Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
Volume 56, Issue 10
Displaying 1-8 of 8 articles from this issue
Review Article
Original Article
  • Akira Kaneko, Tomohide Tatsumi, Takayuki Yakushijin, Naoki Hiramatsu, ...
    2015 Volume 56 Issue 10 Pages 507-517
    Published: October 20, 2015
    Released on J-STAGE: November 02, 2015
    JOURNAL FREE ACCESS
    The study included 200 patients diagnosed with autoimmune hepatitis. Steroids were administered to 162 patients, and a complete response was achieved in 149 patients. However, among the 141 patients who could be evaluated, relapse was observed in 69 patients, and more than half of them relapsed at a prednisolone dose of <5 mg/day. Although there was no significant difference in factors between patients with and without relapse, we could observe significant difference in several factors when 32 patients who relapsed at a prednisolone dose of ≥5 mg/day were classified as the steroid-dependent group, and 62 patients without relapse at a maintenance dose of ≤5 mg were classified as the steroid-independent group. Multivariate analysis of these groups showed that age and cholestatic enzymes were factors associated with relapse. Our results suggest that analyzing data in consideration of steroid dose at relapse is important to investigate the factors associated with relapse.
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Case Reports
  • Fumika Nakamura, Tetsu Tomonari, Jun Okazaki, Hironori Tanaka, Takahir ...
    2015 Volume 56 Issue 10 Pages 518-525
    Published: October 20, 2015
    Released on J-STAGE: November 02, 2015
    JOURNAL FREE ACCESS
    A 67-year-old man was diagnosed as having hepatocellular carcinomas (HCCs) caused by alcoholic liver cirrhosis 7 years ago. He had received radiofrequency ablation therapy and several transcatheter arterial embolization therapy several times. In April 2013, he was admitted to our hospital due to high fever, and computed tomography (CT) demonstrated multiple HCCs, ascites and multiple metastatic nodules in both lungs. Laboratory tests showed a white blood cell (WBC) count of 8,500/μL. The patient was clinically diagnosed as HCCs with metastasis in both lungs with spontaneous bacterial peritonitis. Antibiotic medication showed no effect and he died on 20th day after admission. Finally, WBC count had increased up to 47,800/μL and serum G-CSF was very high (1750 pg/ml). Positive reaction of anti-G-CSF antibody was observed in immunohistochemical staining of the tumor tissue from autopsy specimen. It is suggested that G-CSF was associated with the high-grade transformation of the tumor tissue.
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  • Ayato Murata, Shunsuke Sato, Takuya Genda, Hironori Tsuzura, Yoshio Ka ...
    2015 Volume 56 Issue 10 Pages 526-532
    Published: October 20, 2015
    Released on J-STAGE: November 02, 2015
    JOURNAL FREE ACCESS
    An 82-year-old man with a liver tumor was referred and admitted to our hospital for further examination. Enhanced computed tomography revealed a hypovascular liver tumor with left portal vein invasion. Magnetic resonance cholangiopancreatography demonstrated stenosis of the left hepatic duct and dilatation of the peripheral intrahepatic bile ducts within the tumor. Histological evidence of neuroendocrine tumor (grade 3) was obtained by using percutaneous tumor biopsy. 18F-Fluorodeoxyglucose positron emission tomography and endoscopic investigations were performed to exclude the presence of extrahepatic lesions, and a diagnosis of primary hepatic neuroendocrine tumor was established. Five months after hepatectomy, the patient died of multiple intrahepatic recurrences. The bile duct findings within the resected tumor led us to speculate that the pathogenesis of the primary hepatic neuroendocrine tumor was a transformation of the neuroendocrine cells from the left bile duct.
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Short Communications
  • Hideyuki Kudoh, Yoko Nagasawa, Michiru Ito, Nobuko Watanabe, Isao Naru ...
    2015 Volume 56 Issue 10 Pages 533-535
    Published: October 20, 2015
    Released on J-STAGE: November 02, 2015
    JOURNAL FREE ACCESS
    In this study, we evaluated the sensitivity and performance of HCV drug resistance assay for detection of DCV-resistant mutations using direct sequencing and cycleave PCR. Direct sequencing analysis revealed that SVR rates were 93.5% (43/46) for the patients with Y93 wild, and 40.0% (6/15) for the patients with Y93H mutant. Furthermore, cycleave PCR analysis revealed that SVR rates were 97.4% (37/38) for the patients with Y93 wild, and 45.0% (9/20) for the patients with Y93H mutant. The SVR rate in patients with Y93 wild was higher in the combination method of direct sequencing and cycleave PCR (97.6%) than in the cycleave PCR alone. These results suggested that this assay may be useful indicator for treatment with DCV/ASV dual therapy.
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  • Tomoko Saito, Tetsuhiro Chiba, Yoshihiko Ooka, Toru Wakamatsu, Masanor ...
    2015 Volume 56 Issue 10 Pages 536-539
    Published: October 20, 2015
    Released on J-STAGE: November 02, 2015
    JOURNAL FREE ACCESS
    We describe two patients with hepatic mucosa-associated lymphoid tissue (MALT) lymphoma suspected of actually being hepatocellular carcinoma (HCC) who were treated by radiofrequency ablation (RFA). Pathological examination of biopsy samples revealed tumors composed of MALT lymphoma. Although the tumors were small, they exhibited extremely high intensities on magnetic resonance imaging with diffusion-weighted imaging (DWI). Considering that small HCCs rarely exhibit high intensity in DWI, this finding may assist in the differential diagnosis between HCC and lymphoma. Although Case 1 survived without recurrence for 5 years after RFA, Case 2 experienced MALT lymphoma recurrence after 3 years. Further analyses are required to determine the mechanism underlying hepatic MALT lymphoma development and to establish a standard therapy for this disease.
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  • Kaori Ochiai, Sumiko Nagoshi, Toru Aoyama, Yuji Aoyagi, Yuki Fujihara, ...
    2015 Volume 56 Issue 10 Pages 540-542
    Published: October 20, 2015
    Released on J-STAGE: November 02, 2015
    JOURNAL FREE ACCESS
    Recently we saw two patients with acute hepatitis, infected with hepatitis E virus (HEV) of a rare genotype 3f. One patient (Tokyo/2012) had traveled Spain 1 month before developing hepatitis, while the other patient (Saitama/2014) did not have history of traveling abroad. Nearly entire genomic sequence of HEV was recovered from both patients; 7,336 nucleotides (nt) from the Tokyo case in 2012 (isolate name=JAO-SpaTok12, accession=LC055972) and 7,306 nt from the Saitama case in 2014 (JMH-Sai14, LC055973). Phylogenetic analysis revealed that JMH-Sai14 from the Saitama patient, who denied having traveled abroad, could be classified into a subgroup of genotype 3f, together with European isolates as well as an already reported Japanese isolate HE-JA12-0725 (AB850879) from a patient living in Gunma and having never traveled abroad when he/she developed hepatitis in 2012. On the other hand, the Tokyo patient's sequence segregated to a separate branch together with European isolates. Based on these findings it is possible that HEV genotype 3f has already made inroad into Japan as in the case of 3e.
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Rapid Communication
  • Tomoyuki Takashima, Hiroko Iijima, Tomoko Aoki, Chikage Nakano, Nobuhi ...
    2015 Volume 56 Issue 10 Pages 543-545
    Published: October 20, 2015
    Released on J-STAGE: November 02, 2015
    JOURNAL FREE ACCESS
    We evaluated the usefulness of the enhanced liver fibrosis panel (ELF, ADVIA Centaur®), the new method to assess liver fibrosis using serum fibrosis markers in patients with chronic hepatitis, and compared the result with other serological fibrosis markers. 338 patients with chronic hepatitis were included. ELF score, which consists of hyaluronic acid, procollagen type III propeptide (PIIIP) and tissue inhibitor of matrix metalloproteinase -1 (TIMP-1) was F0; 8.6±1.0, F1; 9.0±0.9, F2; 9.9±1.3, F3; 10.8±1.1, F4; 11.3±0.9, and increased with the development of fibrosis. The area under the receiver operating characteristic curve (AUROC) for the diagnosis of liver cirrhosis was 0.867 and showed good diagnostic accuracy (p<0.001). The ELF score is a useful noninvasive tool for the diagnosis of liver fibrosis stage in patients with chronic hepatitis.
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