Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 108 , Issue 2
Showing 1-13 articles out of 13 articles from the selected issue
Review article
Monthly report; Recent treatment for chronic hepatitis B
Original article
  • Yoko KOMINAMI, Hirotoki OHE, Sayo KOBAYASHI, Daisuke UCHIDA, Norifumi ...
    2011 Volume 108 Issue 2 Pages 223-230
    Published: 2011
    Released: February 07, 2011
    JOURNALS FREE ACCESS
    We investigated whether emergency dynamic computed tomography (CT) is helpful to identify bleeding colonic diverticulum treatable by colonoscopy. We enrolled 95 consecutive patients given diagnoses of colonic diverticular bleeding at Hiroshima City Hospital in the present study, of whom 60 underwent CT before colonoscopy (CT group), and 35 underwent colonoscopy alone (CS group). In the CT group, bleeding diverticula were identified and treated by colonoscopy in 31 of 32 (96.9%) patients in whom extravasation was detected by CT. The interval between bleeding being recognized and CT (median 1.0 hours) in patients in whom extravasation was detected by CT was shorter than that in whom extravasation was not detected (median 5.0 hours). To identify and treat bleeding diverticula by colonoscopy, the use of emergency dynamic CT prior to colonoscopy is recommended.
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Case report
  • Masahiro HIRAKAWA, Yasushi SATO, Hiroyuki OHNUMA, Tamotsu SAGAWA, Hiro ...
    2011 Volume 108 Issue 2 Pages 231-237
    Published: 2011
    Released: February 07, 2011
    JOURNALS FREE ACCESS
    A 75-year-old man received chemoradiotherapy (CRT) for stage IVa esophageal cancer and complete response (CR) was obtained. However, he was referred to our department for recurrence in an area of esophagus not included in the previously irradiated field. Left pleural effusion increased after admission. Tuberculous pleuritis was eventually diagnosed by thoracoscopic pleural biopsy. It is necessary to accurately diagnose the cause of pleural effusion after CRT, because treatment strategies greatly depend on it. It is also necessary to consider the possible onset of tuberculous pleuritis, in particular, in patients with a history of tuberculosis infection.
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  • Takeshi KAWABE, Masahiro YOSHINAGA, Yosuke KITAMURA, Hiroyuki MURAO, K ...
    2011 Volume 108 Issue 2 Pages 238-244
    Published: 2011
    Released: February 07, 2011
    JOURNALS FREE ACCESS
    A 67-year-old woman underwent partial gastrectomy (por2+sig, stage IIIA) for gastric cancer. She was admitted to our hospital because of swelling of her left neck lymph nodes 20 years after surgery. A biopsy specimen revealed poorly differentiated adenocarcinoma with signet-ring cell carcinoma. We diagnosed recurrence of gastric cancer and gave chemotherapy, but she died of myelosuppression and disseminated intravascular coagulation 2 years later. On autopsy, we examined all organs except the brain, but the primary lesion was not recognized. We concluded that this case was late recurrence after partial gastrectomy for advanced gastric cancer.
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  • Tomohito MORISAKI, Ken OHNITA, Fuminao TAKESHIMA, Yuko AKAZAWA, Naoyuk ...
    2011 Volume 108 Issue 2 Pages 245-252
    Published: 2011
    Released: February 07, 2011
    JOURNALS FREE ACCESS
    We report a case of sclerosing cholangitis caused by oral chemotherapy with S-1. A 79-year-old woman with a history of hypertension presented with epigastric discomfort. Upper gastrointestinal endoscopy revealed advanced gastric cancer in the gastric antrum and abdominal computed tomography showed multiple lymph node metastasis. The patient underwent chemotherapy with S-1. Since 2 months later, blood chemistry analysis showed liver dysfunction and hyperbilirubinemia, and chemotherapy was discontinued. Endoscopic retrograde cholangiopancreatography revealed stenosis of the bile duct at the hepatic hilum. There was no evidence of tumor in the liver. We diagnosed chemotherapy-induced sclerosing cholangitis (CISC) caused by S-1. Although treatment with ursodeoxycholic acid and corticosteroids was temporarily effective, she eventually died of CISC and gastric cancer. To the best of our knowledge, this is the first case report of CISC caused by S-1. We present this rare condition with a review of the literature.
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  • Hirokazu DOI, Seiji NAKANISHI, Soichi ICHIKAWA, Hirotaka YAMASHITA
    2011 Volume 108 Issue 2 Pages 253-258
    Published: 2011
    Released: February 07, 2011
    JOURNALS FREE ACCESS
    A parahiatal hernia, that occurs from muscular diaphragmatic defects causing separation from the esophageal hiatus, is rare. We treated a 68-year-old Japanese woman with the symptom of vomiting. Based on imaging studies (upper gastrointestinal studies, gastroscopy, contrast-enhanced computed tomography) we diagnosed parahiatal hernia. On laparoscopic surgery, the hernial orifice was separated from the esophageal hiatus and the crus of the diaphragm was between the hiatus and the orifice. We closed the hernial orifice with mesh. Parahiatal hernia is rare and is difficult to diagnose preoperatively. We present a case and the clinical discuss the characteristics and management of this rare disease.
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  • Takanobu IRIE, Akira TAKEDA, Ryoji TAKADA, Yoshinobu SAITO, Tetsuji FU ...
    2011 Volume 108 Issue 2 Pages 259-266
    Published: 2011
    Released: February 07, 2011
    JOURNALS FREE ACCESS
    An 83-year-old man was admitted with renal dysfunction, anemia, and peripheral leukocytosis. His peripheral leukocyte count was 41000/μl. A computed tomography scan revealed a solid cystic mass in the liver, mural thickening in the ascending colon and nodules in the right lower lung field. Colonoscopy revealed ascending colon cancer, and analysis of the biopsy specimens revealed well-differentiated adenocarcinoma. However, although a liver abscess was suspected, pus and bacteria were not found in the cystic lesion of the liver mass, the solid lesion of the mass was diagnosed as carcinoma. The serum concentration of granulocyte colony-stimulating factor (G-CSF) was elevated to 256pg/ml. Because his general condition worsened, we could not treat these tumors, but he died 38 days after admission. Autopsy revealed adenosquamous carcinoma of the liver, well-differentiated adenocarcinoma of the ascending colon, urothelial carcinoma of the urinary bladder, and metastatic squamous cell carcinoma of the lung. Immunohistochemical analysis revealed positive staining for G-CSF in the liver tumor sample.
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  • Shogo OHKOSHI, Shin-ichi MORITA, Yukari TANAKA, Masahiko YANO, Manabu ...
    2011 Volume 108 Issue 2 Pages 267-274
    Published: 2011
    Released: February 07, 2011
    JOURNALS FREE ACCESS
    We report a case of chronic hepatitis C in whom liver cirrhosis was later diagnosed following abnormality of ALT levels during pegylated interferon α2a and ribavirin treatment. A 62-year-old woman with chronic hepatitis C was treated with pegylated interferon α2a plus ribavirin for 72 weeks. Her HCV RNA became negative 16 weeks after the start of treatment and continued to be negative for most of the treatment duration. Her AST/ALT, ALP/γ-GTP levels became elevated soon after the initiation of treatment and thereafter remained unchanged. However, most of these levels normalized after the end of treatment. Post-treatment liver biopsy showed liver cirrhosis, probably due to the interferon treatment itself. This unusual therapeutic outcome should be considered if the levels of hepatic dysfunction during interferon treatment are severe.
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  • Toshiya NAGASAKI, Hideaki KOMATSU, Yoshihito SHIBATA, Hiroyuki YAMAGUC ...
    2011 Volume 108 Issue 2 Pages 275-279
    Published: 2011
    Released: February 07, 2011
    JOURNALS FREE ACCESS
    A 72-year-old man was referred to our hospital for suspected gallbladder cancer. We performed cholecystectomy with liver bed resection and lymph node dissection. Intraoperative cytological examination of the bile juice revealed some trophozoites of Giardia lamblia, and pathological examination revealed gallbladder cancer. Therefore, we diagnosed giardiasis associated with gallbladder cancer. We administered 750mg per day metronidazole for 10 days. The patient was a farmer by occupation and used animal manure for agricultural purposes; he also consumed his own harvest, which was recognized as the infection route for his giardiasis. We reviewed the literature and found very few cases of giardiasis associated with gallbladder cancer.
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