Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 55, Issue 12
Displaying 1-7 of 7 articles from this issue
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Case Reports
  • A case of giant hepatocellular adenoma with intratumoral hemorrhage
    Keiichi Hatamaru, Ryuichi Kita, Akihiro Nasu, Hiroki Nishikawa, Toru K ...
    2014 Volume 55 Issue 12 Pages 731-739
    Published: December 20, 2014
    Released on J-STAGE: January 07, 2015
    DOIhttps://doi.org/10.2957/kanzo.55.731
    JOURNAL FREE ACCESS
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    A 24-year-old woman had a giant tumor located in the lateral segment of the liver. Computed tomography (CT), magnetic resonance imaging (MRI) and ultrasonography (US) showed a 10 cm mass with intratumoral hemorrhage. Because of abdominal pain and intratumoral hemorrhage, hepatectomy of left lobe was carried out. Histopathologically, the tumor showed mild atypical hepatocytes with severe steatosis and had no apparent portal tract within it. The tumor was finally diagnosed as hepatocellular adenoma, and classified in HNF1α-inactivated type by immunohistochemical analysis. Immunohistochemistry was useful for determining postoperative management. Hepatocellular adenoma is a rare benign tumor in Japan, so we report it with a review of the literature.
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  • A case of hepatocellular carcinoma with bone scintigraphy negative disseminated bone marrow metastasis diagnosed by bone marrow aspiration
    Kazuhiko Koike, Mariko Itsubo, Hisao Tajiri
    2014 Volume 55 Issue 12 Pages 740-748
    Published: December 20, 2014
    Released on J-STAGE: January 07, 2015
    DOIhttps://doi.org/10.2957/kanzo.55.740
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    A 62-year-old man, who had been treated hepatocellular carcinoma over 5 years in our hospital, admitted for several symptoms including fatigue and anorexia. Tumors had been controlled by repeated transcatheter arterial chemoembolization until a few months before detection of extrahepatic metastases including lymph nodes and vertebras. While on admission, palpebral purpura, depression of platelets, elevation of fibrin degradation product, and appearance of blast cells into the peripheral blood were seen. Regardless of no abdominal uptake in bone scintigraphy, multiple lesions with abnormal intensity in many vertebras on magnetic resonance imaging were seen. Under the suspicious of disseminated bone marrow metastasis, bone marrow aspiration was performed, and infiltration of many tumor cells was detected. He died at the deterioration of the general condition 3 days after diagnosis. We might be imaged to complicate disseminated bone marrow metastasis in the patient with metastatic bone tumor.
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  • A case of liver failure due to Wilson's disease who had psychiatric symptoms of " Hikikomori", i.e., social withdrawal
    Hiroka Yamago, Kojiro Michitaka, Akiko Shiraishi, Toshihiko Aibiki, To ...
    2014 Volume 55 Issue 12 Pages 749-755
    Published: December 20, 2014
    Released on J-STAGE: January 07, 2015
    DOIhttps://doi.org/10.2957/kanzo.55.749
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    A 20-year-old man consulted a local doctor due to edema and dyspnea. He was referred to our hospital because he had jaundice and pleural effusion. He had psychiatric symptoms of " Hikikomori", i.e., social withdrawal, and had stayed indoors for 3 years. He was diagnosed with liver failure due to Wilson's disease by blood test, urine cupper, and Kayser-Fleischer ring. Conservative treatments were not effective enough, and he was rescued by liver transplantation. Wilson's disease is known to cause various neuropsychiatric symptoms, and his " Hikikomori" symptoms may be caused by Wilson's disease. We report a case of liver failure due to Wilson's disease who had symptoms of social withdrawal.
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  • Mesenchymal hamartoma of the liver: Report of a case and review of the literature
    Takanori Hiraide, Takanori Sakaguchi, Ryota Kiuchi, Makoto Takeda, Yas ...
    2014 Volume 55 Issue 12 Pages 756-763
    Published: December 20, 2014
    Released on J-STAGE: January 07, 2015
    DOIhttps://doi.org/10.2957/kanzo.55.756
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    Mesenchymal hamartoma of the liver (MHL) is an uncommon benign hepatic tumor typically affecting children under 2 years of age. We report a case of a teenage woman was admitted to our hospital due to an upper abdominal pain. Laboratory examination including alpha-fetoprotein was unremarkable. Abdominal CT showed a giant solid tumor with fluid components with a maximum dimension of 15 cm in the right lobe of the liver. We performed core needle biopsy. Under diagnosis of MHL, right hepatectomy was performed in consideration of malignant transformation. The final pathological diagnosis was MHL. MHL has traditionally been regarded as a benign tumor without malignant potential, however, several reports have highlighted an association between MHL and undifferentiated embryonal sarcoma (UES). Especially, risk of malignancy in teens was higher than other ages. We should consider a risk of malignancy in such kind of tumor.
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Short Communications
  • Interferon-β therapy for five chronic hepatitis C patients with mental disorder
    Hidetaka Shibata, Moto Kitayama, Yasuhiro Kamo, Takuya Honda, Satoshi ...
    2014 Volume 55 Issue 12 Pages 764-766
    Published: December 20, 2014
    Released on J-STAGE: January 07, 2015
    DOIhttps://doi.org/10.2957/kanzo.55.764
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    We report of interferon-β (IFN-β) therapy with or without ribavirin in five patients with chronic hepatitis and mental disorder. Two of three patients diagnosed with depression and one of two patients diagnosed with chronic schizophrenic psychosis had developed a viral response after IFN-β therapy. Symptoms of depression or psychosis are well-known side effects of IFN-α therapy. Therefore, patients with mental disorders are often hesitant toward receiving interferon therapy. Direct acting antivirals (DAAs) will probably become mainstream therapy for IFN-α intolerant patients in the near future. However, the risk of developing mutations related to drug resistance should not be neglected. Therefore, experience with IFN-β therapy used as an alternative to DAAs is required.
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  • The hepatocellular carcinoma epidemiological study in Ibaraki Prefecture
    Naoki Sano, Takafumi Tamura, Kiyoshi Fukunaga, Keisuke Kohno, Kazumasa ...
    2014 Volume 55 Issue 12 Pages 767-770
    Published: December 20, 2014
    Released on J-STAGE: January 07, 2015
    DOIhttps://doi.org/10.2957/kanzo.55.767
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    Death coursed by liver cancer in Ibaraki Prefecture have been more than seven hundred people a year, and the fourth most common as malignant neoplasm. There have been no reports investigating the clinical status of liver cancer at the prefectural level in Ibaraki Prefecture. In order to understand the status of hepatocellular carcinoma in Ibaraki Prefecture, we underwent a hospital-based hepatocellular carcinoma surveillance. Actual status of treatment and its result of hepatocellular carcinoma was revealed. We are going to continue this investigation in the future.
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Rapid Communication
  • Superiority of a new shear wave elastography in evaluation of liver fibrosis
    Hiroko Iijima, Masahiro Yoshida, Mariko Hashimoto, Chikage Nakano, Tom ...
    2014 Volume 55 Issue 12 Pages 771-773
    Published: December 20, 2014
    Released on J-STAGE: January 07, 2015
    DOIhttps://doi.org/10.2957/kanzo.55.771
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    Shear wave with Smart maps (SwSm) installed on Aplio500 developed by Toshiba Medical Systems Corp. allows us to estimate elasticity and visualize shear wave propagation by displaying contour lines of the shear wave arrival time. The usefulness of this device was compared with that of ACUSON (VTQ), Aixplorer (SWE), FibroScan (TE). Fifty-one patients who received liver biopsy, or diagnosed clinically as liver cirrhosis were studied. Correlation between the devices was evaluated in 142 patients who were assessed fibrosis by more than two devices. ROC analysis showed 0.950/0.943/0.913/0.923 in SwSm/VTQ/SWE/TE, respectively. Correlations between the devices were 0.853/0.956/0.885, in SwSm vs VTQ, SwSm vs SWE, SwSm vs TE, respectively. SwSm was superior to the other devices studied here in a non-invasive assessment of liver fibrosis. Moreover, Toshiba SwSm assures a reliable assessment by visualizing propagation of the shear waves.
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