We choose transcatheter arterial infusion chemotherapy (TAI) for advanced hepatocellular carcinoma (HCC) with poor liver function. However, we often have to stop TAI because of increase in the tumor size or aggravation of liver function. In order to obtain improvement in the prognosis of patients with advanced HCC, it is important to understand the exact morbidity and the exact imaging findings on contrast-enhanced CT and angiography at the time of the TAI. We examined and compared the results of TAI using cisplatin in 84 cases of advanced HCC and the imaging findings before and after TAI. In 26 cases, the imaging findings showed that the boundary of HCC was indistinct, with the tumor showing faint enhancement and an increase of the fine blood vessels; 9 of these cases showed PR (35%). By contrast, in 23 cases, imaging findings showed that the boundary of HCC was distinct, and the tumor showed a marked uneven enhancement and dilated tumor vessels; none of these cases showed PR. This study indicates the necessity of proper imaging of HCC nodules before TAI.

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A 60-year-old female with chronic hepatitis C, with a history of treatment with ursodeoxycholic acid and glycyrrhizin, visited our hospital for interferon (IFN) therapy. She was neutropenic (740 /μl) and recommended to be treated with pegylated IFN (PEG-IFN) at reduced dose (one-halves of the standard dose). Serial evaluation revealed, however, that her netropenia advanced even with the half-dose PEG-IFN therapy. This led us to reduce the dose of PEG-IFN further (one quarter of standard dose) for next 18 months. Also, PEG-IFN was used intermittently (with 3-week intervals) to avoid severe neutropenia. Biochemical analysis revealed that the levels of alanine aminotransferase in the sera decreased below basal levels two weeks after treatment commencement. Virological and histological examinations showed that she attained sustained virological response and also had decreased liver fibrosis. This study indicates that intermittent use of PEG-IFN, even at low dose, minimize side effects and contribute to virological and histological improvements in some patients with chronic hepatitis C.

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A tumor was noted by the imaging studies in an alcoholic cirrhotic female patient of 40 years old during hospitalization due to ascites. After 1 year and 6 months, abdominal angiography was performed. CT during hepatic arteriography (CTHA) showed a 4 cm hypovascular tumor in the S5 liver segment, which had a cuneate-shaped enhanced area in it. This area was consistent with an area sparing the portal blood flow in CT during arterial portography (CTAP). Thus, hepatocellular carcinoma was suspected inside the nodule, and S5 of the liver was resected. However, the lesion turned pathologically out to be a large regenerative nodule. When the CTHA-CTAP studies were reviewed carefully, the CTHA demonstrated the cuneate-shaped area in a tumor was in succession with a cystic artery and a gall bladder wall. Finally, the defect area shown by the CTAP was diagnosed as a pseudotumor containing a cystic venous drainage area.

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COBAS TaqMan HBV Test (real-time PCR method) is a new method to detect HBV-DNA with higher sensitivity and broader range of quantification than conventional methods. We evaluated HBV-DNA load by COBAS TaqMan HBV Test in comparison with Amplicor HBV Monitor Test in chronic hepatitis B patients undergoing administration of nucleoside analogue. Forty chronic hepatitis B patients were recruited. In 33 patients with less than 2.6 logcopy/mL by Amplicor HBV Monitor, Taq Man HBV Test showed less than 1.8 logcopy/mL of HBV-DNA and no amplified reaction signal in 22 patients, whereas amplified reaction signal was detected in 11 patients (33.3%). COBAS TaqMan HBV Test is more sensitive and preferable for evaluation of HBV viral load in anti viral therapy.

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