Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 57, Issue 1
Displaying 1-6 of 6 articles from this issue
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Original Article
  • Promotion of intra-hospital referral of hepatitis B and C virus carriers to hepatology specialists by electronic medical record-based alert system: a case study at a university hospital
    Sawako Uchida-Kobayashi, Masaru Enomoto, Hideki Fujii, Ayako Iida-Ueno ...
    2016 Volume 57 Issue 1 Pages 7-16
    Published: January 20, 2016
    Released on J-STAGE: February 01, 2016
    DOIhttps://doi.org/10.2957/kanzo.57.7
    JOURNAL FREE ACCESS
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    It remains unclear whether intra-hospital collaboration regarding hepatitis B and C virus carriers identified by infection screening testing occurs appropriately in non-hepatology departments. Our hospital developed an alert system in April 2013 to promote referral of hepatitis B surface antigen (HBsAg)-positive or anti-heptitic C virus (HCV)-positive patients to the Department of Hepatology through electronic medical records. Since the introduction of the new system, the number of intra-hospital referrals regarding hepatitis virus infections increased from 18.8±5.7 to 29.0±4.5 per month. A steady stream of referrals originated from departments in which there were more patients who tested positive for the hepatitis virus. This alert system is useful for promoting the intra-hospital referral of hepatitis virus carriers who are detected by screening tests to hepatology specialists and is thus considered to be important in the appropriate management of chronic viral hepatitis.
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Case Reports
  • A case report of hepatocellular carcinoma adjacent to hepatic biloma successfully treated by stereotactic body radiation therapy
    Yuki Makino, Ryotaro Sakamori, Hiroya Shiomi, Takayuki Yakushijin, Hay ...
    2016 Volume 57 Issue 1 Pages 17-26
    Published: January 20, 2016
    Released on J-STAGE: February 01, 2016
    DOIhttps://doi.org/10.2957/kanzo.57.17
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    A 80-year-old man had been regularly followed up for hepatitis C since 2002. After hepatocellular carcinoma (HCC) initially developed in 2007, he underwent radiofrequency ablation (RFA) and transcatheter arterial chemoembolization (TACE) for several times. In 2013, 15-mm HCCs recurred both in segments 3 and 5. We first conducted TACE and percutaneous ethanol injection therapy was added for HCC in segment 3. However, since HCC in segment 5 was adjacent to biloma developed by the past RFA, we performed stereotactic body radiation therapy (SBRT) with a total dose of 40 Gy in 4 fractions. Consequently, complete response was achieved one month after SBRT without any adverse events. This lesion has been recurrence-free for 22 months. This is the first case report of HCC adjacent to biloma successfully treated by SBRT. Whereas ablation therapies have a risk of bile duct injury, SBRT might be a safe and effective treatment option.
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  • A case of cirrhosis with hepatitis C virus infection developing hepatocellular carcinoma 20 years after achieving sustained virological response to interferon therapy
    Junya Okabe, Kazuto Fukuda, Takayuki Iwamoto, Yosuke Yamagata, Mizuki ...
    2016 Volume 57 Issue 1 Pages 27-33
    Published: January 20, 2016
    Released on J-STAGE: February 01, 2016
    DOIhttps://doi.org/10.2957/kanzo.57.27
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    An 86-year-old male was diagnosed with liver cirrhosis and hepatitis C virus (HCV) infection, and he was treated with interferon (IFN) therapy 20 years ago. He achieved a sustained virological response (SVR) and was followed up with blood tests and ultrasonography twice a year. Twenty years later, a high-echoic nodule with 15 mm diameter was detected by ultrasonography and diagnosed as a hepatocellular carcinoma by magnetic resonance imaging and hepatic angiography. The patient was treated with transcatheter arterial chemoembolization followed by radiofrequency ablation. Long-term follow-up may be needed for patients with HCV even after the achievement of SVR to IFN therapy.
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  • Pegylated Interferon for the treatment of chronic hepatitis C with HIV-infected patients
    Yuka Endo, Seishu Hayashi, Yousuke Ohsawa, Jun Imamura, Kiminori Kimur ...
    2016 Volume 57 Issue 1 Pages 34-41
    Published: January 20, 2016
    Released on J-STAGE: February 01, 2016
    DOIhttps://doi.org/10.2957/kanzo.57.34
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    Aims: Progression of chronic hepatitis C virus (HCV) infection to end-stage liver disease is accelated in patients coinfected with human immunodeficiency virus (HIV). Treatment of HCV is less effective than in HCV monoinfected persons. Mehods: We examined 13 HCV/HIV coinfected patients, and evaluated the efficacy and safety. The treatments were Peg-IFNα2a (n=3), Peg-IFNα2a/2b+Ribavirin (RBV) (n=10), Peg-IFNα2b/RBV/Telaprevir (TVR) (n=1). Complications were hemophiliacs (n=2), chronic hepatitis B (n=1). The mean CD4+lymphocyte count was 477/μl. HIV load was <20 copies in 12 patients. Results: Five of eight patients (63%) with genotype 1 and all patients (100%) with genotype 2 achieved SVR. The count of CD4+lymphocyte decreased during treatment and recover after treatment. HIV load revealed no remarkable change during treatment. Conclusions: These results support the use of Pegylated Interferon therapy in HCV/HIV co-infected patients.
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Short Communication
  • Evaluation of the sensitivity of bioluminescent enzyme immunoassay for the detection of hepatitis B surface antigen
    Terumi Kaishima, Toshiko Fujii, Shintaro Nagashima, Keiko Katayama, Mi ...
    2016 Volume 57 Issue 1 Pages 42-44
    Published: January 20, 2016
    Released on J-STAGE: February 01, 2016
    DOIhttps://doi.org/10.2957/kanzo.57.42
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    The aim of this study was to evaluate the sensitivity of the bioluminescence enzyme immunoassay for the detection of hepatitis B surface antigen (BLEIA®EIKEN HBsAg) and to compare the sensitivity with microparticle enzyme immunoassay (MEIA). Samples were collected during the early infection phase from six chimpanzees infected with hepatitis B virus (HBV) genotype A or genotype C. In the early infection phase, there was a direct correlation between HBV DNA and HBsAg until the appearance of anti-HBc and anti-HBs. The cut off value of BLEIA, 0.005 IU/mL, was estimated to correspond to 400 copies/mL. BLEIA detected HBsAg earlier than other methods. Therefore, the measurement of HBsAg by BLEIA is suggested to be useful for the investigation of HBV infection.
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Special Report
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