研究者詳細 - 寺井　崇二

論文 - 寺井　崇二

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Usefulness of ultrasonography to assess the response to steroidal therapy for the rare case of type 2b immunoglobulin G4-related sclerosing cholangitis without pancreatitis: A case report. 国際誌

Yuto Tanaka, Kenya Kamimura, Ryota Nakamura, Marina Ohkoshi-Yamada, Yohei Koseki, Takeshi Mizusawa, Satoshi Ikarashi, Kazunao Hayashi, Hiroki Sato, Akira Sakamaki, Junji Yokoyama, Shuji Terai

World journal of clinical cases 8 ( 22 ) 5821 - 5830 2020年11月

記述言語：英語

BACKGROUND: A type 2b immunoglobulin G4 (IgG4)-related sclerosing cholangitis (SC) without autoimmune pancreatitis is a rare condition with IgG4-SC. While the variety of the imaging modalities have tested its usefulness in diagnosing the IgG4-SC, however, the usage of ultrasonography for the assessment of the response to steroidal therapy on the changes of bile duct wall thickness have not been reported in the condition. Therefore, the information of our recent case and reported cases have been summarized. CASE SUMMARY: We report the case of an 82-year-old Japanese man diagnosed with isolated IgG4-related SC based on the increase of serum IgG4, narrowing of the bile duct, its wall thickness, no complication of autoimmune pancreatitis, and IgG4 positive inflammatory cell infiltration to the wall with the fibrotic changes. The cholangiogram revealed type 2b according to the classification. Corticosteroid treatment showed a favorable effect, with the smooth decrease in serum IgG4 and the improvement of the bile duct wall thickness. CONCLUSION: As isolated type 2b, IgG4-SC is rare, the images, histological findings, and clinical course of our case will be helpful for physicians to diagnose and treat the new cases appropriately.

DOI： 10.12998/wjcc.v8.i22.5821

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Stent Placement for Malignant Inferior Vena Cava Syndrome in a Patient with Recurrent Colon Cancer.

Shinichi Morita, Shunsuke Sugawara, Takeshi Suda, Didik Prasetyo, Yuka Kobayashi, Takahiro Hoshi, Satoshi Abe, Kazuyoshi Yagi, Shuji Terai

Internal medicine (Tokyo, Japan) 59 ( 22 ) 2885 - 2890 2020年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

A 70-year-old man was admitted to our hospital with gait disturbance due to marked edema of the lower limbs for more than 6 months. He had been receiving systemic chemotherapy over two years for multiple recurrence after sigmoid colon cancer resection. Contrast-enhanced computed tomography demonstrated severe inferior vena cava (IVC) stenosis due to compression by lymph node metastases, i.e. IVC syndrome. As increased doses of diuretic agents failed to improve the edema, IVC stent placement was performed. This led to significant improvement of the edema and complete gait normalization. This case demonstrates the efficacy of IVC stent placement for IVC syndrome.

DOI： 10.2169/internalmedicine.5033-20

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Pancreas Gas Gangrene Caused by Klebsiella pneumoniae.

Yui Ishii, Atsunori Tsuchiya, Kazunao Hayashi, Shuji Terai

Internal medicine (Tokyo, Japan) 59 ( 22 ) 2963 - 2964 2020年11月

Esophageal High-Resolution Manometry for Diagnosing the Severity of the Chronic Intestinal Pseudo-Obstruction: A Case Series. 国際誌

Hiroki Sato, Kenya Kamimura, Hideaki Matsui, Takashi Owaki, Shinichi Morita, Yuto Tanaka, Natsuki Ishikawa, Yoshifumi Shimada, Junji Yokoyama, Toshifumi Wakai, Shuji Terai

Digestive diseases and sciences 66 ( 11 ) 3960 - 3967 2020年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Chronic intestinal pseudo-obstruction (CIPO) is a severe and refractory intestinal motility disorder. However, due to its rarity and difficult histological investigation, its pathophysiology has not been characterized. AIM: Therefore, in this study, we aimed to determine the role of esophageal high-resolution manometry (HRM) in CIPO and the histological and clinical characteristics of the disease. METHODS: Patients with CIPO were analyzed for clinical characteristics; histological findings; and clinical courses after therapeutic intervention. In addition, HRM was performed to determine the esophageal involvement. RESULTS: Eleven patients were diagnosed with CIPO, and five required the long period of parenteral nutrition showing impaired esophageal motility including achalasia and absent contractility diagnosed with HRM. The four of these five cases showed acute onset of the CIPO following the triggering events of pregnancy, appendicitis, and surgery. In contrast, other six patients with normal or Jackhammer esophagus on HRM had moderate severity of CIPO with gradual onset. The histological analyses revealed that the loss of the intestinal neural ganglion cells and layers by inflammation, destruction, and atrophy are related to the severity of the clinical course of the disease and esophageal HRM findings of achalasia and absent contractility. CONCLUSIONS: HRM may be useful to diagnose the severity of the clinical course and to determine the therapeutic options for CIPO.

DOI： 10.1007/s10620-020-06701-9

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消化管疾患に対する低侵襲治療の現状と今後の展開-内科、外科の立場から- 当院における腹腔鏡・内視鏡合同手術(LECS)の現状と課題

加納陽介, 羽入隆晃, 佐藤裕樹, 水野研一, 市川寛, 石川卓, 宗岡悠介, 茂木大輔, 須藤翔, 小柳英人, 三浦宏平, 滝沢一泰, 中野雅人, 島田能史, 永橋昌幸, 坂田純, 寺井崇二, 若井俊文

日本消化器病学会甲信越支部例会抄録集 67回 69 - 69 2020年11月

Risk factors for walled-off necrosis associated with severe acute pancreatitis: A multicenter retrospective observational study.

Satoshi Ikarashi, Hirokazu Kawai, Kazunao Hayashi, Junji Kohisa, Toshifumi Sato, Yujiro Nozawa, Shinichi Morita, Hiromitsu Oka, Munehiro Sato, Yukio Aruga, Seiichi Yoshikawa, Shuji Terai

Journal of hepato-biliary-pancreatic sciences 27 ( 11 ) 887 - 895 2020年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: This study aimed to identify the risk factors for walled-off necrosis (WON) associated with severe acute pancreatitis (SAP). METHODS: This retrospective study was conducted in eight institutions in Japan between 2014 and 2017. We analyzed WON incidence, patient characteristics, and risk factors for WON in patients with SAP who were observed for >28 days. RESULTS: Of 134 patients with SAP, WON occurred in 40 (29.9%). Male sex (P = .045), body mass index (BMI) ≥25 (P < .001), post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (P = .020), and disseminated intravascular coagulation (DIC) (P = .001) were more frequent in the WON group than in the non-WON group. On admission, the frequency of white blood cell counts ≥ 12 000/µL (P = .037) and hypoenhanced pancreatic lesion on computed tomography (P = .047) were significantly higher in the WON group. In multivariate analysis, BMI ≥ 25 (odds ratio [OR] 5.73, 95% confidence interval [CI] 1.95-16.8; P = .002), post-ERCP (OR 8.08, 95% CI 1.57-41.7; P = .013), and DIC (OR 3.52, 95% CI 1.20-10.4; P = .022) were independent risk factors for WON. CONCLUSIONS: High BMI, post-ERCP pancreatitis, and DIC are risk factors for the development of WON associated with SAP.

DOI： 10.1002/jhbp.787

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急性腹症を契機にC型慢性肝炎が発見された1例

北條雄暉, 上村博輝, 木村莉菓, 大脇崇史, 岩澤貴宏, 渡邉雄介, 高綱将史, 荒生祥尚, 薛徹, 五十嵐聡, 高村昌昭, 寺井崇二

日本消化器病学会甲信越支部例会抄録集 67回 96 - 96 2020年11月

良悪性鑑別困難な胆膵疾患の診断と治療の最前線-内科、外科の立場から- 自己免疫性膵炎と膵癌との鑑別の現状と課題

小川光平, 林和直, 五十嵐聡, 寺井崇二

日本消化器病学会甲信越支部例会抄録集 67回 32 - 32 2020年11月

ウイルス肝炎診療:新旧の課題と解決への戦略当院・関連施設におけるソホスブビル/ベルパタスビル11症例での治療効果と安全性の検討

荒生祥尚, 薛徹, 寺井崇二

肝臓 61 ( Suppl.3 ) A775 - A775 2020年11月

ステロイド治療前後で肝硬度と病理像を評価し得た肝サルコイドーシスの一例

水戸將貴, 荒生祥尚, 夏井一輝, 前田悠一郎, 小島雄一, 林和直, 土屋敦紀, 梅津哉, 寺井崇二

日本消化器病学会甲信越支部例会抄録集 67回 95 - 95 2020年11月

被包化膵壊死への真菌感染による敗血症性ショックをきたした一例

山田麻理奈[大越], 上村顕也, 石川夏生, 小関洋平, 田中裕登, 水澤健, 佐藤裕樹, 五十嵐聡, 林和直, 坂牧僚, 横山純二, 寺井崇二

日本消化器病学会甲信越支部例会抄録集 67回 26 - 26 2020年11月

肝疾患に対するPrecision Medicineの実現可能性を探る:新規バイオマーカーを含めて肝障害の程度、機能回復の指標としての血中セロトニンの検証

薛徹, 上村顕也, 寺井崇二

肝臓 61 ( Suppl.3 ) A832 - A832 2020年11月

よりよい肝移植医療のあり方を探る当県での移植へのゲートウェイとしてのネットワークシステムの取り組み

薛徹, 高村昌昭, 寺井崇二

肝臓 61 ( Suppl.3 ) A800 - A800 2020年11月

短期間に急速な肝脂肪沈着と栄養・運動介入による肝機能の改善を確認できたアスリートの一例

上村博輝, 木村莉菓, 北條雄暉, 渡邊雄介, 高綱将史, 五十嵐聡, 佐野正和, 真田奈緒, 武田安永, 小師優子, 高村昌昭, 寺井崇二

日本消化器病学会甲信越支部例会抄録集 67回 97 - 97 2020年11月

Shear wave elastographyを用いたNAFLDにおける肝線維化の左右差の検討

横尾健, 杉田萌乃, 荒生祥尚, 薛徹, 上村博輝, 坂牧僚, 上村顕也, 土屋淳紀, 高村昌昭, 寺井崇二

超音波医学 47 ( Suppl. ) S349 - S349 2020年11月

令和の時代に求められる肝硬変の多角的治療戦略十全大補湯と間葉系幹細胞の併用療法はCC14投与肝硬変モデルマウスにおいて効果的な抗炎症・抗線維化効果を及ぼす

野尻俊介, 土屋淳紀, 寺井崇二

肝臓 61 ( Suppl.3 ) A853 - A853 2020年11月

臨床応用を見据えた肝の臓器再生研究の展望肝硬変に対する間葉系細胞治療とそのエクソソーム治療の可能性

土屋淳紀, 竹内卓, 寺井崇二

肝臓 61 ( Suppl.3 ) A827 - A827 2020年11月

【肝硬変診療の新時代】肝再生治療開発の現況

竹内卓, 渡邉雄介, 土屋淳紀, 寺井崇二

臨床消化器内科 35 ( 13 ) 1601 - 1605 2020年11月

脂肪性肝疾患:治療のターゲットとゴール脂肪性疾患の病態進行と自律神経ネットワークを介する臓器連関の関与

上村顕也, 大脇崇史, 寺井崇二

肝臓 61 ( Suppl.3 ) A758 - A758 2020年11月

進行肝細胞癌に対する集学的治療:エビデンスとコンセンサス肝癌に対する放射線治療の安全性と有用性の検討

上村顕也, 大越麻理奈, 寺井崇二

肝臓 61 ( Suppl.3 ) A811 - A811 2020年11月

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