Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 52, Issue 9
Displaying 1-5 of 5 articles from this issue
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Original Articles
  • Epidemiological survey of hepatitis E virus infection in Kushiro and Nemuro cities in eastern Hokkaido: relationship between regional difference of HEV prevalence and distinct food cultures
    Toshio Tanabe, Hitoshi Mizuo, Yasuyuki Yazaki, Masaharu Takahashi, Hir ...
    Article type: Original Article
    2011 Volume 52 Issue 9 Pages 567-574
    Published: 2011
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.567
    JOURNAL FREE ACCESS
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    To investigate the regional difference in hepatitis E virus (HEV) infection in Hokkaido where hepatitis E is most prevalent in Japan, serum samples collected from 721 inhabitants in Kushiro and 687 inhabitants in Nemuro were tested for the presence of anti-HEV IgG, and the results were compared with those reported from Kitami and Sapporo where hepatitis E occurs frequently. Anti-HEV IgG was detected at 5.4% in Kushiro, while it was only at 2.0% in Nemuro, being significantly higher in males in both cities. When inhabitants aged ≥40 years were compared, anti-HEV IgG was significantly less frequent in Nemuro (2.1%) than in the other three cities (Kitami, Kushiro, Sapporo) with the comparable positive rate of 12.1%, 7.9%, and 6.4%, respectively. It was hypothesized that different HEV prevalence rate may be associated with amounts of consumption of pig meat and viscera on the background of distinct local industries and food cultures.
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  • Double filtration plasmapheresis and peginterferon plus ribavirin combination therapy for chronic hepatitis C patients with genotype 1b and high viral load not cured by previous interferon therapy
    Noboru Hirashima, Hiroaki Iwase, Tomoyuki Tsuzuki, Asako Kamiya, Misak ...
    Article type: Original Article
    2011 Volume 52 Issue 9 Pages 575-583
    Published: 2011
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.575
    JOURNAL FREE ACCESS
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    Twelve chronic hepatitis C patients (six men and six women; average age 60.3 years) with genotype 1b and high viral load who were not cured by previous interferon (IFN) therapy received double filtration plasmapheresis (DFPP) and peginterferon plus ribavirin (PEG IFN·Rib) combination therapy. In the previous IFN therapy, there were three non-responders (NR) to IFN monotherapy, two NRs to IFNα2b·Rib, two relapsers (Rel) and five NRs to PEG IFNα2b·Rib. Viral load reduction by DFPP was 1.8±1.2 (range: 0.1-4.8) log IU/ml. The mutations of the interferon sensitivity determining region (ISDR) and HCV core amino acid (aa) did not affect the viral load reduction by DFPP. The viral load reduction rate of NRs to a previous IFN monotherapy was significantly higher than that of the patients who previously received Rib combination therapy (p<0.05). Three (100%) of the patients who previously received IFN monotherapy showed a sustained viral response (SVR). The patients who previously received IFNα2b·Rib did not become HCV RNA-negative. Among the patients who previously received PEG IFNα2b·Rib, two Rels showed SVR but five NRs did not showed SVR. Two Rels became HCV RNA-negative after the present treatment at an earlier stage than the previous PEG IFNα2b·Rib. Finally, five of all the patients (41.7%) and two of 9 (22.2%) who previously received Rib combination therapy showed SVR. The rates of patients showing SVR in the cases of ISDR mutation≥2, ISDR mutation of 0 or 1 and either a core aa70 or aa91 mutant, ISDR mutation of 0 or 1 and both a core aa70 and aa91 mutant were 2/2 (100%), 2/6 (33%) and 1/4 (25%), respectively. The indication of DFPP+PEG IFN·Rib for the retreatment of chronic hepatitis C of genotype 1 and a high viral load was suggested for NRs to a previous IFN monotherapy or Rels to a previous PEG IFN·Rib.
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  • Prolonged treatment with ursodeoxycholic acid of patients with primary biliary cirrhosis and their clinical course -Study Group for Urso-PBC Special Survey-
    Gotaro Toda, Hiromi Ishibashi, Saburo Onishi, Takeshi Okanoue, Morikaz ...
    Article type: Original Article
    2011 Volume 52 Issue 9 Pages 584-601
    Published: 2011
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.584
    JOURNAL FREE ACCESS
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    The safety and efficacy of treatment with ursodeoxycholic acid (UDCA) of the patients with primary biliary cirrhosis (PBC) were investigated by following 1462 and 1327 patients, respectively, for 3 to 5 years after the start of treatment. No serious adverse events related to UDCA treatment occurred in the patients investigated and the start of treatment induced the significant fall of serum alkaline phosphatase (Al-P), γGTP, AST, ALT and total bilirubin concentration (T-Bil), which was sustained throughout the investigation period, indicating that the prolonged UDCA treatment was safe and effective in the improvement of liver function tests. In the final visit, however, little or no improvement of Al-P, γGTP, AST, ALT and T-Bil was noticed in some of the patients treated. The stratification of the patients according to the daily dose of UDCA revealed that, in each of the liver function tests, the frequency of those who showed little or no improvement decreased with the increase in the dose, suggesting that the increase in the dose improved the liver function tests in these patients. Twenty three patients died of liver-related causes or received liver transplantation. Multivariate Cox regression analysis indicated that the base line T-Bil greater than 1.2 mg/dl, advanced histological stage and decrease less than 30% of base line level in T-Bil or AST at 6 months after the start of treatment were the predictors for liver-related death or liver transplantation. The response of T-Bil or AST to UDCA treatment is useful to identify the patients who need additional treatment for improvement of prognosis.
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Case Reports
  • A case of de novo hepatitis B developed after 24 months later from autologous peripheral blood cell transplantation
    Katsumasa Kobayashi, Toshiro Kamoshida, Motoko Ono, Yumiko Ota, Atsush ...
    Article type: Case Report
    2011 Volume 52 Issue 9 Pages 602-606
    Published: 2011
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.602
    JOURNAL FREE ACCESS
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    A 60-year-old man received high dose chemotherapy twice including autologous peripheral blood stem cell transplantation for multiple myeloma, and complete remission was sustained. Severe hepatic injury revealed after 24 months later from last treatment. We didn't recognized initially, our examination of conserved serum revealed he was already infected hepatitis B. So we diagnosed that he suffered de novo hepatitis B, and administered entecavir immediately. Generally de novo hepatitis B was easily shifted to fulminant hepatitis and mortality rate was very high. We recommended careful and long-term observation after autologous peripheral blood stem cell transplantation.
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  • An autopsy case with renal cell carcinoma that presented with rapid progression of liver metastasis without lung metastasis
    Hiroteru Kamimura, Toru Ishikawa, Kazuo Higuchi, Michitaka Imai, Kouji ...
    Article type: Case Report
    2011 Volume 52 Issue 9 Pages 607-616
    Published: 2011
    Released on J-STAGE: September 29, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.607
    JOURNAL FREE ACCESS
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    A 68-year-old man was admitted to our hospital with abdominal distension, anorexia and general malaise. Enhanced computed tomography showed a low-density area in segment 8 of the liver and the lower part of the left kidney. Magnetic resonance imaging showed multiple nodules spread throughout the liver. Histological findings of a liver tumor taken by transjugular liver biopsy were diagnosed as hepatocellular carcinoma or metastasis of renal cell carcinoma. However, differential diagnosis was difficult. Despite treatment with transarterial injection chemotherapy, he died 22 days after admission. According to autopsy findings, the liver tumors were diagnosed as multiple metastases from renal cell carcinoma showing sarcomatous changes. No metastatic lung tumors were found other than intrapulmonary lymph node metastasis. The present case suggests the need for recognition that renal cell carcinoma with liver metastasis may show rapid progression without lung metastasis.
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