Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 49, Issue 3
Displaying 1-5 of 5 articles from this issue
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Feature Article
Original Article
  • Analyses of liver abscess cases in our hospital for past ten years
    Yurimi Takahashi, Fujito Kageyama, Yasunori Takehira, Masami Yamada, G ...
    Article type: Original Article
    2008 Volume 49 Issue 3 Pages 101-107
    Published: 2008
    Released on J-STAGE: March 31, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.101
    JOURNAL FREE ACCESS
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    We analyzed a total of 51 cases of liver abscess experienced in our hospital during last 10 years for etiology and clinical course. As for the cases of bacterial abscess (n=43) , 34% of which were seen in patients after papilloplasty, patients were older and abscess' sizes were smaller than those in cases of amoebic abscess (n=6) . Leading cause was Klebsiella p.,showing a gradual increment over the 10 years. Amoebic abscess was seen only in male, and was associated with abdominal pain and diarrhea, more frequently than in bacterial abscess; even the complication of gastrointestinal perforation developed in two. Although detection of the protozoan was possible only in one case, serum levels of anti-amoeba antibody titers were elevated in all the 6 cases, suggesting its usefulness for diagnosis. Eumycetes-related abscess was diagnosed only in two cases in association with chemotherapy-induced granulocytopenia. In both cases, the abscess was small, multiple, and required a long-term therapy. Early diagnosis, proper treatment, and full knowledge about clinical characteristics are important to manage liver abscess. We hereby report our experiences.
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Case Reports
  • A case of severe hepatic injury and pure red cell aplasia induced by valproic acid
    Hiroshi Abe, Takuya Kitahara, Kai Yoshizawa, Tadashi Matsuzaka, Ryoich ...
    Article type: Case Report
    2008 Volume 49 Issue 3 Pages 108-112
    Published: 2008
    Released on J-STAGE: March 31, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.108
    JOURNAL FREE ACCESS
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    A 69-year-old female diagnosed as having epilepsy was treated with valproic acid (VPA). Two months later, she was admitted our hospital because of progressive severe hepatic injury. We immediately discontinued the administration of VPA and began to treat with prednisolone (PSL). Despite the improvement of blood biochemical findings, severe anemia developed soon after the cessation of PSL. She was diagnosed as pure red cell aplasia (PRCA), and cyclosporin A (CyA) therapy was initiated. Then, anemia was rapidly recovered and the exacerbation of anemia has not been observed after the termination of CyA therapy. Here, we report the case of severe hepatic injury and PRCA induced by VPA. Additionally, we discuss the pathogenesis of these side effects.
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  • Successful treatment of refractory F0 type varices hemorrhage with idiopathic portal hypertension via transcatheter left gastric arterial embolization
    Yasunari Hiramine, Takuya Hiwaki, Yukihiko Sho, Yoshiro Baba, Yasushi ...
    Article type: Case Report
    2008 Volume 49 Issue 3 Pages 113-121
    Published: 2008
    Released on J-STAGE: March 31, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.113
    JOURNAL FREE ACCESS
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    A 55-year-old male with no history of health problems was admitted to another hospital because of hematemesis in October 2000. Upper gastrointestinal endoscopy revealed esophageal variceal bleeding. Endoscopic injection sclerotherapy and endoscopic variceal ligation were performed. However, hematemesis occurred three times despite repeated treatment. The patient was admitted to our hospital in April 2004 because of rebleeding. Endoscopic treatment was not possible, thus surgical treatment was performed. Based on the laboratory and histopathological findings, idiopathic portal hypertension was thought to be the cause of esophageal varices. In May 2006, the patient vomited blood and was admitted again. F0 form varices with positive for red color sign were observed in the lower esophagus. Abdominal angiography showed sudare-shaped blood vein (palisade vein) branching from the left gastric artery and Transcatheter Arterial Embolization (TAE) was performed. Hemostasis was achieved immediately after TAE, and rebleeding has not been experienced for over one year.
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Short Communication
  • Interferon therapy for patients with chronic hepatitis C who are positive for anti-GAD antibody
    Kanako Shiotsuki, Takashi Goto, Hisamitsu Miyaaki, Tatsuki Ichikawa, K ...
    Article type: Short Communication
    2008 Volume 49 Issue 3 Pages 122-124
    Published: 2008
    Released on J-STAGE: March 31, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.122
    JOURNAL FREE ACCESS
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    Development of type 1 diabetes mellitus (T1DM) has been reported in patients receiving interferon (IFN) therapy for hepatitis C virus (HCV) infection. We studied two patients with chronic HCV infection who had an anti-glutamic acid decarboxylase antibody (GAD-ab) before IFN therapy. Their blood sugar and GAD-ab levels were monitored during IFN therapy. Case 1 was a 61-year-old man with 16.9 U/mL of GAD-ab. The GAD-ab level decreased during IFN therapy, but remained positive. Case 2 was a 65-year-old woman with 2.0 U/mL of GAD-ab. Her GAD-ab level increased during IFN therapy, but decreased after withdrawal of IFN. Insulin secretion in both patients was kept within physiologically normal range during IFN therapy, and the treatment was completed without developing T1DM in both cases.
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