Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 57, Issue 4
Displaying 1-5 of 5 articles from this issue
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Original Articles
  • The ratio of glycated albumin to glycated hemoglobin increase with decreasing residual hepatic function
    Hiroyasu Miyamoto, Nao Fusiya, Setsuko Akizuki, Ryuzo Hirata, Akihiro ...
    2016 Volume 57 Issue 4 Pages 161-170
    Published: April 20, 2016
    Released on J-STAGE: April 29, 2016
    DOIhttps://doi.org/10.2957/kanzo.57.161
    JOURNAL FREE ACCESS
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    Glycated albumin (GA) and glycated hemoglobin (HbA1c) are well utilized as a marker for monitoring diabetic condition, and which levels are mainly determined by each biological half-life (t1/2). The ratio of GA to HbA1c (GA/HbA1c ratio) has been reported to be fluctuated by GA and/or HbA1C t1/2 change(s) due to various pathological disease conditions and has been suggested to be a possible useful marker in a clinical setting to know the underlying disease states. The aim of present study is to assess whether GA/HbA1c ratio can be applied as a marker for residual liver function in patients with liver cirrhosis (LC) and hepatocellular carcinoma (HCC). Ninety-four cirrhotic patients with HCC were classified by Child-Pugh score (A, B, C) as well as by the liver damage score (A, B, C) based on Japanese HCC Guideline. We evaluated the relationships between GA/HbA1c ratio and the above 2 scores, respectively. Also we observed the correlation between GA/HbA1c ratio and the other laboratory indices known as liver function marker were analyzed. In result, significant positive relationships between GA/HbA1c ratio and the above 2 scores were observed. And significant negative correlations between GA/HbA1c ratio and the laboratory indices: serum albumin, cholinesterase, and prothrombin, and significant positive correlation with % retention of ICG. We concluded the GA/HbA1c ratio could be an useful marker for indicating decrease in the residual liver function.
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  • Current status of alcoholic hepatitis in Japan (2012)
    Yoshinori Horie, Hirotoshi Ebinuma, Hiromasa Kikuchi, Syunsuke Shiba, ...
    2016 Volume 57 Issue 4 Pages 171-177
    Published: April 20, 2016
    Released on J-STAGE: April 29, 2016
    DOIhttps://doi.org/10.2957/kanzo.57.171
    JOURNAL FREE ACCESS
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    Severe alcoholic hepatitis (SAH) has a high mortality rate. Ability of Japan Alcoholic Hepatitis Score (JAS) to predict outcome was confirmed by examining the data of 90 patients with AH in 2012: 53 had moderate AH of whom 45 were alive and 8 were dead, while 37 had SAH of whom 21 were alive and 16 were dead. The prevalence of DIC was higher in patients who had died, while TB at 5 days was higher in SAH patients who had died. WBC and PT (INR) at 5 days were higher in moderate AH patients who had died. These results suggest that JAS allows stratification of the risk of death and can help manage patients with AH. Irrespective of severity, the treatment such as steroid should be carried out if WBC, PT (INR) or TB at 5 days were not yet fully recovered.
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Case Report
  • A case of hepatocellular carcinoma with spontaneous regression of a tumor thrombus invading the main portal trunk
    Yoshihiko Ooka, Tetsuhiro Chiba, Masanori Inoue, Toru Wakamatsu, Tomok ...
    2016 Volume 57 Issue 4 Pages 178-185
    Published: April 20, 2016
    Released on J-STAGE: April 29, 2016
    DOIhttps://doi.org/10.2957/kanzo.57.178
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    We describe a hepatocellular carcinoma (HCC) patient with a spontaneous regression of portal vein tumor thrombus (PVTT) of the main trunk of the portal vein (Vp4). A 63-year-old man with hepatitis C virus infection had been diagnosed with multiple HCC with Vp4 PVTT accompanied by massive ascites. Considering the unfavorable physical condition and liver function, the patient had been recommended to receive the best supportive care. The patient took ursodeoxycholic acid, glycyrrhizin and diuretic but not herbal medicine and was abstained from alcohol entirely. Six months after initial diagnosis, the patient was re-examined in our hospital. Contrast-enhanced computed tomography and ultrasound examination revealed the regression of PVTT but not of intrahepatic lesions associated with HCC. Subsequently, we performed an additional transarterial chemoembolization (TACE) was performed. Six months after the TACE, the patient is alive without recurrence.
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Short Communications
  • Multipolar radiofrequency ablation therapy combined with chemoembolization for hepatocellular carcinoma assisted with C-arm type X-ray fluoroscopy system
    Takashi Tanaka, Akira Anan, Kazuhide Takata, Hiromi Fukuda, Ryo Yamauc ...
    2016 Volume 57 Issue 4 Pages 186-189
    Published: April 20, 2016
    Released on J-STAGE: April 29, 2016
    DOIhttps://doi.org/10.2957/kanzo.57.186
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    We performed ultrasound (US)-guided multipolar radiofrequency ablation (m-RFA) using C-arm type X-ray fluoroscopy several days after transarterial chemoembolization with an emulsion of iodized oil (Lip-TACE) for 2 hepatocellular carcinoma (HCC) cases. In m-RFA, the operator inserts multiple electrodes into the tumor, assisted by US-guidance. Because lipiodol is a radio-opaque contrast agent, outlines of tumors treated with Lip-TACE can be visualized by X-ray fluoroscopy. Therefore, we performed US-guided m-RFA under X-ray fluoroscopy. During electrode insertion, the operator can see the direction and position of the electrode against the target tumor by simultaneous US-guidance and continuous X-ray monitoring. After treatment, a sufficient volume of ablative zone was successfully acquired and no major complications were observed in both cases. This new technical approach may help operators easily visualize the positional relationship between each individual electrode around the tumor site, as well as, achieve safe and appropriate insertion by synchronizing the US and C-arm type X-ray fluoroscopy images.
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  • Safety and effectiveness of 5-fluorouracil loaded microsphere for classical hepatocellular carcinoma
    Kiminori Uka, Nobuaki Hisa, Naofumi Hisa
    2016 Volume 57 Issue 4 Pages 190-192
    Published: April 20, 2016
    Released on J-STAGE: April 29, 2016
    DOIhttps://doi.org/10.2957/kanzo.57.190
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    Aim: We assessed the safety and effectiveness of drug-eluting beads transarterial chemoembolization (DEB TACE) with 5-fluorouracil (5FU) loaded HepaSphere for classical hepatocellular carcinoma (HCC). Regimen: A: 5FU 250 mg/5 ml, non-ionic contrast medium (CM) 5 ml, HepaSphere 25 mg, B: 5FU 400 mg/8 ml, CM 2 ml, HepaSphere 25 mg, C: 5FU 300 mg/6 ml, CM 2 ml, 10% NaCl 2 ml, HepaSphere 25 mg, D: The regimen C is diluted from 10 times. Results: There was no CTCAE Grade 2-5 adverse reaction. The response (CR/PR/SD/PD, CR+PR rate) was as follows; A; 0/1/3/0, 25%, B; 0/1/5/0, 16.7%, C; 1/1/2/0, 50%, D; 1/2/3/0, 50%. Conclusion: DEB TACE with 5FU loaded HepaSphere for classical HCC is safe. It seems to be more favorable with well-tolerated and effective method uses 10% NaCl.
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