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レンバチニブ及び放射線治療後の再肝切除による集学的治療が奏功した門脈腫瘍栓を伴う早期再発肝細胞癌の1例 一例早期复发性肝细胞癌伴有门静脉瘤栓,在放疗后成功接受来伐替尼和再切除术的多模式治疗。
Pub Date : 2023-12-01 DOI: 10.2957/kanzo.64.641
Yuta Jin, Ryo Nishiyama, Y. Koganei, Daiki Kimura, Junya Aoyama, Yutaka Nakano, Shunichi Imai, Tatsuya Shimogawara, Toru Yamada, Tomohisa Egawa
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引用次数: 0
母子感染予防目的で核酸アナログ製剤が投与され,出産後の中止後にB型肝炎の急性増悪を来した一例 一例因产后停用预防母婴传播的核酸类似物而导致乙型肝炎急性加重的病例。
Pub Date : 2023-12-01 DOI: 10.2957/kanzo.64.653
Yasuki Hatayama, Harutoshi Sugiyama, Daisuke Murakami, H. Oura, Yukiko Shima, M. Shirato, Takayoshi Nishino, M. Arai, Naoya Kato
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引用次数: 0
メタノール中毒にて失明したアルコール性肝硬変の1例 一例因甲醇中毒导致失明的酒精性肝硬化病例
Pub Date : 2023-12-01 DOI: 10.2957/kanzo.64.618
Sota Umetani, Masayuki Miyazaki, Yuichi Tachibana, Akihiro Ueda, Tetsuro Akashi
{"title":"メタノール中毒にて失明したアルコール性肝硬変の1例","authors":"Sota Umetani, Masayuki Miyazaki, Yuichi Tachibana, Akihiro Ueda, Tetsuro Akashi","doi":"10.2957/kanzo.64.618","DOIUrl":"https://doi.org/10.2957/kanzo.64.618","url":null,"abstract":"","PeriodicalId":17925,"journal":{"name":"Kanzo","volume":"56 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139013546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
血液透析中の肝細胞癌患者に対しアテゾリズマブ+ベバシズマブ併用療法が可能であった一例 阿特珠单抗加贝伐单抗成功治疗一例血液透析肝细胞癌病例
Pub Date : 2023-12-01 DOI: 10.2957/kanzo.64.632
Mayu Oda, Y. Kisaka, Akiko Ogawa, Katsura Yokoyama, Kotaro Sunago, Nayu Tazuya, Yoshinori Tanaka
{"title":"血液透析中の肝細胞癌患者に対しアテゾリズマブ+ベバシズマブ併用療法が可能であった一例","authors":"Mayu Oda, Y. Kisaka, Akiko Ogawa, Katsura Yokoyama, Kotaro Sunago, Nayu Tazuya, Yoshinori Tanaka","doi":"10.2957/kanzo.64.632","DOIUrl":"https://doi.org/10.2957/kanzo.64.632","url":null,"abstract":"","PeriodicalId":17925,"journal":{"name":"Kanzo","volume":" 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138620674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of the impact of carryover in a fully automated, high-sensitivity hepatitis B core-related antigen assay 评估全自动高灵敏度乙型肝炎核心相关抗原测定中迁移的影响
Pub Date : 2023-12-01 DOI: 10.2957/kanzo.64.656
K. Ohne, S. Kani, Yoshiyuki Kitamura, Haruka Sagi, Atsushi Kaneko, Minoru Ohhashi, Shohei Kikuchi, Yasuhito Tanaka, Takako Inoue
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引用次数: 0
Usefulness of endoscopic biliary drainage for hepatocellular carcinoma associated with obstructive jaundice 内镜下胆道引流对肝细胞癌合并梗阻性黄疸的疗效
Pub Date : 2023-11-01 DOI: 10.2957/kanzo.64.550
Yuka Kaneko, Miyuki Kaneshiro, Hideki Watanabe
胆管浸潤や胆管圧排による閉塞性黄疸を伴う肝細胞癌に対する内視鏡的胆道ドレナージの有効性について検討した.2008年1月から2023年3月までに閉塞性黄疸を呈した肝細胞癌は20例だった.男性16例,女性4例で,平均年齢は75±8歳,門脈浸潤は,Vp0/Vp2/Vp3=13/3/4例,ステント挿入例は16例であった.閉塞性黄疸の改善の有無で全生存期間(OS)を比較すると,黄疸改善例では良好なOSを認めた(p<0.001).プラスチックステント7例,自己拡張型金属ステント9例で両者のOSに明らかな有意差を認めなかった(p=0.218).ドレナージ前後のT.Bil値で有意差を認めた(p=0.001).肝予備能の低下した進行期の肝細胞癌の閉塞性黄疸に対する内視鏡的胆道ドレナージは有用であり,患者の全身状態を考慮しながら検討すべきである.
对胆管浸润和胆管压排伴有梗阻性黄疸的肝细胞癌,内窥镜胆道息肉的有效性进行了探讨。从2008年1月到2023年3月,出现梗阻性黄疸的肝细胞癌有20例。男性16例,女性4例,平均年龄为75±8岁,门静脉浸润为Vp0/Vp2/Vp3 = 13/3/4例,支架插入为16例。通过比较阻塞性黄疸有无改善的总生存期(OS),在黄疸改善例中,OS表现良好(p < 0.001)。在塑料支架7例和自扩张型金属支架9例中,两者的OS没有明显的显著性差异(p=0.218)。承认了在dlenage前后的T.Bil值的显著性差异(p=0.001)。内窥镜胆道筛查对肝储备能力低下的晚期肝细胞癌的阻塞性黄疸是有用的,应考虑患者的全身情况。
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引用次数: 0
肝炎医療コーディネーター活動継続における肝疾患診療連携拠点病院の役割 肝炎医疗协调员持续活动中的肝病诊疗协作据点医院的作用
Pub Date : 2023-11-01 DOI: 10.2957/kanzo.64.583
Hiroko Setoyama, Maki Nomura, Tomomi Yada, Yoko Yoshimaru, Satoshi Narahara, Hiroki Inada, Kentaro Tanaka, Sotaro Kurano, Takayuki Tokunaga, Etsuko Iio, Katsuya Nagaoka, Takehisa Watanabe, Yuichiro Eguchi, Yasuhito Tanaka
Continuation of activities is important for the hepatitis medical care coordinators to fulfill their functions, which must be supported by regional core centers for liver disease management. Thus, we conducted a questionnaire survey among coordinators in Kumamoto Prefecture to identify factors that motivates them to continue their activities. Results showed that coordinators were mainly motivated by a sense of social contribution. The factors considered important in the continuation of their activities are self-evaluation and of others, resolution of concerns about their activities, and the presence of peers/consultants. The regional core centers should actively provide a place and means for the coordinators to be active.
活动的持续对肝炎医疗保健协调员履行其职能至关重要,这必须得到区域肝病管理核心中心的支持。因此,我们对熊本县的协调员进行了问卷调查,以确定激励他们继续开展活动的因素。结果表明,对社会的贡献感是协调员的主要动机。在其活动继续进行方面被认为重要的因素是自我评价和他人评价,解决对其活动的关切,以及同行/顾问的存在。区域核心中心应积极为协调者提供活跃的场所和手段。
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引用次数: 0
病理組織学的なMetastatic carcinomatous cirrhosisをきたした浸潤性小葉癌の1症例 造成组织病理学Metastatic carcinomatous cirrhosis的1个浸润性小叶癌病例
Pub Date : 2023-11-01 DOI: 10.2957/kanzo.64.575
Soo Ryang Kim, Soo Ki Kim, Hisato Kobayashi, Toyokazu Okuda, Atsushi Nakai, Yumi Fujii, Takanobu Hayakumo, Motoko Sasaki, Yu-ichiro Koma, Akira Asai, Hiroki Nishikawa
症例は60歳代女性.X年2月乳癌の診断のもと,左乳房切除,病理所見は浸潤性小葉癌であった.同年3月に多発リンパ節,骨転移に対して薬物療法を開始したが,8月より肝障害が出現した.薬剤性肝障害を疑い,薬物治療を中止するも肝障害は増悪した.造影CT,EOB-MRIなどの画像診断で肝転移巣は認めなかったが,腫瘍マーカーCA15-3の上昇がみられた.10月に腹部超音波カラードップラー画像・ソナゾイド造影所見から類洞閉塞などによる門脈血流低下が示唆された.経頸静脈的肝生検を施行したところ,類洞内に浸潤性小葉癌転移と肝硬変様の高度線維化を認めた.
病例是一位60多岁的女性。X年2月确诊为乳房癌,左乳房切除,病理显示为浸润性小叶癌。同年3月开始对多发淋巴结及骨转移进行药物疗法,8月开始出现肝损害。怀疑是药物性肝损伤,虽然停止了药物治疗,但肝损伤还是加重了。造影CT、EOB-MRI等影像诊断均未发现肝转移灶,但肿瘤标志物CA15-3升高。10月,从腹部超声波到多普勒成像、索象造影显示,类窦梗阻等导致门静脉血流下降。经颈静脉肝活检发现,类窦内浸润性小叶癌转移和肝硬化样高度纤维化。
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引用次数: 0
肝炎ウイルス陽性者対策が急がれる非肝臓専門科は? 肝炎病毒阳性者对策迫在眉睫的非肝脏专科是?
Pub Date : 2023-11-01 DOI: 10.2957/kanzo.64.587
Kenichi Hirota, Takako Inoue, Koji Ogawa, Yoshihisa Arao, Mizuki Endo, Tadashi Ikegami, Hiroki Tojima, Atsushi Suetsugu, Satoru Kakizaki, Hiroko Setoyama, Masaru Enomoto, Masaaki Korenaga
In eight regional core centers for liver disease management, we evaluated the status of HBs antigen (HBsAg) and anti-hepatitis C virus antibody (anti-HCV) testing from 2016 to 2020. Among nonhepatology departments, ophthalmology had the highest number of HBsAg and anti-HCV tests, followed by obstetrics and gynecology, and orthopedics. The highest positive rates of HBsAg were in orthopedics (1.27%), gastroenterological surgery (1.23%), and ophthalmology (1.04%), and those of anti-HCV were in gastroenterological surgery (2.71%), orthopedics (2.57%), and ophthalmology (2.51%). Thus, ophthalmology and orthopedics obtained the highest number of tests and positive rates, with no rate decrease over time. While the Japan Ophthalmologists Association has already commercialized measures against hepatitis, similar measures are needed urgently in orthopedics.
在8个区域肝病管理核心中心,我们评估了2016 - 2020年HBs抗原(HBsAg)和抗丙型肝炎病毒抗体(anti-HCV)检测的状况。在非肝病科中,眼科的HBsAg和抗- hcv检测数量最多,其次是妇产科和骨科。HBsAg阳性率最高的科室为骨科(1.27%)、胃肠外科(1.23%)和眼科(1.04%);抗- hcv阳性率最高的科室为胃肠外科(2.71%)、骨科(2.57%)和眼科(2.51%)。因此,眼科和骨科的检查次数和阳性率最高,且没有随时间下降。虽然日本眼科医师协会已经将治疗肝炎的措施商业化,但矫形外科迫切需要类似的措施。
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引用次数: 0
アテゾリズマブ・ベバシズマブ併用療法後自己免疫性脳炎を発症し,改善後に2次治療に移行した肝細胞癌の1例 阿替唑单抗-贝伐西单抗联合疗法后发生自身免疫性脑炎,改善后转入二线治疗的肝细胞癌1例
Pub Date : 2023-11-01 DOI: 10.2957/kanzo.64.559
Takahiro Osuga, Koji Miyanishi, Ryo Ito, Shingo Tanaka, Tomohiro Kubo, Kota Hamaguchi, Hiroyuki Ohnuma, Kazuyuki Murase, Kohichi Takada, Morihiro Yamamoto, Tatsuo Manabe, Shin Hisahara, Junji Kato
68歳,男性.右背部痛を主訴に近医受診,肝腫瘤を指摘され当院紹介.肝細胞癌,多発リンパ節・骨転移と診断し,アテゾリズマブ・ベバシズマブ併用療法(ATZ+BV)を開始した.投与開始14日目に辻褄の合わない言動と傾眠,16日目にJCS10の意識障害を認めた.血中アンモニア値,頭部MRIに異常なく,髄液検査では僅かな細胞数上昇と蛋白細胞解離を認めた.自己免疫性脳炎を疑い,同日よりステロイドパルス療法を開始した.意識障害は著明に改善し,内服ステロイドに移行後,38日目に後遺症なく自宅退院となった.脳炎の再燃はなく,ATZ+BV開始60日目に2次治療としてレンバチニブを導入した.肝細胞癌に対するATZ+BV後の自己免疫性脳炎は,自験例を含め4例のみ報告されており,初発症状や意識障害出現時期がほぼ一致していた.早期の診断とステロイドパルス療法施行により2次治療へ移行できた症例であると考えられた.
六十八岁,男。主诉右背部疼痛,近医求诊,被指出肝肿大,转诊到本院。诊断为肝细胞癌,多淋巴结及骨转移,开始了ATZ + BV联合疗法。在开始注射14天后,发现其言行不合并嗜睡,16天后发现JCS10意识障碍。血中氨值和头部MRI均无异常,髓液检查发现细胞数小幅上升和蛋白细胞解离。怀疑是自身免疫性脑炎,当天开始了类固醇脉冲疗法。意识障碍明显好转,口服类固醇治疗38天后出院,无后遗症。脑炎没有再次发作,在ATZ + BV开始的第60天,作为2次治疗引入了lenvatinib。针对肝细胞癌的ATZ + BV后的自身免疫性脑炎,包括自验病例在内只有4例报告,首次发病症状和意识障碍出现时间基本一致。由于早期的诊断和类固醇脉冲疗法的施行,被认为是可以进行2次治疗的病例。
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