Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 49, Issue 11
Displaying 1-6 of 6 articles from this issue
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Case Reports
  • A case of chronic hepatitis C in which a 72-week course of pegylated interferon and ribavirin combination therapy resulted in relapse but a subsequent interferon monotherapy could induce sustained virological response
    Chiaki Okuse, Daisuke Kumon, Minoru Kobayashi, Akira Endo, Yuichi Kino ...
    Article type: Case Report
    2008 Volume 49 Issue 11 Pages 495-500
    Published: 2008
    Released on J-STAGE: November 21, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.495
    JOURNAL FREE ACCESS
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    A 59-year-old woman received pegylated interferon-α2b and ribavirin combination therapy for chronic hepatitis C. Her serum HCV RNA level was 980 KIU/ml and genotype of HCV was 1b. Although her HCV RNA became undetectable 28 weeks after the start of the therapy, duration of the therapy was extended for 72 weeks because of the late viral response. Her HCV RNA reappeared 4 weeks after the end of the therapy. Although the level of HCV RNA increased to 2600 KIU/ml 8 weeks later, it became less than 5 KIU/ml 16 weeks later. Therefore, she was re-treated 3 times a week with 9 MU of consensus interferon. Since she remained negative for HCV RNA thereafter, the therapy was ended 24 weeks after its commencement. Finally, she obtained a sustained virological response.
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  • Alveolar echinococcosis in a metropolitan area resident
    Rikuo Doi, Masanori Kawanaka, Yasuyuki Morishima, Hidenori Ojima, Susu ...
    Article type: Case Report
    2008 Volume 49 Issue 11 Pages 501-505
    Published: 2008
    Released on J-STAGE: November 21, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.501
    JOURNAL FREE ACCESS
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    This case report describes a 35-year-old female resident of a metropolitan area of Japan who presented with clinical symptoms of apparent gallbladder cancer and liver metastasis. After an extended right hepatic lobectomy, a resected lesion comprising four tumors (40 mm in diameter) was histopathologically confirmed as alveolar echinococcosis (AE). Although endemic in Japan, AE rarely arises in the mainland, because the causative pathogen, Echinococcus multilocularis, is distributed only in Hokkaido. The patient had visited Hokkaido twice, but she denied any behavior or history that would potentially relate to AE during these visits. A more detailed history revealed that she had kept a stray dog that her husband had picked up from a road in eastern Hokkaido. Although the dog showed no evidence of Echinococcus infection, the possibility of acquiring AE from the dog should be considered.
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  • A case of portal hypertension caused by intrahepatic arterio-portal fistula formed after percutaneous liver biopsy 35 years previously, markedly improved by transcatheter arterial embolization against the fistula
    Noriko Oza, Toshihiko Mizuta, Yoshiaki Egashira, Junichi Nojiri, Keisu ...
    Article type: Case Report
    2008 Volume 49 Issue 11 Pages 506-511
    Published: 2008
    Released on J-STAGE: November 21, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.506
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    An 80-year-old woman who had undergone two percutaneous liver biopsies to examine liver dysfunction 35 years previously was admitted for examination of ascites. Laboratory data demonstrated pancytopenia and elevations of transaminases, alkaline phosphatase and γ-glutamyl transpeptidase. Computed tomography demonstrated massive ascites and atrophic liver. Hepatic angiography showed a shunt formation between the dilated right hepatic artery and the right portal vein. Upper gastrointestinal endoscopy demonstrated severe esophageal varices. We diagnosed portal hypertension caused by an intrahepatic arterio-portal fistula. After transcatheter arterial embolization of the fistula, portal vein flow immediately became normalized to a toward-the-liver flow. Subsequently, the ascites and esophageal varices disappeared, along with normalization of laboratory data and liver size. The marked portal hypertension in this case was thought to be caused by gradually increased blood flow through the intrahepatic arterio-portal fistula that formed after percutaneous liver biopsies 35 years previously.
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  • A case of advanced hepatocellular carcinoma with right hepatic artery diverging from superior mesenteric artery, effectively treated with hepatic arterial infusion chemotherapy using special reservoir system indwelling in aorta named System-I
    Michihiro Yoshida, Fumihiro Okumura, Satoshi Itano, Takashi Monoe, Kay ...
    Article type: Case Report
    2008 Volume 49 Issue 11 Pages 512-519
    Published: 2008
    Released on J-STAGE: November 21, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.512
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    We hereby report a case of advanced hepatocellular carcinoma (HCC) with right hepatic artery (RHA) diverging from superior mesenteric artery (SMA), which completely responded to hepatic arterial infusion chemotherapy (HAIC) using special reservoir system indwelling in aorta named System-I. A 71-year-old man suffering from HCV-related liver cirrhosis was referred to our hospital to treat multiple HCCs in April 2005. Although transarterial chemolipiodolization was performed twice, the tumors progressed. Then, we undertook a therapy with low-dose cisplatin and 5-fluorouracil (low-dose FP) using System-I. We changed the position of the microcatheter alternatively in RHA and LHA every week. After 8 cycles of the low-dose FP therapy, computed tomography and angiography showed complete response of the HCCs, and levels of tumor markers (AFP and PIVKA-II) were normalized. We think that System-I is a very useful system that enables us to perform HAIC without changing the flow of replaced hepatic artery.
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Short Communication
  • Frequency and risk factors for retinopathy associated with pegylated interferon α2b and ribavirin combination therapy in patients with chronic hepatitis C
    Chiaki Okuse, Hiroki Ikeda, Yoshihiko Nagase, Norie Yamada, Masaru Oka ...
    Article type: Short Communication
    2008 Volume 49 Issue 11 Pages 520-523
    Published: 2008
    Released on J-STAGE: November 21, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.520
    JOURNAL FREE ACCESS
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    We investigated the frequency and risk factors for interferon associated retinopathy in 39 patients with chronic hepatitis C who were treated by pegylated interferon α2b and ribavirin combination therapy for 48 weeks. Optic fundi were examined before, 2, 4, 8, 24, and 48 weeks after the start and 24 weeks after the end of therapy. Nine patients (23.1%) developed retinopathy. No patient complained of visual disturbance. Retinopathy disappeared in all patients after the end of therapy. Hypertension was found to be the factor for predicting retinopathy by multiple logistic regression analysis. It is suggested that patients who are being treated for pegylated interferon and ribavirin combination therapy, particularly those with hypertension, should undergo periodic examination of the optic fundi.
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Rapid Communication
  • Reduction of serum alpha-fetoprotein levels by phlebotomy in patients with cirrhosis
    Tetsuro Sohda, Kaoru Iwata, Genryu Hirano, Akira Anan, Yasuaki Takeyam ...
    Article type: Rapid Communication
    2008 Volume 49 Issue 11 Pages 524-525
    Published: 2008
    Released on J-STAGE: November 21, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.524
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    Phlebotomy is a possible therapy for cirrhosis. We have performed phlebotomy in 9 cirrhotic patients consisting of 7 with HCV infection and 2 with non-alcoholic steatohepatitis. Two of these patients have a history of curative therapy for hepatocellular carcinoma. All patients who received phlebotomy had a marked reduction of serum alpha-fetoprotein levels as well as transaminase levels. Although suppression of hepatocellular damage and liver regeneration cause a reduction in AFP, other mechanisms may also be behind such a reduction. However an elevated serum AFP level is thought to be an important predictor of hepatocarcinogenesis, suggesting that phlebotomy may have a strong potential in the suppression of hepatocellular carcinoma.
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