Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 56, Issue 5
Displaying 1-6 of 6 articles from this issue
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Review Article
Original Article
  • An investigation of early prognostic factor of sepsis-associated liver injury
    Kotaro Matsumoto, Kentaro Kikuchi, Yuki Moritoki, Chiyoko Motegi, Hana ...
    2015 Volume 56 Issue 5 Pages 179-185
    Published: May 20, 2015
    Released on J-STAGE: May 29, 2015
    DOIhttps://doi.org/10.2957/kanzo.56.179
    JOURNAL FREE ACCESS
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    We retrospectively investigated the clinical features of sepsis-associated liver injury in Teikyo University Mizonokuchi Hospital and examined which factors useful to predict prognosis in an early onset. In 116 patients with sepsis, 61 cases (52.6%) were diagnosed as sepsis-associated liver injury. Mortality rate was higher in patients having sepsis-associated liver injury. The concurrence of DIC was more frequent in the cases of sepsis-associated liver injury than in septic cases without liver injury. Interestingly, serum levels of FDP and D-dimer were higher in the cases of sepsis-associated liver injury even though without DIC. Ten cases including three cases of MRSA infection presented jaundice and died. As for the fatal cases, serum levels of ALP and γ-GTP were significantly higher than those of survivors. In a multivariate analysis, high ALP level was the only convaleacence prediction factor in the sepsis-associated liver injury. These results suggest that high serum levels of ALP and γ-GTP and detection of MRSA are useful to predict poor prognosis of sepsis-associated liver injury in an early stage.
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Case Reports
  • Hepatocellular carcinoma manifested as pyogenic liver abscess: A case report
    Aritune Ooho, Miho Kurokawa, Naoki Yamashita, Ichiro Makino, Mitsuru K ...
    2015 Volume 56 Issue 5 Pages 186-193
    Published: May 20, 2015
    Released on J-STAGE: May 29, 2015
    DOIhttps://doi.org/10.2957/kanzo.56.186
    JOURNAL FREE ACCESS
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    We report a patient with hepatocellular carcinoma manifested as pyogenic liver abscess. A 73-year-old man had been aware of upper quadrant pain for ten days prior to admission. He was hospitalized for examination of a liver mass detected by ultrasound. Fever and leukocytosis were present on admission. Enhanced computed tomography showed low attenuation and rim enhancement in the left hepatic lobe with a diameter of 6 cm. Ultrasound-guided percutaneous biopsy and bacterial culture showed pyogenic liver abscess caused by multiple intestinal bacteria. The lesion had grown extrahepatically, but symptoms improved after antibiotic treatment. Lateral segmentectomy was performed, and a moderately differentiated hepatocellular carcinoma was found inside the pyogenic abscess. A few cases of hepatocellular carcinoma manifested as liver pyogenic abscess have been reported. Follow-up imaging examination is necessary given the possibility of hepatocellular carcinoma when providing medical treatment for an idiopathic liver abscess.
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  • A case of iliac bone metastasis in a hepatocellular carcinoma patient who survived for more than five years after radiotherapy
    Katsumi Amikura, Hirohiko Sakamoto, Amane Takahashi, Toshiro Ogura, Ki ...
    2015 Volume 56 Issue 5 Pages 194-204
    Published: May 20, 2015
    Released on J-STAGE: May 29, 2015
    DOIhttps://doi.org/10.2957/kanzo.56.194
    JOURNAL FREE ACCESS
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    A 50-year-old man attended our hospital after being diagnosed to have solitary iliac bone metastasis from hepatocellular carcinoma. He underwent hepatic anterior-segmentectomy 10 months prior to this presentation for a hepatocellular carcinoma tumor measuring 70 mm in diameter and comprising 5/8 segment of the liver. No evidence of recurrence was visible in the liver. After he received 51 Gy of radiotherapy and 4 mg of Zoledronic acid were administered five times, his pain improved and the tumor markers all normalized thereafter. The bone metastasis also stabilized and transformed into ossification. The patient has since survived without recurrence for six years after the diagnosis of bone metastasis. Most patients presenting with bone metastases of hepatocellular carcinoma have a poor prognosis. However, patients demonstrating solitary bone metastasis may achieve a long-term survival, namely more than five years, when such cases have a good liver function and has no lesions in the postsurgical liver. It is therefore necessary to select the optimal combined modality therapy for such patients while assuming a potential long-term survival.
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  • A case report of heterochronic triple cancers in alcoholic hepatitis (Twice intrahepatic cholangiocarcinoma and a hepatocellular carcinoma) -The first case-
    Hirofumi Tazawa, Saburo Fukuda, Takahiro Eto, Takashi Moriya, Yoshio K ...
    2015 Volume 56 Issue 5 Pages 205-212
    Published: May 20, 2015
    Released on J-STAGE: May 29, 2015
    DOIhttps://doi.org/10.2957/kanzo.56.205
    JOURNAL FREE ACCESS
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    A 82-year-old man with alcoholic hepatitis was pointed out the elevation of CEA. After further examination revealed the liver tumor in the segment VI, a partial hepatectomy was performed. The histological diagnosis was intrahepatic cholangiocarcinoma (ICC) of liver. Six months later, the liver tumor appeared in the segment VI, and the segmentectomy was performed. The diagnosis was hepatocellular carcinoma (HCC). Furthermore, 17 months later from first operation, the liver tumor reappeared in the segment III, and the segmentectomy was performed. The diagnosis was ICC. We report triple resections of the liver as ICC and HCC in the identical liver. To the best knowledge of our study, this is the first report of heterochronic triple cancers, which were all resected.
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Short Communication
  • Three hepatocellular carcinoma patients with pleural effusion successfully treated by pleurodesis with a view to palliative medicine
    Junichi Senoo, Tetsuhiro Chiba, Tomoko Saito, Yoshihiko Ooka, Sadahisa ...
    2015 Volume 56 Issue 5 Pages 213-216
    Published: May 20, 2015
    Released on J-STAGE: May 29, 2015
    DOIhttps://doi.org/10.2957/kanzo.56.213
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    Pleural effusion often causes respiratory distress and deterioration of activities of daily living. Here, we describe three hepatocellular carcinoma (HCC) patients exhibiting refractory pleural effusion. The pleural effusion in these patients was caused by a different mechanism in each case: ascites transition to the chest cavity, carcinomatous pleuritis, and bacterial infection. Both the administration of conventional diuretics and thoracentesis failed to resolve the pleural effusion. Ultimately, the patients were successfully treated by chemical pleurodesis with OK-432 and minocycline. Although they developed mild fever and pain shortly after treatment, no severe complications were observed. Given that palliative medicine should be provided in the early stage of cancer treatment, pleurodesis could be useful approach for HCC patients with refractory pleural effusion.
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