Osamu Kurai

Spontaneous Regression of Hepatocellular Carcinoma: Report of a Case

A spontaneous regression of hepatocellular carcinoma is an extremely rare phenomenon. A 69-year-old Japanese man with hepatitis C virus-related chronic hepatitis presented with a liver tumor. We diagnosed the tumor to be hepatocellular carcinoma in the course of spontaneous regression, by imaging studies and changes in the tumor markers. Because the possible presence of viable cancer cells could not be ruled out, we recommended surgery. He refused all treatments at first, but finally agreed to undergo surgery about 10 months after presentation. A hepatectomy was performed. Histologically, no viable tumor cells were found. In our case, the vascularity of the tumor according to the imaging findings was followed up during the clinical course. The patient is now doing well and without any evidence of recurrence at 37 months after surgery.

Portal circulation in monkeys and humans studied after ingestion of a capsule containing a radionuclide.

Capsules (8 times 30 mm) of technetium‐99m pertechnetate were designed for measurement of portal blood flow. Most of the radionuclide entered the superior mesenteric vein. The capsule was taken orally and monitored with a collimator for scintigraphy until it reached the small intestine, when a magnetic field completed an electrical circuit in a sensor, burning a thread, releasing a spring, and discharging the preparation.

Influenza A(H1N1)pdm09 vaccine effectiveness and other characteristics associated with hospitalization in chronic liver disease patients

To date, few studies have investigated the clinical effectiveness of influenza vaccine in chronic liver disease patients. The aim of this study was to examine the effectiveness of monovalent inactivated influenza A(H1N1)pdm09 vaccine and other characteristics associated with hospitalization in patients with chronic hepatitis C.

Diagnosis of hepatocellular carcinoma by factor analysis

We examined the usefulness of factor analysis for the diagnosis of hepatocellular carcinoma by analysis of the data obtained by radionuclide angiography. The data could be separated into two factors, a hepatic phase (hepatic artery and portal vein) and an arterial phase (aorta and kidney). In patients with hepatocellular carcinoma, the factor of the tumor is included in the arterial phase, so that the cancerous region could be differentiated from the noncancerous region. The ratio of the radioactivity of the cancerous region to the noncancerous region was used to estimate the blood flow of the tumor region.

A case of focal nodular hyperplasia of liver diagnosed by Power Doppler ultrasonography at first visit.

症例は24歳, 女性. 他院での腹部超音波で肝内腫瘤を認め, 当院を紹介された. 当科外来初診時の腹部超音波では肝のCouinaud分類のS5領域に径35mm大の辺縁がやや不明瞭で, 内部が均一な低ェコー腫瘤を認めた. 同時に施行したパワードプラエコーでは腫瘤内に放射状の血流シグナル, いわゆる車軸状血管像を認め, 肝FNHと診断した. 99mTc-Snコロイドシンチでは同部に円形のhot spotを認め, 腹部血管造影にても車軸状血管像を認めた. しかし肝生検にて他の肝腫瘍も疑われたため肝切除術を施行した. 腫瘤は肉眼上やや赤褐色調が強く, 中央に暗赤褐色を示す領域が放射状に認められたが, 明らかな中心性瘢痕を伴わず, また組織では異型性のない軽度腫大した肝細胞より構成された過形成性病変であったが, グリソン鞘周辺では類洞の著明な拡張を認めるなど, 非定型的なFNHであった.