Toyokazu Okuda

Primary Hepatic Squamous Cell Carcinoma

Soo Ryang Kim, Soo Ki Kim, Hisato Kobayashi, Toyokazu Okuda et autres

Background and Clinical Significance: We present an 85-year-old male case of primary hepatic SCC manifesting as multiple liver nodules with atypical imaging findings. Case Presentation: The patient was negative for hepatitis B surface antigen and hepatitis C virus antibody. Serum tumor markers …

jp (code pays fourni par la source)

Liver Transplantation in Acute‐On‐Chronic Liver Failure

S R Kim, SOO KI KIM, S KIM, Toyokazu Okuda et autres

Acute-on-chronic liver failure (ACLF) represents a distinct clinical syndrome characterized by acute deterioration of chronic liver disease with systemic inflammation, organ failures, and high short-term mortality. Multiple diagnostic frameworks exist globally, including those proposed by the Asian Pacific Association for the Study …

jp (code pays fourni par la source)

Acetaminophen-induced liver injury with atypical histopathologic findings: a case report

Soo Ryang Kim, Soo Ki Kim, Hisato Kobayashi, Toyokazu Okuda et autres

症例は90歳代女性．腰椎圧迫骨折にて入院後に鎮痛目的でアセトアミノフェン（APAP）1.8 g/日を7日間，0.6 g/日を19日間投与された．投与後17日目より肝胆道系酵素上昇が出現し，好酸球増多をともなっていた．抗核抗体（ANA）陰性，抗ミトコンドリア-M2抗体（AMA-M2）陰性，HBs抗原陰性，HCV抗体陰性であった．

jp (code pays fourni par la source)

Invasive lobular carcinoma with metastatic carcinomatous cirrhosis diagnosed using histopathology

Soo Ryang Kim, Soo Ki Kim, Hisato Kobayashi, Toyokazu Okuda et autres

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．

jp (code pays fourni par la source)

Hepatic Inflammatory pseudotumor differentiated from malignant hepatic tumor: A case report

Soo Ryang Kim, Soo Ki Kim, Hisato Kobayashi, T. Fujii et autres

70歳男性，HBV既感染．単純USにて低/等/低エコー，単純CTにて低/等/低吸収（double-target-sign）を呈する3.8 cm大腫瘤精査で入院．動脈相では，造影CTとEOB MRIは造影効果が弱く，造影USでは多血性．造影US門脈相で早期washout，Kupffer相で欠損像を示した．更に，EOB MRI肝細胞相で腫瘤部は中心部よりは信号の高い低信号，echo planar imaging-free induction decay像で著明な低信号を示すなど，多彩な画像所見を呈した．画像上，炎症性偽腫瘍，非定型肝細胞癌，胆管細胞癌，細胆管細胞癌，転移性肝腫瘍が鑑別に挙がった．

jp, ca (code pays fourni par la source)

Drug-induced sarcoidosis-like reaction three months after BNT162b2 mRNA COVID-19 vaccination: A case report and review of literature

Soo Ryang Kim, Soo Ki Kim, T. Fujii, Hisato Kobayashi et autres

BACKGROUND: A 70-year-old man with hepatitis C virus-related recurrent hepatocellular carcinoma was admitted for further diagnosis of a 1 cm iso-hyperechoic nodule in segment (S) 5. CASE SUMMARY: Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOB-MRI) revealed the nodule in S5 …

jp (code pays fourni par la source)

Utility of the MRI-VSRAD system in diagnosing hepatic encephalopathy and/or dementia

Soo Ki Kim, Soo Ryang Kim, Yumi Fujii, Toyokazu Okuda et autres

高齢化時代を迎え，認知症罹患者が増加してきており，肝硬変患者における肝性脳症と認知症は臨床症状に基づく鑑別が困難な場合が多い．今回頭部MRI画像を基に脳の萎縮度を評価するVoxel-based Specific Regional analysis system for Alzheimer's Disease（VSRAD）により，2017年～2021年に当院で肝性脳症治療介入を行った65歳以上の32症例におけるアルツハイマー型認知症合併の可能性を検討したところ37.5%（12/32）で関心領域（海馬傍回）の萎縮を認めた．萎縮を認めた群・萎縮を認めなかった群の2群で臨床的特徴を比較したところ，萎縮を認めた群において「認知高齢者の日常生活自立度」評価における有意な低下が確認された（p=0.02）．肝性脳症診療においてVSRADを活用することでアルツハイマー型認知症合併の評価も含めた病態把握に繋がり得ると考えられた．

jp (code pays fourni par la source)

Radiological and histopathological analyses of two bile duct adenoma cases focused on washout in the portal phase of contrast-enhanced ultrasound

Soo Ki Kim, T. Fujii, Soo Ryang Kim, Hisato Kobayashi et autres

Ultrasound (US) revealed a 6-mm hypoechoic nodule in segment 6 of a 65-year-old man with alcoholic cirrhosis (Case 1) and a 7-mm hypoechoic nodule in segment 5 of a 70-year-old man with chronic hepatitis C (Case 2). Contrast-enhanced US (CEUS), CE computed …

jp (code pays fourni par la source)

Distant metastasis of hepatocellular carcinoma to Meckel’s cave and cranial nerves: A case report and review of literature

Soo Ki Kim, T. Fujii, Ryouhei Komaki, Hisato Kobayashi et autres

BACKGROUND: Metastasis occurs as a late event in the natural history of hepatocellular carcinoma (HCC), and most patients die of liver failure attributed to the tumor supplanting the liver. Conversely, the brain is a less common metastatic site. CASE SUMMARY: ) and …

jp (code pays fourni par la source)

[A case of gastric carcinoma with peritoneal metastasis successfully treated by combination chemotherapy of S-1 and cisplatin].

Kenichi Tanaka, Hidetoshi Gon, Takayoshi Nakajima, Kiyonori Kanemitsu et autres

This case is a 69-year-old woman. We diagnosed gastric cancer and cholecystolithiasis by close inspection of abdominal pain. Because preoperative diagnosis was T2N0M0, Stage I B, we performed an operation. Many lesser tubercles were shown, and were diagnosed as peritoneal metastases pathologically. …

jp (code pays fourni par la source)

A CASE OF PERFORATED PARADUODENAL PAPILLARY DIVERTICULUM AFTER DISTAL GASTRECTOMY RECONSTRUCTION BY THE BILLROTH II METHOD

Satoshi Kiyota, Toyokazu Okuda, Takashi Tsukazaki, Shoji Kubo

症例は67歳，男性．幽門側胃切除術，BillrothII法再建の既往歴あり．心窩部痛を主訴に近医を受診．保存的加療を施行されるも症状が悪化したため，当院紹介となる．来院時，右上腹部に著明な圧痛と筋性防御を認めた．腹部CT検査において，膵頭十二指腸部周囲後腹膜腔の気腫像と液体貯留像を認めた．十二指腸穿孔の術前診断のもと緊急開腹術を施行した．膵頭部周囲後腹膜腔に膿瘍を認め，十二指腸下行脚内側の膵後筋膜を切開したところ褐色泥状物の貯留と穿孔した2cm大の憩室を認めた．十二指腸傍乳頭部憩室穿孔と診断し，憩室切除術・胆道ドレナージ術・十二指腸外瘻術を施行した．術後，憩室切除術部の縫合不全をきたしたが，保存的に軽快した．幽門側胃切除術・BillrothII法再建後の十二指腸傍乳頭部憩室穿孔の1例を経験したので文献的考察を加えて報告する．

[S-1-based chemotherapy for recurrent gastric cancer with peritoneal dissemination resulting in long-term survival--report of a case].

Tomoyuki Wakahara, Akihiro Toyokawa, Ayako Tomono, Soichiro Tani et autres

A 52-year-old man underwent distal gastrectomy for gastric cancer in July 2000. In July 2005, abdominal CT and barium study of the colon revealed peritoneal recurrence, and chemotherapy of S-1 was started. Within 2 courses, the serum CEA level increased, so combination …

jp (code pays fourni par la source)