Analysis of Serum Antibody Level after COVID-19 Vaccine and Side Effects after Vaccine

Background: COVID-19 has caused a large number of deaths, in the elderly. In this situation, vaccines have been considered the main strategy to combat COVID-19 and were developed worldwide in 2020. One problem with COVID-19 vaccination is side effects after vaccination. In this report, we identify the relationship between side effects and elevation of antibodies as determined by monitoring several kinds of antibodies against COVID-19. Objective: We investigated whether the antibody level changed depending on side effects after COVID-19 vaccination. Methods: Healthy volunteers, who received two vaccinations between 10 March and 7 May 2021, were collected for this study. Information including age, gender, smoking history, medical history including allergies and side reactions after vaccination was obtained by questionnaire. Serum levels of antibodies of IgG and IgM against each S1, SP, and NP antigens of COVID-19 were evaluated frequently for 3 - 4 months after the first vaccination. Result: Ten employees working at Iwate Medical University were evaluated in this study. Side effects were observed in 7 of 10 patients, and grade 2 side effects in all 3 patients with a history of allergic disease. Serum S1 and SP IgG were elevated sufficiently in all patients. In all patients, IgG antibody titers fell below the cutoff point in approximately 3 months. No cases had elevated NP antibodies. SP IgM was elevated in three cases;all three cases with elevated IgM had allergic disease and the degree of side effects was relatively higher. Subjects with long-lasting elevated SPIgM were observed. Conclusion: S1 IgG and SP IgG exceeded the cutoff in all subjects after vaccination but decreased below the cutoff in all subjects within 4 months, regardless of side effects or allergic history. On the other hand, elevated SPIgM was suspected to be related to side effects and history of allergies, and cases with persistent elevation of SPIgM were observed.

Interferon alpha plus ribavirin combination treatment of Japanese chronic hepatitis C patients with HCV genotype 2:A project of the Kyushu University Liver Disease Study Group

瞄准：决定一座干扰素高山的功效哈并且为感染遗传型 2 的丙肝病毒(HCV ) 的日本病人的 ribavirin 联合治疗，多中心研究回顾地被分析。方法：总共，有 HCV 遗传型 2 的 173 个病人每天一个星期和 ribavirin 的 600-800 mg 为 24 wk 三次皮下地收到 interferon-alpha。结果：总的来说持续的 virological 反应(SVR ) ，在浆液的定义同样无法发现的 HCV RNA，在治疗的结束以后的 24 wk，在 84.4% 显著地高，(146/173 ) 由 intention-to-treat 分析。在 SVR 的有效差量有或没有 ribavirin (46.9% 对 92.9%) 的中止在病人之间被发现，但是没有差别有或没有 ribavirin 的剂量减小在那些之间被发现。在 SVR 的有效差量也与 16 或更与不到 16 wk 和病人在病人之间被发现 ribavirin 治疗(34.8% 对 92.0%) 的星期。结论：24-wk 干扰素和 ribavirin 治疗为有 HCV 遗传型 2 的日本病人是高度有效的。SVR 的重要预言者是 ribavirin 治疗的继续多达 16 个星期。

Scattered and rapid intrahepatic recurrences after radio frequency ablation for hepatocellular carcinoma

AIM: To evaluate a series of patients with hepatocellular carcinoma (HCC) treated with several different protocols and devices.METHODS: We treated 138 patients [chronic hepatitis/liver cirrhosis (Child-Pugh A/B/C), 3/135 (107/25/3)]with two different devices and protocols: cool-tip needle [initial ablation at 60 W (standard method) (n=37)or at 40 W (modified method) (n = 28)] or; ablation with a LeVeen needle using a standard single-step, full expansion (single-step) method (n = 39) or a multi-step,incremental expansion (multi-step) method.RESULTS: Eleven patients experienced rapid and scattered recurrences 1 to 7 mo after the ablation. Nine patients were treated by the cool-tip original protocol (60 W) (9/37=24%) and the other two by the LeVeen single-step method (2/39=5%). The location of the recurrence was surrounding and limited to the site of ablation segment in three cases, and spread over one lobule or both lobules in the other eight cases. There was no recurrence in the patients treated with the modified cool-tip modified method (40 W) or the LeVeen multi-step method.CONCLUSION: There is a risk of rapid and scattered recurrence after RFA, especially when the standard cooltip procedure is used. Because such recurrence would worsen the prognosis, we recommend that modified protocols for the cool-tip and LeVeen needle methods should be used in clinical practice.

High relative fat-free mass is important for maintaining serum albumin levels in patients with compensated liver cirrhosis

AIM: In patients with liver cirrhosis, hypoalbuminemia causes edema and ascites, and a reduction in the quality of life. Since musculature is catabolized to supply amino acids for albumin synthesis in malnutritional cirrhotic patients, muscular volume is hypothesized to play an important role in albumin production. Therefore, we investigated the correlation between serum albumin levels and the fat-free mass (FFM) in cirrhotic patients.METHODS: Fifty-seven patients (26 males and 31 females)with compensated liver cirrhosis were evaluated. Patients with edema or ascites were excluded from the study.Healthy volunteers (n = 104; 48 males and 56 females)were also evaluated as controls. FFM was measured using 5-500 kHz multifrequency bioelectric impedance analysis.To minimize the difference in FFM distribution between males and females, we introduced a new marker, relative FFM (rFFM), which represents the ratio of FFM in a patient relative to that in a volunteer of the same height. Following FFM measurement, the serum albumin levels of patients were assayed monthly.RESULTS: In patients with active cirrhosis (alanine aminotransaminase [ALT] ＞50 U/L), both albumin (the difference between maximum and minimum levels) and the standard deviation of albumin levels (SD-albumin) during the observation period showed a significant correlation with rFFM. Multiple linear regression analysis using variables such as rFFM, platelet number, and serum cholesterol levels,choline esterase, albumin, bilirubin, and ALT revealed that rFFM and ALT were significant and independent factors that influenced albumin or SD-albumin in cirrhotic patients.CONCLUSION: Our results indicate that cirrhotic patients with high rFFM showed less of a decrease in albumin levels, and that the muscle volume is one of the most important factors for maintaining serum albumins level in active cirrhosis. Exercise and protein-rich nutrition at the early stage of liver cirrhosis may be advisable for maintaining or increasing muscular volume.

Long-term lamivudine treatment for chronic,hepatitis B in Japanese patients:A project of Kyushu University Liver Disease Study

瞄准：与长期的肝炎 B 决定很多日本病人的长期的 lamivudine 治疗的功效。方法：在这回顾，多中心试用，有长期的肝炎 B 的 318 个日本病人每天为多达 36 收到了 lamivudine 的 100 mg (中部 21 ) 瞬间。Virological 反应是到浆液 HBV DNA 水平的衰落不到 3.7 木头 copies/mL。当浆液 HBV DNA 的再现在 treatment.RESULTS 期间铺平最小到超过 10 褶层， Virological 突破被定义：Lamivudine 在 6 瞬间在 318 个病人中的 86.8% 个生产了 virological 反应，在在 12 瞬间的 252 个病人中的 80.2% 个，在在 24 瞬间的 133 个病人中的 69.2% 个，并且在在 36 瞬间的 28 个病人中的 53.6% 个。向前逐步的逻辑回归分析证明 HBV DNA 铺平不到 6.8 木头 copies/mL ( P【0.0001 )， HBeAg 否定性( P【0.0001 )， 100 x 10 的一个血小板计数( 9 )在基线的 /L 或更多( P=0.0162 )，并且超过 3.2 木头 copies/mL 的 HBV DNA 水平的衰落在治疗( P=0.0003 )的开始以后在 3 瞬间作为与基线相比铺平显著地与 virological 反应被联系。在有 virological 回答的病人之中， virological 突破在在 1 瞬间 virologically 反应了的 19 个病人中的5.3%个被看见，在在 3 瞬间的 203 个病人中的20.7%个，在在 6 瞬间的 51 个病人中的27.5%个，在在 9 瞬间的 12 个病人中的33.3%个，并且在在 】=5 瞬间的 3 个病人的100%。virological 突破与推迟的 virological response.CONCLUSION 在病人更经常显著地被发现：Lamivudine 治疗能在大多数测试日本病人压制浆液 HBV DNA。没有 HBeAg，长期的功效可能在基线在病人被看见，当肝硬化不在时，并且在有在 HBV 的衰落的病人， DNA 此后不久铺平治疗的开始。

Relationship between body surface area and ALT normalization after long-term lamivudine treatment

AIM: To further evaluate the relationship between BSA and the effects of lamivudine in a greater number of cases and over a longer period of observation than in our previous evaluation.METHODS: We evaluated 249 patients with chronic hepatitis B. The effects of treatment for one year (n = 249),two years (n = 147), and three years (n = 72) were evaluated from the levels of serum ALT and HBV-DNA,as biological and virological effects (undetectable levels by PCR), respectively. Moreover, several variables that could influence the response to treatment, including ALT,albumin, bilirubin, platelet counts, BSA, HBV-DNA, and HBeAg were analyzed.RESULTS: For 1-year treatment, multivariate analysis revealed that BSA (P=0.0002) was the only factor for the biological effect, and that ALT (P = 0.0017), HBVDNA (P = 0.0004), and HBeAg (P = 0.0021) were independent factors for the virological effect. For 2-year treatment, multivariate analysis again showed that BSA(P = 0.0147) was the only factor for the biological effect,and that ALT (P = 0.0192) and HBeAg (P = 0.0428) were independent factors for the virological effect. For 3-year treatment, multivariate analysis, however, could not reveal BSA (P = 0.0730) as a factor for the normalization of ALT levels.CONCLUSION: BSA is a significant predictor for the normalizing the effect of lamivudine therapy on ALT for an initial 2-year period, suggesting that lamivudine dosage should be based on the individual BSA.

为 hepatocellular 癌的胸墙转移的 Transcatheter 动脉的 embolization

Hemothorax due to rupture of metastatic hepatocellular carcinoma (HCC) is a very rare complication with high mortality because of uncontrollable hemorrhage. A 71-year-old man treated by transcatheter arterial embolization for HCC with massive bleeding from chest wall metastasis is reported. Enhanced computed tomography and selective intercostal angiogram showed a hypervascular mass in the right chest wall and extravasation of contrast agent. After successful transcatheter arterial embolization with gelatin sponge particles and metallic coils, the patient recovered from shock without major complication. To our knowledge, a successfully treated case of hemothorax due to rupture of metastatic HCC has not previously been described.