基本情報
- 所属
- 自治医科大学 医学部 総合医学第1講座 / 附属さいたま医療センター 内科系診療部 消化器内科 准教授
- J-GLOBAL ID
- 201401075076433737
- researchmap会員ID
- B000238206
研究分野
1経歴
1論文
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Biologics: Targets and Therapy 2024年1月
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Internal medicine (Tokyo, Japan) 2023年6月21日A 54-year-old man was admitted with obstructive jaundice. Computed tomography showed common bile duct stricture and a tumor around the celiac artery. Repeated endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and endoscopic retrograde cholangiopancreatography (ERCP) as well as a laparotomic biopsy around the celiac artery were diagnostically unsuccessful. Since the bile duct stricture progressed, EUS-FNA and ERCP were performed a third time, finally leading to the diagnosis of diffuse large B-cell lymphoma. The treatment plan and prognosis of obstructive jaundice differ greatly depending on the disease. It is important to conduct careful follow-up and repeated histological examinations with appropriate modifications until a diagnosis is made.
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Clinical case reports 11(3) e7043 2023年3月A 66-year-old man underwent a single endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) session and distal pancreatectomy for the pancreatic body adenocarcinoma measuring 12 mm in diameter. At 3 years after surgery, we diagnosed needle tract seeding (NTS) and performed total gastrectomy. NTS can occur with small tumors or after a single session of EUS-FNA.
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Cureus 14(9) e29428 2022年9月Immunoreconstitution inflammatory syndrome (IRIS) was reported to occur in 7-13% of AIDS patients on anti-retroviral therapy (ART). IRIS due to Mycobacterium infection is one of the most difficult IRIS types to manage. A male patient in his early 70s was diagnosed with AIDS and treated with an ART. One year after starting ART, abdominal ultrasound was performed for screening and a 4 cm hypoechoic mass was found from the outside of the stomach to the surface of the hepatic lateral segment. Based on various imaging tests, including contrast CT, a malignant tumor, such as malignant lymphoma, was suspected. Then, a percutaneous tumor biopsy was performed. Pathologically, the tumor was recognized as mycobacterial granulomas. Disseminated mycobacterium avium complex can produce granulomas anywhere in the body. The patient was diagnosed with a mycobacterial infection associated with IRIS. When an intra-abdominal mass is found in a patient with HIV, both malignancy and mass formation due to opportunistic infections should be considered differential diseases.
MISC
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肝臓 61(5) 276-278 2020年5月C型非代償性肝硬変に対するソフォスブビル/ベルパタスビル(SOF/VEL)12週治療の有効性・安全性について、多施設共同研究における中間成績を報告した。その結果、治療終了後12週経過した症例は43例であり、他病死と通院自己中断の各1例を除く全例でSVR12が得られていた。治療後はAST、ALT、ALB、PT%の有意な改善が認められ、33例でCP scoreの改善、21例でCP分類の改善が得られていた。有害事象は肝性脳症が7例、疲労、そう痒感、浮腫が各2例、味覚異常が1例にみられたが、いずれも保存的治療で改善していた。尚、肝癌既往例では14例中7例に再発が認められた。
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Chinese Medical Journal 131(8) 999-1000 2018年4月20日
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GASTROENTEROLOGY 152(5) S1038-S1038 2017年4月
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自治医科大学紀要 = Jichi Medical University journal 38 59-63 2015年The case involved a 31-year-old woman. She was hospitalized at our medical center after hemorrhagic stools were observed during treatment for aortitis syndrome. A longitudinal ulcer was observed in the terminal ileum on lower gastrointestinal endoscopy, leading to a diagnosis of small intestinal Crohn's disease. In addition to nutritional care and administration of internal mesalazine, the biological product adalimumab was administered as remission-induction therapy. Upon achieving remission, dosages of prednisolone and methotrexate were reduced and neither disease has recurred or progressed. The occurrence of complications associated with these diseases is rare, with only 19 cases reported in Japan and a total of 55 cases reported worldwide. No patterns have been observed in the pathogenic mechanism. We report herein on the valuable experience gained from treating this case along with consideration of the literature.