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Intracranial malignant solitary fibrous tumor metastasized to the chest wall:A case report and review of literature

World Journal of Clinical Cases 2020年第20期8卷 4844-4852页

作者： daisuke usuda Shinya Yamada Toshihide Izumida Ryusho Sangen Toshihiro Higashikawa Ken Nakagawa Masaharu Iguchi Yuji Kasamaki Department of General Medicine Kanazawa Medical University Himi Municipal HospitalHimi-shi 935-8531Toyama-kenJapan Department of Infectious Diseases Kanazawa Medical UniversityUchinadamachi 920-0293Ishikawa-kenJapan Department of Respiratory Medicine Kanazawa Medical University Himi Municipal HospitalHimi-shi 935-8531Toyama-kenJapan Department of Geriatric Medicine Kanazawa Medical University Himi Municipal HospitalHimi-shi 935-8531Toyama-kenJapan

BACKGROUND Solitary fibrous tumor(SFT)is a rare fibroblastic mesenchymal neoplasm that affects spindle cell soft tissues with broad-spectrum biological behavior;it is predominantly benign,and rarely *** occurs mainly in the tissue structure of the serosa in the pleura and the thorax,and can be found throughout the body,though extra-thoracic localization,including the cephalic region,is *** reported the first case of intracranial malignant SFT metastasized to the chest *** SUMMARY An 81-year-old Japanese man was referred to our hospital due to progressive gait disturbance and appetite *** medical history included partial resection due to brain tumor,four times,and 50-Gray radiation therapy at another hospital,starting when he was 74 years *** unenhanced head computed tomography(CT)scan revealed an 8 cm×5.1 cm×6.5 cm mixed-density mass at the left frontal lobe,accompanying a midline shift,and an unenhanced chest-abdomen CT scan revealed a 6 cm×4.1 cm×6.5 cm low-density mass in the left chest wall.A CT-guided percutaneous lung biopsy was performed,and the pathological findings were SFT corresponding to brain ***,the correct diagnosis of his brain tumor in history of past illness revealed to be SFT,and the unremovable tumor,namely present brain lesions enlarged and metastasized to the chest *** established a definitive diagnosis of intracranial malignant SFT metastasized to the chest *** notified him and his family of the disease,and offered palliative *** passed away on the 29 th hospital *** This case suggests the need for careful,detailed examination,and careful followup when encountering patients presenting with a mass.

关键词： Solitary fibrous tumor Intracranial malignant solitary fibrous tumor Metastasized chest wall tumor Cluster of differentiation 34 STAT6 Case report

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Peroxisome proliferator-activated receptors for hypertension

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World Journal of Cardiology 2014年第8期6卷 744-754页

作者： daisuke usuda Tsugiyasu Kanda Department of Community Medicine Kanazawa Medical University Himi Municipal HospitalHimi-shi 935-8531Toyama-kenJapan

Peroxisome proliferator-activated receptors(PPARs) are ligand-activated transcription factors belonging to the nuclear receptor superfamily, which is composed of four members encoded by distinct genes(α, β, γ, and δ). The genes undergo transactivation or transrepression under specific mechanisms that lead to the induction or repression of target gene expression. As is the case with other nuclear receptors, all four PPAR isoforms contain five or six structural regions in four functional domains; namely, A/B, C, D, and E/F. PPARs have many functions, particularly functions involving control of vascular tone, inflammation, and energy homeostasis, and are, therefore, important targets for hypertension, obesity, obesity-induced inflammation, and metabolic syndrome in general. Hence, PPARs also represent drug targets, and PPARα and PPARγ agonists are used clinically in the treatment of dyslipidemia and type 2 diabetes mellitus, respectively. Because of their pleiotropic effects, they have been identified as active in a number of diseases and are targets for the development of a broad range of therapies for a variety of diseases. It is likely that the range of PPARγ agonist therapeutic actions will result in novel approaches to lifestyle and other diseases. The combination of PPARs with reagents or with other cardiovascular drugs, such as diuretics and angiotensin Ⅱ receptor blockers, should be *** article provides a review of PPAR isoform characteristics, a discussion of progress in our understanding of the biological actions of PPARs, and a summary of PPAR agonist development for patient management. We also include a summary of the experimental and clinical evidence obtained from animal studies and clinical trials conducted to evaluate the usefulness and effectiveness of PPAR agonists in the treatment of lifestyle-related diseases.

关键词： Peroxisome proliferator-activated receptors Nuclear receptor Isoform mRNA Blood pressure Hypertension Obesity Angiotensin II receptor blocker Diabetes mellitus

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Atypical lipomatous tumor in the ligamentum teres of liver:A case report and review of the literature

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World Journal of Clinical Cases 2018年第12期6卷 548-553页

作者： daisuke usuda Kento Takeshima Ryusho Sangen Kisuke Nakamura Kei Hayashi Hideyuki Okamura Yasuhiro Kawai Yuji Kasamaki Yoshitsugu Iinuma Hitoshi Saito Tsugiyasu Kanda Sachio Urashima Department of Community Medicine Kanazawa Medical University Himi Municipal Hospital Department of Infectious Diseases Kanazawa Medical University Department of General and Digestive Surgery Kanazawa Medical University Himi Municipal Hospital Department of Gastroenterology Kanazawa Medical University Himi Municipal Hospital

A 61-year-old male was referred to our hospital with a three-month history of persistent epigastralgia and right hypochondralgia. Initial examination revealed a fist-size mass at the epigastric fossa. Ultrasonography showed a hemangioma and a mosaic echoic lesion in the ventromedian with poor blood-flow signal and linear hyperechoic part inside, and a clear border to the surroundings. Dynamic computed tomography revealed a highly enhanced effect from the portal-venous phase continuing to the equilibrium phase. T1-weighted gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced image revealed a high intensity effect at the early phase that continued to the next phase. On the other hand, it contained a low intensity area by a fat suppression of that image. In addition, a T2-weighted image did not show a high intensity effect. Laparotomy was performed on the second day of hospitalization. The tumor had arisen from the ligamentum teres of the liver, and no metastasis or invasion of other organs was noted. It consisted of a lipid component of mature adipocytes and a fibrous component of deep dyeing pleomorphic or multinuclear atypical stromal cells. Immunohistochemical study of the atypical stromal cells demonstrated that they were positive for MDM2 and CDK4. A pathological diagnosis of atypical lipomatous tumor(ALT) was made, and the patient was discharged on the eighth day following the procedure. At the 6-mo follow-up dynamic CT, the patient was free of recurrence or metastasis. We experienced a patient with ALT in the ligamentum teres of the liver. This case suggests the need for a careful and detailed examination when encountering patients presenting with a mass; when neoplastic lesion is confirmed by image inspection, we should thoroughly investigate, including further image investigations and pathologic examination. The latter is the most important.

关键词： Liposarcoma Atypical lipomatous tumor Malignant adipose mesenchymal tumor Ligamentum teres of liver Operation

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Interstitial Pneumonia in a 94-Year-Old Woman with MPO-ANCA Positive Vasculitis

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Case Reports in Clinical Medicine 2016年第2期5卷 61-65页

作者： daisuke usuda Ryusho Sangen Yoshifumi Iwata Tsugiyasu Kanda Department of Community Medicine Kanazawa Medical University Himi Municipal Hospital Himi Japan Department of Infectious Diseases Kanazawa Medical University Uchinada Japan

The interstitial pneumonia (IP) associated with myeloperoxidase anti-neutrophil cytoplasmic autoantibody (MPO-ANCA) showed characteristic histology dominated by usual IP pattern. We showed a 94-year-old woman, whose prognosis was poor by severity of IP by MPO-ANCA associated vasculitis. The median age at diagnosis of IP by MPO-ANCA associated vasculitis was over 60 years, with a male predominance. Most patients died related to respiratory insufficiency. Our case would be the oldest patient in IP by MPO-ANCA associated vasculitis in the literature.

关键词： Interstitial Pneumonia MPO-ANCA Woman Oldest

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Obligate aerobic, gram-positive, weak acid-fast, nonmotile bacilli, Tsukamurella tyrosinosolvens: Minireview of a rare opportunistic pathogen

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World Journal of Clinical Cases 2022年第24期10卷 8443-8449页

作者： daisuke usuda Risa Tanaka Makoto Suzuki Shintaro Shimozawa Hayabusa Takano Yuta Hotchi Shungo Tokunaga Ippei Osugi Risa Katou Sakurako Ito Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima-ku 177-8521TokyoJapan Department of Medicine Juntendo UniversityBunkyo-ku 113-8421TokyoJapan

Tsukamurella species are obligate aerobic,gram-positive,weak acid-fast,nonmotile *** are found in various environments,such as soil,water,sludge,and petroleum reservoir wastewater,and belong to the order *** 2016,there was a reclassification of species within the genus Tsukamurella,merging the species Tsukamurella tyrosinosolvens(***)and Tsukamurella *** species are clinically considered to be a rare opportunistic pathogen,because most reported cases have been related to bacteremia and intravascular prosthetic devices and *** date,it has been isolated only from human specimens,and has always been associated with clinical disease;human infections are very *** infections have included pneumonia,brain abscesses,catheter-related bloodstream infections,ocular infections,bacteremia,and sepsis presenting with septic pulmonary emboli in patients who are *** date,there is no commercially available test for *** the other hand,sequence-based identification,including matrix-assisted laser desorption ionization time-of-flight mass spectrometry,is an alternative method for identifying clinical isolates that are either slow growers or difficult to identify through biochemical *** golden standards for diagnosis and optimal management still remain to be ***,newer molecular biological techniques can provide accurate identification,and contribute to the appropriate selection of definitive therapy for infections caused by this *** of several antimicrobial agents have been proposed for treatment,though the length of treatment for infections has yet to be determined,and should be individualized according to clinical *** patients often experience severe cases due to infection,and life-threatening *** events associated with dissemination and/or failure of source control have ***

关键词： Tsukamurella tyrosinosolvens Gram-positive bacilli Opportunistic infection Sequence-based identification Matrix-assisted laser desorption ionization time-of-flight mass spectrometry Combination antibiotic therapy

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Exophiala dermatitidis

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World Journal of Clinical Cases 2021年第27期9卷 7963-7972页

作者： daisuke usuda Toshihiro Higashikawa Yuta Hotchi Kenki Usami Shintaro Shimozawa Shungo Tokunaga Ippei Osugi Risa Katou Sakurako Ito Toshihiko Yoshizawa Suguru Asako Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima-ku 177-8521TokyoJapan Department of Geriatric Medicine Kanazawa Medical University Himi Municipal HospitalHimi-shi 935-8531Toyama-kenJapan

Exophiala is a genus comprising several species of opportunistic black yeasts,which belongs to *** is a rare cause of fungal ***,infections are often chronic and recalcitrant,and while the number of cases is steadily increasing in both immunocompromised and immunocompetent people,detailed knowledge remains scarce regarding infection mechanisms,virulence factors,specific predisposing factors,risk factors,and host *** most common manifestations of Exophiala infection are skin infections,and the most frequent type of deep infection is pulmonary infection due to *** invasive disease ranges from cutaneous or subcutaneous infection to systemic dissemination to internal *** final identification of the causative organism should be achieved through a combination of several methods,including the newly introduced diagnostic analysis,matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry,together with sequencing of the ribosomal ribonucleic acid internal transcribed spacer region of the fungi,and histological and culture *** treatment,because anti-infective agents and natural compounds exhibited poor antibiofilm activity,few treatments have ultimately been found to be effective for specific antifungal therapy,so the optimal antifungal therapy and duration of therapy for these infections remain ***,most forms of disease caused by Exophiala dermatitidis require aggressive combination therapies:Both surgical intervention and aggressive antifungal therapy with novel compounds and azoles are necessary for effective treatment.

关键词： Exophiala dermatitidis Black yeast Immunocompromised host Matrixassisted laser desorption/ionization-time-of-flight mass spectrometry Ribosomal ribonucleic acid Antifungal drugs

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Amebic liver abscess by Entamoeba histolytica

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World Journal of Clinical Cases 2022年第36期10卷 13157-13166页

作者： daisuke usuda Shiho Tsuge Riki Sakurai Kenji Kawai Shun Matsubara Risa Tanaka Makoto Suzuki Hayabusa Takano Shintaro Shimozawa Yuta Hotchi Shungo Tokunaga Ippei Osugi Risa Katou Sakurako Ito Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima 177-8521TokyoJapan Department of Sports Medicine Faculty of MedicineJuntendo UniversityBunkyo 113-8421TokyoJapan

Amebic liver abscesses(ALAs)are the most commonly encountered extraintestinal manifestation of human invasive amebiasis,which results from Entamoeba histolytica(***)spreading *** can be complicated by liver abscess in 9%of cases,and ALAs led to almost 50000 fatalities worldwide in *** there have been fewer and fewer cases in the past several years,ALAs remain an important public health problem in endemic *** causes both amebic colitis and liver abscess by breaching the host’s innate defenses and invading the intestinal *** often enter the circulatory system,where they are filtered in the liver and produce abscesses,and develop into severe invasive diseases such as *** clinical presentation can appear to be colitis,including upper-right abdominal pain accompanied by a fever in ALA *** diagnosis requires nonspecific liver imaging as well as detecting *** antibodies;however,these antibodies cannot be used to distinguish between a previous infection and an acute ***,diagnostics primarily aim to use PCR or enzyme-linked immunosorbent assay to detect *** can be treated medically,and percutaneous catheter drainage is only necessary in approximately 15%of *** indicated treatment is to administer an amebicidal drug(such as tinidazole or metronidazole)and paromomycin or other luminal cysticidal agent for clinical *** is good with almost universal *** which diagnostic methods are most efficacious will necessitate further analysis of similar clinical cases.

关键词： Amebic liver abscess Entamoeba histolytica Polymerase chain reaction Enzyme-linked immunosorbent assay Percutaneous catheter drainage Amebicidal drug

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Hemorrhagic shock due to submucosal esophageal hematoma along with mallory-weiss syndrome:A case report

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World Journal of Clinical Cases 2022年第27期10卷 9911-9920页

作者： Jiro Oba daisuke usuda Shiho Tsuge Riki Sakurai Kenji Kawai Shun Matsubara Risa Tanaka Makoto Suzuki Hayabusa Takano Shintaro Shimozawa Yuta Hotchi Kenki Usami Shungo Tokunaga Ippei Osugi Risa Katou Sakurako Ito Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima-ku 177-8521TokyoJapan Faculty of Medicine Juntendo UniversityBunkyo-ku 113-8421TokyoJapan

BACKGROUND Esophageal submucosal hematoma is a rare *** the exact etiology remains uncertain,vessel fragility with external factors is believed to have led to submucosal bleeding and hematoma formation;the vessel was ruptured by a sudden increase in pressure due to nausea,and the hematoma was enlarged by antiplatelet or anticoagulant *** conditions are rare,with a better *** present the first known case of submucosal esophageal hematoma-subsequent hemorrhagic shock due to Mallory-Weiss *** SUMMARY A 73-year-old female underwent endovascular treatment for an unruptured cerebral *** patient received aspirin and clopidogrel before surgery and heparin during surgery,and was well during the *** hours after returning to the ICU,she complained of chest discomfort,vomited 500 m L of fresh blood,and entered hemorrhagic *** submucosal hematoma with Mallory-Weiss syndrome was diagnosed through an endoscopic examination and computed *** addition to a massive fluid and erythrocyte transfusion,we performed a temporary compression for hemostasis with a Sengstaken-Blakemore(S-B)***,she became hemodynamically *** postoperative day 1,we performed an upper gastrointestinal endoscopy and confirmed no expansion of the hematoma nor any recurring bleeding;therefore,we removed the S-B tube and clipped the gastric mucosal laceration at the esophagogastric *** started oral intake on postoperative day *** patient made steady progress,and was discharged on postoperative day *** We present the first known case of submucosal esophageal hematoma subsequent hemorrhagic shock due to Mallory-Weiss syndrome.

关键词： Esophageal submucosal hematoma Hemorrhagic shock Mallory-Weiss syndrome Antithrombotic therapy Anticoagulant therapy Case report

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Angiotensin receptor blocker neprilysin inhibitors

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World Journal of Cardiology 2021年第8期13卷 325-339页

作者： daisuke usuda Toshihiro Higashikawa Yuta Hotchi Kenki Usami Shintaro Shimozawa Shungo Tokunaga Ippei Osugi Risa Katou Sakurako Ito Toshihiko Yoshizawa Suguru Asako Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima-ku 177-8521TokyoJapan Geriatric Medicine Kanazawa Medical University Himi Municipal HospitalHimi-shi 935-8531ToyamaJapan

Heart failure(HF)is a clinical syndrome that results from a structural or functional cardiac disorder that reduces the ability of the ventricle of the heart to fill with,or eject,*** is a multifaceted clinical condition that affects up to 2%of the population in the developed world,and is linked to significant morbidity and mortality;it is therefore considered a major concern for public *** the mechanism of HF,three neurohumoral factors-the reninangiotensin-aldosterone system,the sympathetic nervous system,and natriuretic peptides—are related to the pathology of chronic HF(CHF),and the targets of *** receptor blocker and neprilysin inhibitor(angiotensinreceptor neprilysin inhibitor),namely sacubitril/valsartan(SAC/VAL),has been introduced as a treatment for ***/VAL is an efficacious,safe,and costeffective therapy that improves quality of life and longevity in patients with HF with reduced ejection fraction(HFrEF),and reduces hospital *** inhospital initiation strategy offers a potential new avenue to improve the clinical uptake of SAC/*** the last five years,SAC/VAL has been established as a cornerstone component of comprehensive disease-modifying medical therapy in the management of chronic *** the other hand,further work,with carefully designed and controlled preclinical studies,is necessary for understanding the molecular mechanisms,effects,and confirmation of issues such as long-term safety in both human and animal models.

关键词： Angiotensin receptor blocker and neprilysin inhibitor Chronic heart failure Renin-angiotensin-aldosterone-system Sympathetic nervous system Natriuretic peptide Sacubitril/valsartan

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Diffuse large B cell lymphoma originating from the maxillary sinus with skin metastases:A case report and review of literature

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World Journal of Clinical Cases 2021年第23期9卷 6886-6899页

作者： daisuke usuda Toshihide Izumida Nao Terada Ryusho Sangen Toshihiro Higashikawa Sayumi Sekiguchi Risa Tanaka Makoto Suzuki Yuta Hotchi Shintaro Shimozawa Shungo Tokunaga Ippei Osugi Risa Katou Sakurako Ito Suguru Asako Yoshie Takagi Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Yuji Kasamaki Department of General Medicine Kanazawa Medical University Himi Municipal HospitalHimi-shi 935-8531Toyama-kenJapan Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima-ku 177-0035Tokyo-toJapan Kanazawa Medical University Himi Municipal Hospital Himi-shi 935-8531Toyama-kenJapan

BACKGROUND Diffuse large B-cell lymphoma(DLBCL)is the most common type of malignant lymphoma(ML),accounting for 30%-40%of cases of non-Hodgkin’s lymphoma(NHL)in *** paranasal sinus lymphoma is a rare presentation of extranodal NHL that accounts for only 0.17%of all *** from the maxillary sinus(MS)is a particularly rare presentation,and is thus often difficult to *** have reported the first known case of DLBCL originating from the MS with rapidly occurrent multiple skin *** SUMMARY An 81-year-old Japanese man visited our hospital due to continuous pain for 12 d in the left maxillary nerve *** medical history included splenectomy due to a traffic injury,an old right cerebral infarction from when he was 74-years-old,hypertension,and type 2 diabetes mellitus.A plain head computed tomography(CT)scan revealed a 3 cm×3.1 cm×3 cm sized left *** day 25,left diplopia and ptosis occurred,and a follow-up CT on day 31 revealed the growth of the left MS *** on an MS biopsy on day 50,we established a definitive diagnosis of DLBCL,non-germinal center B-cell-like originating from the left *** patient was admitted on day 62 due to rapid deterioration of his condition,and a plain CT scan revealed the further growth of the left MS mass,as well as multiple systemic metastasis,including of the skin.A skin biopsy on day 70 was found to be the same as that of the left MS *** notified the patient and his family of the disease,and they opted for palliative care,considering on his condition and *** patient died on day *** This case suggests the need for careful,detailed examination,and for careful follow-up,when encountering patients presenting with a mass.

关键词： Diffuse large B cell lymphoma Non-germinal center B-cell-like lymphoma Malignant lymphoma Maxillary sinus Skin metastasis Case report

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