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Drug-induced sarcoidosis-like reaction three months after BNT162b2 mRNA COVID-19 vaccination:A case report and review of literature

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World Journal of Clinical Cases 2023年第1期11卷 177-186页

作者： Soo Ryang Kim Soo Ki Kim Takako Fujii Hisato Kobayashi Toyokazu Okuda Takanobu Hayakumo Atsushi Nakai yumi Fujii Ryuji Suzuki Noriko Sasase Aya Otani yu-ichiro koma Motoko Sasaki Tsutomu Kumabe Osamu Nakashima Department of Gastroenterology Kobe Asahi HospitalKobe 6530801HyogoJapan Department of Radiology Kobe Asahi HospitalKobe 6530801HyogoJapan Department of Clinical Laboratory Kobe Asahi HospitalKobe 6530801HyogoJapan Department of Pharmacy Kobe Asahi HospitalKobe 6530801HyogoJapan Division of Pathology Department of PathologyKobe University Graduate School of MedicineKobe 6530801HyogoJapan Department of Human Pathology Kanazawa University Graduate School of MedicineKanazawa 9208640IshikawaJapan Department of Gastroenterology Kumabe ClinicKumamoto 8611331KumamotoJapan Laboratory Services Center St.Mary's HospitalKurume 830-8543FukuokaJapan

BACKGROUND A 70-year-old man with hepatitis C virus-related recurrent hepatocellular carcinoma was admitted for further diagnosis of a 1 cm iso-hyperechoic nodule in segment(S)5.CASE SUMMARY Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging(EOB-MRI)revealed the nodule in S5 with a defect at the hepatobiliary phase,hyperintensity on diffusion weighted imaging(DWI)and hypointensity on apparent diffusion coefficient(ADC)map.Contrast-enhanced computed tomography revealed hypervascularity at the early phase,and delayed contrast-enhancement was observed at the late phase.Contrast-enhanced ultrasound(US)revealed incomplete defect at the late vascular phase.Inflammatory liver tumor,lymphoproliferative disease,intrahepatic cholangiocarcinoma(small duct type)and bile duct adenoma were suspected through the imaging studies.US guided biopsy,however,showed a noncaseating hepatic sarcoid-like epithelioid granuloma(HSEG),and histopathological analysis disclosed spindle shaped epithelioid cells harboring Langhans-type multinucleated giant cells.One month after admission,EOB-MRI signaled the disappearance of the defect at the hepatobiliary phase,of hyperintensity on DWI,of hypointensity on ADC map,and no stain at the early phase.CONCLUSION That the patient had received BNT162b2 messenger RNA(mRNA)coronavirus disease 2019 vaccination 3 mo before the occurrence of HSEG,and that its disappearance was confirmed 4 mo after mRNA vaccination suggested that the drug-induced sarcoidosis-like reaction(DISR)might be induced by the mRNA vaccination.Fortunately,rechallenge of drug-induced DISR with the third mRNA vaccination was not confirmed.

关键词： Drug-induced sarcoidosis-like reaction BNT162b2 mRNA COVID-19 vaccine Noncaseating granuloma Ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging Th1/Th2 profile Case report

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Scirrhous hepatocellular carcinoma displaying atypical findings on imaging studies

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World Journal of Gastroenterology 2009年第18期15卷 2296-2299页

作者： Soo Ryang Kim Susumu Imoto Taisuke Nakajima Kenji Ando Keiji Mita Katsumi Fukuda Ryo Nishikawa yu-ichiro koma Toshiyuki Matsuoka Masatoshi Kudo Yoshitake Hayashi Department of Gastroenterology Kobe Asahi HospitalKobe653-0801Japan Department of Radiology Osaka City University Medical SchoolOsaka545-8585Japan Department of Gastroenterology and Hepatology Kinki University School of MedicineOsaka-Sayama589-8511Japan Division of Molecular Medicine & Medical Genetics International Center for MedicalResearch and Treatment(ICMRT)Kobe University Graduate School of MedicineKobe650-0017Japan

We describe a 15-mm scirrhous hepatocellular carcinoma(HCC) in a 60-year-old man with B-type cirrhosis.Ultrasound disclosed a 15-mm hypoechoic nodule in segment 7.Contrast-enhanced US revealed heterogeneous,not diffuse,hypervascularity in the early phase and a defect in the Kupffer phase.Contrast-enhanced computed tomography(CT) revealed a heterogeneous hypervascular nodule in the early phase and a low-density area in the late phase.Magnetic resonance imaging(MRI) revealed iso-to hypointensity at T1 and high intensity at T2-weighted sequences.Contrast-enhanced MRI also revealed a heterogeneous hypervascular nodule in the early phase and washout in the late phase.Super-paramagnetic iron oxide-MRI revealed a hyperintense nodule.CT during hepatic arteriography and CT during arterial portography revealed heterogeneous hyperattenuation and a perfusion defect,respectively.Based on these imaging findings the nodule was diagnosed as a mixed well-differentiated and moderately-differentiated HCC.Histologically,the nodule was moderately-differentiated HCC characterized by typical cytological and structural atypia with dense fibrosis.Immunohistochemically,the nodule was positive for heterochromatin protein 1 and alpha-smooth muscle actin,and negative for cytokeratin 19.From the above findings,the nodule was diagnosed as scirrhous HCC.Clinicians engaged in hepatology should exercise caution with suspected scirrhous HCC when imaging studies reveal atypical findings,as shown in our case on the basis of chronic liver disease.

关键词：原发性肝癌影像学表现非典型对比增强MRI 细胞角蛋白19 经肝动脉造影计算机断层扫描超顺磁性氧化铁

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Distant metastasis of hepatocellular carcinoma to Meckel’s cave and cranial nerves:A case report and review of literature

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World Journal of Hepatology 2021年第6期13卷 709-716页

作者： Soo Ki Kim Takako Fujii Ryouhei komaki Hisato Kobayashi Toyokazu Okuda yumi Fujii Takanobu Hayakumo Kanako yuasa Masahiro Takami Aya Ohtani yuka Saijo yu-ichiro koma Soo Ryang Kim Department of Gastroenterology Kobe Asahi HospitalKobe 653-0801HyogoJapan Division of Neurology Kobe University Graduate School of MedicineKobe 650-0017HyogoJapan Department of Radiology Kobe Asahi HospitalKobe 653-0801HyogoJapan Department of Pharmacy Kobe Asahi HospitalKobe 653-0801HyogoJapan Department of Pathology Kobe University Graduate School of MedicineKobe 650-0017HyogoJapan

BACKGROUND Metastasis occurs as a late event in the natural history of hepatocellular carcinoma(HCC),and most patients die of liver failure attributed to the tumor supplanting the liver.Conversely,the brain is a less common metastatic site.CASE SUMMARY We describe a rare case of hepatitis C virus-related multiple HCC metastasizing to the cavernous sinus,Meckel’s cave,and the petrous bone involving multiple cranial nerves in an 82-year-old woman.At admission imaging studies including Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging(MRI)revealed multiple HCC nodules in both right and left lobes.Ultrasound guided biopsy of the left lobe revealed moderately differentiated HCC.Molecular targeted therapy with Lenvatinib(8 mg/d for 94 d,per os)and Ramucirumab(340 mg/d and 320 mg/d,two times by intravenous injection)were administered for 4 mo,resulting in progression of the disease.Three months after the start of molecular target therapy,the patient presented with symptoms of hyperalgesia of the right face and limited abduction of the right eye,indicating disturbances in the right trigeminal and abducens nerves.Brain MRI disclosed a mass involving the cavernous sinus,Meckel’s cave and the petrous bone.Contrast-enhanced MRI with gadolinium-chelated contrast medium revealed a well-defined mass with abnormal enhancement around the right cavernous sinus and the right Meckel’s cave.CONCLUSION The diagnosis of metastatic HCC to the cavernous sinus,Meckel’s cave,and the petrous bone was made based on neurological findings and imaging studies including MRI,but not on histological examinations.Further studies may provide insights into various methods for diagnosing HCC metastasizing to the craniospinal area.

关键词： Meckel’s cave Abducens nerve Trigeminal nerve Hepatocellular carcinoma Magnetic resonance imaging Case report

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Local advanced rectal cancer perforation in the midst of preoperative chemoradiotherapy:A case report and literature review

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World Journal of Clinical Cases 2017年第1期5卷 18-23页

作者： Nobuhisa Takase Kimihiro Yamashita Yasuo Sumi Hiroshi Hasegawa Masashi Yamamoto Shingo Kanaji Yoshiko Matsuda Takeru Matsuda Taro Oshikiri Tetsu Nakamura Satoshi Suzuki yu-ichiro koma Masato komatsu Ryohei Sasaki Yoshihiro Kakeji Division of Gastrointestinal Surgery Department of Surgery Kobe University Graduate School of Medicine Division of Pathology Department of Pathology Kobe University Graduate School of Medicine Division of Diagnostic Pathology Department of Pathology Kobe University Graduate School of Medicine Department of Surgery Hyogo Cancer Center Department of Radiation Oncology Kobe University Graduate School of Medicine

Standard chemoradiotherapy(CRT) for local advanced rectal cancer(LARC) rarely induce rectal perforation. Here we report a rare case of rectal perforation in a patient with LARC in the midst of preoperative CRT. A 56-year-old male was conveyed to our hospital exhibiting general malaise. Colonoscopy and imaging tests resulted in a clinical diagnosis of LARC with direct invasion to adjacent organs and regional lymphadenopathy. Preoperative 5-fluorouracil-based CRT was started. At 25 d after the start of CRT, the patient developed a typical fever. Computed tomography revealed rectal perforation, and he underwent emergency sigmoid colostomy. At 12 d after the surgery, the remaining CRT was completed according to the original plan. The histopathological findings after radical operation revealed a wide field of tumor necrosis and fibrosis without lymph node metastasis. We share this case as important evidence for the treatment of LARC perforation in the midst of preoperative CRT.

关键词： Local advanced rectal cancer Preoperative chemoradiotherapy Rectal perforation 5-fluorouracil Tumor necrosis

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Direct and Indirect Role of Toll-Like Receptors in T Cell Mediated Immunity

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Cellular & Molecular Immunology 2004年第4期1卷 239-246页

作者： Mousa komai-koma Division of Immunology Infection and InflammationUniversity of GlasgowGlasgowG 6NT.UK

Toll-like receptors (TLR) are pathogen-associated molecular patterns (PAMPs) recognition receptors that play an important role in protective immunity against infection and inflammation.They act as central integrators of a wide variety of signals,responding to diverse agonists of microbial products.Stimulation of Toll-like receptors by microbial products leads to signaling pathways that activate not only innate,but also adaptive immunity by APC dependent or independent mechanisms.Recent evidence revealed that TLR signals played a determining role in the skewing of na(?)ve T cells towards either Th1 or Th2 responses.Activation of Toll-like receptors also directly or indirectly influences regulatory T cell functions.Therefore,TLRs are required in both immune activation and immune regulation.Study of TLRs has significantly enhanced our understanding of innate and adaptive immune responses and provides novel therapeutic approaches against infectious and inflammatory diseases.Cellular & Molecular Immunology.2004;1(4):239-246.

关键词： Toll-like receptor adaptive immunity Th1 Th2 regulatory T cell

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Development of A Three-Dimensional Guidance System for Long-Range Maneuvering of A Miniature Autonomous Underwater Vehicle

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China Ocean Engineering 2014年第6期28卷 843-856页

作者： Mansour ATAEI Aghil YOUSEFI-koma Center of Advanced Systems & Technologies Faculty of Mechanical EngineeringCollege of Engineering University of Tehran

The present paper introduces a three-dimensional guidance system developed for a miniature Autonomous Underwater Vehicle（AUV）. The guidance system determines the best trajectory for the vehicle based on target behavior and vehicle capabilities. The dynamic model of this novel AUV is derived based on its special characteristics such as the horizontal posture and the independent diving mechanism. To design the guidance strategy, the main idea is to select the desired depth, presumed proportional to the horizontal distance of the AUV and the target. By connecting the two with a straight line, this strategy helps the AUV move in a trajectory sufficiently close to this line. The adjacency of the trajectory to the line leads to reasonably short travelling distances and avoids unsafe areas. Autopilots are designed using sliding mode controller. Two different engagement geometries are considered to evaluate the strategy＇s performance： stationary target and moving target. The simulation results show that the strategy can provide sufficiently fast and smooth trajectories in both target situations.

关键词： Autonomous Underwater Vehicle（AUV） Three-Dimensional（3D） guidance system Line-of-Sight（LOS） strategy autopilot sliding mode controller

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Directional Wideband Wearable Antenna with Circular Parasitic Element for Microwave Imaging Applications

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Computers, Materials & Continua 2022年第7期72卷 983-998页

作者： N.A.koma’rudin Z.Zakaria A.A.Althuwayb H.Lago H.Alsariera H.Nornikman A.J.A.Al-Gburi P.J.Soh Faculty of Electronic and Computer Engineering(FKEKK) Universiti Teknikal Malaysia Melaka(UTeM)Durian Tunggal76100MelakaMalaysia Electrical Engineering Department Jouf UniversitySakaka72388AljoufKingdom of Saudi Arabia Faculty of Engineering Universiti Malaysia Sabah(UMS)Kota Kinabalu88400SabahMalaysia Centre for Wireless Communications(CWC) University of OuluOulu90014Finland Advanced Communication Engineering(ACE)CoE Faculty of Electronic Engineering TechnologyUniversiti Malaysia Perlis(UniMAP)Arau02600PerlisMalaysia

This work proposes a wideband and unidirectional antenna consisting of dual layer of coplanar waveguide based on the circular parasitic element technique.The design procedure is implemented in three stages:Design A,which operates at 3.94 GHz with a bandwidth of 3.83 GHz and a fractional bandwidth(FBW)of 97.2%;Design B,which operates at 3.98 GHz with a bandwidth of 0.66 GHz(FBW of 56.53%);and Design C as the final antenna.The final Design C is designed to resonate at several frequencies between 2.89 and 7.0 GHz for microwave imaging applications with a bandwidth of 4.11 GHz(79.8%)centered at 5.15 GHz.This antenna is fabricated fully using two textile materials:felt as the substrate and ShieldIt as the conductor.It features a unidirectional radiation with a gain of 5.5 dBi,and reduced lowback radiation from 2.06 to−7.81 dB.The front-to-back ratio(FBR)for Design A,Design B and Design C are 4.82,2.94 and 11.36 dB,respectively.This antenna is wideband with unidirectional radiation,lightweight,and flexible.

关键词： Wearable antennas ultrawideband antennas unidirectional antennas microwave imaging

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C-reactive protein may be a prognostic factor for the whole gastroenteropancreatic neuroendocrine tumor group

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World Journal of Gastrointestinal Oncology 2019年第2期11卷 139-152页

作者： ?mer koma? G?ksel Bengi ?zgül Sa?ol Mesut Akarsu Department of Internal Medicine Dokuz Eylul University Faculty of Medicine Department of Gastroenterology Dokuz Eylul University Faculty of Medicine Department of Pathology Dokuz Eylul University Faculty of Medicine

BACKGROUND Long non-coding RNAs(lncRNAs) are a kind of single-stranded RNA of more than 200 nucleotides in length and have no protein-coding function. Amounting studies have indicated that lncRNAs could play a vital role in the initiation and development of cancers, including gastric cancer(GC). Considering the crucial functions of lncRNAs, the identification and exploration of novel lncRNAs in GC is necessary.AIM To identify independent prognostic markers for the whole gastroenteropancreatic neuroendocrine tumor(GEP-NET) group.METHODS Ninety-three patients diagnosed with GEP-NETs within a specified period were included in this study. Patient data were retrospectively analyzed. The relationships between all independent variables and 5-year survival status calculated during the follow-up period(months) were assessed. In addition, the relationships between the independent variables were investigated.RESULTS When 5-year survival rate was compared, a statistically significant relationship between the age at diagnosis, male gender, tumor size, tumor stage, liver and/or distant metastasis, and tumor grade determined by the Ki-67 level and mitotic count, and the level of C-reactive protein(CRP), was observed. The meansurvival(overall survival) of the study group was 102.5 ± 6.3(SD) mo. The percentages of 1, 3 and 5-year survival were 90%, 72%, and 61%, respectively. In63 of 93 patients, Ki-67 and the mitotic count determined the same grade. The Ki-67 levels in 29 patients and the mitotic count in only 1 patient were in the higher grade. The risk of death increased by 4% for every 1 year increase at the diagnosis age and was 2.0-fold higher for male patients, 3.0-fold higher for G3 according to the mitotic count, 3.7-fold higher for G3 according to the Ki-67 level, 12.7-fold higher for cases with tumor stage 3 or 4 by a 1 cm increase in the ratio of 9% in tumor size, and 6.1-fold higher for patients with liver metastasis for every 1 mg/dL increase in the ratio of 1.5% in CRP level. There was a significant difference betw

关键词： Gastroenteropancreatic neuroendocrine tumors C-reactive protein Prognostic factor Neuroendocrine tumors Gastrointestinal system

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Programmed cell death during terminal bud senescence in a sympodial branching tree, Eucommia ulmoides

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Progress in Natural Science:Materials International 2004年第8期 46-51页

作者： Kalima-N’koma MWANGE Beijing 100871 China College of Life Sciences Peking University

Eucommia ulmoides Oliv. is a typical sympodial branching tree. The apical bud of the branch ages and dies every year, replaced by the nearby axillary bud in the second year. Structural assays and a series of biochemical analyses were performed to analyze the senescence mechanism in the apical bud. It was revealed that most cells of the apical bud underwent the programmed cell death (PCD) during the senescence: the chromosomes were congregated and the nuclear contents were condensed, as shown by 4′,6-diamidino-2-phenylindole (DAPI) fluorescence. DNA fragmentation was detected during senescence using the terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick end in situ labeling (TUNEL) method, coincident with the appearance of a DNA ladder. Moreover, a 20 kD DNase related to fragmentation was found. PCD was initiated first in the young leaves, leaf primordia and peripheral zone cells, then in the central mother cells and initial layer cells in the apical meristem. The terminal buds remain in vegetative growth during senescence, in contrast to buds of many annual plants.

关键词： DNA fragmentation DNase Eucommia ulmoides Oliv. programmed cell death terminal bud senescence sympodium.

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Evaluation study on properties of a macroporous silica-based CMPO extraction resin to be used forminor actinides separation from high level liquid waste

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Nuclear Science and Techniques 2011年第1期22卷 18-24页

作者： LIU Ruiqin WEI yuezhou Daisuke Tozawa XU yuanlai Shigekazu Usuda Hiromichi Yamazaki Keizo Ishii yuichi Sano Yoshikazu koma School of Nuclear Science and Engineering Shanghai Jiao Tong UniversityShanghai 200240China Cyclotron and Radioisotope Center Tohoku UniversityAoba 6-3Aramaki-Aoba-kuSendaiMiyagi980-8578Japan Japan Atomic Energy Agency (JAEA) TokaiIbaraki319-1195Japan

Basic properties of a silica-based octyl(phenyl)-N,N-diisobutylcarbamoyl-methylphosphine oxide (CMPO) extraction resin (CMPO/SiO2-P) was investigated.Adsorption behavior for some rare earth elements (RE) which are constituents of high level liquid waste (HLLW) and the long-term stability of the extraction resin in nitric acid solution were examined.The CMPO extraction resin was significantly stable in 3 mol·L?1 HNO3 solution at 50oC.Furthermore,the RE(III) were efficiently separated from non-adsorptive fission product (FP) elements such as Sr(II) in a column experiment using a highly nitric acid solution.The separation behaviors of the elements are considered to result from the difference in their adsorption and elution selectivity based on the complex formation with CMPO.There was no strong dependency of RE(III) separation efficiency on feed solution flow rate.Only from the perspectives of the acid-resistant behavior of CMPO extraction resin and the elution kinetics for the metal ions with the extraction resin,the CMPO extraction resin can be used in the modified MAREC process for HLLW partitioning.

关键词：萃取树脂高放废液锕系元素分离性能大孔硅提取基础选择性吸附

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