Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
Volume 61 , Issue 8
Showing 1-7 articles out of 7 articles from the selected issue
Special Report
Original Article
  • Hirotomo Harimoto, Hidenori Kanazawa, Yoshiyuki Narahara, Hideko Kidok ...
    2020 Volume 61 Issue 8 Pages 399-409
    Published: August 01, 2020
    Released: August 06, 2020
    JOURNALS FREE ACCESS

    Patients with refractory hepatic hydrothorax (HHT) who fail to respond to medical treatment experience a low quality of life and poor prognosis. In this study, we evaluated the use of transjugular intrahepatic portosystemic shunt (TIPS) in 20 patients with refractory HHT from 2001 to 2015. The mean age was 61.1±10.8 years and the mean Child-Pugh score (CPS) was 9.7±1.5 points. All patients experienced successful insertion of the TIPS and had no need for thoracenteses after TIPS. The one-year survival rate among all patients was 69% and the median survival length was 23.2 months; otherwise, the results were improved to 73% and 27.8 months when the analysis was limited to patients with a CPS score of less than 11 points. Two of four patients with CPS scores of 12 points died of liver failure within 60 days after TIPS. In conclusion, TIPS is effective for refractory HHT and may improve the survival of patients; however, its use should be limited to patients with CPS scores of less than 11 points.

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Case Reports
  • Kojiro Kobayashi, Hidenari Nagai, Takanori Mukozu, Daigo Matsui, Teppe ...
    2020 Volume 61 Issue 8 Pages 410-417
    Published: August 01, 2020
    Released: August 06, 2020
    JOURNALS FREE ACCESS

    An 80-year-old woman complaining of back pain was admitted with a giant tumor located in the right lobe of the liver. Based on various imaging studies, she was diagnosed as having hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) and invasion of the portal trunk. She commenced treatment with lenvatinib. However, serum levels of free T3 and free T4 increased after two months of lenvatinib treatment. Destructive thyroiditis was diagnosed and she began taking thiamazol. It was confirmed that she showed decreased thyroid function after thiamazol treatment; however, her thyroid function was restored by changing from thiamazole to levothyroxine sodium hydrate. Necrosis of the HCC was confirmed by computed tomography. We report this patient who showed a complete response of giant HCC with PVTT to lenvatinib therapy, which induced destructive thyroiditis.

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  • Hiroyuki Suzuki, Hideki Iwamoto, Takashi Niizeki, Shigeo Shimose, Tomo ...
    2020 Volume 61 Issue 8 Pages 418-425
    Published: August 01, 2020
    Released: August 06, 2020
    JOURNALS FREE ACCESS

    Therapeutic strategies for unresectable and advanced hepatocellular carcinoma (HCC) are considerably limited worldwide. We experienced a case with unresectable advanced HCC treated with hepatectomy after down-sizing with hepatic arterial infusion therapy (new FP therapy) and transcatheter arterial chemoembolization (TACE). HCC recurred early after surgical resection; however, long-term survival was achieved by treatment with multidisciplinary therapies including TACE and multikinase inhibitors. Additionally, we analyzed the secretory proteins of angiogenesis growth factors by pre- and postregorafenib or -lenvatinib administration to search for biomarkers of HCC treatment.

    Advanced HCC patients might achieve long-term survival by maintaining the liver function and with treatment by multidisciplinary therapies encompassing those with high rates of disease control.

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  • Takanobu Iwadare, Tomoo Yamazaki, Satoru Joshita, Naoyuki Fujimori, Ke ...
    2020 Volume 61 Issue 8 Pages 426-433
    Published: August 01, 2020
    Released: August 06, 2020
    JOURNALS FREE ACCESS

    A 60-year-old male with prior liver resection for S5 hepatocellular carcinoma (HCC) caused by hepatitis C virus infection experienced multiple HCC recurrences despite repeated treatments with percutaneous ethanol injection therapy and transcatheter arterial chemoembolization. Three months after beginning sorafenib, thoracic vertebra and adrenal gland metastases were detected by computed tomography (CT) and increases in intrahepatic HCC tumors were noted. His treatment was switched to 80 mg/day of regorafenib. Severe Grade 3 hand-foot syndrome was observed in the third week of regorafenib that required three weeks for improvement. However, AFP and PIVKA-II values decreased dramatically and CT imaging revealed the disappearance of intrahepatic and metastatic tumors. To address hand-foot syndrome symptoms, regorafenib was reduced to 40 mg/day via a revised treatment course of three weeks of administration and two weeks of withdrawal. The results of long-term regorafenib therapy of more than 12 months indicate that revising the drug dosage and duration is important for successful extended treatment.

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Short Communications
  • Isao Hidaka, Sumire Harano, Takashi Oono, Issei Saeki, Takuya Iwamoto, ...
    2020 Volume 61 Issue 8 Pages 434-437
    Published: August 01, 2020
    Released: August 06, 2020
    JOURNALS FREE ACCESS

    Liver cirrhosis and liver cancer are chronic diseases that require long-term treatment and early identification of symptoms is important. This study sought to examine whether nurse-directed assessments are useful for the early detection of symptoms in patients with chronic liver disease. A survey interview was conducted by nurses at the time of admission among patients with cirrhosis or hepatocellular carcinoma using an original symptom check sheet. Fifty-eight patients were included in this study. The results of the survey revealed that 79.3% of all subjects were symptomatic, with reports including pruritus and calf muscle cramps. Early treatment of symptoms was carried out following admission. The use of a checklist is useful and results in the early detection of symptoms.

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  • Ken Nsihino, Katsunori Ishii, Tomohiro Tanikawa, Noriyo Urata, Jun Nak ...
    2020 Volume 61 Issue 8 Pages 438-441
    Published: August 01, 2020
    Released: August 06, 2020
    JOURNALS FREE ACCESS

    Patients with nonalcoholic steatohepatitis associated with type 2 diabetes were given SGLT2 inhibitors for 30 months. Among 29 patients, ALT decreased by 30% or more in 51.7% of cases. ALT decreased by a median of −35.4% (−79% to 26%) or −42 (−187 to 86) IU/L, while reductions in the body mass index of −1 (−2.9 to 1.26) kg/m2 and HbA1c of −0.3% (−0.26% to 1.8%) were observed. However, the changes in ALT, BMI, and HbA1c did not correlate. In many cases, ALT, BMI, and HbA1c decreased at the start of administration but, in some cases, the rebound levels decreased afterward. SGLT2 inhibitor administration may achieve greater effects by continuing dietary exercise guidance.

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