Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 48, Issue 10
Displaying 1-7 of 7 articles from this issue
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Review Article
Original Articles
  • Epidemiologic study for the occurrence of acute hepatitis in recent years in Chugoku area
    Yohei Fukumoto, Yukihiro Kishimoto, Naoto Maeda, Eiji Nishimuki, Eiji ...
    Article type: Original Article
    2007 Volume 48 Issue 10 Pages 484-489
    Published: 2007
    Released on J-STAGE: November 01, 2007
    DOIhttps://doi.org/10.2957/kanzo.48.484
    JOURNAL FREE ACCESS
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    On the symposium of "Epidemiologic Study for Occurrence of Acute Hepatitis" in the 2006 annual meeting of Chugoku Branch of Japanese Association of Gastroenterology, a total of 1,815 cases of acute hepatitis occurred in recent 5 to 25 years were reported from 15 hospitals in all Chugoku area. As a result, the cause of acute hepatitis was virus in 52%, drug in 14%, autoimmune in 1% and unknown in 33%. In the recent 10 years, a total occurrence of acute hepatitis was reduced by about 15%. The major factor of this reduction was the reduction of hepatitis A. On the other hand, the number of acute hepatitis of unknown cause was increased and that of drug-induced hepatitis was also seen with a tendency of increase. Concerning to the occurrence of acute viral hepatitis in this area, the frequency of hepatitis B became the highest in replacement of hepatitis A, while the rate of hepatitis C remained unchanged. Then, the recent proportion of the cause of acute viral hepatitis was HBV in 45%, HAV in 25%, HCV in 15%, HEV in 1%, and EBV/CMV combined in 15%.
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  • Mechanism of splenomegaly in chronic liver disease: Relationship between the spleen/liver count ratio in an arterial phase of Tc-99m GSA scintigraphy and splenic volume
    Hitoshi Tochio, Megumu Hino, Yoshihiro Okabe, Hiroyuki Ootsuka, Hisato ...
    Article type: Original Article
    2007 Volume 48 Issue 10 Pages 490-497
    Published: 2007
    Released on J-STAGE: November 01, 2007
    DOIhttps://doi.org/10.2957/kanzo.48.490
    JOURNAL FREE ACCESS
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    It is obvious that an increase of splenic arterial blood flow contributes to splenomegaly in chronic liver disease, but it remains obscure how and why the increment occurs. We performed Tc-99m GSA scintigraphy and compared the radioactivity counts between the liver and spleen at 30 seconds after intravenous infusion in 29 patients with chronic liver disease. In addition, we measured the spleen volume of these patients by CT: a spurious spleen volume deduced from the lengths along three-dimensional axes. As a result, the spleen/liver radioactivity ratio (corresponding to blood flow ratio) showed a positive correlation with the spurious spleen volume. Namely, the bigger the spleen was, the higher the spleen/liver arterial blood flow ratio would be. Thus, our present results suggest that hepatic arterial hemodynamics may be involved in the mechanism of splenomegaly in chronic liver disease.
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Case Reports
  • A case of chronic hepatitis C with leukocytopenia and thrombocytopenia that showed sustained virological response to a low-dose consensus interferon treatment
    Toru Takahashi, Tomofumi Miura, Satoshi Yamada, Yasunori Tsuboi, Tsuto ...
    Article type: Case Report
    2007 Volume 48 Issue 10 Pages 498-504
    Published: 2007
    Released on J-STAGE: November 01, 2007
    DOIhttps://doi.org/10.2957/kanzo.48.498
    JOURNAL FREE ACCESS
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    Sustained virological response was achieved in a case of chronic hepatitis C with leukocytopenia and thrombocytopenia by a low-dose consensus interferon treatment. This case had a high viral load of the serotype 2 HCV before treatment. Neither splenomegaly nor liver cirrhosis was indicated by imaging examinations, and histological diagnosis of the liver biopsy was CH (F2/A2). The elevated serum PAIgG level gradually fell down to within the normal range by the treatment, along with a gradual increase of leukocyte and thrombocyte counts. In conclusion, interferon treatment should also be considered even for cases with rare complications such as leucocytopenia and thrombocytopenia just as in our case, if the cases are considered to be interferon-sensitive by expert hepatologists.
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  • Management of imatinib mesilate (IM)-related hepatic injury by adjusting the dose of the drug in a patient with chronic myelogenous leukemia (CML): A case report
    Minoru Ayada, Tetsuya Ishikawa, Akihiko Okumura, Naoki Hotta, Keiko Fu ...
    Article type: Case Report
    2007 Volume 48 Issue 10 Pages 505-510
    Published: 2007
    Released on J-STAGE: November 01, 2007
    DOIhttps://doi.org/10.2957/kanzo.48.505
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    A 72-year-old female, with chronic myelogenous leukemia (CML) treated successfully with 400mg/day of imatinib mesilate (IM), developed laboratory signs of a cholestatic type of liver injury after one-year administration of IM, and was admitted to our hospital. We decided to stop the administration of IM to the patient. Thereafter the abnormalities in liver function tests recovered to the normal level promptly. However, with a necessity to use IM for preventing the recurrence of CML, we re-started administration of IM at a lower dose, by weighing the risk for liver injury and the benefit for CML in a balance. With careful monitoring of liver function tests, the dose of IM was gradually increased and reached 300mg/d, and the recurrence of liver injury or CML has not been observed. Here, we report the case of IM-related liver injury, controlled well after the re-administration of IM with the lower dose.
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  • A case of small, single, and hypovascular hepatocellular carcinoma undiscovered until bone metastasis
    Toshiko Onitake, Mikiya Kitamoto, Ikue Noda, Hiroyasu Yamada, Masaaki ...
    Article type: Case Report
    2007 Volume 48 Issue 10 Pages 511-516
    Published: 2007
    Released on J-STAGE: November 01, 2007
    DOIhttps://doi.org/10.2957/kanzo.48.511
    JOURNAL FREE ACCESS
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    A 71 year-old man with chronic hepatitis C under periodical medical check showed a gradual increase of serum AFP level despite negative imaging study results for any tumor in the liver. But, when he complained right thigh pain, CT images indicated a hypovascular nodule, 1 cm in size, in the Segment 8 of the liver, while MRI revealed metastatic bone lesions at right thigh. Then, he received radiation for the metastatic bone lesions. Three months later, he underwent the Kotz prosthesis operation due to bone fracture at the site, which provided histological diagnosis of the lesion as a moderately differentiated hepatocellular carcinoma (HCC). At that time, his hepatic nodule was still a small one without hypervascularity, while multiple lung metastases were already present. After 3 months, the hepatic nodule in Segment 8 advanced with portal vein tumor thrombosis, along with further elevations of AFP and PIVKA-II, and enlargement of lung metastases. Eventually he died of deterioration of general conditions due to progressive malignant lesions. Thus, here we report this rare case of a small, single, and hypovascular HCC, which showed peculiarly an early development of bone metastasis.
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Special Article
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