| Title Alternative | A case of duodenal diverticulitis in a patient receiving tocilizumab for rheumatoid arthritis |
|---|---|
| Author | Iwamuro, Masaya| Baba, Yuki| Kawahara, Yoshiro| Okada, Hiroyuki| |
| Abstract | A Japanese woman was diagnosed with rheumatoid arthritis at the age of 41. At the age of 56, her rheumatoid arthritis worsened and a subcutaneous injection of tocilizumab and oral prednisolone was administered, which led to an improvement of arthritis. At the age of 57, right lower abdominal pain and vomiting suddenly appeared. Abdominal computed tomography showed a parapapillary diverticulum in the descending duodenum. The diverticulum was filled with residue, and an inflammation of the surrounding adipose tissue was observed; no free air was found. The patient was diagnosed with duodenal diverticulitis and treated with antibiotics, which resulted in an uneventful recovery. The maximum value of CRP was 1.88㎎/dL on the third day of hospitalization. Esophagogastroduodenoscopy performed on the 8th day of hospitalization revealed a parapapillary diverticulum with adhesion of pus and redness of the mucosa at the opening of the diverticulum, consistent with diverticulitis. This case highlights that diverticulitis in infrequent areas such as the duodenum may occur in patients who are treated with tocilizumab. In addition, inflammation of diverticulitis may be underestimated because abnormal laboratory values such as those induced by inflammatory reactions are less likely to occur during tocilizumab treatment. |
| Keywords | トシリズマブ（tocilizumab） 十二指腸憩室（duodenal diverticulum） 憩室炎（diverticulitis） |
| Publication Title | Journal of Okayama Medical Association |
| Published Date | 2022-12-01 |
| Volume | volume134 |
| Issue | issue3 |
| Start Page | 166 |
| End Page | 170 |
| ISSN | 0030-1558 |
| Related Url | isVersionOf https://doi.org/10.4044/joma.134.166 |
| language | Japanese |
| Copyright Holders | Copyright (c) 2022 岡山医学会 |
| File Version | publisher |
| DOI | 10.4044/joma.134.166 |
| Author | Morimoto, Yoshinori| Iwagaki, Hiromi| Morishita, Norio| Nakagawa, Hitoshi| Matsubara, Nagahide| Isozaki, Hiroshi| Kaji, Eisuke| Okada, Hiroyuki| Mizuno, Motoo| Shiratori, Yasushi| Tnaka, Noriaki| |
|---|---|
| Published Date | 2005-09-30 |
| Publication Title | 岡山医学会雑誌 |
| Volume | volume115 |
| Issue | issue2 |
| Content Type | Journal Article |
| Author | Nakarai, Asuka| Kato, Jun| Hiraoka, Sakiko| Kuriyama, Motoaki| Inokuchi, Toshihiro| Takei, Daisuke| Moritou, Yuki| Akita, Mitsuhiro| Takahashi, Sakuma| Harada, Keita| Okada, Hiroyuki| Yamamoto, Kazuhide| |
|---|---|
| Published Date | 2013-12-02 |
| Publication Title | 岡山医学会雑誌 |
| Volume | volume125 |
| Issue | issue3 |
| Content Type | Journal Article |
| Author | Takata, Katsuyoshi| Sato, Yasuharu| Nakamura, Naoya| Tokunaka, Mami| Miki, Yukari| Kikuti, Yara Yukie| Igarashi, Kazuhiko| Ito, Etsuro| Harigae, Hideo| Kato, Seiichi| Hayashi, Eiko| Oka, Takashi| Hoshii, Yoshinobu| Tari, Akira| Okada, Hiroyuki| Mohamado, ABD Alkader Lamia| Maeda, Yoshinobu| Tanimoto, Mitsune| Kinoshita, Tomohiro| Yoshino, Tadashi| |
|---|---|
| Published Date | 2013-08-01 |
| Publication Title | 岡山医学会雑誌 |
| Volume | volume125 |
| Issue | issue2 |
| Content Type | Journal Article |
| Title Alternative | Adenocarcinoma in the jejunum 20 years after surgery for familial adenomatous polyposis |
|---|---|
| FullText URL | 129_111.pdf |
| Author | Sugihara, Yuusaku| Kawano, Seiji| Harada, Keita| Takashima, Shiho| Takei, Daisuke| Inokuchi, Toshihiro| Takahara, Masahiro| Hiraoka, Sakiko| Mori, Yoshiko| Kishimoto, Hiroyuki| Nagasaka, Takeshi| Okada, Hiroyuki| |
| Abstract | A 58-year-old Japanese man visited a local clinic for the evaluation of a stomachache. He was diagnosed with intestinal obstruction. His medical history included a proctocolectomy at the age of 38 years, due to familial adenomatous polyposis (FAP). He was referred to our institution, where he underwent a computed tomography examination and endoscopy of the small intestine. The pathological diagnosis was adenocarcinoma. No invasive or metastatic lesions were observed. Therefore, partial resection of the ileum with lymphadenectomy and reconstruction of the ileostomy were performed. Pathological examination revealed that the tumor was type 2, pT3 (SS) , pN1, pPM0, pDM0, pRM0, INFb, ly1, v1, pEX0, PN0. Twenty-nine days after the surgery, the patient was diagnosed with lung metastasis and he underwent lung radiofrequency ablation. We suggest that long-term follow-up is necessary for patients after surgery for FAP, because of the risk of malignant disease developing in other organs. |
| Keywords | 家族性大腸腺腫症 (familial adenomatous polyposis) 小腸癌 (jejunal cancer) 小腸内視鏡検査 (small intestine endoscope) |
| Publication Title | Journal of Okayama Medical Association |
| Published Date | 2017-08-01 |
| Volume | volume129 |
| Issue | issue2 |
| Start Page | 111 |
| End Page | 114 |
| ISSN | 0030-1558 |
| Related Url | https://doi.org/10.4044/joma.129.111 |
| language | Japanese |
| Copyright Holders | Copyright (c) 2017 岡山医学会 |
| File Version | publisher |
| DOI | 10.4044/joma.129.111 |
| NAID | 130006039373 |
| Title Alternative | Magnified observation of spontaneous morphological changes of duodenal follicular lymphoma |
|---|---|
| FullText URL | 128_111.pdf |
| Author | Iwamuro, Masaya| Takata, Katsuyoshi| Kawano, Seiji| Kawahara, Yoshiro| Yoshino, Tadashi| Okada, Hiroyuki| |
| Abstract | A 63-year-old Japanese woman was diagnosed with duodenal follicular lymphoma. The initial esophagogastroduodenoscopic examination with magnifying observation revealed opaque white spots and enlarged whitish villi. Nine months later, esophagogastroduodenoscopy showed that the size of the lymphoma lesion decreased, and only opaque white spots were visible. The histological analysis of biopsy samples obtained during the initial endoscopy examination showed both neoplastic follicles and an inter-follicular infiltration of lymphoma cells, whereas the biopsy samples obtained at the endoscopy performed 9 months later showed only neoplastic follicle formation. These results suggest that the magnifying endoscopic features may reflect the underlying pathological mechanisms : enlarged whitish villi are probably due to lymphoma cell infiltration in the inter-follicular area, and opaque white spots are probably caused by neoplastic follicle formation. |
| Keywords | 消化管原発濾胞性リンパ腫（primary gastrointestinal follicular lymphoma） 悪性リンパ腫（malignant lymphoma） 拡大内視鏡検査（magnifying endoscopy） |
| Publication Title | Journal of Okayama Medical Association |
| Published Date | 2016-08-01 |
| Volume | volume128 |
| Issue | issue2 |
| Start Page | 111 |
| End Page | 116 |
| ISSN | 0030-1558 |
| Related Url | isVersionOf https://doi.org/10.4044/joma.128.111 |
| language | Japanese |
| Copyright Holders | Copyright (c) 2016 岡山医学会 |
| File Version | publisher |
| DOI | 10.4044/joma.128.111 |
| NAID | 130005262531 |
| Author | Kawano, Seiji| Okada, Hiroyuki| Kawahara, Yoshiro| Inoue, Masafumi| Yamamoto, Kazuhide| |
|---|---|
| Published Date | 2009-08-03 |
| Publication Title | 岡山医学会雑誌 |
| Volume | volume121 |
| Issue | issue2 |
| Content Type | Journal Article |
| Title Alternative | Fermented persimmon extract (kaki-shibu) is useful as a standard for component analyses of persimmon phytobezoars |
|---|---|
| FullText URL | 126_127.pdf |
| Author | Iwamuro, Masaya| Okamoto, Yuko| Murata, Toshihiro| Kawai, Yoshinari| Shiraha, Hidenori| Okada, Hiroyuki| Yamamoto, Kazuhide| |
| Abstract | The definite diagnosis of persimmon phytobezoar (i.e., diospyrobezoar) is often accomplished by a component analysis using infrared spectroscopy. However, no studies have been conducted to investigate which substance is the best as a standard for the component analysis. Here we analyzed tannic acid, Japanese persimmon (kaki), fermented persimmon extract (kaki-shibu), conventional dried persimmon, and dried persimmon smoked in sulfur (ampo-kaki) by infrared spectroscopy to determine which would be optimal as a component analysis standard. The spectrum between 1,600 to 600cm－1 of a persimmon phytobezoar was quite similar to the spectrum of kaki-shibu rather than that of tannic acid. Consequently, we conclude that kaki-shibu should be used as a standard for infrared spectroscopy analyses of persimmon phytobezoars. |
| Keywords | 柿胃石（gastric phytobezoar） タンニン酸（tannic acid） 消化管異物（gastrointestinal foreign body） 成分分析（component analysis） |
| Publication Title | 岡山医学会雑誌 |
| Published Date | 2014-08-01 |
| Volume | volume126 |
| Issue | issue2 |
| Start Page | 127 |
| End Page | 131 |
| ISSN | 0030-1558 |
| language | Japanese |
| Copyright Holders | Copyright (c) 2014 岡山医学会 |
| File Version | publisher |
| DOI | 10.4044/joma.126.127 |
| NAID | 130004685263 |
| Author | Okada, Hiroyuki| |
|---|---|
| Published Date | 2012-12-03 |
| Publication Title | 岡山医学会雑誌 |
| Volume | volume124 |
| Issue | issue3 |
| Content Type | Journal Article |
| Author | Inoue, Masafumi| Okada, Hiroyuki| Kawahara, Yoshiro| Kawano, Seiji| Yamamoto, Kazuhide| |
|---|---|
| Published Date | 2009-08-03 |
| Publication Title | 岡山医学会雑誌 |
| Volume | volume121 |
| Issue | issue2 |
| Content Type | Journal Article |
| Author | Gotoda, Tatsuhiro| Kawano, Seiji| Kono, Yoshiyasu| Miura, Kou| Kanzaki, Hiromitsu| Iwamuro, Masaya| Kawahara, Yoshiro| Tanaka, Takehiro| Yoshino, Tadashi| Shirakawad, Yasuhiro| Tabata, Masahiro| Tanimoto, Mitsune| Okada, Hiroyuki| |
|---|---|
| Published Date | 2016-12-01 |
| Publication Title | Journal of Okayama Medical Association |
| Volume | volume128 |
| Issue | issue3 |
| Content Type | Journal Article |
