Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 47, Issue 3
Displaying 1-9 of 9 articles from this issue
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Original Article
  • Clinical study of Radiofrequency Ablation under Biliary Duct Cooling via Endoscopic Naso-biliary Drainage
    Mamoru NISHIMURA, Kazuya KARIYAMA, Akiko WAKUTA, Hideyuki TSUJI, Jiro ...
    Article type: Original Article
    2006 Volume 47 Issue 3 Pages 123-128
    Published: 2006
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.47.123
    JOURNAL FREE ACCESS
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    Percutaneous radiofrequency ablation (RFA) for patients with hepatocellular carcinoma (HCC) is an effective minimal invasive therapy and widely used. Nevertheless, the majar complications of the therapy, the formation of biloma and obstractive jaundice due to intrahepatic biliary tract injury, have been documented. We treated 5 cases with HCC by RFA under biliary duct cooling via endoscopic naso-biliary drainage (ENBD) tube as preciously reported. Although postoperative pancreatitis occurred in 2 cases, other complication were not recognized and the local recurrence was not observed in 4 of 5 cases. The device is effective to obtain complete cure by preventing biliary tract injury in RFA.
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Case Reports
  • Chorea induced by PEG-IFN and rivabirin therapy for type C chronic hepatitis
    Aiko HAYASHI, Yoshiaki INUI, Chie WATANABE, Yumi MATSUMOTO, Naoe YOSHI ...
    Article type: Case Report
    2006 Volume 47 Issue 3 Pages 129-133
    Published: 2006
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.47.129
    JOURNAL FREE ACCESS
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    A 70-year-old man with chronic hepatitis C having treated by interferon (IFN) 13 years before was given the combination therapy of Peg-IFN and ribavirin. Seven weeks later, we confirmed the involuntary movement and the decrease of muscle tone. The involuntary movement of inner and external rotation was repeated at his right leg. On brain MRI, no abnormal finding was pointed out. Five months after the discontinuation of Peg-IFN and ribavirin, these symptoms disappeared. We rarely experience a case showing chorea during IFN therapy, but we should keep in mind about this kind of side effect of IFN.
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  • A case of idiopathic hepatic peliosis with difficulty in preoperative diagnosis
    Naoki YAMAMOTO, Yasuhiko OONO, Norikazu SUZAKI, Kazuyoshi OOTA, Akinor ...
    Article type: Case Report
    2006 Volume 47 Issue 3 Pages 134-139
    Published: 2006
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.47.134
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    A 60-year-old man suffering from diabetes mellitus and with slight impairment of liver functions was admitted to our hospital. Computed tomography and ultrasonography of the abdomen revealed an ill-defined and heterogeneous lesion at S 8 of the liver. The patient was diagnosed as cholangiocellular carcinoma and the anterior segment of the liver was resected. Histological evaluation of liver specimen changed the diagnosis to hepatic peliosis. A preoperative diagnosis of hepatic peliosis could not be made in this case because of atypical findings provided by abdominal imaging and absence of primary disease. Although hepatic peliosis is a rare disease entity, a close examination of the liver is necessary to diagnose this disease because an increase of this pathological condition is predicted due to recent increase of use of steroid hormones and immunosuppressant drugs.
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  • Radiofrequency ablation therapy for hepatocellular carcinoma under water-cooling of colon using a balloon catheter : a case report
    Takeshi MATSUI, Kunihiko TSUJI, Hiroyuki NISHIMORI, Takahiro MATSUNAGA ...
    Article type: Case Report
    2006 Volume 47 Issue 3 Pages 140-146
    Published: 2006
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.47.140
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    We report a case of hepatocellular carcinoma in segment 4 of the liver, which was treated by radiofrequency ablation therapy (RFA) under water-cooling of transverse colon to prevent it from burning. A 80-year-old man was an outpatient because of HCV-positive liver cirrhosis since 1998. He was referred and contrast-enhanced computed tomography identified a tumor in segment 4 of the liver. He underwent several abdominal operations for traffic injury in 1981 and a tumor of the ileo-cecal region in 1998. We diagnosed the tumor a hepatocellular carcinoma, 18 mm in diameter and identified the adhesion of transverse colon to the liver surface adjacent to the tumor. We could not perform laproscopic RFA or RFA with physiological saline in the abdominal cavity because of the adhesion of the colon to the liver. Therefore, we performed RFA while the transverse colon was occluded using a balloon catheter and continuously water-cooled with physiological saline to avoid the colon burning. There was no severe complication. He has been alive without recurrence for 3 years and a month.
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  • A case of radiofrequency ablation therapy for liver metastases in a patient with an implanted pacemaker generator
    Naohiro YOSHIDA, Hisashi DOYAMA, Satoko MASHIYAMA, Kenichi TAKEMURA, S ...
    Article type: Case Report
    2006 Volume 47 Issue 3 Pages 147-151
    Published: 2006
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.47.147
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    Here, we report a case of radiofrequency ablation therapy (RFA) for liver metastases from colon cancer in a patient with an implanted pacemaker generator. Radiofrequency ablation is becoming an important means of therapy for liver cancer but can cause electromagnetic interference (EMI) in patients with an implanted pacemaker generator. We have been able to prevent EMI in such patients by devising sufficient countermeasures. With careful management, RFA is potentially useful for treatment of patients with such implants.
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  • Small hepatocellular carcinoma with macroscopic portal vein thrombus: A case report
    Hideo OTA, Hiroaki NAGANO, Masato NAKAMURA, Hiroshi WADA, Takehiro NOD ...
    Article type: Case Report
    2006 Volume 47 Issue 3 Pages 152-160
    Published: 2006
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.47.152
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    We experienced a case of small hepatocellular carcinoma (HCC) with macroscopic tumor thrombus in the portal vein. A 49-years-old male underwent partial hepatectomy of medial segment of liver for the first occurrence of HCC in 1991. Six years after the first operation, he underwent subsegmentectomy of posterior inferior segment of liver for recurrent HCC. Four years after the second operation, abdominal computer tomography revealed portal vein thrombus, but no main tumor could not be detected. The preoperative diagnosis was occult HCC with tumor thrombus in the left lateral inferior portal vein. In March 2002, he underwent subsegmentectomy of lateral inferior segment of liver in our department (Department of Surgery, Osaka University Hospital). Pathological finding showed recurrence of HCC with portal vein thrombus. Three years after the last operation, a new lesion was not seen.
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Short Communications
  • Hepatitis E virus isolates of genotype 4 recovered from wild boars in the Iriomote Island, Okinawa
    M Nakamura, K Taira, A Ohno, M Taira, H Sakugawa, K Takahashi, S Mishi ...
    Article type: Short Communication
    2006 Volume 47 Issue 3 Pages 161-162
    Published: 2006
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.47.161
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    We investigated for HEV-RNA in serum samples obtained from 15 wild boars in the Iriomote Island of Okinawa Prefecture, and 2 of 15 (13.3%) were positive for HEV-RNA. Sequence analysis of a part of ORF1 region (326 nt) indicated that the 2 isolates from the Iriomote's boars (wbOK126 and wbOK128) were fairly remote from known strains: none of known sequences showed a nucleotide similarity greater than 90%. In phylogenetic tree analyses, however, the wbOK126 and wbOK128 isolates segregated to genotype 4, and formed a cluster with Chinese strains, rather than with Japanese ones interestingly. Regarding the geographical situation of the Iriomote Island (i.e., nearer to China than to Japan's main lands), our present results provide a clue to the origin of Japan-indigenous HEV strains.
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  • Risk Factors for Acute Hepatitis E : a Questionnaire Survey of Patients in Northern Japan
    S Ohnishi, J Kang, T Arakawa, Y Karino, J Toyota, H Maekubo
    Article type: Short Communication
    2006 Volume 47 Issue 3 Pages 163-164
    Published: 2006
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.47.163
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    Hepatitis E virus (HEV) infection is a zoonotic food-borne disease. In Hokkaido, ingestion of raw pork liver or intestines is considered to be responsible for HEV infection. We interviewed patients on animal internal organ intake prior to developing hepatitis E, to investigate into this relationship. Among 32 patients with hepatitis E, four patients had history of raw or undercooked liver, and nine undercooked intestines intake. Two patients ingested both raw liver and undercooked intestines. 11 cases (34%) had no history of eating intestine during latency period. In this series of patients in Sapporo, ingestion of liver or intestine was at most responsible for 34% of patients with hepatitis E and was a predominant risk factor of HEV infection.
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Rapid Communication
  • Zinc supplementation improves ALT level in chronic hepatitis C patients during combination therapy of PEG-interferon α-2b and ribavirin
    Y Murakami, T Koyabu, A Kawashima, N Kakibuchi, T Kawakami, K Takaguch ...
    Article type: Rapid Communication
    2006 Volume 47 Issue 3 Pages 165
    Published: 2006
    Released on J-STAGE: November 24, 2006
    DOIhttps://doi.org/10.2957/kanzo.47.165
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    We investigated the effects of zinc supplementation on the clinical observations in chronic hepatitis C patients during PEG-interferon α-2b plus ribavirin (PEG-IFN/R) therapy. Patients were randomly allocated to receive daily 150 mg polaprezinc (Zn group, n=11) or no supplement (control, n=12) in addition to PEG-IFN/R therapy and daily antioxidant vitamin supplementation (300 mg of vitamin E and 600 mg of vitamin C). Ten of 11 patients (91%) in Zn group and 7 of 12 (58%) control patients showed decrease in ALT levels (</=35 U/l) after 8 weeks of therapy. This observation indicates that polaprezinc supplementation may induce antioxidative functions in liver which resulted in improvement of hepatocyte injury during PEG-IFN/R therapy.
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