Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 52, Issue 10
Displaying 1-9 of 9 articles from this issue
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Feature Article
Original Articles
  • Low-dose PEG-IFNα2a maintenance therapy significantly reduces serum levels of ALT and AFP in chronic hepatitis C patients compared to glycyrrhizin
    Yoshio Sumida, Takefumi Nakamura, Tatsuro Kobata, Takehiro Sando, Moto ...
    Article type: Original Article
    2011 Volume 52 Issue 10 Pages 644-651
    Published: 2011
    Released on J-STAGE: October 27, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.644
    JOURNAL FREE ACCESS
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    Sixty-four CHC patients were treated with low-dose PEG-IFN maintenance therapy (median initial dose of 90 μg/wk for longer than 24 wks) or SNMC (median initial dose of 170 ml/wk for longer than 24 wks) at nine hepatology centers. The median observation period was 154 wks in the PEG-IFN group and 145 wks in the SNMC group. The ALT levels (median, IU/L) at baseline and at wks 24 and 48 were 64, 34 and 30 in the PEG-IFN group and 80, 47 and 52 in the SNMC group, respectively. The AFP levels (median, ng/mL) at baseline, wks 24 and 48 were 12, 9.2 and 7.2 in the PEG-IFN group and 12, 12.5 and 18 in the SNMC group, respectively. More patients had AFP <10 ng/mL in the PEG-IFN group than in the SNMC group. HCC developed in three patients (8%) in the PEG-IFN group and in three patients (11%) in the SNMC group. Platelet counts, hemoglobin levels and white cell counts during the treatment period were significantly lower in the PEG-IFN group than in the SNMC group, but all of the patients were able to continue treatment following dose modifications.
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  • Efficacy of combination therapy of pegylated interferon alfa-2b plus ribavirin for 48 weeks in chronic hepatitis C patients with serotype 1 high viral load: Results of multicenter trial in Tohoku area of Japan
    Akio Miyasaka, Juichi Sakamoto, Shinsaku Fukuda, Takashi Goto, Hirohid ...
    Article type: Original Article
    2011 Volume 52 Issue 10 Pages 652-661
    Published: 2011
    Released on J-STAGE: October 27, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.652
    JOURNAL FREE ACCESS
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    We estimated 256 chronic hepatitis C (C-CH) patients with serotype 1 high viral load who received pegylaed interferon alfa-2b and ribavirin for 48 weeks. All patients were assessed for efficacy, tolerance and safety. Discontinuation of therapy for adverse events was 17.8% (45/256) for 48 weeks and 53 patients showed mild or moderate adverse events. The sustained virological response (SVR) rate was 44.5% (114/256). The SVR rate was significantly higher in patients less than 56 years old than more than 56 years old and was tend to be lower in the patients who reduced peylated interferon alfa-2b, ribavirin or both dosage than patients who received full dose. In logistic regression analysis, four independent factors were significantly associated with SVR; body mass index (= or >23.5), platelet counts (=or >16.4μ/l), adherence to pegylaed interferon alfa-2b (=or >80%) until 12 weeks and adherence to ribavirin (=or >80%) until 12 weeks. In conclusion, these results suggest that the combination therapy with pegylaed interferon alfa-2b and ribavirin may be safety and tolerance for C-CH patients with serogroup1 high viral load.
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Case Reports
  • Two cases of alcoholic liver cirrhosis with diffuse intrahepatic arterio-portal shunt treated by transjugular intrahepatic portosystemic shunt
    Takeshi Fukuda, Yoshiyuki Narahara, Hidenori Kanazawa, Norio Itokawa, ...
    Article type: Case Report
    2011 Volume 52 Issue 10 Pages 662-670
    Published: 2011
    Released on J-STAGE: October 27, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.662
    JOURNAL FREE ACCESS
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    Case 1 was a 56 year old man with alcoholic liver cirrhosis and refractory ascites and pleural effusion. Hepatofugal portal blood flow from diffuse Arterio-portal shunt (A-P shunt) was observed throughout the liver in the hepatic arteriography. Transjugular intrahepatic portosystemic shunt (TIPS) was performed for the treatment of refractory ascites and the pleural effusion. After TIPS, ascites and pleural effusion was almost disappeared. Case 2 was a 70 year old man with alcoholic liver cirrhosis and refractory ascites. A-P shunt was observed throughout the liver in the hepatic arteriography and portal blood flow was demonstrated as hepatofugal. TIPS was performed for the treatment of refractory ascites. After TIPS, ascites was decreased. TIPS may be effective for the treatment of refractory ascites due to diffuse intrahepatic A-P shunt.
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  • Successful treatment against lymphnode metastasis by endoscopic ultrasonography-guided ethanol injection in a case of hepatocellular carcinoma
    Yoshinori Ohno, Ayano Ochiai, Sigeru Kutsuna, Yoshiko Sasaki, Tomoe Oo ...
    Article type: Case Report
    2011 Volume 52 Issue 10 Pages 671-678
    Published: 2011
    Released on J-STAGE: October 27, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.671
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    A 69-year-old man developed hepatocellular carcinoma (HCC) in January 2005, and was treated by radiofrequency ablation (RFA). After the transcatheter arterial chemoembolization (TACE) and RFA had been repeated twice for recurrent HCCs, he admitted to our hospital due to recurrent HCC in S4 and lymphnode metastasis near the pancreas head. Celiac angiography showed a tumor stain in S4 and pancreas head area, measuring 35 mm and 25 mm in diameter respectively. The latter stain was recognized as a solitary hypervascular lymphnode metastasis near the pancreas head by CTHA. HCC in S4 was treated by TACE followed by RFA. The lymphnode metastasis which was treated by endoscopic ultrasonography-guided ethanol injection was successfully treated. A significant decrease in the size of the lymphnode and tumor markers were observed 2 months after treatment, and the lymphnode had almost disappeared 8 months later. All four cases of ethanol injection therapy against lymphnode metastasis of HCC in our hospital were treated successfully. The results in this case suggest that the ethanol injection therapy may be effective in the treatment of lymphnode metastasis of HCC, and endoscopic ultrasonography allows an easy approach to the lymphnode especially around the pancreas head area.
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  • A case of primary biliary cirrhosis associated with hepatocellular carcinoma and systemic lupus erythematodes
    Haruya Ishiguro, Takazumi Kimura, Toshiki Nikami, Kai Yoshizawa, Hiros ...
    Article type: Case Report
    2011 Volume 52 Issue 10 Pages 679-686
    Published: 2011
    Released on J-STAGE: October 27, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.679
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    A 80-years-old woman was referred to our hospital for investigation of liver damage. Laboratory data and liver histology confirmed primary biliary cirrhosis (PBC). In this patient, a pancytopenia progressed gradually for a year, and the pericardium water retention suggesting pericarditis appeared in September, 2009. In addition antinuclear antibody was high tighter and double-stranded DNA antibody was positive. She was diagnosed as having systemic lupus erythematosus (SLE) according to diagnostic criteria of United States American College of Rheumatology and administration of the oral 20 mg prednisolone was started. At the same time, hepatocellular carcinoma (HCC), the diameter 22 mm in S2, left lobe of liver, was noted on abdominal enhanced computed tomography. In January, 2010, after confirming the improvement of pancytopenia and pericarditis, HCC was treated with both transcatheter arterial chemoembolization and radio frequency ablation. We reported the very rare case having PBC, SLE and HCC simultaneously.
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  • Percutaneous transhepatic artery chemolipiodolization for multiple hepatocellular carcinomas
    Naoya Kida, Hidetaka Takashima, Takeshi Nishikawa, Koichi Tomikashi, S ...
    Article type: Case Report
    2011 Volume 52 Issue 10 Pages 687-694
    Published: 2011
    Released on J-STAGE: October 27, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.687
    JOURNAL FREE ACCESS
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    Transarterial treatment procedures such as chemolipiodolization and chemoembolization are an important part of multimodal therapy for multiple hepatocellular carcinomas (HCC). We examined a 69-year-old man diagnosed with multiple HCC. Angiography revealed that the celiac artery had been occluded by a previous surgical procedure. We inserted a microcatheter through the superior mesenteric artery to the proper hepatic artery and performed chemoembolization. Five months later, reccurence in the form of several HCC tumors was observed in the anterior segment of right hepatic lobe, and the main trunk of the right hepatic artery was occluded because of the effects of transarterial chemoembolization. A new approach was therefore required to perform selective transarterial therapy, as opposed to the conventional approach. We therefore attempted to puncture A8 percutaneously under ultrasonographic guidance and achieved the desired therapeutic effects without critical complications. At present, this approach may lead to serious complications, such as bleeding from the hepatic artery. Hence, a good understanding of not only the overall clinical status but also the hemodynamic profile of the patient is essential before this treatment is performed.
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Short Communication
  • Clinical trial of RFA therapy with a newly developed 4D-US probe
    Atsunori Kusakabe, Shunsuke Nojiri, Etsuko Iio, Kentaro Matsuura, Nobo ...
    Article type: Short Communication
    2011 Volume 52 Issue 10 Pages 695-698
    Published: 2011
    Released on J-STAGE: October 27, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.695
    JOURNAL FREE ACCESS
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    To evaluate whether 4D US guidance (4D biopsy mode) in RFA therapy is effective, we conducted percutaneous RFA using a newly developed 4D-US probe for 5 subjects (5 HCC lesions) between January and May 2011. We used Aplio XG (Toshiba Medical Systems) as the US system and PVT-375MV (3.5MHz) as the newly developed 4D US probe. RFA needle was inserted into the target lesion under 4D US guidance (biopsy mode). Using 4D biopsy mode, we could simultaneously confirm whether the needle tip inserted at the center of the target from two different sections in all cases: therefore, adequate RFA efficiency could be achieved in all 5 subjects. Using a real-time 4D US device for RFA, more accurate insertion could be achieved and more effective therapy could be performed. Therefore, 4D US would be a more useful tool for RFA therapy.
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Erratum
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