Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 52, Issue 2
Displaying 1-11 of 11 articles from this issue
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Editorial
Original Articles
  • Evaluation of usefulness of hepatitis B vaccination at St. Marianna University School of Medicine Hospital and related facilities
    Chiaki Okuse, Hiroshi Yotsuyanagi, Norie Yamada, Kiyomi Yasuda, Masato ...
    Article type: Original Article
    2011 Volume 52 Issue 2 Pages 87-93
    Published: 2011
    Released on J-STAGE: March 22, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.87
    JOURNAL FREE ACCESS
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    The Immunogenicity of hepatitis B (HB) vaccine was evaluated among 601 persons who were inoculated with HB vaccine. Seroconversion (SC) to HB surface antibody (HBsAb) was observed in 92.2% of the persons. Rate of SC tended to decrease with aging, and significant difference was observed between group aged 20-29 and group aged 19 or under (86.0% versus 96.1%: P<0.0001). Rate of SC in male was significantly lower than that in female (78.7% versus 97.5%: P<0.0001). In male, rate of SC in the group aged 20-29 was significantly lower than that in the group aged 19 or under (72.5% versus 91.7%: P=0.0411), while no obvious difference with aging was found in female. These results suggested that response to HB vaccination may be impaired in male and aged persons. Thus, HB vaccination should be done before 20 years old, especially in male, to acquire sufficient amount of HBsAb.
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  • The anti-viral effect and the influence on the values of ALT and AFP by low-dose PEG-IFNα2a treatment for prevention of cancer in patients with chronic hepatitis C
    Hiroshi Adachi, Katsuhisa Inamura, Toshiyuki Okamura, Tatsuho Sugimoto
    Article type: Original Article
    2011 Volume 52 Issue 2 Pages 94-101
    Published: 2011
    Released on J-STAGE: March 22, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.94
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    Low-dose PEG-IFNα2a was administered to 40 cases who were difficult or who stopped because of no effect or harmful side effects with PEG-IFN/RBV combination therapy who developed liver fibrosis, to whom HCVRNA measurement by real-time PCR assays. HCV RNA was undetectable in 13.6% of the Genotype 1 and high viral load cases during treatment, in all cases with a low viral loads by providing 45 μg of PEG-IFNα2a, in Genotype 2 and high viral load cases by providing 90 μg. The improvement of the values of ALT and AFP in 48 and/or 72 weeks by providing low-dose PEG-IFNα2a suggested the effectiveness to prevent HCC, whether HCVRNA was undetectable or not. Three cases developed HCC within the period of observation, who had previous treatment for HCC. No cases had discontinued treatment because of adverse events.
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  • Renal dysfunction in chronic hepatitis B patients treated with adefovir dipivoxil
    Itaru Ozeki, Yoshiyasu Karino, Jun Akaike, Rikuumi Kimura, Tomohiro Ar ...
    Article type: Original Article
    2011 Volume 52 Issue 2 Pages 102-111
    Published: 2011
    Released on J-STAGE: March 22, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.102
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    Long-term adefovir administration has been reported overseas to induce renal impairment in a certain percentage of patients. In Japan, its influences on renal function are unclear. In patients continuously treated with nucleotide analogues, we compared changes in the serum creatinine level and estimated glomerular filtration rate among patients in the control and treated and not treated with adefovir. The group treated with adefovir showed a significant increase in the serum creatinine level and a significant decrease in the estimated glomerular filtration rate compared with the group not receiving adefovir (p<0.001). There were no significant differences in these changes between the control and the group not receiving adefovir.
    Logistic regression analysis revealed adefovir administration to be a significant factor (odds ratio, 6.6), inducing a ≥20% decrease in the estimated glomerular filtration rate. In patients in whom daily was changed to alternate-day adefovir administration due to renal impairment, the serum creatinine level gradually decreased, suggesting that renal impairment is reversible.
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Case Reports
  • A case of pelioid type of hepatocellular carcinoma composed of the two different nodules
    Keita Kai, Atushi Miyoshi, Yoshiaki Egashira, Hiroshi Kubo, Kenji Kita ...
    Article type: Case Report
    2011 Volume 52 Issue 2 Pages 112-119
    Published: 2011
    Released on J-STAGE: March 22, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.112
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    We experienced a case of Pelioid type of Hepatocellular carcinoma (P-HCC) composed of the two different nodules. A 78-year-old Japanese male was admitted to the hospital for the treatment of hepatic nodule found by screening abdominal ultrasonography. The radiological studies revealed the hepatic nodule at posterior segment showing the features of cholangiocellular carcinoma and classical HCC with fat deposition. Under the diagnosis of the combined type of HCC, the surgical resection was performed. The tumor was composed of well-defined black nodular components and white nodular components. The histology of black nodular components was P-HCC, while white nodule was conventional HCC with fat deposition. As small numbers of cases of P-HCC have been reported in literatures, clinicopathological features of P-HCC are little known. The accumulation of the reports of P-HCC is expected.
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  • A case of sepsis due to Edwardsiella tarda with alcoholic liver cirrhosis complicated by hepatocellular carcinoma and lung cancer
    Shiho Tokunaga, Tomohiko Tanino, Masahiko Koda, Tomomitu Matono, Takak ...
    Article type: Case Report
    2011 Volume 52 Issue 2 Pages 120-125
    Published: 2011
    Released on J-STAGE: March 22, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.120
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    A 76-year-old man was admitted to our hospital due to a liver tumor. After he undergoing a liver biopsy, he developed a fever with a shaking chill. He reported haven eaten sushi 2 days before and the day of the biopsy. Edwardsiella tarda was isolated from his blood culture, and cholecystitis was suspected by abdominal ultrasound and computed tomography. Percutaneous transhepatic gallbladder aspiration was performed with MEPM and γ-globulin administration. He recovered and was discharged on day 51. The patient was diagnosed with sepsis caused by Edwardsiella tarda after ingestion of sushi. Although Edwardsiella tarda is a rare human pathogen, it should be kept in mind that this infection is a life- threatening disese, especially in immunocompromised or cirrhotic patients.
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  • A case of hepatocellular carcinoma with hyperlipidemia
    Kazue Morishima, Masanobu Hyodo, Masaru Koizumi, Hidenori Sasanuma, Yo ...
    Article type: Case Report
    2011 Volume 52 Issue 2 Pages 126-130
    Published: 2011
    Released on J-STAGE: March 22, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.126
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    A 69-year-old man was admitted to the hospital with back pain. Computed tomography and magnetic resonance imaging of the abdomen revealed a large tumor in the right hepatic lobe suggesting hepatocellular carcinoma. Other small masses were detected in both hepatic lobes. His laboratory data showed elevated serum cholesterol and triglyceride levels at 855 mg/dl and 753 mg/dl respectively. Alpha-fetoprotein and PIVKA-II were 1.0 ng/ml and 2772 mAU/ml respectively. After resection of the main tumor, serum cholesterol and triglyceride levels improved to near normal levels. This suggests that the hypercholesterolemia was caused by hepatocellular carcinoma as a paraneoplastic syndrome.
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  • Transhepatic arterial chemoembolization induced pathological complete remission of advanced hepatocellular carcinoma with tumor thrombus in the left hepatic vein
    Akishige Kanazawa, Tadashi Tsukamoto, Sadatoshi Shimizu, Satoshi Yamam ...
    Article type: Case Report
    2011 Volume 52 Issue 2 Pages 131-138
    Published: 2011
    Released on J-STAGE: March 22, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.131
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    Cures for advanced hepatocellular carcinoma (HCC) with hepatic vein tumor thrombus (HVTT) are rare and difficult. We report a case of pathologically confirmed complete remission of HCC induced by transhepatic arterial chemoembolization (TACE). A 70-year-old male patient had a recurrent HCC in the lateral segment with tumor thrombus in the left hepatic vein. He was treated with TACE with Epilubicine, Lipiodol, and Gelpart. Eighteen days after TACE, he received a lateral segmentectomy, and histopathology revealed complete necrosis of all tumor cells. He was in good health at 10-month follow-up. These results suggest that TACE is one of the curative therapeutic modalities for treating advanced HCC with HVTT.
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  • A case of successfully treated advanced hepatocellular carcinoma with portal vein tumor thrombus and bile duct obstruction by multimodal therapy
    Takuya Shimizuguchi, Maki Shirai, Kiminori Kimura, Jun Imamura, Shunic ...
    Article type: Case Report
    2011 Volume 52 Issue 2 Pages 139-146
    Published: 2011
    Released on J-STAGE: March 22, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.139
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    A 61year-old male, consulted our hospital because of upper abdominal pain. On admission, laboratory blood examination indicated significant elevation in hepatic enzyme and bile system enzymes. By CT scan and ERCP, he was diagnosed as hepatocellular carcinoma with portal vein tumor thrombus and bile duct obstruction. Bile duct drainage was successfully performed using expandable metallic stents. Surgical resection, locoregional therapy, and TACE were contraindicated due to liver damage and portal vein tumor thrombus. Therefore, IFNα and 5-FU combined systemic chemotherapy was selected. After two courses of IFNα/5-FU therapy, the main tumor nodule became visible and the portal vein tumor thrombus decreased in size, making series of TACE and RFA possible. It has been well known that patients suffering from hepatocellular carcinoma with portal vein and bile duct tumor thrombus are poor prognosis. Long time survival may be expected by the combination of IFNα/5-FU systemic chemotherapy and multimodal therapy even in patients with advancer hepatocellular carcinoma.
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Short Communication
  • Effect of early antiviral agent therapy (NS3 and NS5A inhibitors) in chronic hepatitis C null responders
    Yoshiyuki Suzuki, Hitomi Sezaki, Norio Akuta, Fumitaka Suzuki, Hiroya ...
    Article type: Short Communication
    2011 Volume 52 Issue 2 Pages 147-149
    Published: 2011
    Released on J-STAGE: March 22, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.147
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    To further improve therapeutic effect on chronic hepatitis C, we have administered NS3 inhibitor and NS5A inhibitor together, and examined effects of early antiviral agent therapy. The subjects were five cases where interferon is ineffective (null responders). The NS5A and NS3 inhibitors are oral drugs and were daily administered for 24 weeks. Figure 1 shows time-dependent change of the number of viruses after the therapy started, and rapid decrease of viruses is recognized. Within 12 hours, HCV-RNA decreased by more than 2 log IU/ml in every patient. Two patients became negative for the virus by the 15th day after the therapy started. Furthermore, 80% of cases by the 28th day and all the cases by the 56th day became negative. The new therapy has manifested excellent early antiviral effect.
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Special Article
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