http://hdl.handle.net/10564/1542 2001-02 2026-04-10T15:42:27Z http://hdl.handle.net/10564/651 タイトル: 針刺事故により急性C型肝炎を発症し, その後のインターフェロン(IFN)治療にてC型肝炎ウイルスを排除し得た2症例 著者: 杉本, 有美; 中本, 照子; 小嶌, 秀之; 山尾, 純一; 福井, 博; 小島, 邦行; 徳岡, 泰紀; 森岡, 千恵; 澤井, 正佳; 榑松, 由佳子; 簗瀬, 公嗣; 城井, 啓; 山本, 浩治; 美登路, 昭; 餅, 忠雄; 米田, 論; 岩澤, 秀; 山根, 佳子; 西村, 公男; 吉川, 正英 抄録: Transmission of hepatitis C virus (HCV) via accidental injuries in a problem for health care workers. We encountered two cases of acute hepatitis C, in whom HCV transmission was caused through accidental exposure to blood drawn from HCV- infected patients. Both of them pricked their fingers with a needle contaminated with blood from HCV-infected patients with liver cirrhosis. Case 1 was a 52-year-old nurse, who developed jaundice (T.Bil 3.3 mg/dl) with transaminase elevation (AST 1262 IU/ml, ALT 1348 IU/ml) at Day44 after the needle-stick accident. Case 2 was a 37-year-old nurse, who developed jaundice (T.Bil 5.5) with transaminase elevation (AST 863, ALT 872) at Day47 after the needle-stick accident. Both of them were negative for anti-HCV before the accidents and became positive in the association with jaundice and prominently elevated transaminases. We made a diagnosis of acute hepatitis C. Although their transaminase levels gradually decreased, they re-elevated and then fluctuated above the upper limit of normal range. Liver biopsies, performed on Day144 in Case 1 and on Day77 in case 2, presented piecemeal necrosis. Lymphoblastoid IFNa was introduced in Case 1, and recombinant IFNα-2a in Case 2. IFNs were given at a daily dose of 6 and 9 million units (MU), respectively, daily for the initial two weeks and three times a week for following 10 weeks. HCV-RNA in serum was not detected at the end of the daily treatment period with IFNα in each of the patients by RT-PCR. Serum HCV-RNA by repeated RT-PCR was thereafter negative in both patients. We believe that IFNα treatment should be introduced to the patients of acute hepatitis, in whom a chronic course of disease is suspected from persistent abnormal liver function and viremia. 2001-02-27T15:00:00Z http://hdl.handle.net/10564/650 タイトル: 糖尿病に合併したガス産生性巨大肝膿瘍の1例 著者: 中本, 照子; 山根, 佳子; 中谷, 敏也; 奥, 和美; 岩澤, 秀; 西村, 公男; 島谷, 英彦; 渡邊, 厳; 山尾, 純一; 菊池, 英亮; 栗山, 茂樹; 福井, 博; 吉川, 正英 抄録: We report the case ofa 52-year-old woman who developedalarge gas- forming pyogenic liver abscess. She had complaints of fever for 8 days with a dull pain in the right upper quadrant of the abdomen. An emergent blood examination revealed leukocytosis (white blood cells 20210/μl), abnormal liver function including elevated transaminase and alkaline phosphatase values (AST 675 IU/L, ALT 359 IU/L, ALP 1083 U/L) and high glucose level (435 mg/dl). Although she was once notified of a elevated serum glucose level at her pregnancy 15 years before, no further examinations had been done until the present occasion. The diagnosis of gas-forming liver abscess was easily made by abdominal ultrasonography and computed tomography. The patient was successfully treated with intravenous administration of appropriate antibiotics following immediate percutaneous transhepatic abscess drainage (PTAD). Klebsiella Pneumoniae (K. Pneumoniae) was detected in a specimen from the PTAD tube. Liver abscess caused by K. Pneumoniae should be considered as an infectious complication in diabetic patients. 2001-02-27T15:00:00Z http://hdl.handle.net/10564/649 タイトル: 男性同性愛者にみられたアメーバ性肝膿瘍の1例 著者: 瀧, 朋子; 今津, 博雄; 宮本, 洋二; 野口, 隆一; 小林, 洋三; 中谷, 敏也; 中山, 雅樹; 松井, 勉; 福井, 博; 吉川, 正英; 石坂, 重昭 抄録: A 49-year-old man was admitted because of high-grade fever, diarrhea and right hypochondralgia. Abdominal echogram and computed tomogram showed a solitary liver abscess just below the right diaphragm. The clinical diagnosis of amebiasis was established by the positive antibody of Entamoeba'histolytica. The patient underwent percutaneus transhepatic abscess drainage and medication with metronidazole. A fluid of anchovy sauce was aspirated and the abscess disappeared. 2001-02-27T15:00:00Z http://hdl.handle.net/10564/648 タイトル: 塵肺症(溶接工肺)に合併した非定型抗酸菌症の1例 著者: 竹内, 章治; 田村, 猛夏; 松澤, 邦明; 眞島, 浩子; 生駒, 行拡; 宮﨑, 隆治; 濱田, 薫; 米田, 尚弘; 成田, 亘啓 抄録: We report the case of a 45-year-old male welder who was admitted to our hospital due to an abnormal shadow on chest roentogenograph. Mycobacterim avium was isolated from sputum by PCR method. He was treated with INH, RFP, EB and clarithromycin. Infiltration shadow was improved but bilateral diffuse small nodular shadows were remained. He was diagnosised as welder's lung by transbroncheal lung biopsy. We should take notice of complication of pneumoconiosis in treatment with atypical mycobacteriosis. 2001-02-27T15:00:00Z