Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 46, Issue 2
Displaying 1-5 of 5 articles from this issue
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Review Article
  • Staging system for hepatocellular carcinoma
    —its concept and clinical impact—
    Masatoshi KUDO
    Article type: Review Article
    2005 Volume 46 Issue 2 Pages 53-63
    Published: 2005
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.46.53
    JOURNAL FREE ACCESS
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    In this article, the concept and clinical impact of the staging systems for hepatocellular carcinoma (HCC) were reviewed. Among the several scoring systems so far available, such as Barcelona Clinic Liver Cancer (BCLC), Cancer of the Liver Italian Program (CLIP), and Japan Integrated Staging (JIS) systems, the JIS system is extremely efficient in the stratification ability of the HCC patients from the very early stage through highly advanced stage of HCC: particularly in the areas like Japan, where small HCC less than 2 cm in diameter can be diagnosed based on the screening program for early detection of HCC. This efficiency of the JIS system is due to an excellent tumor-node-metastasis (TNM) staging system developed by Liver Cancer Study Group of Japan (LCSGJ). JIS system is an integated staging system between child-Pugh stage and the TNM stage by LCSGJ. Therefore, the TNM stage by LCSGJ and the JIS score is expected to be used as a global standard staging system in the near future.
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Original Article
  • Changes in HBV DNA determined by ultra-sensitive quantitative method in chronic hepatitis B patients treated with long-term lamivudine
    Kiyotaka FUJISE, Minoru NIIYA, Masaru TAKAGI, Takashi ARAKI, Kunihiko ...
    Article type: Original Article
    2005 Volume 46 Issue 2 Pages 64-70
    Published: 2005
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.46.64
    JOURNAL FREE ACCESS
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    This study on patients with hepatitis B treated with long-term lamivudine (LAM) aimed to predict the time of relapse of hepatitis accompanying the emergence of LAM-resistant strain and to determine the time of discontinuation of treatment. The changes in hepatitis B virus (HBV) DNA were determined using sensitive quantitative methods. Eight HBV DNA-positive patients with chronic active hepatitis (seven males, aged 35 to 59 years, F3 in four cases, HBe antigen positive in three cases, genotype C in all cases, core promoter mutation in all cases) who were treated with LAM continuously for 24 months or longer were studied. HBV DNA was determined quantitatively by TMA-HPA method, Amplicor HBV monitor method and ultra-sensitive HBV RTD-PCR direct (DIRECT) method. In four cases, the DNA quantity showed another increase and YMDD mutant emerged after a long period, however all four cases showed a slight increase in DNA quantity during LAM treatment. In one case, such course was caught only by DIRECT method. In conclusion, it was suggested that the DIRECT method was useful to follow the changes in HBV DNA in patients treated with LAM.
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Case Reports
  • An Adult Case of Fulminant Wilson's Disease
    Satoru YATSUJI, Katsutoshi TOKUSHIGE, Etsuko HASHIMOTO, Masakazu YAMAM ...
    Article type: Case Report
    2005 Volume 46 Issue 2 Pages 71-77
    Published: 2005
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.46.71
    JOURNAL FREE ACCESS
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    We experienced a 25-years-old fulminant hepatitis patient who could be diagnosed as Wilson's disease. The patient was originally healthy and admitted due to jaundice. She was diagnosed as unknown etiology fulminant hepatitis. Despite plasma exchange therapy, her hepatic coma and data did not improve and she received living related liver transplantation from her father. Her liver was liver cirrhosis with hepatocyte necrosis and cell infiltration and positive for copper staining. From copper-related marker, she was diagnosed as Wilson's disease. As far as we investigated, 25-years-old is highest age among fulminant Wilson's disease cases in Japan. Although it was difficult to diagnose Wilson's disease in cases without Kayser-Fleischer ring and neurological abnormality, Wilson's disease should be considered as an etiology of unknown fulminant hepatitis even adult cases and the ratios of ALP/T-Bil and AST/ALT and urinary copper were useful for the diagnosis of fulmiant Wilson's diseases.
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  • Spontaneous regression of hepatocellular carcinoma in S4 after another tumor in S1 was chemoembolized
    Tetsuro TAKAYAMA, Shinichiro TADA, Shigeo YOSHIZAWA, Hidetsugu SAITO, ...
    Article type: Case Report
    2005 Volume 46 Issue 2 Pages 78-84
    Published: 2005
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.46.78
    JOURNAL FREE ACCESS
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    An HCV-infected 77 year-old female with a history of blood transfusion when operated for disk herniation in 1960 developed multiple hepatocellular carcinoma in 2003: one in S1 and another in S4. Considering the impaired function of her cirrhotic liver, we planned to undertake transarterial chemoembolization (TAE) first for only the S1 tumor and later for the S4 tumor. One day, about 4 weeks after TAE was done successfully for her S1 tumor, she suddenly suffered from high fever and a sharp increase in transaminases. On the following day, we performed dynamic CT scanning and found that the S4 tumor had lost its tumor-specific enhancement, suggesting an extensive spontaneous necrosis of this tumor. The S4 tumor continued to regress thereafter. This was a rare event with almost no report in literature to our knowledge, particularly in that we could trace the time course of tumor-regression.
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Special Article
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