Kanzo

Original Articles

Experience of long-term low dose pegylated interferon therapy for chronic hepatitis C patients who cannot treat with standard of care therapy

Tsutomu Kawai

2012 Volume 53 Issue 11 Pages 699-706
Published: 2012
Released on J-STAGE: November 28, 2012

DOIhttps://doi.org/10.2957/kanzo.53.699

JOURNAL FREE ACCESS

Show abstractHide abstract

84 chronic hepatitis patients who could not started ribavirin combined therapy due to advanced age and the low value of blood cell counts or prior non responders, treated with pegylated interferon alfa-2a monotherapy, which performed more than two years observation were examined efficacy and safety retrospectively. The very low incidences of hepatocellular carcinoma were observed 0% in year 1, 1.6% in year 2, and 1.6% in year 3 in the patients without previously had a hepatocellular carcinoma. The median value of AFP and ALT was significantly decrease compared between pretreatment and week 96. The HCV-RNA negativity was observed in 31 patients (37%), and 2 log or more reduction were observed in 16 patients (19%). The median of platelets counts decreased in first four weeks, however the upward tendency was shown after 48 week. This treatment had the efficacy in HCV-RNA, ALT and AFP, it expected to inhibit the incidence of hepatocellar carcinoma.

View full abstract

Download PDF (663K)
Report of questionnaire survey about the rate of having hepatitis screening and the prevalence of hepatitis virus infection among the general population and the working population

Keiko Katayama, Junko Matsuo, Tomoyuki Akita, Ayako Tabuchi, Akito Sak ...

2012 Volume 53 Issue 11 Pages 707-720
Published: 2012
Released on J-STAGE: November 28, 2012

DOIhttps://doi.org/10.2957/kanzo.53.707

JOURNAL FREE ACCESS

Show abstractHide abstract

We conducted this research for two purposes in 2008. Firstly, we survey awareness of hepatitis screening among general population and the occupational field. The summary of a questionnaire showed that there are a poor awareness about hepatitis screening and a subsidy for IFN therapy. Secondly, we surveyed prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) among occupational field as the pilot study. The results of serological examinations indicated that prevalence of HBV among the occupational field was higher than the general population. Based on the results of the survey, we perceived a need of a well-targeted publicity campaign of importance of hepatitis screening.

View full abstract

Download PDF (1861K)
The safety and the efficacy of radiofrequency ablation (RFA) guided by contrast-enhanced sonography with Perflubutane microbubbles for hepatic lesion in clinical practice

Akiko Hayakawa, Kenji Abe, Masatoshi Tanigawa, Megumi Takahashi, Yasuh ...

2012 Volume 53 Issue 11 Pages 721-733
Published: 2012
Released on J-STAGE: November 28, 2012

DOIhttps://doi.org/10.2957/kanzo.53.721

JOURNAL FREE ACCESS

Show abstractHide abstract

To investigate the safety and the efficacy of RFA guided by contrast-enhanced ultrasound (CEUS) with perflubutane, we conducted a post-marketing surveillance on the subjects undergoing RFA on hepatic lesions with (SZ group) or without (C group) CEUS guide. We collected CRFs from 328 subjects as SZ group and 340 subjects as C group, and adverse events (AE) were reported 67.1%, 69.3% respectively. Nausea and vomiting were reported as adverse reactions from a subject in SZ group. There were no difference between two groups on the incidence and variety of AEs. Overall efficacy as RFA guide was 90.9%, visual improvement of lesions was 75.0%. Moreover, RFA success rate in the lesions of which visual confirmation of lesion in B mode were insufficient was significantly higher in SZ group. Perflubutane could be used as CEUS guide for RFA safely, and it was demonstrated that visual improvement by CEUS improves RFA success rate.

View full abstract

Download PDF (518K)
The biliary drainage for patients with obstructive jaundice due to hepatocellular carcinoma

Yoshimoto Nomura, Takashi Kagaya, Teruyuki Ueda, Hajime Sunagozaka, Ha ...

2012 Volume 53 Issue 11 Pages 734-740
Published: 2012
Released on J-STAGE: November 28, 2012

DOIhttps://doi.org/10.2957/kanzo.53.734

JOURNAL FREE ACCESS

Show abstractHide abstract

Obstructive jaundice due to HCC often occurred when tumor was reached highly advanced stage. And HCC is sometimes prone to bleed, so it is very difficult to treat these HCC comparing with other malignant obstructive jaundice. We retrospectively investigated the significance of biliary drainage. In 12 patients, 8 cases (66.7%) were successfully drainaged by endoscopically with no severe complication. Survival period after first drainage was relatively short (1.6 months), but after drainage, 10 cases (83.3%) could be treated by chemotherapy. And if the chemotherapy was effective, survival period was extended significantly (P<0.01). Therefore, we recommend that the biliary drainage should be performed.

View full abstract

Download PDF (619K)

Case Reports

Stevens-Johnson syndrome induced by sorafenib for therapy of HCC: A case report

Teppei Yoshioka, Yukinori Yamada, Hironao Sueyoshi, Shunsuke Yoshii, S ...

2012 Volume 53 Issue 11 Pages 741-747
Published: 2012
Released on J-STAGE: November 28, 2012

DOIhttps://doi.org/10.2957/kanzo.53.741

JOURNAL FREE ACCESS

Show abstractHide abstract

A 74-year-old Japanese male, suffering from stage IVA hepatocellular carcinoma (HCC) with subcarinal lymph node metastasis, was hospitalized for the sorafenib therapy. His hepatic reserve function was assessed as Child-Pugh score 5 and Liver damage grade A. Sorafenib was administered by 800 mg per day. On day 14, just after the development of fever, because erythematous lesions appeared in his trunk, the administration of sorafenib was immediately withdrawn under suspicion for erythema multiforme. However, on day 16, erythema expanded over his limbs and multiple erosions appeared in oral mucosa. Consequently, he was diagnosed as Stevens-Johnson syndrome and treated with prednisolone (20 mg/day). On day 31, his skin lesions disappeared and the fever went down, so prednisolone was withdrawn. When skin lesions are noticed during the sorafenib treatment, we should pay attention to Stevens-Johnson syndrome which is rare but serious, in addition to hand-foot skin reaction which is common for sorafenib.

View full abstract

Download PDF (1055K)
A severe drug induced hepatitis caused by a dietary supplement "Nin-niku Ran-oh" made from garlic and egg yolk

Kinya Okamoto, Ken-ichi Miyoshi, Manabu Kishina, Yuki Fujise, Jyun Kat ...

2012 Volume 53 Issue 11 Pages 748-753
Published: 2012
Released on J-STAGE: November 28, 2012

DOIhttps://doi.org/10.2957/kanzo.53.748

JOURNAL FREE ACCESS

Show abstractHide abstract

Dietary supplements are easily available and increasingly used, and adverse hepatic reactions have been reported following their intake.
A 60 years old woman who took some dietary supplements developed appetite loss, general fatigue, jaundice and subcutaneous hemorrhage together with a > 40-fold increase of transaminase levels and prothrombin time elongation. There were no evidence of viral hepatitis, autoimmune, metabolic or alcohol-related liver disorders. Drug-induced lymphocyte stimulation test was positive to the dietary supplement "Nin-niku Ran-oh", which is made from garlic and egg yolk. DDW-J 2004 drug-induced liver injury score was 10 and diagnosed as highly probable. Seven weeks after discontinuation of the supplements, the liver functions recovered to normal.

View full abstract

Download PDF (569K)
Two cases with imported hepatitis A who were presumed to have contracted the disease while visiting Indonesia based on molecular analysis of hepatitis A virus strains

Tatsuro Kobata, Ryoji Tatsumi, Takahiro Takemoto, Toshiki Tanaka, Kuni ...

2012 Volume 53 Issue 11 Pages 754-762
Published: 2012
Released on J-STAGE: November 28, 2012

DOIhttps://doi.org/10.2957/kanzo.53.754

JOURNAL FREE ACCESS

Show abstractHide abstract

Patient 1 (30-year-old man) first visited our facility in January 2012 with chief complaints of fever, vomiting, and diarrhea, and was diagnosed with acute hepatitis A (aspartate aminotransferase [AST]/alanine aminotransferase [ALT] levels, 1141/1980 IU/L; total bilirubin [T-Bil] level, 7.55 mg/dL; and IgM hepatitis A virus [IgM-HAV] antibody-positive). He had a history of visiting Southeast Asian countries including Indonesia. Patient 2 (38-year-old man) had high fever and chills in May 2012 while traveling in Indonesia. He visited a local hospital where the symptoms remained unidentified. After returning to Japan, he was diagnosed with acute hepatitis A (AST/ALT levels, 835/1780 IU/L; T-Bil level, 2.2 mg/dL; and IgM-HAV antibody-positive). HAV RNA was detectable in the serum samples of both patients, and the implicated HAV strains shared 99.3% identities within the 481-nucleotide VP1-2B sequence. Phylogenetic analysis of HAV suggested infection during stay in Indonesia. Thus, HAV vaccination is highly recommended before visiting HAV-endemic countries/districts.

View full abstract

Download PDF (754K)
Hepatocellular carcinoma in a chronic hepatitis C patient 15 years after achieving a sustained virological response

Emiri Watanabe, Yohei Koizumi, Masashi Hirooka, Hironori Ochi, Fujimas ...

2012 Volume 53 Issue 11 Pages 763-768
Published: 2012
Released on J-STAGE: November 28, 2012

DOIhttps://doi.org/10.2957/kanzo.53.763

JOURNAL FREE ACCESS

Show abstractHide abstract

An 84-year-old female with chronic hepatitis C (HCV) was treated with interferon (IFN) and achieved sustained virological response (SVR) 15 years ago. She was then followed-up by blood tests with tumor markers and ultrasound (US) examinations every 6 months. Fifteen years later, a hepatocellular carcinoma (HCC) tumor was detected as a 21-mm-diameter nodule. Hepatic resection was performed, and the pathological diagnosis was moderately differentiated HCC, trabecular type. Regular, long-term follow-up that includes screening with blood tests and imaging is needed for patients with HCV, even those who achieve SVR after IFN treatment.

View full abstract

Download PDF (668K)
A Case of Hepatocellular Carcinoma with Sarcomatous Change Showing Rapid Recurrence in Pleural Dissemination after Hepatectomy

Jun Kadono, Naoki Ishizaki, Chiaki Taki, Toru Nandate, Yutaka Imoto, S ...

2012 Volume 53 Issue 11 Pages 769-778
Published: 2012
Released on J-STAGE: November 28, 2012

DOIhttps://doi.org/10.2957/kanzo.53.769

JOURNAL FREE ACCESS

Show abstractHide abstract

We report a case of hepatocellular carcinoma with sarcomatous change that rapidly recurred in pleural dissemination after hepatectomy. A 61-year-old man was diagnosed as having a hepatic mass. Hepatocellular carcinoma accompanied by multiple intrahepatic metastases was diagnosed based on computed tomography and magnetic resonance imaging. Extended right hepatic lobectomy under thoracolaparotomy was performed after portal vein embolization. Forty days after hepatectomy, the patient was complicated with massive pleural effusion. Thoracoscopy showed diffuse irregular thickened pleura, in which, spindle cells positive for Vimentin, Keratin and EMA were demonstrated. Same type spindle cells were recognized around hepatocellular carcinoma in the liver. Final diagnosis of hepatocellular carcinoma with sarcomatous change was made. The patient died 56 days after hepatectomy. Close follow-up is needed in cases of hepatocellular carcioma with sarcomatous change, because the carcinoma has a strong potential for recurrence such as dissemination.

View full abstract

Download PDF (1299K)

Rapid Communication

Expression of OATP1B3 protein in subtypes of hepatocellular adenoma

Yurie Soejima, Fukuo Kondo, Masafumi Inoue, Yoshihisa Takahashi, Keiji ...

2012 Volume 53 Issue 11 Pages 779-780
Published: 2012
Released on J-STAGE: November 28, 2012

DOIhttps://doi.org/10.2957/kanzo.53.779

JOURNAL FREE ACCESS

Show abstractHide abstract

Thirty-five nodules of hepatocellular adenomas (HCA) were immunohistochemically classified into four subgroups of HNF1α inactivated HCA (H-HCA) (11 cases, 31%), β-catenin activated HCA (b-HCA) (7 cases, 20%), inflammatory HCA (I-HCA) (10 cases, 29%), and unclassified HCA (u-HCA) (7 cases, 20%). Decreased expression of OATP1B3 protein was shown in most cases of H-HCA, I-HCA, and u-HCA but not in all cases of b-HCA and nuclear beta-catenin positive cases. These results indicated the close association between OATP1B3 immunostain and nuclear beta-catenin accumulation in HCA and suggested a characteristic image on Gd-EOB-MRI for nuclear beta-catenin positive HCA cases as well as a risk of development of hepatocellular carcinoma.

View full abstract

Download PDF (138K)

Short Communication

Efficacy of COX-2 inhibitor, Meloxicam, for recurrent hepatocellular carcinoma after curative treatment

Tomoki Ryu, Yuko Takami, Masaki Tateishi, Yoshiyuki Wada, Hideki Saits ...

2012 Volume 53 Issue 11 Pages 781-783
Published: 2012
Released on J-STAGE: November 28, 2012

DOIhttps://doi.org/10.2957/kanzo.53.781

JOURNAL FREE ACCESS

Show abstractHide abstract

Hepatocellular carcinoma (HCC) has a high rate of recurrence even after the curative treatment. Recently, it is suggested COX-2 inhibitor may offer a chemoprepentive approach for HCC. We have treated 236 patients with meloxicam for recurrent HCC after curative treatment. We evaluated the effects of meloxicam according to mRECIST six months after taking meloxicam of 114 cases received their curative surgery for HCC in our institute since January 2004. Of these 114 cases, tumor control rate was 40.4%, and overall survival rates at 3-, and 5-years were 88.7% and 63.3% in the PD group, whereas 95.4% and 86.8% respectively, in the CR/PR/SD groups (P=0.0603). Taking COX-2 inhibitor for recurrent HCC may prolong the time to progression and give the better prognosis.

View full abstract

Download PDF (195K)

Register with J-STAGE for free!