Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 49, Issue 8
Displaying 1-6 of 6 articles from this issue
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Review Article
Case Reports
  • A case of acute hepatitis C, most likely by interspousal sexual transmission after 40 years of marriage
    Tatsuya Aikawa, Maki Kojima, Kuniko Miyamoto, Chisato Ueno, Masaharu T ...
    Article type: Case Report
    2008 Volume 49 Issue 8 Pages 352-361
    Published: 2008
    Released on J-STAGE: September 10, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.352
    JOURNAL FREE ACCESS
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    A 67-year-old man contracted acute hepatitis C after 40 years of marriage, who had no discernible risk factors for acquiring hepatitis C virus (HCV) infection, except that he had a monogamous sexual relationship (once or twice a month) with his wife with chronic hepatitis C who was infected with HCV of the same genotype (1b) and had a high-titer HCV RNA in the serum (>5,000 KIU/ml). The HCV isolates from the patient and his wife shared 99.7% identity in the 1,087 nucleotide (nt) sequence of the NS5B region, although these two isolates were only 96.7% identical to the 98 reported genotype 1b isolates. Phylogenetic analysis of the 1,087-nt sequence revealed that the two isolates segregated into a cluster with a bootstrap value of 100%. These results suggest that the patient had acquired HCV infection from his wife, most likely by interspousal sexual transmission.
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  • A case of drug-induced liver injury caused by external medication(s) for external hemorrhoids
    Yoshihiko Morisawa, Atsushi Tanaka, Ryo Miura, Masako Fukami, Hideaki ...
    Article type: Case Report
    2008 Volume 49 Issue 8 Pages 362-367
    Published: 2008
    Released on J-STAGE: September 10, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.362
    JOURNAL FREE ACCESS
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    A 63-year-old man was admitted to our hospital for surgical operation for rectal cancer, but the operation was postponed because of an elevation of liver enzymes. The liver function tests became normal without any specific treatment, and he was discharged. A week later, however, he was readmitted with abnormal liver functions. Viral markers as well as autoantibodies in the sera were negative. He denied intake of any oral or parental medicines during routine queries, however, our detailed inquiry revealed that he had used sets of suppositories and ointments for external hemorrhoids before the 1st admission and also during interval of 1st and 2nd admissions. However, he did not use these drugs during hospital admissions. On the basis of chronological and circumstantial evidences, it may be proposed that either one or both external drugs (suppositories and ointments) were responsible for liver injuries. Notably, the exacerbation of liver injury after re-administration provides further supports for this notion.
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  • A Crohn's disease patient who developed nonalcoholic steatosis and cirrhosis of the liver after surgical excision of the small intestines
    Yoriko Higuchi, Kazufumi Dohmen, Shunichiro Ayabe, Hirofumi Tanaka, Ma ...
    Article type: Case Report
    2008 Volume 49 Issue 8 Pages 368-375
    Published: 2008
    Released on J-STAGE: September 10, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.368
    JOURNAL FREE ACCESS
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    A 51-year-old female was admitted to our hospital for abdominal fullness and leg edema. Ultrasonography (US), computed tomography and histopathological findings obtained by liver biopsy revealed liver cirrhosis. She had been diagnosed to have Crohn's disease at the age of 23, and received surgical operations at the age of 23 and 35 to excise the small intestines (resulting in a 2-meter shortening), because her Crohn's disease did not respond to medications. Fatty liver was recognized on US at the age of 38. She has neither drunk alcohol nor taken the treatment with steroid hormone or parenteral nutrition. Laboratory examinations showed negativity for HBs antigen and HCV antibody. The values of serum total cholesterol, triglyceride and body mass index were within normal ranges. Thus, the most likely cause of her fatty liver with the development to cirrhosis may be the short bowel syndrome, induced by previous intestinectomy.
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  • A case of sarcomatoid carcinoma of the liver
    Shinichiro Takao, Narito Takada, Jiro Watanabe, Masami Kuniyoshi, Take ...
    Article type: Case Report
    2008 Volume 49 Issue 8 Pages 376-385
    Published: 2008
    Released on J-STAGE: September 10, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.376
    JOURNAL FREE ACCESS
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    A 65-year-old man was admitted to our hospital because of the liver tumor with approximate diameter of 4 cm. It was difficult to make a qualitative diagnosis although extensive examinations implied a primary hepatic lesion. As a result of targeted biopsy of the lesion, a pathological diagnosis of sarcomatoid carcinoma was suggested, and then surgical resection was performed. The tumor was simple nodular and mainly consisted of spindle cells with remarkable pleomorphism and mitosis in compact and fascicular fashion. Immunohistochemically, the tumor cells were positive for AE1/AE3 and vimentin, confirming the diagnosis of sarcomatoid carcinoma.
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Short Communication
  • Pegylated interferon-α2b and ribavirin combination therapy for pediatric patients with chronic hepatitis C
    Ayano Inui, Haruki Komatsu, Tsuyoshi Sogo, Takuji Hashimoto, Tomoo Fuj ...
    Article type: Short Communication
    2008 Volume 49 Issue 8 Pages 386-388
    Published: 2008
    Released on J-STAGE: September 10, 2008
    DOIhttps://doi.org/10.2957/kanzo.49.386
    JOURNAL FREE ACCESS
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    Thirteen Japanese children and young adults (age range 10-40 years, median 18 years) with chronic hepatitis C have been treated with pegylated interferon α2b and ribavirin combination therapy in our pediatric center. The HCV RNA levels before treatment were 5-3,900 KIU/ml (median 1,500 KIU/ml), with HCV genotype 1 in 7 patients, 2a in 5, and 2b in 1. Of the 13 patients, 8 have completed the treatment course with sufficient follow-up to date, and 7 (with HCV genotype 1b in 4, 2a in 2 and 2b in 1) of them (88%) have achieved sustained virological response. The major adverse effect related to therapy was fever. This combination therapy was well tolerated in all the patients without cessation of the therapy. Our present results encourage treatment of pediatric hepatitis C patients with pegylated interferon and ribavirin, as in adult patients.
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