted peritoneovenous shunt (PVS), and then ascites decreased gradually. Two months after PVS, entecavir administration was started. Twenty months after PVS, the patient is still alive with good performance status and his liver function is getting better.
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  • A case of cholangiolocellular carcinoma of which image findings changed during the time of progression
    Naoki Izawa, Koutaro Matsunaga, Yoshihiko Nagase, Midori Nakazawa, Yas ...
    Article type: Case Report
    2008 Volume 49 Issue 9 Pages 430-439
    Published: 2008
    Released on J-STAGE: October 14, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.430
    JOURNAL FREE ACCESS
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    We experienced a case of cholangiolocellular carcinoma (CoCC) of which image findings changed during the time of progression. A 69 years old woman was treated with pegylated interferon (Peg-IFN) combined with ribavirin for chronic hepatitis C in March 2006. Before the therapy, ultrasonography detected a hypoechoic tumor in S5 of the liver. The size of the tumor was approximately 10 mm. Dynamic CT scan showed that the periphery of the tumor enhanced in arterial-phase and homogeneous enhancement of the tumor in delayed-phase. We diagnosed it as a hemangioma and followed up the tumor. About 1 year later, after the therapy completed, we found that the size of the tumor enlarged to approximately 15 mm on ultrasonography. On dynamic CT the periphery of the tumor was enhanced in arterial-phase, and washed out in delayed-phase. The center of the tumor was not enhanced in any phases. Based on these findings, we suspected hepatocellular carcinoma (HCC) or mixed type of HCC and cholangiocellular caricinoma (CCC), and performed right hepatic lobectomy. Histological finding showed small irregular tubules in outer part and scattered small duct structures in inter part of the tumor. Immunohistochemically, the tumor represented positive cells for CK7 and CK19 while no positive cell observed for HepPar1. EMA stain showed localized positivity on apical surface of the tubules. These findings represented the typical characteristics of CoCC. We reported small CoCC of which size was successfully followed during the time of progression.
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  • Two cases of hepatic angiomyolipoma with different ultrasonographic and radiographic findings
    Itsuko Hirayama, Yasuhiro Asahina, Kaoru Tsuchiya, Mitsuaki Sato, Tomo ...
    Article type: Case Report
    2008 Volume 49 Issue 9 Pages 440-448
    Published: 2008
    Released on J-STAGE: October 14, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.440
    JOURNAL FREE ACCESS
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    Case 1: A 44 year-old woman was diagnosed with a liver tumor on health screening without hepatitis virus antigen and antibody. Combined imaging (contrast enhanced ultrasonography, superparamagnetic iron oxide-enhanced MRI, and CT angiography) findings suggested liver angiomyolipoma, which was later confirmed pathologically. Since no increase in the tumor size was observed after subsequent follow-ups, hepatic resection was not performed.
    Case 2: A 40 year-old woman was diagnosed with a liver tumor. Unlike case 1, the possibility of HCC could not be eliminated based on combined imaging findings. Since the tumor was found to be progressively increasing in size within a short period, hepatic resection was performed. Angiomyolipoma was diagnosed based on pathological findings. Although angiomyolipoma was diagnosed in both the cases, imaging tests in case 1 showed typical findings with the presence of large amount of adipose cells in the tumor, whereas case 2 had fewer adipose cells, making diagnosis by combined imaging difficult. Ultrasonography with contrast agent, which visualizes the hepatic vein, was useful for diagnosis in case 2.
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Short Communication
  • Clinical predictor for development of hepatocellular carcinoma in patients with primary biliary cirrhosis
    Yasuyuki Tomiyama, Kenji Ohmoto, Naoko Yoshioka, Tomoya Kawase, Noriku ...
    Article type: Short Communication
    2008 Volume 49 Issue 9 Pages 449-451
    Published: 2008
    Released on J-STAGE: October 14, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.449
    JOURNAL FREE ACCESS
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    The aim of this study was to clarify the factors for predicting the development of hepatocellular carcinoma (HCC) in patients with primary biliary cirrhosis (PBC). HCC developed in 7 (7.4%) of the 95 PBC patients who were negative for hepatitis B and C virus markers. The degree of liver fibrosis was only a significant factor for the development of HCC in multivariate analysis. However, the presence of diabetes mellitus was significantly more frequent in patients with HCC than those without. More extensive study may be required to identify if body mass index or presence of DM may be associated with the development of HCC in PBC patients, since such patients are increasing currently.
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Rapid Communication
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