Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 57, Issue 3
Displaying 1-6 of 6 articles from this issue
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Case Reports
  • A case of alcoholic liver cirrhosis complicated with hepatic IgA nephropathy and massive chylous ascites
    Hideaki Taniguchi, Mina Ueharu, Koutaro Shibagaki, Hiraku Fujita, Dais ...
    2016 Volume 57 Issue 3 Pages 117-124
    Published: March 18, 2016
    Released on J-STAGE: April 08, 2016
    DOIhttps://doi.org/10.2957/kanzo.57.117
    JOURNAL FREE ACCESS
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    A 58-year-old man with a history of heavy drinking was referred to our hospital because of abdominal distension and leg edema. Abdominal CT showed an irregular shaped liver and massive ascites, consistent with cirrhosis with portal hypertension. Laboratory data indicated not only alcoholic liver damage but also renal dysfunction with significant levels of proteinuria (1.87 g/day) and hematuria. Abdominal paracentesis revealed chylous ascites, showing milky color and high level of triglyceride. At the time of admission, ascites did not respond to diuritics, but got resolved along with improving of his liver function. A renal biopsy obtained at 35 hospital day demonstrated IgA nephropathy showing mesangial cell proliferation and IgA deposits. This case was diagnosed as having hepatic IgA nephropathy associated with alcoholic liver damage. Abnormal proteinuria and renal function was improved gradually and the exacerbation was not occurred after abstinence from alcohol. Hepatic IgA nephropathy should be considered as a possible diagnosis in patients with liver damage, proteinuria, and hematuria.
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  • Two cases of malignant lymphoma with acute liver failure by the hepatic infiltration
    Risa Omori, Kenichi Morikawa, Tie Tashiro, Yuta Mitsui, Shun Fujiwara, ...
    2016 Volume 57 Issue 3 Pages 125-131
    Published: March 18, 2016
    Released on J-STAGE: April 08, 2016
    DOIhttps://doi.org/10.2957/kanzo.57.125
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    Case 1: A 60-year-old Japanese man was hospitalized because of acute liver failure. He has been treated with plasma exchange and continuous hemodiafiltration. After detailed examination of liver injury, he was diagnosed as having diffuse large B cell lymphoma by a bone-marrow biopsy. Case 2: A 66-year-old Japanese man was admitted for treatment for acute cholecystitis with liver injury. After careful examination of liver injury, he was diagnosed as having the hepatic infiltration of Hodgkin lymphoma by a liver needle biopsy. Both cases could discharge after chemotherapy against malignant lymphoma.
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Short Communications
  • Drug-eluting beads transarterial chemoembolization is feasible treatment option for advanced hepatocellular carcinoma with portal vein tumor thrombosis
    Shunji Watanabe, Naoki Morimoto, Toshiya Otake, Mamiko Tsukui, Natsumi ...
    2016 Volume 57 Issue 3 Pages 132-134
    Published: March 18, 2016
    Released on J-STAGE: April 08, 2016
    DOIhttps://doi.org/10.2957/kanzo.57.132
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    Portal venous tumor thrombosis (PVTT) is one of the poor prognosticated factors of hepatocellular carcinoma (HCC). Satisfactory therapeutic effect is not always obtained in spite of performing multidisciplinary treatment. We report herein two cases with HCC with PVTT in first branch or more obtained good effect without complication by drug-eluting beads transarterial chemoembolization (DEB-TACE). Case No. 1: 55-year-old male with cirrhosis and multiple HCC with PVTT in right first branch to main trunk was admitted to our hospital. DEB-TACE was performed in right hepatic artery. No complication including hepatic infarction occurred, while good response of PVTT reduction was obtained. Clinical course of case No. 2 was similar. Although cytotoxic agent might lead effect, DEB-TACE that occlude peripheral artery is able to perform safely and considered feasible treatment option for HCC with PVTT.
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  • Initial experience of radiofrequency ablation for liver tumors with a new adjustable radiofrequency electrode
    Ryo Shimizu, Nobuhito Taniki, Manabu Hayashi, Ryo Kanazawa, Hiroko Miu ...
    2016 Volume 57 Issue 3 Pages 135-137
    Published: March 18, 2016
    Released on J-STAGE: April 08, 2016
    DOIhttps://doi.org/10.2957/kanzo.57.135
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    The VIVARF system (STARmed; Korea) became available in Japan in 2015. This system has an internally cooled electrode in which we can change the length of the active tip from 0.5 cm to 3 cm. We therefore performed experimental and clinical tests. At first, the electrode tip appeared too hyperechogenic. After two improvements, however, the visibility of the electrode became comparable to a conventional internally cooled electrode. Its efficacy and safety seemed comparable to a conventional electrode in clinical cases. This new adjustable RF electrode is more cost-effective in some cases and may have more potential than fixed tip electrodes.
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  • Added value of Sonazoid-enhanced Superb Micro-vascular Imaging in the evaluation of focal solid hepatic lesions: An observer study
    Katsutoshi Sugimoto, Mayumi Kojima, Sayuri Ogawa, Yoshiyuki Kobayashi, ...
    2016 Volume 57 Issue 3 Pages 138-141
    Published: March 18, 2016
    Released on J-STAGE: April 08, 2016
    DOIhttps://doi.org/10.2957/kanzo.57.138
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    To evaluate the added value of Sonazoid-enhanced Superb Micro-vascular Imaging (SMI) in routine contrast-enhanced ultrasound (CEUS) examinations for the evaluation of focal solid hepatic lesions, CEUS was performed in 37 patients with focal hepatic lesions: 26 patients with hepatocellular carcinoma (HCC), 3 with metastasis, 4 with hemangioma, 3 with focal nodular hyperplasia (FNH), and 1 with adenoma. The images were evaluated by three independent readers (R1-R3) who characterized the liver lesions with and without the use of SMI. Confidence in the final diagnosis was scored using a continuous rating scale. The mean diagnostic confidence scores for HCC and FNH were significantly improved by the addition of SMI. We therefore suggest that SMI should be widely employed in routine CEUS examinations for the differential diagnosis of focal solid hepatic lesions.
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Rapid Communication
  • Therapeutic safety and effectiveness of dual oral therapy with Daclatasvir and Asunaprevir for chronic HCV patients with renal dysfunction
    Motoyuki Kohjima, Kenta Motomura, Toshimasa Koyanagi, Seiya Tada, Naok ...
    2016 Volume 57 Issue 3 Pages 142-145
    Published: March 18, 2016
    Released on J-STAGE: April 08, 2016
    DOIhttps://doi.org/10.2957/kanzo.57.142
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    We investigated the safety and effectiveness of the dual oral therapy with Daclatasvir (DCV) and Asunaprevir (ASV) for patients with renal dysfunction. This study enrolled 682 HCV genotype 1b patients treated with DCV and ASV and included 83 patients with eGFR less than 50 ml/min/1.73 m2, and 17 patients with eGFR less than 30 ml/min/1.73 m2. Serum creatinine and eGFR were not altered during the treatment and the rate of complications and viral response was similar between patients with renal dysfunction and patients without renal dysfunction. The treatment with DCV and ASV was well tolerated and safety enough even for the HCV patients with renal dysfunction and could be productive therapeutic option for aged patients that accounts many of patients with HCV genotype 1b infection in Japan.
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