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論文

論文
Kobayashi, Mio ; Kakuda, Yuko ; Harada, Kenichi ; Sato, Yasunori ; Sasaki, Motoko ; Ikeda, Hiroko ; Terada, Mitsuhiro ; Mukai, Munenori ; Kaneko, Shuichi ; Nakanuma, Yasuni ; 小林, 水緒 ; 原田, 憲一 ; 佐藤, 保則 ; 佐々木, 素子 ; 池田, 博子 ; 金子, 周一 ; 中沼, 安二
出版情報: World Journal of Gastroenterology.  20  pp.3597-3608,  2014.  Baishideng Publishing Group Co
URL: http://hdl.handle.net/2297/00061729
概要: 金沢大学医薬保健研究域医学系<br />AIM: To investigate histological and immunohistochemical differences in hepatitis between autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC) with AIH features. METHODS: Liver needle biopsies of 41 PBC with AIH features and 43 AIH patients were examined. The activity of periportal and lobular inflammation was scored 0 (none or minimal activity) to 4 (severe), and the degree of hepatitic rosette formation and emperipolesis was semiquantatively scored 0-3. The infiltration of mononuclear cells positive for CD20, CD38, CD3, CD4, and CD8 and positive for immunoglobulins (IgG, IgM, and IgA) at the periportal areas (interface hepatitis) and in the hepatic lobules (lobular hepatitis) were semiquantitatively scored in immunostained liver sections (score 0-6). Serum aspartate aminotransferase (AST), immunoglobulins, and autoantibodies at the time of liver biopsy were correlated with the histological and immunohistochemical scores of individual lesions. RESULTS: Lobular hepatitis, hepatitic rosette formation, and emperipolesis were more extensive and frequent in AIH than in PBC. CD3+, CD4+, and CD8+ cell infiltration scores were higher in the hepatic lobules and at the interface in AIH but were also found in PBC. The degree of mononuclear cell infiltration correlated well with the degree of interface and lobular hepatitis in PBC, but to a lesser degree in AIH. CD20+ cells were mainly found in the portal tracts and, occasionally, at the interface in both diseases. Elevated AST correlated well with the hepatocyte necroinflammation and mononuclear cell infiltration, specifically CD38+ cells in PBC. No correlation existed between autoantibodies and inflammatory cell infiltration in PBC or AIH. While most AIH cases were IgG-predominant at the interface, PBC cases were divided into IgM-predominant, IgM/IgGequal, and IgG-predominant types, with the latter sharing several features with AIH. CONCLUSION: These results suggest that the hepatocellular injuries associated with interface and lobular hepatitis in AIH and PBC with interface hepatitis may not be identical. © 2014 Baishideng Publishing Group Co., Limited. All rights reserved. 続きを見る
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Sato, Hirohide ; Sato, Yasunori ; Harada, Kenichi ; Sasaki, Motoko ; Hirano, Katsuyasu ; Nakanuma, Yasuni ; 佐藤, 保則 ; 原田, 憲一 ; 佐々木, 素子 ; 中沼, 安二
出版情報: World Journal of Gastroenterology.  19  pp.6125-6126,  2013.  Baishideng Publishing Group Co
URL: http://hdl.handle.net/2297/00061731
概要: 金沢大学医薬保健研究域医学系<br />A 77-year-old woman complained of epigastralgia, and a tumor (5 cm in diameter) of the gallbladder n eck was detected by image analysis. Following cholecystectomy, the tumor was pathologically diagnosed as intraductal papillary neoplasm (IPN), gastric type, with associated invasive carcinoma. About 10 mo later, intraluminal multiple masses (3 foci, up to 1.8 cm) were noted in the extrahepatic bile duct, and the resected specimen showed that all tumors had similar gross and microscopic features as seen in gallbladder IPN without invasion, and they were synchronous multiple lesions. This case showed a papillary tumor of the gallbladder of gastric phenotype, and confirmed that the gallbladder is a target of IPN in addition to the bile ducts. © 2013 Baishideng. All rights reserved. 続きを見る
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Onishi, Ichiro ; Kitagawa, Hirohisa ; Harada, Kenichi ; Maruzen, Syogo ; Sakai, Seisyo ; Makino, Isamu ; Hayashi, Hironori ; Nakagawara, Hisatoshi ; Tajima, Hidehiro ; Takamura, Hiroyuki ; Fujimura, Takashi ; Kayahara, Masato ; Ikeda, Hiroko ; Ohta, Tetsuo ; Nakanuma, Yasuni ; 北川, 裕久 ; 原田, 憲一 ; 牧野, 勇 ; 林, 泰寛 ; 中川原, 寿俊 ; 田島, 秀浩 ; 高村, 博之 ; 藤村, 隆 ; 萱原, 正都 ; 池田, 博子 ; 太田, 哲生 ; 中沼, 安二
出版情報: World Journal of Gastroenterology.  19  pp.3161-3164,  2013.  Baishideng Publishing Group Co
URL: http://hdl.handle.net/2297/00061732
概要: 金沢大学医薬保健研究域医学系<br />We present the first case of an intraductal papillary neoplasm of the bile duct (IPNB) accompanying a mixed adenoneuroendocrine carcinoma (MANEC). A 74-yearold woman presented with fever of unknown cause. Laboratory data revealed jaundice and liver injury. Contrast-enhanced computed tomography revealed a 20 mm polypoid tumor in the dilated distal bile duct, which exhibited early enhancement and papillary growth. Upper gastrointestinal endoscopy revealed mucus production from the papilla of Vater, characterized by its protruding and dilated orifice. Endoscopic ultrasonography visualized the polypoid tumor in the distal bile duct, but no invasive region was suggested by diagnostic imaging. Therefore, the initial diagnosis was IPNB. After endoscopic nasobiliary drainage, a pylorus-preserving pancreaticoduodenectomy was performed. Pathological examination of the resected bile duct revealed papillary proliferation of biliary-type cells with nuclear atypia, indicating pancreaticobiliary-type IPNB. In addition, solid portions comprised of tumor cells with characteristic salt-and-pepper nuclei were evident. Immunohistochemistry revealed expression of the neuroendocrine marker synaptophysin in this solid component, diagnosing it as a neuroendocrine tumor (NET). Furthermore, the MIB-1 proliferation index of NET was higher than that of IPNB, and microinvasion of the NET component was found, indicating neuroendocrine carcinoma (NET G3). This unique case of MANEC, comprising IPNB and NET, provides insight into the pathogenesis of biliary NET. © 2013 Baishideng. All rights reserved. 続きを見る
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Mizushima, Ichiro ; Inoue, Dai ; Yamamoto, Motohisa ; Yamada, Kazunori ; Saeki, Takako ; Ubara, Yoshifumi ; Matsui, Shoko ; Masaki, Yasufumi ; Wada, Takashi ; Kasashima, Satomi ; Harada, Kenichi ; Takahashi, Hiroki ; Notohara, Kenji ; Nakanuma, Yasuni ; Umehara, Hisanori ; Yamagishi, Masakazu ; Kawano, Mitsuhiro ; 水島, 伊知郎 ; 井上, 大  ; 山田, 和徳 ; 和田, 隆志 ; 笠島, 里美 ; 原田, 憲一 ; 中沼, 安二 ; 梅原, 久範 ; 山岸, 正和 ; 川野, 充弘
出版情報: Arthritis Research and Therapy.  16  pp.R156-,  2014-07-23.  BioMed Central Ltd.
URL: http://hdl.handle.net/2297/00050648
概要: 金沢大学医薬保健研究域医学系<br />Introduction: Immunoglobulin G4 (IgG4)-related aortitis/periaortitis and periarteritis are vascular manifestations of IgG4-related disease. In this disease, the affected aneurysmal lesion has been suspected to be at risk of rupture. In this study, we aimed to clarify the clinical course after corticosteroid therapy in IgG4-related aortitis/periaortitis and periarteritis.Methods: We retrospectively evaluated clinical features, including laboratory data, imaging findings and the course after corticosteroid therapy, in 40 patients diagnosed with IgG4-related aortitis/periaortitis and periarteritis on the basis of periaortic/periarterial radiological findings, satisfaction of the comprehensive diagnostic criteria or each organ-specific diagnostic criteria, and exclusion of other diseases. Results: The patients were mainly elderly, with an average age of 66.4 years and with a marked male predominance and extensive other organ involvement. Subjective symptoms were scanty, and only a small proportion had elevated serum C-reactive protein levels. The affected aorta/artery were the abdominal aortas or the iliac arteries in most cases. Thirty-six patients were treated with prednisolone, and the periaortic/periarterial lesions improved in most of them during the follow-up period. Two (50.0%) of four patients with luminal dilatation of the affected lesions before corticosteroid therapy had exacerbations of luminal dilatation after therapy, whereas none of the twenty-six patients without it had a new appearance of luminal dilatation after therapy. Conclusions: The results of this retrospective multicenter study highlight three important points: (1) the possibility of latent existence and progression of periaortic/periarterial lesions, (2) the efficacy of corticosteroid therapy in preventing new aneurysm formation in patients without luminal dilatation of periaortic/periarterial lesions and (3) the possibility that a small proportion of patients may actually develop luminal dilatation of periaortic/periarterial lesions in IgG4-related aortitis/periaortitis and periarteritis. A larger-scale prospective study is required to confirm the efficacy and safety of corticosteroid therapy in patients with versus those without luminal dilatation and to devise a more useful and safe treatment strategy, including administration of other immunosuppressants. © 2014 Mizushima et al.; licensee BioMed Central Ltd. 続きを見る
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論文
中沼, 安二 ; 原田, 憲一 ; 木村, 康 ; 佐藤, 保則 ; 佐々木, 素子 ; 池田, 博子
出版情報: 消化器外科 = Gastroenterological surgery.  32(11)  pp.1715-1725,  2009-10-01.  へるす出版
URL: http://hdl.handle.net/2297/35201
概要: 胆道癌の病理(肉眼像と組織像)を、『胆道癌取扱い規約』に従い、胆道癌を中心に解説した。胆道癌、とくに肝門部癌の分類と位置づけを述べた。現在、胆道癌の患者は世界的に増加傾向にあり、また外科的切除が唯一の根治的治療法であることから、手術に関連し た病理情報が患者の予後の推定、治療法の開発、手術法の改善に重要である。また、胆道癌の予後良好群の設定とその解析、さらには胆道癌の前癌病変の解析も今後の課題と思われる。 続きを見る
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論文
原田, 憲一 ; 中沼, 安二
出版情報: 胆と膵 = The Biliary tract & pancreas.  33  pp.485-490,  2012-01-01.  医学図書出版
URL: http://hdl.handle.net/2297/40311
概要: IgG4関連硬化性胆管炎はIgG4関連疾患の胆管病変であるが, 1型自己免疫性膵炎に合併する症例が多く, 胆管病変と膵管病変とは類似性がみられる. 病理像はIgG4陽性形質細胞の浸潤と線維化が特徴であり, 診断に際しては原発性硬化性胆管炎や 腫瘍性病変との鑑別が重要である. また, IgG4陽性細胞の浸潤はIgG4関連疾患に特異的な所見ではなく胆管癌でもみられるため, とくに胆管生検材料によるIgG4関連硬化性胆管炎と胆管癌との病理学的鑑別は注意を要する. 現在, 国内外で診断基準が提案または策定中であるが, 診断基準に過度に固執することなく, 個々の症例を臨床病理学的に診断することが重要である. 「はじめに」線維化を伴う胆道系炎症性疾患は硬化性胆管炎として包括されており, 硬化性胆管炎のプロトタイプとして原発性硬化性胆管炎に加えて, 近年IgG4関連硬化性胆管炎(IgG4-SC)が新たに加わった. 続きを見る
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原田, 憲一 ; 一瀬, 久美子 ; 中沼, 安二
出版情報: 消化器と免疫 = Digestive organ and immunology.  42  pp.33-36,  2005-01-01.  日本消化器免疫学会 / マイライフ社
URL: http://hdl.handle.net/2297/29616
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原田, 憲一 ; 佐藤, 保則 ; 中沼, 安二
出版情報: 消化器と免疫 = Digestive organ and immunology.  45  pp.161-164,  2008-01-01.  日本消化器免疫学会 / マイライフ社
URL: http://hdl.handle.net/2297/29615
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原田, 憲一 ; 一瀬, 久美子 ; 中沼, 安二
出版情報: 消化器と免疫 = Digestive organ and immunology.  41  pp.163-166,  2004-01-01.  日本消化器免疫学会 / マイライフ社
URL: http://hdl.handle.net/2297/29614
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論文
中沼, 安二 ; 原田, 憲一
出版情報: 小児外科 = Japanese journal of pediatric surgery.  40  pp.7-11,  2008-01-01.  東京医学社 / 東京医学社小児外科編集部
URL: http://hdl.handle.net/2297/29708