We conducted a national questionnaire-based web survey among care managers (CM) in Japan working as long-term home-care providers to examine their medical knowledge about chronic hepatitis C (CHC). The survey results yielded a total of 697 responses. Although over 80% of CM were aware of the infection route and disease progression of hepatitis C virus (HCV) infection, only 28.0% knew HCV could be treated with oral drugs alone. The average number of care recipients under each CM was 30.8±17.0, and each CM was aware 0.55±1.05 recipients infected with HCV. Approximately 37.7% of CM had heard of individuals with HCV being refused admission through long-term care facilities and their associated management offices. However, 40.5% of CM are supposed to be certified as hepatitis medical coordinators if they could contribute to society. Consequently, CM may play a crucial, socially important role in countermeasures for CHC, including sharing accurate knowledge and increasing awareness.

A male patient in his 70s was referred to our hospital for epigastralgia and leg pain evaluation, which revealed a massive protruding hepatocellular carcinoma (HCC) in the left lobe of the liver accompanied by lumbar spinal metastases. We performed left lateral hepatic segmentectomy and palliative radiotherapy to evaluate the lumbar spine and sacrum with denosumab injection. After symptom improvement, he was given atezolizumab and bevacizumab (Atezo/Bev) as systemic therapy. After two courses, his lumbago worsened and his performance status (PS) deteriorated to four. We performed balloon kyphoplasty (BKP) for pain relief and PS improvement. The patient's lumbago was relieved postoperatively, Atezo/Bev therapy was re-instituted, and he was doing well 25 months postoperatively and after 24 courses of outpatient Atezo/Bev therapy. Multidisciplinary treatment, comprising radiotherapy and BKP, with careful attention to the patient's general condition, may be useful to improve prognosis in patients with HCC accompanied by vertebral metastases.

The standard treatment for aPBC is to combine a fibrate with UDCA. Bezafibrate and fenofibrate are fibrates that elevate serum creatinine levels while decreasing the estimated glomerular filtration rate (eGFR). Pemafibrate is a selective peroxisome proliferator-activated receptor α modulator, which is primarily metabolized by the liver. This study assessed the effects of switching from fenofibrate to pemafibrate treatment in 16 aPBC patients over 144 weeks. In patients with aPBC treated with fenofibrate, serum creatinine levels increased significantly, while eGFR decreased significantly over 48 weeks. Moreover, patients with aPBC who switched to pemafibrate had significantly lower serum creatinine levels and higher eGFR over 144 weeks. Pemafibrate may be another option for aPBC patients, given its beneficial effects on renal function.

This retrospective study aims to evaluate the short-term clinical outcome of microwave ablation (MWA) for hepatocellular carcinoma (HCC) using Mimapro™. This study included 49 patients with HCC treated with MWA from December 2021 to August 2022. The median age was 77 (interquartile range: 73-80) years old and 41 (83.7%) were males. The performance status in 44 (89.8%) patients was 0. Child-Pugh classes A and B were observed in 44 (89.8%) and 5 (10.2%) patients, respectively. The initial and final complete ablation rates were 91.8% (45/49) and 100.0% (49/49), respectively. Major complications were not observed. Further analysis will be conducted to evaluate the long-term clinical outcome of MWA using Mimapro™.