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51.
Characteristic Findings of Endoscopic Retrograde Cholangiopancreatography in Autoimmune Pancreatitis
Susumu Iwasaki Terumi Kamisawa Satomi Koizumi Kazuro Chiba Taku Tabata Sawako Kuruma Go Kuwata Takashi Fujiwara Koichi Koizumi Takeo Arakawa Kumiko Momma Seiichi Hara Yoshinori Igarashi 《Gut and liver》2015,9(1):113-117
Background/Aims
Diffuse or segmental irregular narrowing of the main pancreatic duct (MPD), as observed by endoscopic retrograde cholangiopancreatography (ERCP), is a characteristic feature of autoimmune pancreatitis (AIP).Methods
ERCP findings were retrospectively examined in 40 patients with AIP in whom irregular narrowing of the MPD was detected near the orifice. The MPD opening sign was defined as the MPD within 1.5 cm from the orifice being maintained. The distal common bile duct (CBD) sign was defined as the distal CBD within 1.5 cm from the orifice being maintained. Endoscopic findings of a swollen major papilla and histological findings of specimens obtained from the major papilla were examined in 26 and 21 patients, respectively.Results
The MPD opening sign was detected in 26 of the 40 patients (65%). The distal CBD sign was detected in 25 of the 32 patients (78%), which showed stenosis of the lower bile duct. The patients who showed the MPD opening sign frequently showed the distal CBD sign (p=0.018). Lymphoplasmacytic infiltration, but not dense fibrosis, was histologically detected in biopsy specimens obtained from the major papilla.Conclusions
On ERCP, the MPD and CBD adjacent to the major papilla are frequently maintained in patients with AIP involving the pancreatic head. These signs are useful for diagnosing AIP on ERCP. 相似文献52.
Yohei Kumano Takashi Kawahara Sawako Chiba Yoko Maeda Mari Ohtaka Takuya Kondo Taku Mochizuki Yusuke Hattori Jun-Ichi Teranishi Yasuhide Miyoshi Yasushi Yumura Yoshiaki Inayama Masahiro Yao Hiroji Uemura 《Case reports in oncology》2015,8(3):394-398
A 73-year-old male was referred to our department for further treatment of a right retroperitoneal tumor. Contrast CT showed a tumor mass measuring 33 × 26 mm in size with poor contrast enhancement. Because we were unable to rule out tumor malignancy, we planned an operation. The tumor was easily separated and removed without nephrectomy. Histological study revealed a schwannoma. It is rare for this kind of tumor to arise from the retroperitoneum (approximately 0.7% of all cases), in particular at the renal hilum. We herein report a rare case of retroperitoneal schwannoma arising from the renal hilum.Key Words: Schwannoma, Retroperitoneal tumor, Renal hilum 相似文献
53.
Kadowaki S Miura F Amano H Toyota N Wada K Shibuya M Maeno S Takada T Sano K 《Journal of hepato-biliary-pancreatic sciences》2012,19(5):566-577
Background/Purpose
It is generally thought that an internal short stent placed across the pancreaticojejunostomy (PJ) following pancreatoduodenectomy (PD) usually passes spontaneously through the rectum thereafter; however, we experienced some patients who presented with pancreatitis and cholangitis owing to delayed defecation of the stent. The purpose of this study was to clarify when the stent eventually became detached from the PJ and how it passed through the body until it was finally defecated. In addition, we also investigated the factors that may prevent such detachment and defecation.Methods
This study retrospectively analyzed 57 patients who had had internal short stents placed across the PJ following PD. Defecation from the body, detachment from the PJ, and distal migration of the stent was confirmed by X-ray or computed tomography (CT) during the postoperative course. The cumulative rates of defecation and detachment of the stents, complications in relation to delayed defecation of the stents, and factors predictive of the delayed defecation, delayed detachment, and distal migration of the stents were analyzed.Results
Defecation of the stent was confirmed in 35 patients. The median time to defecation after PD and the cumulative defecation rate at 1?year were 454?days and 41?%, respectively. Acute pancreatitis occurred in 2 patients with the stent remaining in the pancreatic duct. One patient experienced acute cholangitis owing to migration of the stent to the bile duct. Multivariate analysis showed that ≥5 stitches in the duct-to-mucosa anastomosis, stent size of ≥5?Fr, and pancreatic fistula classified as either Grade B or C were independent predictive factors for delayed defecation of the stent. Five or more stitches in the duct-to-mucosa anastomosis was an independent predictive factor for delayed detachment of the stent. A stent size of ≥5?Fr was a risk factor for distal migration of the stent.Conclusion
In more than half of the study patients, internal short stents were not defecated within 1?year. Retrieval of the stent should be considered following the migration of an internal short stent. A stent size of ≥5?Fr was an independent predictive factor for delayed defecation and distal migration of a stent. Five or more stitches in the duct-to-mucosa anastomosis was an independent predictive factor for delayed defecation and detachment of a stent. 相似文献54.
Misato Amaki Terumi Kamisawa Taku Tabata Seiichi Hara Sawako Kuruma Kazuro Chiba Takashi Fujiwara Go Kuwata Hideto Egashira Koichi Koizumi Keigo Setoguchi Junko Fujiwara Takeo Arakawa Kumiko Momma Noriko Ozaki 《Clinical journal of gastroenterology》2012,5(3):199-203
Autoimmune pancreatitis (AIP) that developed in a short period in a patient with IgG4-related dacryoadenitis and sialadenitis is reported. A 67-year-old man was diagnosed as having IgG4-related dacryoadenitis and sialadenitis histologically, serologically, and radiologically. At that time, the pancreas was normal on computed tomographic scanning, magnetic resonance imaging, and 18F-fluorodeoxyglucose positron emission tomography. However, AIP occurred in the pancreatic body and tail during the 3-month period of observation of the initial diseases. All IgG4-related lesions improved promptly after steroid therapy. This report emphasizes that, since IgG4-related disease can develop in other organs within a short period in a patient with IgG4-related disease, periodic imaging follow-up is necessary. 相似文献
55.
Maeno S Kondo F Sano K Takada T Asano T 《Journal of hepato-biliary-pancreatic sciences》2012,19(3):289-296
Background/purpose
The origin of cholangiolocellular carcinoma (CoCC) is still controversial. To solve this problem, morphometric and immunohistochemical features of CoCC were examined.Materials and methods
Cancerous ducts: 15 CoCC lesions from 13 resected and two autopsied cases. Non-neoplastic ducts: 20 specimens of non-cancerous areas of eight resected CoCC cases and of 12 resected hepatocellular carcinoma (HCC) cases. From these specimens, cholangioles, interlobular ducts of small size (ILD-S), interlobular ducts of medium size (ILD-M) and septal ducts were randomly selected.Morphometry
The outer and inner diameters of these ducts were measured. Immunohistochemistry: two hepatocyte markers [Hep Par 1 and ??-fetoptotein (AFP)], two cholangiocyte markers (cytokeratin CK7, CK19), a marker for mucin (Muc1), a hepatic stem/progenitor cell marker (c-Kit) and epithelial membrane antigen (EMA) were used.Results
Morphometry: both mean values of the outer and inner diameters of CoCC were far larger than those of cholangioles, and showed intermediate values between those of ILD-S and ILD-M. Immunohistochemistry: all ducts of CoCCs were negative for the two hepatocyte markers and positive for CK 7. Most CoCC ducts were positive for CK 19. Positive rate of c-Kit of cholangiole was most remote from that of CoCC. The positive rates of EMA in the membranous area of ducts were similarly very high in CoCC, cholangiole and ILD-S.Conclusion
These results suggest that CoCCs may originate from ILDs. 相似文献56.
57.
58.
Shintaro Sukegawa Rieko Shimizu Yuka Sukegawa Kazuaki Hasegawa Sawako Ono Ai Fujimura Izumi Yamamoto Keisuke Nakano Kiyofumi Takabatake Hotaka Kawai Hitoshi Nagatsuka Yoshihiko Furuki 《Materials》2022,15(9)
This retrospective study clarified the success rate of endoscopic endodontic surgeries and identified predictors accounting for successful surgeries. In this retrospective study, 242 patients (90 males, 152 females) who underwent endoscopic endodontic surgery at a single general hospital and were diagnosed through follow-up one year later were included. Risk factors were categorized into attributes, general health, anatomy, and surgery. Then, the correlation coefficient was calculated for the success or failure of endodontic surgery for each variable, the odds ratio was calculated for the upper variable, and factors related to the surgical prognosis factor were identified. The success rate of endodontic surgery was 95.3%, showing that it was a highly predictable treatment. The top three correlation coefficients were post, age, and perilesional sclerotic signs. Among them, the presence of posts was the highest, compared with the odds ratio, which was 9.592. This retrospective study revealed the success rate and risk factors accounting for endoscopic endodontic surgeries. Among the selected clinical variables, the presence of posts was the most decisive risk factor determining the success of endodontic surgeries. 相似文献
59.
Kohta Fujiwara Jun Hata Yuji Oshima Sawako Hashimoto Takeshi Yoshitomi 《Seminars in ophthalmology》2018,33(6):813-819
Purpose: To estimate the prevalence and risk factors for polypoidal choroidal vasculopathy (PCV) in a general Japanese population. Methods: This population-based, cross-sectional study was conducted in 2007 with subjects from the Hisayama Study. Of the 3,648 residents in Hisayama, Japan, 2,663 who were ≥ 50 years old were enrolled in this study. The characteristics of PCV were determined by fundus examination or based on indocyanine green and fluorescein angiographic findings. We evaluated the contributions of the risk factors for PCV. Results: Among the 207 participants with age-related macular degeneration (AMD), 174 (6.5%) had early AMD, and 33 (1.2%) had late AMD, including 10 participants with PCV (0.4%). Male and smoking habit were significant risk factors for the development of PCV. Conclusions: The prevalence of PCV is higher among Japanese subjects than Caucasians in Western countries. Male gender and smoking habit were significant risk factors for PCV in a general Japanese population. 相似文献
60.
The metabolism of L-3-O-methyldopa, a precursor of dopa in man 总被引:5,自引:0,他引:5
I Kuruma G Bartholini R Tissot A Pletscher 《Clinical pharmacology and therapeutics》1971,12(4):678-682