Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 50, Issue 9
Displaying 1-7 of 7 articles from this issue
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Review Article
Original Article
  • Current status of alcoholic liver cirrhosis and factors involved in the progression
    Yoshinori Horie, Hiromasa Ishii, Yoshiyuki Yamagishi, Hirotosi Ebinuma ...
    Article type: Original Article
    2009 Volume 50 Issue 9 Pages 507-513
    Published: 2009
    Released on J-STAGE: September 24, 2009
    DOIhttps://doi.org/10.2957/kanzo.50.507
    JOURNAL FREE ACCESS
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    We addressed the recent trend in alcoholic liver cirrhosis (LC) in Japan. Nation wide survey was carried by asking the hospitals that are qualified by the Japanese Society of Gastroenterology for the number of hospitalized-patients of LC in 2007 and etiology of LC. Concerning alcoholic LC, we also obtained the amount of daily alcohol intake and period of habitual drinking.
    There was no significant gender difference in daily alcohol intake, while the period of habitual drinking in female patients with LC was shorter than that in male patients. Among the patients whose daily alcohol intake was less than 110 g/day, prevalence of diabetes mellitus and/or obesity (BMI≥25) were significantly higher.
    Shorter period of alcohol drinking was found in the female alcoholic LC compared with male LC. Obesity and diabetes mellitus appeared to be involved in the progression of alcoholic LC. Education of low risk drinking and improvement of total life style are important to decrease the prevalence of alcoholic liver disease.
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Case Reports
  • A case of breakthrough hepatitis caused by HBV-DNA mutations after 4 years combination therapy of Lamivudine and Adefovir dipivoxil
    Masayuki Miyazaki, Nobito Higuchi, Masatake Tanaka, Akihiro Ueda, Masa ...
    Article type: Case Report
    2009 Volume 50 Issue 9 Pages 514-519
    Published: 2009
    Released on J-STAGE: September 24, 2009
    DOIhttps://doi.org/10.2957/kanzo.50.514
    JOURNAL FREE ACCESS
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    A 49-year-old man was admitted to our hospital suffering from acute hepatitis exacerbation caused by hepatitis B virus in July 2008. He had been diagnosed as chronic hepatitis B in 1999 and been successfully treated with lamivudine. In 2004, he experienced the first breakthrough hepatitis, which was controlled with an addition of adefovir dipivoxil to lamivudine. On admission, we found the elevation of the serum HBV-DNA level, which was revealed to contain the adefovir dipivoxil-resistant mutations: A181V/T and N236T. Although the appearance of mutations against adefovir dipivoxil has been described in some reports, it was rare that such mutations caused breakthrough hepatitis. We applied him the combination therapy with adefovir dipivoxil and entecavir, which decreased the serum HBV-DNA and alanine aminotransferase concentration within a month.
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  • A case of recurrent hepatitis C after liver transplantation associated with pulmonary tuberculosis and mediastinal tuberculous lymphadenitis
    Akiyoshi Kinoshita, Munenori Itagaki, Yoshihiko Aoki, Hiroshi Matsudai ...
    Article type: Case Report
    2009 Volume 50 Issue 9 Pages 520-526
    Published: 2009
    Released on J-STAGE: September 24, 2009
    DOIhttps://doi.org/10.2957/kanzo.50.520
    JOURNAL FREE ACCESS
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    A 50-year-old man underwent orthotopic liver transplantation in June 2006 for decompensated cirrhosis due to hepatitis C virus infection. In March 2007 he was diagnosed with recurrent hepatitis C and he was given interferon α2b and ribavirin. 17 months after interferon treatment, serum HCV-RNA was negative. At the same period, a CT scan of the chest showed multiple mediastinal lymphadenopathy, and a pale opacity in the left upper lobe. Thoracoscopic biopsy of mediastinal lymph node confirmed mediastinal tuberculous lymphadenitis. Then he was treated with combined therapy with 4 anti-tuberculous drugs (RFP, INH, EB, and PZA). Until now he has been given interferon α2b and ribavirin with anti-tuberculous therapy. Although mediastinal tuberculous lymphadenitis after liver transplantation is rare, we must recognize the disease as a complication after liver transplantation.
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  • A case of senile woman diagnosed with autoimmune hepatitis
    Ryohei Hayashi, Mikiya Kitamoto, Ikue Noda, Chiyuki Watanabe, Hiroyasu ...
    Article type: Case Report
    2009 Volume 50 Issue 9 Pages 527-531
    Published: 2009
    Released on J-STAGE: September 24, 2009
    DOIhttps://doi.org/10.2957/kanzo.50.527
    JOURNAL FREE ACCESS
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    A 86-year-old woman with abnormal liver function test admitted to our hospital. Serologic tests for hepatitis virus infection were all negative, and she had no previous history of alcohol and drug. Antinuclear antibody was positive (×40, speckled type), and the autoimmune hepatitis score was 17 points with liver biopsy showing interface hepatitis. She was diagnosed with autoimmune hepatitis, and was administered with 30 mg of prednisolone/day and 600 mg of ursodeoxycholic acid/day. Her liver function test improved immediately, and the dose of prednisolone gradually decreased to 10 mg.
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  • A case report of successful treatment with a cholesterol absorption inhibitor for decompensated burned-out NASH
    Kojiro Seki, Takanori Boku, Atsushi Umemura, Mika Matsumoto, Masayuki ...
    Article type: Case Report
    2009 Volume 50 Issue 9 Pages 532-539
    Published: 2009
    Released on J-STAGE: September 24, 2009
    DOIhttps://doi.org/10.2957/kanzo.50.532
    JOURNAL FREE ACCESS
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    A 78-year-old woman, who had diabetes mellitus, hyperlipidemia and non-alcoholic steatohepatitis (NASH), suffered from refractory ascites due to burned-out NASH. Treatment with ezetimibe, a cholesterol absorption inhibitor, was started. Seventeen weeks after initiation of ezetimibe therapy, ascites disappeared. She selfishly discontinued ezetimibe therapy for 4 weeks and massive ascites appeared again. Although ezetimibe therapy was resumed, liver function tests and control of ascites were deteriorated for a few weeks. About 12 weeks after resumption of ezetimibe therapy, improvement of liver function tests was observed, and 34 weeks after resumption of ezetimibe therapy, ascites disappeared. This is the first case reporting that ezetimibe therapy to patient with decompensated burned-out NASH was clinically effective.
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  • Two cases of hepatocellular carcinoma with erythrocytosis
    Tomoyuki Abe, Ken Shirabe, Chikato Koga, Norifumi Harimoto, Eiji Tsuji ...
    Article type: Case Report
    2009 Volume 50 Issue 9 Pages 540-546
    Published: 2009
    Released on J-STAGE: September 24, 2009
    DOIhttps://doi.org/10.2957/kanzo.50.540
    JOURNAL FREE ACCESS
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    Two cases of HCC with erythrocytosis are presented. A 58-year-old male with a huge tumor in the right lobe of the liver, showed a high concentration of hemoglobin and Epo, AFP. Right lobectomy with a part of diaphgram resection was performed. Histological findings of the specimen showed a poorly differentiated HCC. Erythrocytosis disappeared and the serum levels of Epo and AFP returned to the normal range after operation. There is no recurrence for 2 years after the operation. A 58-year-old male was admitted to our hospital because of a huge liver tumor at the right lobe. In laboratory findings, erythrocytosis and high level of AFP and Epo are detected. The extended right lobectomy of the liver was performed. Erythrocytosis disappeared and the serum levels of AFP returned to the normal range. 1 year and 1 month later, recurrent tumors appeared in the remnant liver and lung.
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