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1.
Nihon Shokakibyo Gakkai Zasshi ; 120(4): 346-354, 2023.
Article in Japanese | MEDLINE | ID: mdl-37032099

ABSTRACT

A 70-year-old man presented to our hospital with fever and abdominal pain. A mass was found in the left lobe of his liver. Three months later, disseminated peritoneal nodules and ascites appeared. Liver biopsy and review laparoscopy did not lead to a diagnosis. Approximately five months later, a pathological autopsy was performed, and a final diagnosis of sarcomatoid intrahepatic cholangiocarcinoma was made. Differentiating sarcomatoid cholangiocarcinoma from sarcomatoid malignant peritoneal mesothelioma was difficult due to the similarity of clinical and pathological findings. Because the two diseases are treated differently, being able to differentiate them is a challenge in the future.


Subject(s)
Bile Duct Neoplasms , Cholangiocarcinoma , Male , Humans , Aged , Cholangiocarcinoma/diagnostic imaging , Liver/pathology , Ascites , Bile Ducts, Intrahepatic/diagnostic imaging , Bile Ducts, Intrahepatic/pathology , Bile Duct Neoplasms/diagnostic imaging
2.
DEN Open ; 3(1): e138, 2023 Apr.
Article in English | MEDLINE | ID: mdl-35898821

ABSTRACT

Objectives: Distally located small common bile duct stones are often difficult to treat or grasp endoscopically. Therefore, multiple devices, such as baskets or balloon catheters, are frequently used in such cases. However, it is desirable to use a single device for stone extraction from the perspective of cost-effectiveness. In this multicenter study, we evaluated the efficacy of a new eight-wire basket catheter for extracting small (≤10 mm) common bile duct stones. Methods: We retrospectively analyzed the records of 144 patients who underwent stone extraction using the eight-wire basket catheter for common bile duct stones ≤10 mm. The success rate of complete stone extraction and the risk factors for the difficulty in stone extraction with the eight-wire catheter alone were mainly evaluated. Results: The success rate of stone extraction with the eight-wire catheter alone was 86.1%. The final rate of complete stone extraction was 98.0%. The mean of the maximum diameter of the common bile duct and the largest stone dimension were 10.5 ± 3.5, and 5.1 ± 2.1 mm, respectively. Common bile duct diameter ≥12 mm and stone diameter ≥6 mm were identified as independent risk factors for the difficulty in stone extraction with the eight-wire catheter alone. Conclusions: The success rate of the new eight-wire basket for small common bile duct stone extraction was acceptable. The device is beneficial and could be used from the start for the extraction of small stones < 6 mm.

3.
Nihon Shokakibyo Gakkai Zasshi ; 118(10): 975-980, 2021.
Article in Japanese | MEDLINE | ID: mdl-34629348

ABSTRACT

The patient is a female in her thirties. The patient was diagnosed with pustular psoriasis during the treatment course for pneumonia with the appearance of small pustules of the skin and with an increase of serum total bilirubin level. Pustular psoriasis is a designated intractable disease with extremely low prevalence in which the skin of the whole body is flushed with high fever and many sterile pustules occur. This disease has been reported to be accompanied by liver dysfunction. Liver dysfunction appeared 1-2 weeks after the eruption appears in most cases, but this is the rare case in which the liver disorder precedes.


Subject(s)
Liver Diseases , Psoriasis , Skin Diseases, Vesiculobullous , Female , Humans , Liver Diseases/complications , Psoriasis/complications , Skin
4.
Intern Med ; 60(15): 2413-2417, 2021 Aug 01.
Article in English | MEDLINE | ID: mdl-33612684

ABSTRACT

Systemic steroid is required for the exacerbation of ulcerative colitis (UC), although its administration should be avoided in patients with a low bone mineral density (BMD) exacerbated by side effects of steroids. We herein report the successful induction of remission in an UC case with a low BMD due to Fanconi-Bickel syndrome-or glycogen storage disease type XI-using granulocyte and monocyte adsorptive apheresis (GMA). For a 43-year-old woman with a BMD of 50% the young adult mean, GMA was performed 2 times a week for a total of 10 times. GMA might be a steroid-free treatment option for UC patients with a low BMD.


Subject(s)
Blood Component Removal , Bone Diseases, Metabolic , Colitis, Ulcerative , Fanconi Syndrome , Adult , Colitis, Ulcerative/complications , Colitis, Ulcerative/therapy , Female , Granulocytes , Humans , Leukapheresis , Monocytes , Remission Induction , Treatment Outcome
5.
Nihon Shokakibyo Gakkai Zasshi ; 114(3): 464-472, 2017.
Article in Japanese | MEDLINE | ID: mdl-28260715

ABSTRACT

Patients with immunoglobulin (Ig) G4-related sclerosing cholangitis typically have a high serum IgG4 level. However, here we describe our experience of a patient with a normal serum IgG4 level for whom the cholangitis was diagnosed by liver biopsy. A 61-year-old male presented with elevated liver enzymes and a normal serum IgG4 level. The hilar, intrahepatic, and upper extrahepatic bile ducts were stenotic, with no evidence of a pancreatic lesion. We therefore performed a liver biopsy to differentiate between cholangiocarcinoma and primary sclerosing cholangitis. Pathological examination revealed lymphoplasmacytic infiltrates around the bile ducts with a storiform fibrosis. IgG4-positive plasma cells were also observed. These results fulfilled the Japanese diagnostic criteria for IgG4-related sclerosing cholangitis. When this condition is suspected, liver biopsy should be performed even when serum IgG4 levels are normal.


Subject(s)
Cholangitis, Sclerosing/pathology , Biopsy , Cholangiopancreatography, Magnetic Resonance , Cholangitis, Sclerosing/complications , Cholangitis, Sclerosing/diagnostic imaging , Cholestasis, Intrahepatic/diagnostic imaging , Cholestasis, Intrahepatic/etiology , Humans , Immunoglobulin G/blood , Male , Middle Aged , Tomography, X-Ray Computed
6.
Gan To Kagaku Ryoho ; 42(6): 731-3, 2015 Jun.
Article in Japanese | MEDLINE | ID: mdl-26199246

ABSTRACT

A 77-year-old man presented with epigastralgia. Gastrointestinal endoscopic examination showed advanced gastric cancer, type 3, in the distal antrum. The patient refused surgery and preferred chemotherapy. The regimen consisted of 80 mg/body/day of S-1, continuously administered from day 1-14, followed by discontinuation for 2 weeks. After 2 courses, the patient experienced fatigue and recurrent vomiting. Laboratory studies revealed severe anemia; the hemoglobin level was 5.5 g/dL. An upper gastrointestinal endoscopy revealed pyloric stenosis and significant tumor reduction. Therefore, distal gastrectomy was performed. Histological examination did not reveal any viable cancer cells in the stomach and lymph nodes. Thus, a Grade 3 postchemotherapeutic effect was revealed.


Subject(s)
Antimetabolites, Antineoplastic/therapeutic use , Oxonic Acid/therapeutic use , Stomach Neoplasms/drug therapy , Tegafur/therapeutic use , Aged , Drug Combinations , Gastrectomy , Humans , Lymphatic Metastasis , Male , Neoadjuvant Therapy , Stomach Neoplasms/pathology , Stomach Neoplasms/surgery
7.
Gan To Kagaku Ryoho ; 37(11): 2173-6, 2010 Nov.
Article in Japanese | MEDLINE | ID: mdl-21084821

ABSTRACT

A 63-year-old male complaining of jaundice was examined and diagnosed with advanced gastric cancer (type 3, tub 2, cT3, cN3, cH0, cM1, cStage IV), and obstructive jaundice due to lymph node metastasis. Since curative surgery was deemed not possible, we started chemotherapy with S-1+CDDP. S-1 (120 mg/day) was administered orally for 21 days, followed by CDDP (60 mg/m2) div on day 8. After the 9th course, a significant tumor reduction was obtained. Total gastrectomy and lymph node resection (D1) were performed. The histological diagnosis revealed complete disappearance of cancer cells in both the main tumor and lymph nodes. Herein we report this rare case with a view of the literature.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Lymphatic Metastasis/pathology , Stomach Neoplasms/drug therapy , Stomach Neoplasms/pathology , Antimetabolites, Antineoplastic/administration & dosage , Antineoplastic Agents/administration & dosage , Cisplatin/administration & dosage , Drug Combinations , Humans , Male , Middle Aged , Oxonic Acid/administration & dosage , Tegafur/administration & dosage , Treatment Outcome
8.
Clin Cardiol ; 31(6): 275-80, 2008 Jun.
Article in English | MEDLINE | ID: mdl-18431739

ABSTRACT

There have been some reports in medical literature of patients with profound, reversible left-ventricular (LV) dysfunction after sudden emotional stress. Originally, in Japan, the pattern was called tako-tsubo cardiomyopathy. ST-segment elevation is seen with this syndrome, and it may look like acute ST-elevation myocardial infarction. However, it has also been well established that a subarachnoid hemorrhage can manifest with cardiac abnormalities. The authors describe a case involving a cerebral hemorrhage and a potential tako-tsubo-like cardiomyopathy in the same patient. In conclusion, even though the patient's presentation appears to be a tako-tsubo syndrome, the radiographic evidence of a cerebral hemorrhage presents as a stronger etiology for the cardiac changes that occur in our patient.


Subject(s)
Cerebral Hemorrhage/etiology , Takotsubo Cardiomyopathy/complications , Aged , Cerebral Hemorrhage/diagnosis , Diagnosis, Differential , Echocardiography , Electrocardiography , Female , Follow-Up Studies , Humans , Takotsubo Cardiomyopathy/diagnosis , Tomography, X-Ray Computed
9.
Gan To Kagaku Ryoho ; 34(3): 423-6, 2007 Mar.
Article in Japanese | MEDLINE | ID: mdl-17353635

ABSTRACT

The patient was a 66-year-old male with extremely advanced gastric cancer type 3 and diagnosed with adenocarcinoma by endoscopic biopsies specimens. Combined chemotherapy of TS-1, CDDP and docetaxel was prescribed in order for tumor reduction and downstaging. TS-1 (80 mg/m(2)) was administered 28 days followed by 14 days rest as one course. CDDP (8 mg/m(2)) was administered on days 1, 2, 14 and 15 and docetaxel (40 mg/m(2)) was administered on day 1 and 14, followed by 4 weeks rest as one course. After 2 courses of treatment, a CT scan revealed a minor response of tumor reduction. Therefore, total gastrectomy, partial pancreas body and tail resection, and D 2 lymph node dissection were performed. The patient had undergone adjuvant chemotherapy of TS-1 and biweekly docetaxel after surgery with no recurrence for 13 months. Adverse reactions were grade 3 neutropenia and grade 2 diarrhea. Combined chemotherapy of TS-1, low-dose CDDP and docetaxel were intensive and required constant patient monitoring. However, it proved effective and feasible as a neoadjuvant chemotherapy regimen for advanced gastric cancer.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Adenosquamous/drug therapy , Stomach Neoplasms/drug therapy , Aged , Carcinoma, Adenosquamous/pathology , Carcinoma, Adenosquamous/surgery , Cisplatin/administration & dosage , Combined Modality Therapy , Docetaxel , Drug Administration Schedule , Drug Combinations , Humans , Male , Oxonic Acid/administration & dosage , Remission Induction , Stomach Neoplasms/pathology , Stomach Neoplasms/surgery , Taxoids/administration & dosage , Tegafur/administration & dosage
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