Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 50, Issue 10
Displaying 1-10 of 10 articles from this issue
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Original Article
  • Long term effects of pioglitazone therapy with nonalcoholic steatohepatitis
    Haruo Nakayama, Shigetoshi Iwahasi, Toshiaki Ojima, Masao Kusano, Shig ...
    Article type: Original Article
    2009 Volume 50 Issue 10 Pages 555-564
    Published: 2009
    Released on J-STAGE: November 10, 2009
    DOIhttps://doi.org/10.2957/kanzo.50.555
    JOURNAL FREE ACCESS
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    Several studies of 48 weeks pioglitazone therapy demonstrated significant improvements in nonalcoholic steatohepatitis (NASH). The aim of the study is to assess long term effects of over 2 years pioglitazone therapy with NASH. Twenty-three patients with NASH were treated with pioglitazone for over 2 yrs (46.5±11.9 months) and fifteen performed biopsy before and at the 2 yrs after treatment. Piogilitazone therapy improved aminotransferase level rapidly within 3 months and has sustained the long biochemical improvements. TG level (p=0.012), HbA1c (p=0.006) and 2 hr plasma glucose level in 75 gOGTT (p=0.005) were significantly improved. Histologic features including steatosis (p=0.006), lobular inflammation (p=0.02), fibrosis (p=0.02) were improved. Weight gain was the main adverse effect, averaging 1.5 kg in 2 yrs. In conclusion, These finding suggest that over 2 yrs of pioglitazone therapy can lead to the long-term improvement in biochemical and histological features of NASH.
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Case Reports
  • Two HCV-related chronic hepatitis patients with Peg-interferon α-2a induced generalized rash
    Tomoko Komiya, Akiko Saito, Yuki Yoneda, Sneha Patel, Michiyo Chiba, K ...
    Article type: Case Report
    2009 Volume 50 Issue 10 Pages 565-570
    Published: 2009
    Released on J-STAGE: November 10, 2009
    DOIhttps://doi.org/10.2957/kanzo.50.565
    JOURNAL FREE ACCESS
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    We describe two HCV-related chronic hepatitis patients who developed generalized rashes when treated with Peg-interferon (Peg-IFN) α-2a. Patient 1, a 75 year-old male, had a past history of TB-drug induced hepatitis and was post-TAE/RFA for hepatocellular carcinoma. He was treated with 45 μg of Peg-IFNα-2a weekly. Patient 2, a 70 year-old female, had no significant past medical history other than her HCV hepatitis. She was given 90 μg of Peg-IFNα-2a weekly. The HCV-RNA genotype 1b levels of these patients were 350 and 430 KIU/ml, respectively. Both developed erythema at the injection sites during the 3rd to 4rh weeks of treatment and generalized erythematous macular/papular lesions during the 10th to 11th weeks. Peg-IFN was stopped and both patients were treated with oral anti-histamines and topical steroid creams. At 6-7 weeks after treatment discontinuation, the original doses of Peg-IFN were restarted and continued for a total of 47 weeks in patient 1 and 60 weeks in patient 2. Despite the low doses of Peg-IFNα-2a used in these elderly patients, we obtained an adequate sustained virologic response. The courses of these two patients suggest that generalized rashes associated with IFN may not be of allergic origin. Retreatment with same IFN is potentially appropriate in such cases.
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  • A case of stage IVa hepatocellular carcinoma with lymph node metastasis successfully treated by multidisciplinary therapy
    Hisataka Ogawa, Masanori Tsujie, Atsushi Miyamoto, Toshimasa Tsujinaka ...
    Article type: Case Report
    2009 Volume 50 Issue 10 Pages 571-577
    Published: 2009
    Released on J-STAGE: November 10, 2009
    DOIhttps://doi.org/10.2957/kanzo.50.571
    JOURNAL FREE ACCESS
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    Lymph node metastasis due to hepatocellular carcinoma is generally found in patients in advanced stages of disease with poor prognosis. The effects on prognosis of treatment of lymph node metastasis due to hepatocellular carcinoma are unclear. We report here a case of hepatocellular carcinoma with lymph node metastasis successfully treated by multidisciplinary therapy including surgery, transcatheter arterial chemoembolization, general chemotherapy, and radiation therapy. Control of regional liver disease is needed to obtain a better prognosis in patients with advanced hepatocellular carcinoma with lymph node metastasis.
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  • Successful treatment for metastatic lesions in the liver and farciform ligament from ovarian cancer with intra-arterial chemoembolization using degradable starch microspheres (DSM-TAE) and radiofrequency ablation therapy: a case report
    Toru Ishikawa, Kazuo Higuchi, Tomoyuki Kubota, Keiichi Seki, Hironobu ...
    Article type: Case Report
    2009 Volume 50 Issue 10 Pages 578-583
    Published: 2009
    Released on J-STAGE: November 10, 2009
    DOIhttps://doi.org/10.2957/kanzo.50.578
    JOURNAL FREE ACCESS
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    A 55-year-old woman was admitted to our hospital for the metastases in the liver and farciform ligament from ovarian cancer. She was treated by intra-arterial chemoembolization using degradable starch microspheres (DSM-TAE) and radiofrequency ablation therapy (RFA). After two courses of this therapy by DSM-TAE and RFA, the abdominal CT revealed a wedge shaped low attenuation area in the segment of left lobe of the liver, together with a pattern of gas distribution insides. It was diagnosed as hepatic infarction. This area showed cystic change and was absorbed later. She has been followed with no evidence of recurrence for 20 months. The results recognized in this case suggest that DSM-TAE and RFA can be effective therapy for the treatment of meatastases in the liver and farciform ligament from ovarian cancer.
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Short Communication
Rapid Communications
  • Low hepatitis B virus core-related antigen is a predictor of absence in post-treatment recurrence of hepatocellular carcinoma during antiviral therapy
    Tetsuya Hosaka, Fumitaka Suzuki, Masahiro Kobayashi, Miharu Hirakawa, ...
    Article type: Rapid Communication
    2009 Volume 50 Issue 10 Pages 588-589
    Published: 2009
    Released on J-STAGE: November 10, 2009
    DOIhttps://doi.org/10.2957/kanzo.50.588
    JOURNAL FREE ACCESS
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    The tumor recurrence rate of hepatocellular carcinoma (HCC) is still high even in patients who receive a curative therapy. We analyzed predictive value of HBV-related viral markers, including HBcrAg, HBV DNA, and HBeAg, for HCC recurrence in the patients who developed HCC during antiviral nucleot(s)ide analogues therapy. By univariate analysis, HBV DNA, HBcrAg, tumor number and presence of portal vein invasion were significant predictive factors. By multivariate analysis, HBcrAg and presence of portal vein invasion were independent and significant predictive factors of recurrence after curative therapy for HCC. We conclude that HBcrAg is useful as a predictor of post-treatment recurrence of HCC after curative therapy in patients who received antiviral therapy.
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  • Rapid virological response obtained by natural IFN αfor a patient of chronic hepatitis C with a high viral load of HCV genotype 1b who is refractory to peg-interferon α+ribavirin combination therapy
    Akira Kawano, Yuichiro Kado, Hirohisa Shigematsu, Koichiro Miki, Toshi ...
    Article type: Rapid Communication
    2009 Volume 50 Issue 10 Pages 590-592
    Published: 2009
    Released on J-STAGE: November 10, 2009
    DOIhttps://doi.org/10.2957/kanzo.50.590
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    Interferon monotherapy is considered to have limited effectiveness in patients with HCV of a high viral load. Here, we reported a 21-year old male of chronic hepatitis C with a high viral load of HCV genotype 1b. He received both peg-interferon α-2b plus ribavirin and peg-interferon α-2a plus ribavirin combination therapy. But there were no virological response. Nevertheless, after starting natural interferon α(human lymphoblastoid interferon (HLBI), Sumiferon; Dainippon Sumitomo Pharmaceutical Co., Osaka, Japan), he became HCV-RNA negative at 4 week. The therapy is continued and HCV-RNA negativity is sustained for over 40 weeks. Eradication of HCV might be expected. Natural IFN α contains more than 20 subtypes, and one or more of them may have therapeutic effect against HCV virus of this patient.
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  • Time intensity curves of Sonazoid in portal vein in the patients with chronic liver disease and in healthy volunteers
    Sachiyo Kogita, Yasuharu Imai, Yasushi Seki, Tomoyuki Uto, Tetsuya Iwa ...
    Article type: Rapid Communication
    2009 Volume 50 Issue 10 Pages 593-594
    Published: 2009
    Released on J-STAGE: November 10, 2009
    DOIhttps://doi.org/10.2957/kanzo.50.593
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    Sonazoid, an ultrasonography contrast agent which consists of perflubutane microbubbles with shells, is stable in blood vessels and remains for a long time. We investigated time intensity curves of Sonazoid in portal vein in the patients with chronic liver disease and healthy volunteers. Among 25 patients with chronic liver disease, Sonazoid remained at the rates of 54.8±15.2%, 32.5±13.3%, 25.2±12.2%, 8.8±7.1% in the portal vein, 10, 20, 30, and 60 minutes after injection, respectively. In healthy volunteers, Sonazoid remained at the rates of 60.1±12.9%, 41.4±11.4%, 32.0±10.3%, 7.8±4.5% in the portal vein, 10, 20, 30, and 60 minutes after injection, respectively. It is recommended that Kupffer images of Sonazoid-enhanced contrast ultrasonography is evaluated 60 minutes after injection of Sonazoid to avoid an influence of sonazoid remaining in the vessels.
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  • A case of advanced hepatocellular carcinoma died of metabolic encephalopathy on the early course of treatment with sorafenib
    Mitsuyoshi Honjo, Katsutoshi Sugimoto, Yuki Miyata, Takatomo Sano, Shi ...
    Article type: Rapid Communication
    2009 Volume 50 Issue 10 Pages 595-597
    Published: 2009
    Released on J-STAGE: November 10, 2009
    DOIhttps://doi.org/10.2957/kanzo.50.595
    JOURNAL FREE ACCESS
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    We experienced a case which was died of metabolic encephalopathy on the early course of oral treatment with sorafenib. The patient was 60's-year-old with advanced-stage of hepatocellular carcinoma. After 14 days of oral treatment with sorafenib, we found that the patient had disorientation and asterixis, which developed to deep coma, without serious hepatic failure. The patient died after 17 days of sorafenib treatment. We diagnosed as metabolic encephalopathy because he did not display obvious signs of hepatic failure. There was no factor which caused metabolic encephalopathy except for sorafenib administration. We have to consider the causal relationship between sorafenib administration and metabolic encephalopathy.
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Special Article
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