نتایج جستجو برای: pivka
تعداد نتایج: 203 فیلتر نتایج به سال:
BACKGROUND Vitamin K epoxide reductase subunit 1 (VKORC1) is the molecular target of coumarin anticoagulants and mutations in VKORC1 have been identified previously in individuals who required high warfarin doses. OBJECTIVE Detailed characterization of the relationship between variation in VKORC1 and the warfarin resistance phenotype. PATIENTS AND METHODS Serum warfarin concentration and co...
We have retrospectively investigated patients with hepatocellular carcinoma (HCC) (912 cases) treated in the Affiliated Hospitals of Keio University (the Keio Association for the Study of Liver Diseases: KASLD) and here we review the recent diagnosis and treatment of HCC. HCC is a major cause of death in Japan and a major etiology of this disease is chronic viral infection such as hepatitis C v...
In patients with hepatocellular carcinoma (HCC), the presence of bile duct tumor thrombi (BDTT) in the major bile ducts indicates poor prognosis compared with that of HCC patients without BDTT. However, the prognostic significance of incidental microscopic BDTT in the peripheral bile ducts after curative liver resection is not known. We compared the outcomes of HCC patients with and without mic...
BACKGROUND The haplotypes in the gene vitamin K epoxide reductase complex subunit 1 (VKORC1) have been found to affect warfarin dose response through effects on the formation of reduced-form vitamin K, a cofactor for gamma-carboxylation of vitamin K-dependent proteins, which is involved in the coagulation cascade and has a potential impact on atherosclerosis. We hypothesized that VKORC1-depende...
Vitamin Kdeficiency bleeding (VKDB) previously known as hemorrhagic disease of the newborn has been classified as Early (0-24hrs), Classic (2-7 days) and Late (1-6 months). Child birth following the maternal ingestion of anti-epileptic drugs such as Phenytoin, is liable to result in early VKDB as well as bone changes in the fetus. Other maternal risk factors for VKDB include medications such as...
症例は78歳の男性で，近医で肝腫瘤を指摘され紹介受診した．造影CTで肝右葉に動脈相で濃染し，平衡相でwash outする直径10 cmの腫瘤を認め，PIVKA-IIとAFP-L3の上昇を認め肝細胞癌と診断した．肝右葉切除が必要と考えられたが，予定残肝容積率が33%で，経回結腸静脈門脈塞栓術（trans-ileocecal portal vein embolization；以下，TIPEと略記）を施行した．TIPE後28日目の造影CTで腫瘍は5 cm大に縮小し，予定残肝容積率が44%と増大し肝右葉切除を施行，術後合併症なく退院した．切除標本は肉眼的には出血壊死の所見で，組織学的には出血を伴う壊死組織と変性組織で占められ腫瘍細胞を認めなかった．現在術後12か月経過し，再発所見なく経過している．TIPEにより完全壊死を来した肝細胞癌と考えられる1例を経験したため，報告する．
症例は70歳代男性，B型肝炎ウイルスのキャリアであることを指摘されていたが医療機関への定期受診はされていなかった．発熱と倦怠感を主訴に前医を受診し，肝細胞癌と診断された．CTでは明らかな骨転移は指摘されなかったが，追加検査のFDG-PETでは骨皮質の破壊を伴わないものの骨髄内への集積増加を認めた．引き続き施行した骨髄生検では肝細胞癌の骨髄転移を認め，cStageIVBと診断した．レンバチニブによる治療を約9カ月間行ったが，口内炎や下痢，倦怠感の増悪により投与困難となり，治療開始10カ月目に死亡退院となった．PIVKA-II高値の症例では，CTで肝外転移が指摘されなくてもFDG-PETを追加施行する意義がある．
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