Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 37, Issue 5
Displaying 1-10 of 10 articles from this issue
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  • [title in Japanese]
    [in Japanese]
    1996 Volume 37 Issue 5 Pages 253-255
    Published: May 25, 1996
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.37.253
    JOURNAL FREE ACCESS
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  • Angiographic characteristics of hepatocellular adenoma
    Comparison with hepatocellular carcinoma
    Takayuki HAYASHI, Ryuzo SEKIGUCHI, Mitsuo SATAKE, Ryoko IWATA, Koji MU ...
    1996 Volume 37 Issue 5 Pages 256-263
    Published: May 25, 1996
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.37.256
    JOURNAL FREE ACCESS
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    A case of huge hepatocellular adenoma (HCA), which was very difficult to differentiate from well-differentiated hepatocellular carcinoma (HCC), is reported. Also, the angiographic charac- teristics of both HCC and HCA, 12 cases of mononodal type HCC (capsulated type: 2 cases, uncapsulated type: 10 cases) and 3 cases of HCA including the reported case which sized over 8cm in diameter, were compared.
    Like HCC, HCA appears as rounded relatively homogeneous hypervascular mass that stretch markedly the dilated hepatic artery branches. In HCA, numerous small vascular branches, which perforate toward the center of the tumor from the displaced branches, shows regular vascular running and even vascular caliber as if brushed over, compared with irregular vascular running and uneven vascular caliber with abrupt interruption for HCC.
    Angiographic characteristics of the tumor such as tumor staining, its boundary, vascular running and vascular caliber, play an important role to differentiate HCA from HCC.
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  • A case of chronic hepatitis type C showing hypermacrocreatinine-kinasenemia during interferon therapy
    Kazuya KARIYAMA, Toshihiro HIGASHI, Hideki TANI, Tokurou UESU, Shinnos ...
    1996 Volume 37 Issue 5 Pages 264-267
    Published: May 25, 1996
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.37.264
    JOURNAL FREE ACCESS
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    A 64-year-old male was admitted for the treatment of chronic hepatitis type C. Interferon (IFN)-α, (600 million units intramuscular injection) was started every day for 2 weeks and thereafter 3 times a week for 5.5 months, and HCV·RNA in serum rapidly disappeared. Creatinine kinase (CK), lactate dehydrogease (LDH), aldolase, myoglobulin and toroponin in serum elevated at the end of the IFN therapy, and these myogenic enzymes gradually decreased and returned to the normal limits after the treatment was finished. The CK isoenzyme pattern showed that MM fraction was predominant and there was an extra-band which was proved to be a macro-CK bound to IgA-λ. Although particular symptoms, including muscle pain and atrophy, were not recognized during the therapy, it was suggested that asymptomatic myopathy developed as a side effect of the IFN therapy. Since IFN-induced myopathy has rarely been reported, myopathy should be taken into account when myogenic enzymes, including CK, are elevated during the therapy.
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  • Two cases of autoimmune hepatitis in elderly women with positive HLA-DR2 and negative HLA-DR4
    Kazuyoshi NAGAYAMA, Namiki IZUMI, Yuji HOSHINO, Keiichi ONO, Osamu NOG ...
    1996 Volume 37 Issue 5 Pages 268-275
    Published: May 25, 1996
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.37.268
    JOURNAL FREE ACCESS
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    The first case was a 76-year-old female, who was admitted to our hospital because of liver dysfunction. Her past medical history was not remarkable except an admission to another hospital two years ago for the diagnosis of acute hepatitis. Her laboratory data were as follows: GOT (AST) 755 U/l, GPT (ALT) 902 U/l, total bilirubin 2.9mg/dl, IgG 3230mg/dl, antinuclear antibody >×5120, LE cell and anti-smooth muscle antibody were negative. Neither HBsAg nor HCV-RNA were detected. HLA-A2, A24(9), B35, B52(5), DR12(5), DR2 were positive. Histological examination of the liver revealed active cirrhosis and plasma cell infiltration. The diagnosis of autoimmune hepatitis was made, and corticosteroid therapy was effective.
    The second case was a 78-year-old female, who was admitted to our hospital because of the first episode of liver dysfunction. Her laboratory data were as follows: GOT (AST) 246 U/l, GPT (ALT) 152 U/l, total hilirubin 1.7mg/dl, IgG 3050 mg/dl, antinuclear antibody >×1280, LE cell was positive, and anti-smooth muscle antibody was ×80. Neither HBsAg nor HCV-RNA were detected. HLA-A2, A11, B51, B62, Cw1, DR2, DR5, DRw52, DQw1, DQw3 were positive. Histological examination of the liver revealed chronic aggressive hepatitis and plasma cell infiltration. The diagnosis of autoimmune hepatitis was made, and corticosteroid therapy was effective.
    In Japanese patients with autoimmune hepatitis, a strong association with HLA-DR4 has been established. However, few reports have documented the association between autoimmune hepatitis and HLA-DR2. The presently reported two cases are suggested to demonstrate a close association between elderly-onset cases of Japanese autoimmune hepatitis and HLA-DR2.
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  • Corticosterid induced HCV-RNA positivity in a case of autoimmune hepatitis
    Takefukmi TAKAHASHI, Nobuya SANO, Hirohito HONDA, Susumu ITO
    1996 Volume 37 Issue 5 Pages 276-280
    Published: May 25, 1996
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.37.276
    JOURNAL FREE ACCESS
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    A 49-year-old man was admitted to our hospital because of general malaise and elevation of aminotranseferases in June 1994. On admission, he was diagnosed as chronic active hepatitis C because HCV-Ab was positive since 1992. The aminotranseferases improved to almost normal level, but total bilillbin and gammaglobulin drastically increased. Laboratory tests revealed high titers of antinuclear antibodies, and elevations of IgG. The histological examination of the liver showed the findings of chronic active hepatitis, compatible with autoimmune hepatitis. In addition, HCV-RNA became undertectable at this point, he was diagnosed as AIH and treated with corticosteroid. The liver function improved, but during the follow up examination after discharge, HCV-RNA became positive (108copy/ml) in sera. The present case suggests the relationship between AIH and chronic hepatitis C.
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  • A case of primary biliary cirrhosis survived by living related liver transplantation
    Kunihiko TSUJI, Seiji WATANABE, Syunji KITAZAWA, Ikuo SATOU, KANG Jong ...
    1996 Volume 37 Issue 5 Pages 281-285
    Published: May 25, 1996
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.37.281
    JOURNAL FREE ACCESS
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    A 49-year-old woman was diagnosed as symptomatic primary biliary cirrhosis (PBC) Scheuer II 11 years ago. Firstly, she was admitted to our hospital because of increased icterus on January 1993 and found to be cirrhotic stage (Scheuer IV). Liver cirrhosis was in decompensated state 1 years after the admission. Because of elevated serum bilirubin level of 27mg/dl on July, 1994, liver transplatation was considered as an only the rapeutic way. The patient and her family expressed a strong will of liver transplantation, and an indication of living related liver transplantation (LRDLT) was considered. While waiting for LRDLT, the raptured gastric varices were treated by endoscopic sclerotherapy. Under permission of the committee on ethics of Kyoto University, LRDLT was performed on November, 1994 at Kyoto university. Her liver functions have been all in normal ranges, 11 month following after LRDLT.
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  • A case of hepatic encephalopathy successfully treated for a long term by embolization of portocaval shunt
    Toshiyuki MATSUOKA, Yuji HAYAKAWA, Sumio TAKASHIMA
    1996 Volume 37 Issue 5 Pages 286-290
    Published: May 25, 1996
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.37.286
    JOURNAL FREE ACCESS
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    A 73-year-old woman with portocaval shunt was treated successfully by percutaneous vascular embolization. The patient had had recurrent disturbances of consciousness and hyperammonemia after gastrectomy in spite of liver dysfunction being mild, and was found to have collateral circulation from the superior mesenteric vein to the inferior vena cava. Embolization was done through the inferior vena cava. The hepatic encephalopathy was controlled after embolization for five and a half years and no side effects or complications appeared. This procedure seemed to be safe, and might be used instead of surgical ligation in suitable patients.
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  • A case of Adult Still's disease with severe liver injury and DIC improved by administration of cyclosporine
    Toru ISHIKAWA, Naoki ISHIKAWA, Hironobu OTA, Toshiaki YOSHIDA, Akira H ...
    1996 Volume 37 Issue 5 Pages 291-295
    Published: May 25, 1996
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.37.291
    JOURNAL FREE ACCESS
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    A 44-year-old man was admitted to our hospital because of left cervical lymph node swelling and fever. We ruled out the bacterial infection and collagen diseases, and diagnosed this case Adult Still's disease. Despite of the corticosteroid administration, severe liver injury and DIC were observed during steroid tapering. He recovered from severe liver injury with steroid pulse therapy, but high fever still continued. Therefore, we started cyclosporine therapy. According to the increase of the cyclosporine concentration, serum ferritin level and liver dysfunction improved. Adult Still's disease with severe liver injury and DIC is rare, and it was suggested that cyclosporine was effective for this disease.
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  • [title in Japanese]
    [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1996 Volume 37 Issue 5 Pages 296-297
    Published: May 25, 1996
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.37.296
    JOURNAL FREE ACCESS
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  • [title in Japanese]
    [in Japanese]
    1996 Volume 37 Issue 5 Pages 298-300
    Published: May 25, 1996
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.37.298
    JOURNAL FREE ACCESS
    Download PDF (140K)
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