Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 46, Issue 3
Displaying 1-6 of 6 articles from this issue
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Original Articles
  • Clinicopathological study of hepatocellular carcinoma with infiltration of the bile duct
    Yutaka TAKAHASHI, Takehito OHTUBO, Masakazu YAMAMOTO, Satoshi KATAGIRI ...
    Article type: Original Article
    2005 Volume 46 Issue 3 Pages 99-106
    Published: 2005
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.46.99
    JOURNAL FREE ACCESS
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    Although infiltration of the portal veins and hepatic veins is common in hepatocellular carcinoma (HCC), infiltration of bile duct is rare. We clinicopathologically evaluated HCC with infiltration of the bile duct. Of 1452 hepatic resection for HCC performed at our institute (1986∼2002), 40 case of HCC with infiltration of bile duct were included in this study. With regard to macroscopic tumor type, the single nodular type were rare. There were many cases of tumor thrombus in the portal veins and hepatic veins. There were many cases without capsule formation. With regard to histological grading, there were many cases of moderately and poorly differentiated HCC relatively, Many cases showed metastasis to regional lymph nodes and recurrence at sites other than the liver. The survival rate was bad. The findings of this study suggest that HCC with infiltration of the bile duct has its own clinicopathological characteristics, it closely related to cholangiocell carcinoma.
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  • Total clearance (CL/F) of ribavirin is the factor most influencing incidence of hemolytic anemia in interferon α plus ribavirin combination therapy
    Joji TOYOTA, Yosiyasu KARINO, Jun AKAIKE, Takumi OHMURA, Takahiro SATO ...
    Article type: Original Article
    2005 Volume 46 Issue 3 Pages 107-118
    Published: 2005
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.46.107
    JOURNAL FREE ACCESS
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    Prediction of the need for dose adjustment of ribavirin was examined using total clearance (CL/F) of ribavirin, a factor which includes all risks (elderly age, female gender, low body weight, and reduced renal function) of anemia during interferon α plus ribavirin combination therapy. When examined by quartiles, (≤10, <10-≤15, <15-≤20, and >20), a CL/F of ≤15L/hr was identified as the strongest factor for ribavirin dose reduction and discontinuation. Since CL/F of ribavirin is the index of the steady state of serum ribavirin concentrations, it was shown to significantly correlate with serum ribavirin concentrations at week 4. A serum ribavirin concentration at week 4 of 2000-2500 ng/ml was estimated to be optimal for efficacy and safety based on linear regression analysis. Also, in patients with CL/F of ≤15L/hr, a prediction of the need for dose reduction due to anemia was thought possible based on change in hemoglobin levels at week 1.
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Case Reports
  • A case of chronic hepatitis B with genotype B which developed hepatoceller carcinoma during lamivudine treatment
    Yuki NISHIMURA, Namiki IZUMI, Yuko ONUKI, Kazunari INOUE, Ken UEDA, Ka ...
    Article type: Case Report
    2005 Volume 46 Issue 3 Pages 119-125
    Published: 2005
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.46.119
    JOURNAL FREE ACCESS
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    A 63-year-old man was diagnosed as chronic hepatitis B in 2000 with a histrogic findings of the liver was A2F2. He received interferon therapy, but non-response. Lamivudine treatment was begun from March, 2002. HBV-DNA and GPT (glutamic-pyruvic transaminase) levels have improved, but abdominal computed tomograpy revealed hypervascular liver tumor at S6 in February, 2003. It was diagnosed as hepatoceller carcinoma and surgical treatment was given. HBV genotype of this case was found to be Ba subgroup, which is frequent in Taiwan but rare in Japan. These results suggest that HBV genotype is associated with the mechanism of chronic hepatitis B and the development of HCC even under lamivudine administration.
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  • Synchronous double cancer of hepatocellular carcinoma and liver metastasis from sigmoid colon cancer in the same subsegment of the liver-A case report
    Hirotoshi TAKEMOTO, Takeshi TONO, Jun OKAMURA
    Article type: Case Report
    2005 Volume 46 Issue 3 Pages 126-132
    Published: 2005
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.46.126
    JOURNAL FREE ACCESS
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    A 57-year-old man was diagnosed as sigmoid colon cancer by Barium enema and 5 nodules were also observed in liver S8/4, S8, S4, S5 and S5 by CT. The largest nodule in S8/4 (50 mm) was recognized as perfusion defect in CTAP. It was strongly enhanced at early phase and washed out at late phase in CTHA, which was diagnosed as HCC. Three of the remaining 4 nodules showed similar pattern. However, the outline of the nodule in S5 (10 mm) was enhanced at early phase in CTHA, which was compatible with liver metastasis. Sigmoidectomy and hepatic central bi-segmentectomy were performed on July 2002.
    Histological findings revealed the sigmoid colon lesion was moderately differentiated adenocarcinoma, and the nodule of S8/4 was HCC. However, the nodule in S5 was adenocarcinoma and diagnosed as liver metastasis, which was concordant with preoperative diagnosis. He has been free of the disease for 18 months postoperatively.
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  • Autoimmune hepatitis induced by pravastatin : two cases
    Makoto OKADA, Takeaki SATOH, Jiro WATANABE, Hayato SANEFUJI, Makoto NA ...
    Article type: Case Report
    2005 Volume 46 Issue 3 Pages 133-141
    Published: 2005
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.46.133
    JOURNAL FREE ACCESS
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    Case 1, a 68-year-old female, was referred to our hospital because of the development of liver injury (AST 268 IU/l, ALT 247 IU/l) after the treatment of her hypercholesterolemia using pravastatin for 3 months. The diagnosis of autoimmune hepatitis (AIH) was made on the basis of liver biopsy findings as well as the laboratory data including ANA×640 and IgG 2,160 mg/dl. Her liver function showed a rapid improvement after withdrawal of the drug. Case 2, a 62-year-old female, who had had hypercholesterolemia and mild abnormality of liver function tests, developed severe liver damage with jaundice (AST 859 IU/l, ALT 1,170 IU/l, T-Bil 9.7 mg/dl) after pravastatin treatment for 1 month. Laboratory data on admission showed ANA×1,280 and IgG 1,440 mg/dl. Liver biopsy findings were consistent with those of an acute exacerbation of AIH. Prednisolone administration subsequent to withdrawal of pravastatin resulted in a recovery. It was suggested that pravastatin induced AIH in these 2 cases.
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