無症候性原発性胆汁性肝硬変,慢性甲状腺炎および三重複癌を合併した一男性症例を報告.症例は65才,男性.昭和58年10月嗄声のため当院受診.喉頭癌と診断.胆道系酵素上昇,血沈および血清IgM異常高値,抗ミトコンドリア抗体陽性,肝生検にて慢性非化膿性破壊性胆管炎像を認め,掻痒感,黄疸を欠くことから無症候性原発性胆汁性肝硬変と診断. T3, T4低下. TSH上昇,サイロイドテスト,マイクロゾームテスト強陽性であり,甲状腺シンチ所見らより慢性甲状腺炎と診断.中部食道に小隆起性病変と不正形のびらんを認め,生検にて扁平上皮癌と診断.胃にも小隆起性病変を認め,生検にて高分化腺癌と診断.免疫病理学的に興味深い症例と思われる.

Primary Biliary Cirrhosis

10.2169/naika.75.57

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Predicting the response to 48‐week combination therapy with peginterferon α‐2b plus ribavirin from the estimated HCV RNA load index after negative serum change in genotype 1b hepatitis C patients

Hepatology Research (2009)

Keiji Tsuji Yoshiiku Kawakami Shiomi Aimitsu Hiroshi Kohno Yasuyuki Aisaka

We estimated viral dynamics after serum hepatitis C virus (HCV) RNA became negative and assessed the relation between the estimated viral load at the end of treatment (EVE) index and the response to the combination therapy with peginterferon alpha-2b plus ribavirin.Patients with chronic HCV, genotype 1b, and a high viral load were treated with this combination therapy for 48 weeks, and serum HCV RNA was measured frequently during the treatment period. In the patients showing an end-of-treatment response (ETR), the viral load profile from the start of treatment until serum HCV RNA became negative was expressed by an approximate curve. Then the EVE index was calculated by using the expression obtained from the curve, and differences between the sustained virologic response (SVR) and relapse groups were investigated.The SVR rate increased as the EVE index became lower, and the EVE index was significantly lower in the SVR group than in the relapse group. The SVR rate was higher for those in whom the EVE index was below the cut-off point.Prediction of SVR and relapse from the EVE index is more useful than prediction from viral dynamics at the time when HCV RNA becomes negative or when HCV RNA shows a decrease of 2-log or more.

Antiviral Therapy

Hepatitis C

10.1111/j.1872-034x.2009.00488.x

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Contents, Vol. 26, 1983

Digestion (1983)

Joy Dlugosz Ulrich R. Fölsch W. Creutzfeldt Kyoichi Kobashi Yoshika Takeda

10.1159/000198885

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Correction: Reduction of hepatitis B surface antigen in sequential versus add-on pegylated interferon to nucleoside/nucleotide analogue therapy in HBe-antigen-negative chronic hepatitis B patients: A pilot study

Antiviral Therapy (2017)

Yumiko Tatsukawa Masataka Tsuge Yoshiiku Kawakami Yuichi Hiyama Eisuke Murakami

Pegylated interferon

Hepatitis B

Nucleoside analogue

10.3851/imp3289

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Prospective study of short‐term peginterferon‐α‐2a monotherapy in patients who had a virological response at 2 weeks after initiation of interferon therapy

Journal of Gastroenterology and Hepatology (2008)

Soocheol Jeong Yoshiiku Kawakami Mikiya Kitamoto Hiroto Ishihara Keiji Tsuji

Abstract Background and Aims: Long‐term interferon (IFN) therapy is effective in eliminating hepatitis C virus (HCV). However, it carries the risk of adverse effects and reduced quality of life. To assess whether short‐term IFN therapy effectively eliminates HCV, we performed a prospective pilot study of pegylated (peg)IFN‐α‐2a therapy for 8 or 24 weeks. Methods: After excluding patients with high titers of genotype‐1, 55 HCV patients received pegIFN‐α‐2a. Patients who became negative for HCV‐RNA at week 2 were allocated to either an 8‐week ( n = 19) or 24‐week ( n = 15) course of IFN. We evaluated the efficacy of and tolerance to IFN therapy. Results: The sustained virological response rate was excellent in the two groups (8 weeks, 89.5% [17/19]; 24 weeks, 100% [15/15], respectively,). IFN dose reduction was required in one patient of the 8‐week group, but in six patients of the 24‐week group ( P = 0.028). Treatment was completed by all patients of the 8‐week group, but discontinued in five patients of the 24‐week group ( P = 0.011). Conclusions: The 8‐week IFN therapy is more tolerable than the 24‐week therapy and had similar outcomes. Excluding the patients with high titers of genotype‐1, we recommend switching to an 8‐week course of pegIFN‐α monotherapy once patients show an ultra rapid virological response at week 2 from the start of IFN therapy.

Combination therapy

Pegylated interferon

10.1111/j.1440-1746.2008.05356.x

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The efficacy of sequential treatment with lamivudine and alpha-interferon in anti-HBe-negative chronic hepatitis B patients -Examination of HBsAg seroclearance-

Kanzo (2013)

Nami Mori Masaki Tsuge Yoshiiku Kawakami Kazuaki Chayama Hiroiku Kawakami

Fourteen patients with anti-HBe-negative chronic hepatitis B were treated with sequential treatment with lamivudine and alpha-interferon. Complete response (CR) was defined as normalization of ALT (<40 IU/l) and eradication of HBV-DNA (<3.7 LEG/ml, TMA method). Non responder (NR) was defined as anything other than CR. HBsAg clearance after 6 months and 2 years at the end of sequential treatment was achieved in 2 of 4 CR. They showed an on-treatment HBsAg decline ≥50% at the end of sequential treatment.

Hepatitis B

Interferon alfa

10.2957/kanzo.54.720

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A case of recurrent intrahepatic cholestatic jaundice of pregnancy

Kanzo (1979)

Tetsuaki KUNIMASA Seiki Yamashita Koichi MORIO Nobutaka Matsuo Akio SUMITANI

第1回および第2回妊娠により肝内胆汁うっ滞を呈した症例を経験した.患者は22歳の女性で第1回,第2回妊娠中期より全身掻痒感と黄疸が出現した.生化学的検査で血清ビリルビン,Al-P,LAP,総コレステロールの著明な上昇を認めたが,他の肝機能は正常範囲であった.分娩後自覚症状および黄疸,生化学的検査は速やかに改善された.非妊娠時におけるエチニール・エストラジオール負荷で妊娠後期と同様の臨床症状および生化学的変化が現われ,エストロゲンの増加が疾患の病因であることが証明された.血清γ-GTPは妊娠後期およびエチニール・エストラジオール負荷で下降した.エチニール・エストラジオールを添加抗原としたリンパ球幼若化試験は陰性で細胞性免疫の成立は認められずエストロゲンが肝へ直接作用することが強く示唆された.

Cholestatic Jaundice

Obstructive jaundice

10.2957/kanzo.20.610

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Author Index, Vol. 26, 1983

Digestion (1983)

Joy Dlugosz Ulrich R. Fölsch W. Creutzfeldt Kyoichi Kobashi Yoshika Takeda

10.1159/000198898

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Kanzo (1982)

Eiichi Takezaki Manabu TAKEMOTO Koichi MORIO Toshio Nakanishi Masaya KIKUKAWA

肝uridine diphosphate glucuronyl transferase (UDP-GT)活性が肝予備能の指標として有用なことに着目し,α-naphthyl isothiocyanate (ANIT)を用いた動物実験で,UDP-GT活性の変動とグルカゴン負荷試験時のcyclic AMPの変動が相似た傾向を示すことを認めた.UDP-GT活性はグルカゴンおよびdibutyryl cyclic AMP投与で,ANITによる肝細胞障害の程度に応じて上昇し,又,この酵素活性の上昇は蛋白合成阻害剤であるActinomycin Dによって阻害された.即ち,UDP-GT活性の酵素合成にcyclic AMPが関与することが示唆され,肝細胞障害時のUDP-GT活性とグルカゴン負荷後のcyclic AMPの変動の両者にcyclic AMPが介在することで,両者が相似た傾向を示すことが理解された.

Transferase

10.2957/kanzo.23.1270

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