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Aug 4, 2021 (posted viaProZ.com): Currently translating a series of presentations on COVID epidemiology in Japan, as well as editing journal articles and case reports about novel chemotherapies. ...more, + 1 other entry »
Freelance translator and/or interpreter, Verified member
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Translation - English 1. Cautions prior to implantation
1) This product should be handled only by a physician proficient in its use.
2) When using electrical equipment, verify that it is electrically insulated in order to protect the patient from the danger of leakage current.
3) It is recommended that sterilized backups of all products for implantation be prepared in the event of accidental damage or contamination.
4) Verify use-by dates; do not use products for which the use-by date has passed.
5) Prior to unsealing the sterile packaging for this product, verify that there are no abnormalities in the product packaging and seals, such as damage, discoloration, or pinholes.
Do not use if any abnormalities are found.
6) Verify that all accessories are present.
Do not use if any product abnormalities are found.
7) Verify the compatibility of the lead and ICD in advance.
8) The vein lifter is not to be used during the venotomy to puncture the vein or make incisions in tissue.
Make sure that the vein lifter does not puncture the insulating sheath of the lead (the permeation of body fluids into the leads may hinder them from functioning appropriately).
9) Make sure that the surface of the electrodes does not come into contact with any surface contaminants.
10) In order to lessen the possibility of damage to the lead or lead separation, do not apply any excessive force to the lead or manipulate it using surgical instruments.
Japanese to English: Pembrolizumab関連硬化性胆管炎を発症した進行期非小細胞肺癌の1例 / A case of pembrolizumab-related sclerosing cholangitis in a patient with progressive-stage non-small cell lung cancer General field: Medical Detailed field: Medical: Pharmaceuticals
Source text - Japanese 症例は81歳女性。非小細胞肺癌(cT4N0M1c, Stage IVB, PD-L1 TPS≧75%)に対しPembrolizumabで加療開始した。4コース目投与前に、微熱、食思不振を認めた。血液検査で白血球CRP、肝胆道系酵素の上昇を認め、腹部超音波検査で胆のう腫大・壁肥厚、総胆管拡張、胆泥を認めた。急性胆道炎を疑い抗菌薬等保存的治療を開始した。MRCPでは肝内胆管の浮腫以外には所見を認めなかった。肝生検では肝細胞の変性と壊死、胆汁うっ滞と胆管炎を認め薬剤性肝障害を疑い、UDCAを開始したところ肝機能障害は改善した。
その約2か月後に心窩部痛、肝胆道酵素の再上昇を認めた。血液検査や画像検査から他疾患が否定的であり、前回と比較しMRCPで肝内胆管が全体に勢定状所見を呈したことからPembrolizumabによる硬化性胆管炎と診断し、PSL 0.5mg/kg投与を開始した。肝胆道系酵素の改善に伴いPSLを漸減中である。比較的稀であるPembrolizumabによる硬化性胆管炎を経験したため、文献的考察を加えて報告する。
Translation - English The patient was an 81-year-old female, who had been started on pembrolizumab to treat her non-small cell lung cancer (cT4N0M1c, Stage IV B, PD-L1 TPS≥75%). Prior to the administration of her 4th course, she developed a mild fever and a loss of appetite. Blood tests revealed elevations of white blood cells, CRP, and hepatobiliary enzymes. An abdominal ultrasound revealed swelling and wall thickening of the gall bladder, dilation of the common bile duct, and biliary sludge. We suspected acute cholangitis and started her on conservative treatment with antibiotics, etc. MRCP revealed no findings other than edema of her intrahepatic bile ducts. A liver biopsy showed degeneration and necrosis of her liver cells, as well as cholestasis and cholangitis, leading us to suspect a drug-induced hepatic disorder. We started her on UDCA and her impaired hepatic function improved. Approximately 2 months later, the patient experienced epigastric pain and another elevation of her hepatobiliary enzymes. Based on blood and imaging tests, she was negative for any other diseases, and since compared to last time an MRCP showed an overall pruned-tree appearance in her intrahepatic bile ducts, we diagnosed her with pembrolizumab-induced sclerosing cholangitis and started her on PSL 0.5 mg/kg. We are currently tapering her off PSL as her hepatobiliary enzymes improve. We are reporting on our experience with a relatively rare case of pembrolizumab-induced sclerosing cholangitis in order to add to the discussion in the literature.
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Master's degree - University of the Sciences
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Years of experience: 24. Registered at ProZ.com: Jun 2004. Became a member: May 2006.
Member since May '06
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