Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
Volume 55, Issue 5
Displaying 1-8 of 8 articles from this issue
Case Reports
  • Haruka Yoshida, Katsuaki Ukai, Nobukazu Tanabe, Yutaka Mano, Keiichi T ...
    2014 Volume 55 Issue 5 Pages 245-253
    Published: May 20, 2014
    Released on J-STAGE: May 30, 2014
    JOURNAL FREE ACCESS
    A 62-year-old man, who had experienced temporary relief for approximately 2 weeks from the symptoms of fever, fatigue and abdominal distension after treatment with oral antibiotics and anti-inflammatory medication at a nearby hospital, was referred to our hospital for recurrence of symptoms that did not respond to conservative therapies. Upon admission, he was diagnosed with severe liver dysfunction. Contrast-enhanced computed tomography and angiography indicated occlusion of the hepatic venules. Transvenous liver biopsy specimens revealed the presence of hepatic veno-occlusive disease (HVOD) features. His liver function worsened rapidly thereafter and he died of ruptured esophageal varices after one and a half months of hospitalization. Hence, HVOD should be considered as a possible diagnosis in patients with ascites, jaundice, and painful hepatomegaly even in the absence of a history of stem cell transplant, chemotherapy, or radiation factors commonly associated with HVOD.
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  • Toshifumi Mori, Sayo Matsumoto, Yoshitaka Imoto, Hirohiko Shinomiya, S ...
    2014 Volume 55 Issue 5 Pages 254-258
    Published: May 20, 2014
    Released on J-STAGE: May 30, 2014
    JOURNAL FREE ACCESS
    Human infection with the parasite Schistosoma japonicum is currently known to be endemic in China and South-east Asia, and infection with this parasite is rarely seen in Japan. However, we sometimes encounter unexpected and uncommon diseases as imported infectious diseases. We describe a rare case of Schistosomasis japonicum imported from a country in South-east Asia, presented with a complaint of dyspnea. The computed tomography and ultrasonography showed characteristic abnormality in the liver and serum antibody improved after administration of Praziquantel.
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  • Keita Ogake, Hiroya Iida, Tsukasa Aihara, Shinichi Ikuta, Hidehiko Wak ...
    2014 Volume 55 Issue 5 Pages 259-266
    Published: May 20, 2014
    Released on J-STAGE: May 30, 2014
    JOURNAL FREE ACCESS
    The patient was male and was in his 50s. He underwent radiofrequency ablation (RFA) for two hepatocellular carcinomas (HCC). Until 12 minutes after the beginning of the procedure, tissue impedance (IMP) did not increase and there was no bubble-appearance on the ultrasound. After that, a third-degree skin burn occurred around the needle-insertion point. We checked the needle that was removed from the patient. There was an exposed point from which the insulating coating around the ablation needle had peeled away. This point was in contact with the skin during the procedure and this was obviously the cause of the skin burn. Monitoring of tissue IMP was performed during ablation, and it showed an abnormal pattern. At 6 minutes after beginning of the procedure, the IMP decreased suddenly and it plateaued out. In conclusion, monitoring of the IMP wave is useful to detect damage of the insulating coating and to prevent skin burn during RFA.
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  • Hajime Ishii, Kunio Nakane, Satoko Tsuda, Tatsuya Yoshida, Hideo Ohno, ...
    2014 Volume 55 Issue 5 Pages 267-273
    Published: May 20, 2014
    Released on J-STAGE: May 30, 2014
    JOURNAL FREE ACCESS
    A 71-year-old man was told he had liver dysfunction at a screening in May 2010. He was diagnosed with acute hepatitis B and admitted to a local hospital. His hepatitis improved and he was discharged in July. However, he subsequently developed refractory pleural effusion. He was admitted to Akita City Hospital in the end of September. Tuberculous pleuritis was diagnosed based on a positive culture test and polymerase chain reaction test of the pleural effusion. After treatment with antituberculous drugs, the pleural effusion improved. As for the mechanism of onset of the tuberculous pleuritis, endogenous revival of tuberculosis with decreased immunocompetence associated with aging was suspected, and the possibility of involvement of acute hepatitis B could not be ruled out. We herein report a case of tuberculous pleuritis that occurred after acute hepatitis B.
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  • Yuka Takagawa, Naoto Kawabe, Senju Hashimoto, Masao Harata, Michihito ...
    2014 Volume 55 Issue 5 Pages 274-283
    Published: May 20, 2014
    Released on J-STAGE: May 30, 2014
    JOURNAL FREE ACCESS
    We report a case of a 70-year-old woman with multiple hepatic tumors. She was a type C cirrhosis patient. Abdominal US showed hypoechoic nodules with unclear boundary. Contrast-enhanced US with Sonazoid showed the same sites enhanced in the vascular phase, and showed contrast defect in the postvascular phase. Plain CT showed low density tumors with unclear boundary. In dynamic CT, arterial phase showed the tumors enhanced faintly, and portal-venous phase showed low density tumors compared with surrounding liver. Gd-EOB-MRI showed multiple tumors which were enhanced in arterial phase, and showed low intensity in hepatocyte phase. Portal vein was observed in the S3 tumor. PET-CT showed multiple abnormal accumulation in the liver, mediastinal lymph node, and hilar lymph node. We underwent a liver tumor biopsy because the tumors were atypical as HCC, and showed an elevation of IL-2R. Biopsy histology showed the finding of MALT lymphoma. Thus we underwent chemotherapy. This case is a valuable case because multiple lesions of hepatic MALT lymphoma with type C cirrhosis is rare, and chemotherapy has become possible after diagnosis by tumor biopsy.
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Short Communications
  • Atsushi Ohyama, Kazuya Kariyama, Kazuhiro Nouso, Ayano Oonishi, Akiko ...
    2014 Volume 55 Issue 5 Pages 284-286
    Published: May 20, 2014
    Released on J-STAGE: May 30, 2014
    JOURNAL FREE ACCESS
    Many nonB-nonC HCCs were found at an advanced stage because of the difficulties of surveillance. We examined the correlation between the follow-up status of 67 nonB-nonC HCCs and their clinical features. HCCs were found earlier when the patients were followed up at outpatients of Board Certified Hepatologist than in cases without regular check up by doctors or in cases followed up by uncertified physicians. We speculated that regular surveillance of HCC was necessary when the patients had the risk of HCC (NASH, alcoholic liver diseases et al.) regardless of their main diseases to achieve the early detection and to improve the prognosis of the patients with nonB-nonC HCC.
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  • Haruyuki Nakazawa, Mami Shimazaki, Hiroki Kobayashi, Yurie Uchiyama, S ...
    2014 Volume 55 Issue 5 Pages 287-289
    Published: May 20, 2014
    Released on J-STAGE: May 30, 2014
    JOURNAL FREE ACCESS
    To investigate the regional difference in hepatitis E virus (HEV) infection in Nagano Prefecture, we tested a total of 260 blood donors that were collected in 2006 and 2011 (Northern region: 56, Eastern region: 55, Central region: 52, Southern region: 97) for the presence of anti-HEV IgG. Anti-HEV IgG was detected at 16.2%in Nagano Prefecture, being significantly higher in males. In 2006 anti-HEV IgG was higher in Southern region (31.9%) than in the other three regions (Northern, Central and Eastern region). However, other than the northern region was positive rate at the same level in 2011. Since there is a possibility that the actual eating habits and infection status of the region has changed during five years, it is necessary to conduct monitoring in the future.
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Rapid Communication
  • Katsutoshi Sugimoto, Fuminori Moriyasu, Mayumi Ando, Takatomo Sano, Yu ...
    2014 Volume 55 Issue 5 Pages 290-292
    Published: May 20, 2014
    Released on J-STAGE: May 30, 2014
    JOURNAL FREE ACCESS
    We report a woman in her late 60s with hepatocellular carcinoma in whom the tumor was successfully treated by irreversible electroporation (IRE). Vascular-phase contrast-enhanced US (CEUS) with Sonazoid and dynamic CT at 1 day after treatment showed no tumor enhancement, but the safety margin of ablation appeared to be insufficient. On the other hand, in Kupffer-phase CEUS, the ablation zone showed a clear contrast defect with a sufficient ablation margin, indicating cell death of hepatocytes, cancer cells, and Kupffer cells in this area following IRE treatment. Very similar findings were observed in hepatobiliary-phase Gd-EOB-DTPA-enhanced MRI at 7 days after treatment. These results suggest that both Kupffer-phase CEUS and hepatobiliary-phase Gd-EOB-DTPA-enhanced MRI may be useful for assessing the ablation zone in patients who have undergone IRE.
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