Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
Volume 48, Issue 4
Displaying 1-6 of 6 articles from this issue
Original Articles
  • Kaku Omori, Nobuyuki Torii, Kiyoshi Hasegawa, Etsuko Hashimoto, Keiko ...
    2007 Volume 48 Issue 4 Pages 145-152
    Published: 2007
    Released on J-STAGE: May 15, 2007
    JOURNAL FREE ACCESS
    Of 25 patients with acute hepatitis B of genotype A who visited our hospitals, 8 (32%) presented no symptoms, while 15 (60%) received lamivudine treatment for prolonged or severe hepatitis. Of the 15 patients with lamivudine, one died of subacute fulminant hepatitis and 4 showed chronicity, but 10 resolved without any reactivation after stopping lamivudine treatment. The time interval until HBsAg clearance was not significantly different between spontaneously resolved cases and lamivudine-treatment cases. Of the 4 cases without any symptom initially but showing chronicity of hepatitis later, 2 were treated by combination of lamivudine and interferon, resulting in seroconversion of HBsAg. Thus we conclude that lamivudine is effective for prolonged hepatitis B of genotype A, and additional interferon is useful for cases with chronicity.
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  • Eiki Yoshimatsu, Kentaro Takatsuka, Shogo Iwabuchi
    2007 Volume 48 Issue 4 Pages 153-160
    Published: 2007
    Released on J-STAGE: May 15, 2007
    JOURNAL FREE ACCESS
    Blood flows in the splenic and portal veins were measured by an ultrasound-Doppler method in 43 patients with liver cirrhosis who underwent partial splenic embolization (PSE). The change of digestive tract blood flow due to PSE was calculated from the differences between splenic vein and portal vein flows, and the results were compared with the changes of serum albumin levels. The change of the portal/splenic blood flow ratio by PSE showed a positive correlation with the change of albumin levels. The change of albumin levels by PSE might be influenced by the hepatic functional reserve, collateral circulation, varices, and/or postoperative interferon treatment. But the increase of portal and splenic vein blood flow (considered to be digestive tract blood flow) appeared to be the most relevant factor for the increase of albumin. The decrease of splenic vein blood flow due to PSE may result in a favorable influence on albumin synthesis by the liver, through an increase of blood flow from the digestive tract to the liver via portal vein.
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  • Yoshihiro Kanbara, Takuro Yoshikawa, Masanori Takahashi, Shinobu Tsuch ...
    2007 Volume 48 Issue 4 Pages 161-166
    Published: 2007
    Released on J-STAGE: May 15, 2007
    JOURNAL FREE ACCESS
    Post-treatment recurrence of hepatocellular carcinoma (HCC) is highly frequent due to intrahepatic metastasis and/or metachronous carcinogenesis, making relapse-free survival a rare event. The aims of the current study are to evaluate the clinicopathological features of HCC patients who survived for a long time post-operatively. Of 133 patients who had undergone curative resection of HCC, 42 survived for more than 5 years without recurrence. Ten year survival rate of these 42 patients was 77%. Multivariate stepwise logistic regression analysis identified the "A-factor", which is the marker of the activity of hepatitis, as an independently significant predictor of the recurrence-free 5-year survivors. The rate of moderate activity of hepatitis (A2) in patients with hepatitis C was higher than that in those with hepatitis B. The lower degree of activity of hepatitis was associated with the longer-term disease-free survival. Thus, the stabilization of hepatic inflammation by conservative and/or antiviral drugs such as interferon may be useful for the long-term disease-free survival in patients who underwent curative resection of HCC.
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Case Reports
  • Yutaka Matano, Sei Tatsumi, Naoyuki Ibe, Jun Yoshikawa, Kouichi Tokuuy ...
    2007 Volume 48 Issue 4 Pages 167-174
    Published: 2007
    Released on J-STAGE: May 15, 2007
    JOURNAL FREE ACCESS
    An HBsAg-positive 43 years old man received proton radiotherapy (fraction size 2Gy, total dose 70Gy) for a large hepatocellular carcinoma (HCC) complicated with tumor thrombus of the main trunk of portal vein in March 2004. Four months later, however, he was admitted to our hospital because multiple new lesions of HCC developed. Angiography on admission indicated multiple nodular staining in left lobe of the liver but no signs for tumor thrombus in the portal vein. He was then treated with transcatheter arterial chemoembolization (TACE) with epirubicin hydrochloride (EPI), followed by a continuous arterial infusion therapy using low doses of cisplatin hydrochloride (CDDP) and 5-fluorouracil (5-FU). After the first course of the chemotherapy, all the tumor stains had disappeared on angiography, and the serum levels of tumor markers had decreased significantly as well. With additional courses of chemotherapy thereafter, the patient remains free from relapses of HCC for more than 2 years until now.
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  • Katsuhiko Ito, Fukuo Kondo, Takayuki Ishii, Satoru Ootawa, Yoshiaki Sh ...
    2007 Volume 48 Issue 4 Pages 175-180
    Published: 2007
    Released on J-STAGE: May 15, 2007
    JOURNAL FREE ACCESS
    A 57-year-old man was admitted to our hospital for severe anemia. Abdominal ultrasonography showed 4 tumors in S4, S3, S5 and S8 segments of the liver, with a diameter of 8, 1.5, 1.5 and 2 cm, respectively. The tumors in S3, S5 and S8 were diagnosed as cavernous hemangiomas because dynamic CT showed a pattern of marginal enhancement and a delay in wash-out of contrast medium. On the other hand, the tumor in S4 was difficult to diagnose although a cavernous hemangioma or hepatocellular carcinoma was suggested by dynamic CT. We then resected this tumor by left lobe hepatectomy without preoperative diagnosis. On macroscopic examination, the tumor was soft and encapsulated. Microscopic examination showed a few fat cells and many smooth muscle cells. Immunohistochemically, the smooth muscle cells were positively stained with anti-SMA and HMB-45. Thus the tumor was finally diagnosed as angiomyolipoma. It is of note that this tumor had hemangiomatous areas within the tumor and fibrous capsule. The atypical image findings of this tumor were most likely due to the scarcity of fat cells along with the presence of capsule and the hemangiomatous areas.
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  • Hideki Nakatsuka, Yoshinobu Sato, Hiroshi Oya, Satoshi Yamamoto, Isao ...
    2007 Volume 48 Issue 4 Pages 181-186
    Published: 2007
    Released on J-STAGE: May 15, 2007
    JOURNAL FREE ACCESS
    We report a case of spur cell anemia with alcoholic liver cirrhosis successfully cured by living liver transplantation (LDLT). The patient was a 31-year-old woman with a history of ethanol abuse from 16 years old. She was diagnosed as liver cirrhosis at 29 years old. She had also severe hemolytic anemia. Scanning electron micrograph showed spur cells in her peripheral blood. The erythrocyte membrane was rich in free cholesterol. The ratio of free cholesterol/phospholipids was higher than normal. Medical treatment didn't improve anemia and liver failure. Living donor liver transplantation was underwent with right liver robe graft. Anemia was improved soon and there were no spur cells at 9 months after transplantation. This is the first report of LDLT for spur cell anemia. This case indicates that the contribution of liver to spur cell anemia and the efficacy of liver transplantation for complete resolution.
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