Kanzo

[title in Japanese]

[in Japanese]

1995 Volume 36 Issue 9 Pages 503-505
Published: September 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.503

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Evaluation of the side effects of interferon therapy by questionnaire in chronic hepatitis C

Ushio HOSHINO, Takeaki SUOU, Hironaka KAWASAKI

1995 Volume 36 Issue 9 Pages 506-510
Published: September 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.506

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We investigated the side effects of interferon (IFN) therapy by a questionnaire in 313 patients of chronic hepatitis C compared with those in 191 patients reported previously. The recall rate was 75%. Almost all patients had fever, and other flu like symptoms occurred, to 60-70% of patients, and these symptoms were two or three times frequent compared with the past report. Alopecia occurred to 64% of patients, and was significantly frequent compared with 14% in the past report. Eruption, sleeping disturbance, mental disorder and bleeding tendency were 12-41% frequency in our patients, but a little was reported in the past. The side effects were mild in almost all patients, but many patients needed some medications against the complaints. Ten percent of patients refused the readministration of IFN because of the side effects, expensive fee for treatment and difficulty in coming to hospital. Patients suffered from the side effects of IFN beyond our expectations. So we must inform to patients about the side effects before IFN therapy and attend to complaints of patients.

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Detection of positive and negative strands of HCV RNA in liver biopsy specimems

False detection of positive strand for self-annealing of negative strand

Hisashi HISATOMI, Humiko TSURUZONO, Kazumasa HIKIJI, Masahiko TOMIMATS ...

1995 Volume 36 Issue 9 Pages 511-516
Published: September 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.511

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Usually HCV RNA in liver tissue was detected by reverse transcriptase polymerase chain reaction (RT-PCR) using primers for 5' non coding region. But doubts have been raised as to the validity of positive and negative strands of HCV RNA detection. The problem is that negative strand HCV RNA may act as a template for synthesis of a positive strand cDNA. Now, our study determined the method of RT-PCR technique without false positive detection HCV RNA in liver biopsy specimems. Positive strand of HCV RNA were detected in livers tissues in 9 (45%) of 20 patients with chronic hepatitis C who had treated with interferon and HCV RNA in serum was negative at the termination of interferon. And negative strand of HCV RNA were detected in livers tissues in 7 (35%) of 20 patients with chronic hepatitis C who had treated with interferon and HCV RNA in serum was negative. At 12 months after interferon therapy, HCV RNA in serum was negative in 13 (65%) of 20 patients. So interferon therapy induced complete response in 13 (100%) of 13 patients who had not detected negative strand of HCV RNA in liver. But, at 3 months after interferon therapy, HCV RNA in serum was positive in 7 (100%) of 7 patients who had detected negative strand of HCV RNA in liver. These results suggest that patients who had detected negative strand of HCV RNA in liver at the termination of interferon are partial responders.

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Clinicopathological analysis of small hepatocellular carcimoma, including the case of preoperative transcatheter arterial embolization and percutaneous ethanol injection therapy

Takashi MAEBA, Keiichi OKANO, Yukihiko KARASAWA, Yasutaka KOKUDO, Isao ...

1995 Volume 36 Issue 9 Pages 517-523
Published: September 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.517

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51 cases of small hepatocellular carcinoma (HCC) (≤29mm in diameter) were examined in view of histological progression. Many cases which diameter is more than 25mm showed the histological features similar to advanced HCC that is 50% of extracapusular invasion, 36% of intrahepatic metastasis and 21% of infiltration to portal vein. On the other hand, histological effectiveness of transcatheter arterial embolization (TAE) or percutaneous ethanol injection therapy (PEIT) before the hepatic resection were also evaluated. The rate at which each therapy achieved complete necrosis in main tumor was relatively high (TAE; 58%, PEIT; 100%), but the effective rate of both therapy in lesion of extracapusular invasion was not high (11%). The 5 year cumulative survival rate after hepatic resection for 51 cases of small HCC was 58.2%. This result seemed to be higher than after TAE or PEIT alone, but the 5 year cumulative recurrence rate was also high (58.2%). These recurrent cases after the hepatic resection included at leas 35% of those regarded as metachronous multicentric carcinogenesis. These data indicated the limitation of surgical therapy against small HCC, but it was an another fact that there were some advanced cases of small HCC which could hardly obtain the complete therapeutic effect by PEIT or TAE especially in those diameter were more than 25mm.
For this reason, we concluded that surgical therapy should be the first therapeutic choice for small HCC which liver function were considered relatively normal.

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The effect of vanadate on bile secretion in the perfused rat liver

Yoshio KAWAMURA, Tomihiro HAYAKAWA, Makoto HOSHINO

1995 Volume 36 Issue 9 Pages 524-531
Published: September 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.524

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Vanadate is an essential trace element and has been shown to mimic most of the actions of insulin in hepatocytes. The oral administration of vanadate was reported to normalize an increase in biliary excretion of phospholipids in diabetes rats. But its effect on bile secretion is unclear. We investigated the effect of vanadate on biliary excretion of phospholipids, bile acids and horseradish peroxidase (HRP) using a single-pass isolated perfused rat liver model. Vanadate increased bile flow before and after taurocholate (TCA) infusion and inhibited TCA-induced biliary excretion of phospholipids without affecting bile acid secretion. A transient 15-min infusion of vanadate resulted in a reversible increase of bile flow and a continuous decrease of the biliary excretion of phospholipids. A one-minute load of HRP (25mg) produced an early and late peak in biliary excretion of HRP. Vanadate significantly increased HRP excretion in both peaks. These findings indicate that vanadate inhibits biliary excretion of phospholipids but not bile acids and suggested that its inhibitory effect might be not due to the blockage in vesicle transport.

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A case of chronic hepatitis type C with ventricular tachycardia during interferon therapy

Satoru KAKIZAKI, Akira KOJIMA, Toshihiko YAMADA, Takehiko ABE, Hideaki ...

1995 Volume 36 Issue 9 Pages 532-536
Published: September 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.532

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Fifty-one-year-old female treated with interferon (IFN) for chronic hepatitis type C was reported. She had the history of blood transfusion because of artificial abortion at 42 years old. She had been well until she was pointed out liver function abnormality at the regular physical examination. Liver biopsy proved chronic active hepatitis 2A and she started the treatment of 6 megaunit of IFN (natural alpha) 6 days a week for 6 weeks and then reduced the injection of IFN to every other day for 6 weeks. Twelve weeks after start of IFN injection, the patient complained of faintenss, palpitation and chest oppression. EKG was within normal limit at the time but the treadmill test evoked the ventricular tachycardia (VT) and she felt the same symptoms like faintness and palpitation. After the cessation of IFN, lidocaine was given and VT was improved and never occurred. According to the clinical course, VT was supposed to be elicited by IFN.
Although IFN-induced-arrhythmia in the patients with chronic hepatitis tye C was rarely reported, special attention should be given to arrhythmia as a side effect of the IFN treatment.

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A case of alcoholic focal fatty liver with multiple nodules in the liver that improved in the follow-up period

Masanori KOBAYASHI, Toshio SUZUKI, Akihiko URUSHIHARA, Akihiro MATSUMO ...

1995 Volume 36 Issue 9 Pages 537-541
Published: September 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.537

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A 56-year-old male with a history of chronic alcohol consumption consulted his family doctor general fatigue. Multiple hyperechoic nodular lesions of the liver were observed by ultrasonography, and he was refered to our clinic. On admission, CT scan also showed multiple nodular lesions in the livier. However, hepatic angiography resulted in normal study.
Histological examination of the lesion, performed by ultrasound-guided needle biopsy, showed focal fatty degeneration of hepatocyte accompanied by mononuclear cell infiltration. These findings indicate that the multiple nodular lesions of the liver were focal fatty degeneration induced by chronic alcoholism. The lesions improved markedly of the several months of abstinence, and this change further confirmed our diagnosis.

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A case of small hepatocellular carcinoma growing into the intrahepatic bile duct

Tsukasa KINJO, Naoji HANASHIRO, Masayuki SHIRAISHI, Toshiomi KUSANO, Y ...

1995 Volume 36 Issue 9 Pages 542-546
Published: September 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.542

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A 33-year-old man with hepatocellula carcinoma (HCC) growing into the intrahepatic bile duct (IHBD) is presented. He was admitted to the hospital because of upper abdominal and back pain with a elevated liver enzyme and AFP level. ERC showed filling defect in the left IHBD, and CT demonstrated the peripheral left IHBD distal to the tumor. Abdominal ultrasonography, MRI, and selective hepatic artery angiography demonstrated a tumor in the medial lobe of the liver. On the diagnosis of hepatocellular carcinoma in the medial lobe, extended left lobectomy was carried out. The tumor, pathologicaly moderately differentiated hepatocellular carcinoma spreaded into the hepatic falciform ligament and the left IHBD was filled with tumor cast and clotted blood. This case is a HCC growing into the IHBD with the distal peripheral dilated bile ducts similar to the characteristic features of cholangiocellular carcinoma. The patient has been doing well for one year since operation without evidence of recurrence.

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A case of cutaneous T-cell lymphoma complicated by hypoglycemia and granulomatous lesion in the liver

Tomoaki ISOBE, Hayato ONISHI, Yoshisuke SOBUE, Katsuhiko TSUKADA, Kats ...

1995 Volume 36 Issue 9 Pages 547-552
Published: September 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.547

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A 64-year-old male had developed erythroderma in 1975. In October of 1989, the patient was admitted to our hospital for treatment of hypoglycemia. The elevation of biliary enzymes and the presence of hepatosplenomegaly suggested the existence of liver disease. Liver biopsy revealed multiple granulomatous lesions. Infiltrating cells consisted of lymphocytes with atypia. T-cell lymphoma was confirmed by electromicroscopy and immuno-staining. Skin biopsy, which exhibited granulomatous lesions similar to those seen in the liver, led to a diagnosis of cutaneous T-cell lymphoma (CTL).
Retrospective review of a skin biopsy in 1975 showed a littel variation of the same lesion. In addition, since an insulin receptor antibody was detected serologically, the hypoglycemia attack may have been one of the paraneoplastic syndrome induced by CTL. CTL complicated by granulomatous lesion in the liver is rare and CTL complicated by hypoglycemia has not been reported in Japan.

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[title in Japanese]

[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...

1995 Volume 36 Issue 9 Pages 553-554
Published: September 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.553

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[title in Japanese]

[in Japanese], [in Japanese], [in Japanese]

1995 Volume 36 Issue 9 Pages 555-557
Published: September 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.555

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