Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 49, Issue 7
Displaying 1-5 of 5 articles from this issue
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Original Article
  • Prediction of efficacy and viral kinetics using COBAS TaqMan HCV "automated" during antiviral treatment of hepatitis C
    Joji Toyota, Yosiyasu Karino, Jun Akaike, Takumi Ohmura, Takahiro Sato ...
    Article type: Original Article
    2008 Volume 49 Issue 7 Pages 297-306
    Published: 2008
    Released on J-STAGE: August 07, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.297
    JOURNAL FREE ACCESS
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    Pretreatment and in-treatment viral kinetics as measured by Amp-M/Amp-Q and TaqMan were compared in 93 patients treated for chronic hepatitis C with peginterferon plus ribavirin combination therapy. In the association between pretreatment HCV RNA levels and virological efficacy, no clear fixed trend was observed by Amp-M whereas with TaqMan, a high SVR rate of 68.8% was observed in patients with 5- log RNA levels and a 40% non-response rate was observed in patients with high viral load (7- log and higher RNA levels). When the timing of HCV RNA negativity was compared by Amp-Q and TaqMan, a delay of 4 or more weeks was observed by TaqMan in over one-half of patients. The dissociation between the two test systems in the timing of negativity was particularly large in patients with slow viral attenuation. HCV dynamics in the early stage of treatment was also confirmed to be an important factor for predicting efficacy. Based on the above, TaqMan is more sensitive than Amp-Q and linearity is observed up through a higher viral region than Amp-M. TaqMan is therefore considered to be a superior method of measurement for HCV RNA monitoring in hepatitis C.
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Case Reports
  • A case of Child-Pugh class B cirrhosis in hepatitis C infection successfully treated with interferon beta after balloon-occluded retrograde transvenous obliteration for gastric varices
    Akira Sato, Kayo Adachi, Toshiya Ishii, Masayo Yamaguchi, Mika Kobayas ...
    Article type: Case Report
    2008 Volume 49 Issue 7 Pages 307-313
    Published: 2008
    Released on J-STAGE: August 07, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.307
    JOURNAL FREE ACCESS
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    Sustained virological response was achieved by interferon beta treatment in a case of hepatitis C virus (HCV) cirrhosis with a Child-Pugh score of 8 and gastric varices. A 52-year-old man with cirrhosis due to HCV-genotype 2a and low viral load underwent balloon-occluded retrograde transvenous obliteration for F3 gastric varices. Although mild jaundice remained, his percent prothrombin time improved from 55.3% to more than 70% after treatment, and he was given interferon beta for 32 weeks. One year after interferon treatment, serum HCV-RNA is negative and Child-Pugh score has decreased to 5 as a result of improved jaundice. Interferon therapy should be considered, even in patients with advanced HCV cirrhosis and portal hypertension, if the patient has HCV-genotype 2 and low viral load.
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  • A case of advanced hepatocellular carcinoma successfully treated by combined therapies including transarterial chemoembolization using Lipiodol- CDDP powder suspension
    Yukio Iwashita, Kengo Fukuzawa, Shinji Itoh, Kiminori Watanabe, Satosh ...
    Article type: Case Report
    2008 Volume 49 Issue 7 Pages 314-319
    Published: 2008
    Released on J-STAGE: August 07, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.314
    JOURNAL FREE ACCESS
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    We report a case of advanced multiple hepatocellular carcinomas (HCC), successfully treated by combination therapies of transarterial chemoembolization (TACE), surgical operation and radiofrequency ablation therapy (RFA). The patient was a 60-year-old man, who had been investigated in another hospital for abdominal pain and general fatigue, and was subsequently referred to our hospital with a diagnosis of HCC. A huge tumor with a diameter larger than 10 cm and a set of multiple intrahepatic metastases (IM) to bilateral lobes were recognized. In addition, portal vein tumor thrombosis of the left branch (Vp3) was observed. He received serial treatments with TACE using lipiodol- CDDP powder suspension. After 4 courses of this therapy, CT revealed that these IM tumors had disappeared. Therefore we performed a left hepatic lobectomy. Then he was treated with RFA. He has still been well for 28 months since the first detection of HCC. It was suggested that a TACE using CDDP powder may be one of the most effective treatment modalities against advanced HCC.
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  • A case of Vp4 hepatocellular carcinoma with lung and brain metastases, successfully treated by multimodal therapy
    Yoshihiro Kanbara, Takuro Yoshikawa, Shinobu Tsuchida, Kimihiko Ueno, ...
    Article type: Case Report
    2008 Volume 49 Issue 7 Pages 320-326
    Published: 2008
    Released on J-STAGE: August 07, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.320
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    Patient was a 66 years old man with hepatocellular carcinoma (HCC) complicated with tumor thrombus of the main trunk of portal vein (Vp4). Complete remission was obtained by continuous arterial infusion of low dose FP (CDDP+5-FU), followed by intermittent infusion of 5-FU at 750 mg per dose for 16 months. About 24 months after starting the therapy, however, multiple pulmonary metastases and solitary brain metastasis were recognized. He underwent a tumorectomy for the brain metastasis to improve the quality of life, while the multiple pulmonary metastases grew rapidly despite additional courses of systemic chemotherapy (5-FU+CDDP+EPI). Then, about 5 months after the relapse, all the chemotherapy was withdrawn and replaced by an oral administration of Juzen-taiho-to (TJ-48). Five months later, the serum levels of tumor markers (AFP and PIVKA II) had significantly decreased, and the lung tumors had disappeared on CT. Since then until now, the patient has been free from recurrence of HCC for more than 2 years. Because the pulmonary metastases presented an aggravation tendency at the withdrawal of chemotherapy, TJ-48 must have played an important role in the cure.
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  • A case of primary biliary cirrhosis complicated by isolated ACTH deficiency
    Natsumi Sakamoto, Masaki Satoh, Yuta Takahashi, Fumiko Honma, Kyoko Mo ...
    Article type: Case Report
    2008 Volume 49 Issue 7 Pages 327-332
    Published: 2008
    Released on J-STAGE: August 07, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.327
    JOURNAL FREE ACCESS
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    A 58-year-old woman was diagnosed with primary biliary cirrhosis at a nearby hospital in 1997. In 2003 she was admitted to our hospital with erysipelas and acute poststreptococcal glomerulonephritis. On admission she was found to have pancytopenia and hypothyroidism, and was further diagnosed with isolated ACTH deficiency and also Hashimoto's disease as a result of a biochemical blood test. Both pancytopenia and hypothyroidism responded to hydrocortisone, and she was discharged. In 2007, however, she was readmitted to our hospital because of vertigo, vomiting and general fatigue, which are symptoms of acute adrenal insufficiency. After the administration of steroids, her condition improved temporarily, but she developed pneumonia and died of multiple organ failure due to respiratory failure and disseminated intravascular coagulation. Although primary biliary cirrhosis and isolated ACTH deficiency are considered autoimmune diseases, the combination of the two is extremely rare. To our knowledge this is the second reported case.
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