Dokkyo Medical University Repository / 獨協医科大学リポジトリ
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Exacerbation in Glycemic Control by Switching from Subcutaneous Dulaglutide Injection to Oral Semaglutide Administration in a Patient with Type 2 Diabetes, Who Had Undergone Gastrectomy
Get PDFWe describe a case of an 83-year-old man with type 2 diabetes, who had undergone laparoscopy-assisted pyloric 2/3 gastrectomy 7 years ago. Switch from subcutaneous injection of dulaglutide, a glucagon-like protein-1(GLP-1) receptor agonist (GLP-1RA), to administration of oral semaglutide, another GLP-1RA, exacerbated his glycemic status. Because semaglutide is absorbed from the stomach, administration of oral semaglutide to patients after gastrectomy should be avoided even if the surgery is a partial gastrectomy.journal articl
A Case of Ulcerative Giant Phyllodes Tumor of the Breast
Get PDFA female patient in her 40's noticed a lump in her right breast ten years before her current presentation. One year earlier, the lump began rapidly increasing in size and was accompanied by the development of skin ulcers. Computed tomography revealed a giant mass on the outer side of the right breast. Based on analysis of a biopsy specimen, borderline phyllodes tumor was diagnosed. The patient underwent a simple mastectomy of the right breast with a skin graft. The resected tumor was 6.1 kg in weight, had a maximum diameter of 39 cm, and was pathologically diagnosed as a borderline phyllodes tumor. At postoperative year 2, the patient has had neither a local recurrence nor distant metastasis.journal articl
Incidence, clinical characteristics, and predictors of cardiovascular immune-related adverse events associated with immune checkpoint inhibitors
Get PDF獨協医科大学博士（医学）令和5年度doctoral thesi
Bacillus subtilis Septic Thrombophlebitis due to Ingestion of Natto
Get PDFA 75-year-old man was initially admitted to a hospital with complaints of malaise and fever of 39°C. He had Bacillus subtilis bacteremia and septic thrombophlebitis. He was immunocompetent and a regular consumer of natto, a traditional Japanese food fermented with B. subtilis. We suppose he was natto-induced septic thrombophlebitis.journal articl
Changes and Possible Risk Factors in the Prevalence of Allergic Rhinitis among Children in Ulaanbaatar, Mongolia from 2009 to 2021
Get PDFBackground: The WHO Collaborating Center at Dokkyo Medical University conducted a survey in Ulaanbaatar in 2009 on the prevalence of pediatric asthma and allergic rhinitis (AR). We report on a follow-up survey done in 2021 to measure changes since 2009 and identify risk factors.
Methods: Questionnaire based on International Study of Asthma and Allergies in Childhood with modifications was used in 2009 and 2021. The parent (s) of 200 boys and 200 girls, 6-7 years old, were randomly selected from and interviewed at the 10 clinic areas used in 2009. 50% were city districts and 50% were urban districts. Statistical data was analyzed using odds ratios analysis and chi-square testing.
Results: Comparing 2009 and 2021, prevalence of AR decreased by 13.6%. In houses where there was exposure to tobacco smoke, AR decreased by 21.3% from 64.0% to 42.7%. In children with asthma, AR decreased by 9.8% from 25.8% to 16.0%. In children with respiratory infection when <1 year old, AR decreased by 7.9% from 41.8% to 33.9%.
Conclusion: In comparing 2009 and 2021, the significance was greater between children with than without AR, with P < 0.001 for those exposed to tobacco smoke, and P < 0.005 for those with asthma. There was no significance for children with a history of respiratory infection when <1 year old. There was significance of exposure to tobacco smoke and having asthma as risk factors for AR but not for children with a history of respiratory infection when <1 year old.journal articl
A Case of a Subcapsular Abscess of the Liver Caused by Sclerosing Cholangitis Due to Pembrolizumab
Get PDFThe patient was a 71-year-old man who was diagnosed with primary lung cancer and was receiving chemotherapy with an immune checkpoint inhibitor. Blood tests performed 2 months after the start of treatment showed elevated hepatobiliary enzymes. Magnetic resonance imaging (MRI) showed multiple bead-like stenoses and dilatations of intrahepatic bile ducts in both lobes of the liver, and liver biopsy was performed to differentiate primary sclerosing cholangitis and drug-induced sclerosing cholangitis caused by immune checkpoint inhibitor treatment (immune-related adverse event (irAE) sclerosing cholangitis). Pathologically, the patient was found to have infiltration of inflammatory cells, mainly lymphocytes, in the portal vein area, consistent with irAE sclerosing cholangitis, and prednisolone therapy was started. Six months after discontinuation of chemotherapy, the patient again showed elevated hepatobiliary enzymes and inflammatory findings. Although the frequency of irAE sclerosing cholangitis itself is very low, when it does occur, it is refractory to treatment and often makes it difficult to continue chemotherapy. In the present case, the patient relapsed 6 months after discontinuation of chemotherapy, suggesting the need for long-term follow-up after discontinuation of the drug. In this report, a case of a subcapsular abscess in the liver caused by sclerosing cholangitis due to pembrolizumab is described.journal articl
