RESUMEN
A 56-year-old man with HCV infection was referred to our hospital for further evaluation and treatment of hepatic tumor. Abdominal enhanced computed tomography demonstrated an S8 hepatic tumor, about 15mm in maximal diameter. The tumor showed enhancement on the arterial phase and washout on equilibrium phase. EOB-MRI scan also showed the hepatic tumor with enhancement in the early phase and washout in the delayed phase. Liver function was normal. Serum AFP and PIVKA- II were normal and CEA and CA19-9 were elevated. However, no other tumor was detected by the colonoscopy, esophagogastroduodenoscopy and PET-CT. Under the diagnosis of HCC, partial hepatectomy was performed. Histologically, the tumor was composed of neoplastic glands with irregularly dilated lumen of adenocarcinoma, resembling ductal plate malformation(DPM). And Von Meyenburg complexes and foci of ordinary intrahepatic cholangiocarcinoma(ICC)were also found. ICC with this histologic features reported as a new subtype of ICCs.
Asunto(s)
Neoplasias de los Conductos Biliares/diagnóstico por imagen , Colangiocarcinoma/diagnóstico por imagen , Neoplasias de los Conductos Biliares/patología , Neoplasias de los Conductos Biliares/cirugía , Colangiocarcinoma/cirugía , Hepatectomía , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Imagen Multimodal , Tomografía Computarizada por Rayos XRESUMEN
Emotional and behavioral disorders in children are school-health concerns; however, Japanese screening tools for such disorders are not yet available. We examined the association between psychosocial functioning as measured by the Pediatric Symptom Checklist (PSC) and self-rated health within school settings. A cross-sectional study was conducted for 2513 fifth and eighth graders from all of the primary and secondary schools in Shunan City, Japan. The Japanese PSC had high internal consistency (Cronbach's α = 0.90) and a factor structure similar to that of the English PSC. When the cut-off values were set to ≥ 28 and ≥ 17, 4-9% and 20-39% of our respondents, respectively, reported high PSC scores. A multiple ordinal logistic regression analysis showed that the odds ratio of a positive PSC score (≥ 28) for poorer self-rated health among ratings of "very good," "good," "fair," and "poor" was 3.5 (95% confidence interval = 2.6-4.8). There was a clear association between psychosocial dysfunction identified by a PSC score ≥ 28 and poor self-rated health. We offer directions for further research on appropriate PSC cut-off values with Japanese samples.