Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 46, Issue 5
Displaying 1-8 of 8 articles from this issue
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Case Reports
  • Effective use of minute quantities of IFN for hard-to-cure cirrhosis of the liver with hepatitis C virus infection
    Shinya NAKAJIMA
    Article type: Case Report
    2005 Volume 46 Issue 5 Pages 257-261
    Published: 2005
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.46.257
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    A 53-year-old male patient with cirrhosis was seen by this clinic in 1998. He had received interferon (IFN) in 1995 for chronic hepatitis C but this was later changed to glycyrrhizin (SNMC). Although the dose of SNMC was increased to 60 ml, serum transaminase levels remained at 100 to 150 IU/l. One million units (MU) of IFN-alpha were administered and gradually decreased to 0.05 MU. Transaminase levels decreased below the basal level at 1 million units (MU) of IFN, 0.3 MU, and 0.1 MU but rose at 0.05 MU. Administration of 0.1 MU IFN was continued. Serum transaminase levels were 60 to 100 IU/l during this period. Mean activity of 2-5AS rose to 2.4-fold because of 0.1 MU IFN, but the HCV titer did not decrease. There were no adverse reactions. Here, I report a case where a minute quantity of IFN (0.1 MU) was useful in preventing the progression of liver damage.
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  • A case of decompensated hepatitis B virus-related cirrhosis successfully treated with lamivudine and adefovir allowing repeated treatments for hepatocellular carcinomas
    Michiyo KODAMA, Mikiya KITAMOTO, Hideki NAKAHARA, Yasuhiko FUKUDA, Wak ...
    Article type: Case Report
    2005 Volume 46 Issue 5 Pages 262-269
    Published: 2005
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.46.262
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    A 59-year-old man, who had been repeatedly hospitalized because of hepatic exacerbations with icterus and acites, was diagnosed with hepatocellular carcinoma (HCC) evaluated on stage III. However, because of hepatic dysfunction due to hepatitis B virus-related cirrhosis, he was treated with lamivudine (100 mg) prior to treatment for HCC. Three months later, his hepatic function was improved from class B with 9 points to class B with 7 points according to Child-Pugh classification. Then, he underwent a successful treatment of HCC with ablation. Fifteen months after the administration of lamivudine, YVDD mutant was detected. Three months later, HBV DNA levels re-increased and level of alanine aminotransferase elevated. Thus, he was treated with adefovir (10 mg) in addition to lamivudine. Three months later, HBV DNA level became undetectable again (PCR method). During 30 months after the administration of lamivudine, his hepatic function was improved and maintained despite of several times of treatments for HCC.
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  • A case of HCC with erythrocytosis resulted in liver failure after hepatic resection
    Hideki AOKI, Norihisa TAKAKURA, Shigehiro SHIOZAKI, Ryoichi OKAMOTO, Y ...
    Article type: Case Report
    2005 Volume 46 Issue 5 Pages 270-276
    Published: 2005
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.46.270
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    We report a case of HCC with erythrocytosis resulted in liver failure after hepatic resection. Seventy-seven year-old man was admitted to our hospital for evaluation of liver tumor 10 cm in diameter located in segment 8 and 4. Because erythrocytosis was found out, venesection was carried out for 2 days before surgery. He underwent central bisegmentectomy after hematocrit became below 45%. Liver function was deteriorated after hepatic resection. Portal thrombus was found in abdominal CT on 7 th post operative day. Emergent operation was performed to remove portal thrombus immediately. Because portal flow was reverse, portal thrombus was thought to be secondary. Despite removal of portal thrombus and subsequent plasma exchange, it was not sufficient to improve liver failure. He died of multiple organ failure 14 days after hepatic resection. Intraoperative liver biopsy revealed massive coagulation necrosis of the liver. We suspect hepatectomy besides erythrocytosis and diabetes mellitus caused sinusoidal obstruction syndrome.
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  • A case of recurrent hepatocellular carcinoma, based on different hepatic pathogenesis from initial condition, developed 18 years after hepatic resection
    Mariko ITSUBO, Kazuhiko KOIKE, Masahisa OSADA, Susumu KOBAYASHI
    Article type: Case Report
    2005 Volume 46 Issue 5 Pages 277-283
    Published: 2005
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.46.277
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    We report a male patient with second primary hepatocellular carcinoma (HCC) diagnosed 18 years after hepatectomy for primary well differentiated HCC developed without underlying chronic liver disease at 64 years of age. Although he had been a carrier of hepatitis B virus (HBV), the conversion of the serological surface marker of HBV from antigen to antibody was revealed at 67 years of age. He was diagnosed as having small HCC at the 82 years of age. The biopsy specimen of non-tumorous liver showed chronic hepatitis probably due to hepatitis C virus (HCV) infection from blood transfusion at past hepatectomy. Serum HCV RNA has been present with unstable ALT level after hepatectomy. HBV DNA was not detected in the liver tissue. The etiology of HCC in each event were thought to be different; direct carcinogenesis of HBV without underlying chronic liver disease at first, and development in chronic hepatitis C next.
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  • Refractory gastric varices treated by multi-endovascular and endoscopic techniques
    Takeshi HASHIMOTO, Jun KOIZUMI, Shigenari HOZAWA, Takuro SAITO, Kayoko ...
    Article type: Case Report
    2005 Volume 46 Issue 5 Pages 284-289
    Published: 2005
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.46.284
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    We report a case of refractory gastric varices treated by multi-endovascular and endoscopic techniques. A 41-year-old man was hospitalized with recurrent hematemesis. Enhanced CT and MRI revealed gastric varices with G-R shunt and B-RTO was offered. However, G-R shunt was too large to be occluded. After failed B-RTO, we performed TIPS (transjugular intrahepatic portosystemic shunt) and embolization of the gastric coronary vein via the TIPS. However, recurrent hematemesis has occurred and the short gastric veins were considered to be the feeding vein to gastric varices, Additional PSE and repeated B-RTO after EIS were required to obtain complete thrombosis of gastric varices. We think that subsequent embolization of the ruptured varix should be performed, even if successful decompression of portal trunk is obtained by TIPS. Moreover, when short gastric veins is considered to be an inflow to gastric varices, the balloon occlusion of the splenic artery or PSE should be an additional alternative, which enabled B-RTO or DBOE by reducing the blood flow to varices.
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Short Communications
  • A Japanese patient with seronegative hepatitis E caused by a Greece/Spain-origin-like HEV after visiting Thailand
    K MIYAJI, Y HONGOU, Y YAMADA, S FUJIWARA, Y ARISAKA, T FUJIYAMA, S KOG ...
    Article type: Short Communication
    2005 Volume 46 Issue 5 Pages 290-291
    Published: 2005
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.46.290
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    This case of hepatitis E was interesting in the following points. 1) Although thought as an imported infection from Thailand, this case had shorter or longer incubation period for that, and had an HEV genotype which is rare in Thailand. 2) Domestic infection was thought then, but the HEV isolate from the patient was more homologous to Greece/Spain isolates than to Japanese strains. 3) Response of antibodies to HEV was delayed than in usual cases. Also noteworthy was that a highly increased level of the serum 2'-5' OAS suggested strongly that the hepatitis in this patient would be virus-origin. But for the finding, we would not have tried to test HEV RNA in the absence of antibodies to HEV.
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  • Atorvastatin in the treatment of nonalcoholic steatohepatitis
    H Hyogo, K Iwamoto, K Arihiro, T Ajima, T Ishitobi, M Inoue, M Ogi, Y ...
    Article type: Short Communication
    2005 Volume 46 Issue 5 Pages 292-293
    Published: 2005
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.46.292
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    The effectiveness of HMG-CoA reductase inhibitor, atorvastatin, was studied in patients with nonalcoholic steatohepatitis (NASH). Twenty five patients (nineteen patients had hypercholesterolemia at the start of treatment) with biopsyproven NASH were treated with atorvastatin (10 mg/d) for 48 weeks. BMI did not change during the treatment period. Significant improvements were observed in blood markers of hepatic fibrosis, liver densities and adipocytokine levels with an improvement in serum aminotransferase level. No side effect of treatment was noted at any time during the study. In conclusion, the present data raise the possibility that an atorvastatin may be one of the effective therapies for NASH.
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Rapid Communication
  • The estimation of protein intake by urinary urea nitrogen in patients with liver cirrhosis
    Yohei Kida, Hiroyuki Sahara, Takashi Machii, Hiroki Ueda, Masakazu Ich ...
    Article type: Rapid Communication
    2005 Volume 46 Issue 5 Pages 294
    Published: 2005
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.46.294
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    This study was carried out in order to find out whether the estimation of protein intake (EPI) from urinary urea nitrogen (UUN) was useful for patient with liver cirrhosis. The actual protein intake (API) is defined as the sum, dietary protein intake and protein intake of BCAA supplement. EPI was defined, { [UUN (g/day) + 0.031 × Body weight (kg)] × 0.625 + urine protein} × 1.25. For all 27 patients there was a significant positive correlation between API and EPI. EPI was correlated with API (R=0.681, Spearman r=0.54, N=27, p=0.0006). EPI from UUN was useful for patient with liver cirrhosis and education for patients.
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