Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 53, Issue 7
Displaying 1-7 of 7 articles from this issue
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Original Article
  • Analysis of hepatic functional reserve in HIV/HCV co-infected patients
    Akihiko Soyama, Susumu Eguchi, Mitsuhisa Takatsuki, Masaaki Hidaka, Iz ...
    2012 Volume 53 Issue 7 Pages 403-408
    Published: 2012
    Released on J-STAGE: August 09, 2012
    DOIhttps://doi.org/10.2957/kanzo.53.403
    JOURNAL FREE ACCESS
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    Background: As survival of HIV-infected persons has improved due to widespread use of highly active antiretroviral therapy, mortality due to HCV-related liver disease has increased in HIV/HCV co-infected patients. Aim: To establish the appropriate therapeutic strategy for HIV/HCV co-infected patients, evaluation of liver function including hepatic functional reserve was conducted. Patients and Methods: In addition to liver function tests by blood examinations, hepatic functional reserve of the patients was evaluated by indocyanine green retention rate and liver asialo scintigraphy. Results: In spite of relatively maintained general liver function tests, approximately 40% of the patients with HIV/HCV co-infected patients had impaired hepatic functional reserve. Conclusion: This fact must be taken into account to establish therapeutic strategy with considering the appropriate timing of liver transplantation in HIV/HCV co-infected patients.
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Case Reports
  • Successfully treated severe alcoholic hepatitis in a young woman
    Yoshitaka Nawata, Kouichi Hamada, Satoshi Saitoh
    2012 Volume 53 Issue 7 Pages 409-416
    Published: 2012
    Released on J-STAGE: August 09, 2012
    DOIhttps://doi.org/10.2957/kanzo.53.409
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    A 24-year-old woman with a history of excessive alcohol intake since age 18 was admitted to our hospital with fever and jaundice in June 2011. On admission, laboratory data showed severe bilirubin, AST, ALP, γ-GTP elevations and PT decrease. Abdominal plain CT imaging revealed a significantly enlarged low-density liver. We diagnosed severe alcoholic hepatitis (SAH) based on criteria established by Takada et. al. Although the patient stopped drinking after admission, jaundice rapidly progressed. Subsequent bilirubin absorption therapy and corticosteroid administration showed successful decrease in bilirubin levels and other liver-related laboratory data. Liver density markedly ameliorated in abdominal plain CT taken on day 30, and liver biopsy on day 50 showed ballooning cell, Mallory body and pericellular fibrosis with mild inflammatory infiltrate, consistent with the recovery phase of severe alcoholic hepatitis. This is by far the youngest successfully treated SAH case ever reported in Japan.
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  • Spontaneous regression of multiple lung metastases of hepatocellular carcinoma: report of two cases
    Takeshi Senju, Akihide Masumoto, Toshimasa Koyanagi, Hirotaka Tajiri, ...
    2012 Volume 53 Issue 7 Pages 417-424
    Published: 2012
    Released on J-STAGE: August 09, 2012
    DOIhttps://doi.org/10.2957/kanzo.53.417
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    We describe two cases of hepatocellular carcinoma (HCC), lung metastases of which showed remarkable spontaneous regression. Case 1 is a 65-year-old man who had repeatedly received therapy of transcatheter arterial chemoembolization (TACE) for his HCC. Nineteen months after the diagnosis of HCC, multiple lung metastases appeared. Two months after the start of best supportive care without any anti-cancer treatment, metastatic lesions of the lung almost completely disappeared. Case 2 is a 78-year-old female. She had received repeated therapy of TACE for her recurrent HCC subsequently to a hepatectomy. Five years after the first development of HCC, multiple lung metastases were detected. After six months of palliative care instead of anti-cancer treatment, lung metastases revealed remarkable regression. Although the mechanism of the spontaneous regression is unclear, case 1 had quit smoking and drinking followed by repeated medication of NSAIDs, and case 2 had kept eating health foods, after the diagnosis of their lung metastases.
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Short Communications
  • Renal dysfunction with telaprevir in combination with peginterferon alfa-2b and ribavirin therapy
    Itaru Ozeki, Mutsuumi Kimura, Tomohiro Arakawa, Tomoaki Nakajima, Yasu ...
    2012 Volume 53 Issue 7 Pages 425-428
    Published: 2012
    Released on J-STAGE: August 09, 2012
    DOIhttps://doi.org/10.2957/kanzo.53.425
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    The purpose of this study is to investigate the effect of telaprevir based-regimen on the renal function of HCV patients. The telaprevir based-regimen caused a transient and reversible decrease in eGFR in patients (n=17) who were enrolled in a phase 3 trial in Japan. In addition, we examined the relationship between baseline characteristics and the renal function of patients (n=25) after marketting. Age was significantly related to the renal dysfunction. The present result indicates that the kidney function of aged patients including creatinine elevation is required to be careful monitored.
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  • A new scoring system for prognostic stratification in patients with alcoholic hepatitis in Japan
    Yoshinori Horie, Yoshiyuki Yamagishi, Hirotoshi Ebinuma, Toshifumi Hib ...
    2012 Volume 53 Issue 7 Pages 429-431
    Published: 2012
    Released on J-STAGE: August 09, 2012
    DOIhttps://doi.org/10.2957/kanzo.53.429
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    Using variables in some scoring systems for alcoholic hepatitis (AH), we generated a new scoring system (Japan Alcoholic Hepatitis Score: JAS). Its ability to predict outcome was compared with that of Glasgow alcoholic hepatitis score (GAHS) in the data of patients with severe AH during 2004-2009 in Japan. Fifty seven hospitals provided full demographic data on 141 patients with AH (Alive 90, Dead 51). JAS was more accurate than GAHS in predicting 100-day mortality (area under the receiver operating characteristic, 0.71 vs 0.61, respectively). Cut off value was 10. JAS allows the stratification of the risk of death in alcoholic hepatitis in Japan, and can help the management of patients with AH.
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Rapid Communications
  • Use of non-trocar technique for laparoscopic radiofrequency ablation
    Shinobu Tsuchida, Takumi Fukumoto, Tetsuo Ajiki, Nobuya Kusunoki, Masa ...
    2012 Volume 53 Issue 7 Pages 432-433
    Published: 2012
    Released on J-STAGE: August 09, 2012
    DOIhttps://doi.org/10.2957/kanzo.53.432
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    We have developed a novel insertion method, a non-trocar technique for laparoscopic radiofrequency ablation, whereby an ablation needle is accurately and easily punctured into the target tumor in the liver using the 13-mm echo probe, PVM-787LA (TOSHIBA, Tokyo). By exiting methods, an ablation needle must be inserted into the abdominal cavity through the puncture hole at a distance from the echo probe due to the existence of 15-mm trocar. Under these circumstances, it is difficult to attach and slide an ablation needle along the groove of the probe in the abdominal cavity because of the large longitudinal dissociation between the needle and the probe. In order to avoid this dissociation, the echo probe is inserted directly through the hole from which the 12-mm trocar was pulled out and an ablation needle is inserted directly into the abdominal cavity through the puncture hole very adjacent to the probe. Then, an ablation needle can be easily slid along the groove of the probe.
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  • Mechanism of renal dysfunction in the early phase of telaprevir therapy in combination with peginterferon-alfa2b and ribavirin
    Sadatsugu Sakane, Yuko Sakakibara, Toshiyuki Yoshio, Shoichi Nakazuru, ...
    2012 Volume 53 Issue 7 Pages 434-435
    Published: 2012
    Released on J-STAGE: August 09, 2012
    DOIhttps://doi.org/10.2957/kanzo.53.434
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    Seventeen patients with chronic hepatitis C undergoing telaprevir therapy showed a decrease in the estimated glomerular filtration rate (eGFR), which averaged 77.5 ml/min/1.73 m2 before treatment, by 14.6 ml/min/1.73 m2 on average at day 4. To distinguish between the two main causes of acute renal dysfunction, prerenal mechanism and acute tubular necrosis, we measured the sodium concentration in urine (UNa) and fractional excretion of sodium (FENa). The eGFR decrease showed a significant correlation with UNa and also with FENa. These findings indicate that the prerenal mechanism is responsible for the eGFR decline. As patients with an eGFR drop in the early phase of therapy may have an additional risk of adverse events, renal function should be closely monitored.
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