Kanzo

Original Articles

Histological findings and interferon treatment outcomes in patients with normal ALT levels and high viral load of HCV genotype 2

Ayako Urabe, Shiomi Aimitsu, Yasuyuki Aisaka, Hiroshi Kohno, Hiroiku K ...

Article type: Original Article
2007 Volume 48 Issue 12 Pages 581-588
Published: 2007
Released on J-STAGE: January 16, 2008

DOIhttps://doi.org/10.2957/kanzo.48.581

JOURNAL FREE ACCESS

Show abstractHide abstract

Some cases of chronic hepatitis C with persistently normal ALT levels show an advanced stage of hepatic fibrosis when examined histologically. Thus the indication of antiviral therapy for this category of patients, particularly for those infected with HCV genotype 2 in view of its high sensitivity to interferon (IFN), has been much argued in recent years. We investigated for a correlation (s) between histologically determined stage of fibrosis (F0 to F3) and the IFN treatment outcomes in 24 patients with high viral load of HCV genotype 2, divided into two groups: 12 patients who had had persistently normal ALT levels (PNALT) and another 12 who had shown transient upsurges of ALT occasionally. As for fibrosis, just before treatment, there were 9 cases (75%) with F1 and 3 (25%) with F2, but none with F0 or F3 in each of the two groups of patients. Rate of sustained virological response (SVR) to the IFN-alpha 2b+ ribavirin therapy was similarly high in both groups (75% in PNALT and 83% in the other), while the time interval between initiation of therapy and disappearance of viremia was significantly shorter in the PNALT group. These findings warrant an indication of IFN therapy for PNALT patients with high viral load of HCV genotype 2.

View full abstract

Download PDF (385K)
Utility of interventional-CT (IVR-CT) in transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma: a comparative study of TACE with and without IVR-CT

Hiroyuki Kamamoto, Toshiya Horibe, Kosei Kudo, Junichi Taira, Katsutos ...

Article type: Original Article
2007 Volume 48 Issue 12 Pages 589-597
Published: 2007
Released on J-STAGE: January 16, 2008

DOIhttps://doi.org/10.2957/kanzo.48.589

JOURNAL FREE ACCESS

Show abstractHide abstract

Utility of interventional-CT (IVR-CT) is expected for both diagnosis and treatment assistance, but few reports have demonstrated its benefit to date. To investigate the utility of IVR-CT, we here retrospectively compared the outcomes of transcatheter arterial chemoembolization (TACE) with and without IVR-CT performed by the same operator in the same institute during the same period. As a result, recurrence-free survival periods were 301 days and 243 days by TACE with and without IVR-CT, however, there is no significant difference, respectively. In particular, in cases with four or more nodules, the recurrence-free survival period was significantly longer by TACE with IVR-CT. Therefore, IVR-CT is thought to be an effective modality for improving treatment outcomes.

View full abstract

Download PDF (566K)
Chronological analysis for the hepatocellular carcinoma development

Michiyasu Yagura, Akihisa Tanaka, Masanobu Iri, Hiroshi Kamitsukasa

Article type: Original Article
2007 Volume 48 Issue 12 Pages 598-603
Published: 2007
Released on J-STAGE: January 16, 2008

DOIhttps://doi.org/10.2957/kanzo.48.598

JOURNAL FREE ACCESS

Show abstractHide abstract

We chronologically analyzed the hepatocellular carcinoma cases during 1885 to 2005 every five years, i.e. 1st. term (1986∼90), 2nd. term (1991∼95), 3rd. term (1996∼2000), 4th. Term (2001∼05), respectively. HBV group has slightly decreased, HCV group has slightly increased and alcoholic group whose ethanol consumption is over 80g per day for more than 10 years and UN group in which HBV, HCV and AL group were excluded has remained unchanged in frequency, respectively. Female's percentage of HCC development has increased. The age of HCC development has been getting older year by year, except for HBV group which has remained unchanged. The percentage of chronic hepatitis in noncarcinomatous part of the liver has increased. The age of HCC development is significantly lower in patients with DM, on the other hand significantly higher in patients with hypertension. The above results suggest that we must pay attention to HCC development even in case of histologically or clinically chronic hepatitis in the elderly patients.

View full abstract

Download PDF (315K)

Case Reports

Hepatocellular carcinoma arising in nonalcoholic steatohepatitis (NASH) without advanced fibrosis: a case report

Yuriko Atsumi, Satoru Yatsuji, Nobuyuki Torii, Katsutoshi Tokushige, E ...

Article type: Case Report
2007 Volume 48 Issue 12 Pages 604-609
Published: 2007
Released on J-STAGE: January 16, 2008

DOIhttps://doi.org/10.2957/kanzo.48.604

JOURNAL FREE ACCESS

Show abstractHide abstract

A 65-year-old man with a 5-year history of non-insulin dependent diabetes and hypertension was referred to our hospital for close examinations of hepatic steatosis and a tumor (40mm in diameter) in S7, suggested by ultrasonography on an occasional medical check-up. He was obese with BMI at 27.8, merely a social drinker, negative for HBsAg nor anti-HCV, and had serum values of hepato-biliary enzymes and tumor markers within normal range. Since ultrasonography and angiography confirmed the presence of the liver tumor with a diagnosis of single hepatocellular carcinoma (HCC), we performed surgical operation. The tumor was diagnosed histologically as a well to moderately differentiated HCC with trabecular pattern, while the non-canceraous areas of the liver showed only a picture of steatohepatitis without advanced fibrosis (F1, A2). With the patient's history taken together, it was most likely that a nonalcoholic steatohepatitis (NASH) was the cause of the HCC without cirrhosis in this case. The HCC recurred 82 months later, and 3 times again after that, but was treated successfully by radio-frequency ablation therapy every time, and the patient is now alive and well without any sign of recurrence. This case warrants more attention to NASH even at a stage well before developing cirrhosis of the liver.

View full abstract

Download PDF (521K)
Successful treatment of hemobilia associated with biliary tract infiltration of hepatocellular carcinoma by transcatheter arterial embolization: a case report

Yoshiki Katakura, Chiaki Okuse, Gaku Igarashi, Moriaki Hatsugai, Kouta ...

Article type: Case Report
2007 Volume 48 Issue 12 Pages 610-615
Published: 2007
Released on J-STAGE: January 16, 2008

DOIhttps://doi.org/10.2957/kanzo.48.610

JOURNAL FREE ACCESS

Show abstractHide abstract

A 58-year-old man, diagnosed with hepatocellular carcinoma (HCC) when he was 55 years old and having been treated by a hepatic arterial infusion chemotherapy (HAIC) for one year, was admitted to our hospital for the 6th course of HAIC; but this time he was suffering from tarry stool. Gastrointestinal endoscopy showed the existence of blood clot out of papilla of Vater, and abdominal CT demonstrated infiltration of HCC in right biliary tract, leading to the diagnosis of hemobilia associated with biliary tract infiltration of HCC. Tumor stain in the location consistent with right biliary tract was demonstrated on abdominal angiography. Transcatheter arterial embolization (TAE) was carried out with a result of disappearance of hemobilia. Despite additional 2 courses of HAIC, he died of hepatic failure 7 months later. Based on 41 cases so far reported in Japan, prognosis of HCC complicated with hemobilia is poor. Nevertheless, our present case suggests that TAE is effective for stopping hemobilia, and may thus enable continuing chemotherapy thereafter.

View full abstract

Download PDF (462K)

Register with J-STAGE for free!