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101.
Koichiro Haruki Takeyuki Misawa Takeshi Gocho Ryota Saito Hiroaki Shiba Tadashi Akiba Katsuhiko Yanaga 《Clinical journal of gastroenterology》2016,9(5):319-323
Hepatocellular carcinoma (HCC) with gastric metastasis is extremely rare. There have been few reports on curative surgical resection for gastric metastasis of HCC. We herein report such a case successfully treated by simultaneous surgical resection. A 73-year-old male was admitted for evaluation and treatment of a liver tumor. Computed tomography showed an exophytic tumor of 170 mm in diameter located in the left lobe of the liver with poor delineation to the gastric wall. Upper gastrointestinal endoscopy revealed a submucosal tumor with ulceration in the antrum of the stomach. With a diagnosis of HCC with invasion to the gastric wall, an en bloc resection was planned, and the patient underwent laparotomy. The patients underwent left hemihepatectomy with partial resection of the stomach for adhesion and distal gastrectomy for the tumor. Pathological examination of the liver tumor revealed poorly differentiated HCC, and pathological diagnosis of the tumor in the submucosal and muscular layer of the stomach was compatible with metastasis from HCC, which was separate from the liver tumor. Therefore, we diagnosed the tumor as HCC with hematogenous gastric metastasis. The patient remains well with no evidence of tumor recurrence as of 13 months after resection. 相似文献
102.
Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholangitis (with videos)
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Seiki Kiriyama Kazuto Kozaka Tadahiro Takada Steven M. Strasberg Henry A. Pitt Toshifumi Gabata Jiro Hata Kui‐Hin Liau Fumihiko Miura Akihiko Horiguchi Keng‐Hao Liu Cheng‐Hsi Su Keita Wada Palepu Jagannath Takao Itoi Dirk J. Gouma Yasuhisa Mori Shuntaro Mukai Mariano Eduardo Giménez Wayne Shih‐Wei Huang Myung‐Hwan Kim Kohji Okamoto Giulio Belli Christos Dervenis Angus C. W. Chan Wan Yee Lau Itaru Endo Harumi Gomi Masahiro Yoshida Toshihiko Mayumi Todd H. Baron Eduardo de Santibañes Anthony Yuen Bun Teoh Tsann‐Long Hwang Chen‐Guo Ker Miin‐Fu Chen Ho‐Seong Han Yoo‐Seok Yoon In‐Seok Choi Dong‐Sup Yoon Ryota Higuchi Seigo Kitano Masafumi Inomata Daniel J. Deziel Eduard Jonas Koichi Hirata Yoshinobu Sumiyama Kazuo Inui Masakazu Yamamoto 《Journal of hepato-biliary-pancreatic sciences》2018,25(1):17-30
Although the diagnostic and severity grading criteria on the 2013 Tokyo Guidelines (TG13) are used worldwide as the primary standard for management of acute cholangitis (AC), they need to be validated through implementation and assessment in actual clinical practice. Here, we conduct a systematic review of the literature to validate the TG13 diagnostic and severity grading criteria for AC and propose TG18 criteria. While there is little evidence evaluating the TG13 criteria, they were validated through a large‐scale case series study in Japan and Taiwan. Analyzing big data from this study confirmed that the diagnostic rate of AC based on the TG13 diagnostic criteria was higher than that based on the TG07 criteria, and that 30‐day mortality in patients with a higher severity based on the TG13 severity grading criteria was significantly higher. Furthermore, a comparison of patients treated with early or urgent biliary drainage versus patients not treated this way showed no difference in 30‐day mortality among patients with Grade I or Grade III AC, but significantly lower 30‐day mortality in patients with Grade II AC who were treated with early or urgent biliary drainage. This suggests that the TG13 severity grading criteria can be used to identify Grade II patients whose prognoses may be improved through biliary drainage. The TG13 severity grading criteria may therefore be useful as an indicator for biliary drainage as well as a predictive factor when assessing the patient's prognosis. The TG13 diagnostic and severity grading criteria for AC can provide results quickly, are minimally invasive for the patients, and are inexpensive. We recommend that the TG13 criteria be adopted in the TG18 guidelines and used as standard practice in the clinical setting. Free full articles and mobile app of TG18 are available at: http://www.jshbps.jp/modules/en/index.php?content_id=47 . Related clinical questions and references are also included. 相似文献
103.
Takayoshi Komatsu-Fujii Yuko Chinuki Hiroyuki Niihara Kenji Hayashida Masataka Ohta Ryota Okazaki Sakae Kaneko Eishin Morita 《Allergology international》2018,67(1):90-95
Background
In severe drug eruptions, precise evaluation of disease severity at an early stage is needed to start appropriate treatment. It is not always easy to diagnose these conditions at their early stage. In addition, there are no reported prognostic biomarkers of disease severity in drug eruptions. The aim of this study was to test whether the thymus and activation-regulated chemokine (TARC) level in serum at an early stage of a drug eruption can serve as a prognostic biomarker of systemic inflammation.Methods
Study participants included 76 patients who received a diagnosis of a drug eruption, one of the following: drug rash with eosinophilia and systemic symptoms/drug-induced hypersensitivity syndrome, maculopapular exanthema, and erythema multiforme. Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) was eliminated in this study because scoring system for evaluating the severity was established. Correlation coefficients between serum TARC levels and indicators of systemic inflammation, including the neutrophil-to-lymphocyte ratio, Glasgow prognostic score, modified systemic inflammatory response syndrome (mSIRS) score, and C-reactive protein in serum were evaluated.Results
Serum TARC levels positively correlated with the neutrophil-to-lymphocyte ratio, Glasgow prognostic score, mSIRS score, C-reactive protein, albumin, white blood cell count, body temperature, and pulse rate. TARC levels negatively correlated with systolic blood pressure. Among these parameters, the mSIRS score showed strong correlation (correlation coefficient: 0.68).Conclusions
Serum TARC levels correlate well with indicators of systemic inflammation and of disease severity among patients with a drug eruption except SJS/TEN. Serum TARC may be a prognostic biomarker of severity of inflammation in drug eruptions. 相似文献104.
105.
106.
A 79-year-old woman with a complaint of persistent upper abdominal pain was admitted to our hospital for the treatment of thrombosed acute type B aortic dissection. Computed tomography showed the complete static occlusion of the celiac artery. Because of progressive symptom with elevation of liver enzymes and metabolic acidosis 11?h after admission, endovascular revascularization was attempted on an emergent basis. After a failed catheterization of the celiac ostium in an antegrade fashion due to a hard occlusion, we succeeded in a retrograde recanalization through the pancreaticoduodenal arcade via the superior mesenteric artery with stent placement using a pull-through technique. This technique is useful and safe when an antegrade approach seems difficult. 相似文献
107.
Komiyama T Kihara H Hirose K Yoshimoto R Shigematsu H 《Journal of vascular surgery》2004,39(3):661-667
OBJECTIVE: The effect of AT-1015, a serotonin(2A) receptor antagonist, on the resaturation of ischemic muscle in a hypercholesterolemic rabbit model was examined with near-infrared spectroscopy. METHODS: New Zealand White male rabbits were fed normal chow or cholesterol-rich chow. Ischemia was induced in the right hindlimb by ligation of the femoral artery, accompanied by balloon injury of the iliac artery. At 3 days after induction of ischemia, the bilateral gastrocnemius muscles were subjected to passive contraction for 2 minutes. The oxygen resaturation time of the gastrocnemius muscle after exercise was measured by near-infrared spectroscopy. AT-1015 was orally administered for 3 days after induction of ischemia. Assay of serotonin level in platelet-poor plasma and histologic examination of muscle and artery were performed in another set of rabbits. RESULTS: Oxygen resaturation time of the ischemic gastrocnemius was significantly prolonged in hypercholesterolemic rabbits compared with in normal rabbits without AT-1015, whereas there was no difference between both groups of rabbits that were administered AT-1015. Plasma level of serotonin in hypercholesterolemic rabbits was significantly increased compared with that in normal rabbits. No histologic differences were found in both muscle and artery among all groups. CONCLUSIONS: A serotonin(2A) receptor antagonist improved the oxygen resaturation of ischemic calf muscle after exercise in hypercholesterolemia. The interaction between plasma free serotonin and the serotonin(2A) receptor may play an important role in muscle oxygenation in ischemic limbs. 相似文献
108.
109.
Taizo Wada MD Yasuko Ishimoto MSc Mayumi Hirosaki MA Akiko Konno BSc Yoriko Kasahara MPH Yumi Kimura MPH Hiroaki Nakatsuka MD Ryota Sakamoto MD Masayuki Ishine MD Kiyohito Okumiya MD Michiko Fujisawa MD Kuniaki Otsuka MD Kozo Matsubayashi MD 《Journal of the American Geriatrics Society》2009,57(12):2369-2371
110.
Ryoko Higashiyama Tohru Ohnuma Yuto Takebayashi Ryo Hanzawa Nobuto Shibata Hidenaga Yamamori Yuka Yasuda Itaru Kushima Branko Aleksic Kenji Kondo Masashi Ikeda Ryota Hashimoto Nakao Iwata Norio Ozaki Heii Arai 《American journal of medical genetics. Part B, Neuropsychiatric genetics》2016,171(3):447-457