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もしかして: internal medicine  internal medicine impact factor  internal medicine 意味  internal medicine インパクトファクター  internal medicine 投稿規定  internal medicine case report  internal medicine 採択率  internal medicine 査読期間  internal medicine journal  internal medicine department 

An Infected Massive Persistent Sciatic Artery Aneurysm Treated by an Aneurysmal Incision and Drainage after Angiographic Embolization CiNiiでみる

著者名:
Yamashita Shun  Tago Masaki  Tokushima Yoshinori  Aihara Hidetoshi  Takeshita Go  Fujiki Kazuya  Fujiwara Motoshi  Yamashita Shu-ichi 

抄録:

A man in his 80s undergoing chronic hemodialysis presented with a high fever. A 10-cm soft mass was palpable in his right buttock. Abdominal computed tomography and angiography showed an incomplete-type unilateral persistent sciatic artery aneurysm (PSAA) with gas patterns and a blood flow through the aneurysm. Incision drainage was performed after arterial embolization. Gram staining of the hematoma showed gram-positive cocci that had formed chains, thus leading to a diagnosis of an infected PSAA. Drainage by incision after arterial embolization was used as the therapeutic method of choice for a massive infected PSAA with a sustained blood flow in order to prevent sciatic nerve injury and bleeding associated with PSAA resection.


出版年月日:
2022 , 
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Safety Profile of Ixazomib in Patients with Relapsed/Refractory Multiple Myeloma in Japan: An All-case Post-marketing Surveillance CiNiiでみる

著者名:
Kakimoto Yoshihide  Hoshino Miyako  Hashimoto Mikiko  Hiraizumi Masaya  Shimizu Kohei  Chou Takaaki 

抄録:

Objective To evaluate the safety profile of ixazomib combined with lenalidomide and dexamethasone in patients with relapsed/refractory multiple myeloma (RRMM) in clinical practice in Japan through an all-case post-marketing surveillance.

Methods This was a nationwide non-interventional observational study conducted in Japan. The study included all patients who received ixazomib from May 24 to September 24, 2017. Ixazomib was administered to RRMM patients according to the Japanese package insert. All enrolled patients were observed until the completion of the sixth treatment cycle or until ixazomib discontinuation. The patient treatment course, including adverse events (AEs), was reported.

Results The safety analysis set included 741 patients; the median age was 71 (range 35-92) years old, and the median number of prior treatment lines was 3 (range 1-30). Adverse drug reactions (ADRs) occurred in 572 (77.2%) patients, most commonly being thrombocytopenia (49.9%), diarrhea (29.2%), and nausea (12.4%). Serious ADRs occurred in 193 (26.0%) patients, most commonly being thrombocytopenia (9.9%) and diarrhea (5.9%). Thrombocytopenia, severe gastrointestinal disorders, infections, skin disorders, and peripheral neuropathy were prespecified as ADRs of clinical importance; the frequency of these ADRs (grade ≥3) were 28.5%, 9.4%, 7.4%, 2.2%, and 1.3%, respectively. Treatment discontinuation was most common with thrombocytopenia and severe gastrointestinal disorders (49 and 43 patients, respectively). Eleven patients died due to ADRs (16 events).

Conclusion These results suggest that ixazomib has a tolerable safety profile in clinical practice in Japan. However, close AE management for thrombocytopenia and gastrointestinal disorders should be considered.


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Clubbing Due to Laxative Abuse CiNiiでみる

著者名:
Suzuki Kiyozumi  Otsuka Hiromasa 

抄録:

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The Effects of Stress on Glycemic Control Brought on by Changes in Social Conditions due to COVID-19 CiNiiでみる

著者名:
Masuda Mio  Tomonaga Osamu 

抄録:

Objective The stress brought on by changes in social conditions due to COVID-19 is diverse. However, there have been no studies examining the relationship between the type of stress felt by an individual due to such changes in social conditions and the degree of change in HbA1c, prompting us to conduct this study.

Methods We conducted a collaborative study at two diabetes clinics. A total of 1,000 subjects responded to the questionnaire. Data on HbA1c and body weight before and after the declaration of the state of emergency were collected.

Results We conducted a questionnaire on some stressors, but when comparing the two groups with respect to whether or not they felt stress from each item, only "school closures for children," seemed to be associated with a significant difference in the amount of change in HbA1c. In the stressed group, i.e. the group of parents who experienced stress due to their children's schools being closed, the HbA1c value changed from 7.30±0.78 to 7.30±1.13 (p=0.985). By contrast, in the unstressed group, the HbA1c value significantly decreased from 7.28±0.98 to 7.06±0.85 (p<0.001). In addition, as a result of comparing the amount of change between the 2 groups, a significant decrease was observed in the unstressed group compared with the stressed group (p=0.032). There was no significant difference in body weight change between the two groups.

Conclusion Stress that cannot be avoided by one's own will, such as school closures for children, may affect glycemic control.


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A Case of Radiation-associated Angiosarcoma Presenting as Massive Pleural Effusion CiNiiでみる

著者名:
Ogino Hirokazu  Bando Yoshimi  Goto Hisatsugu  Nokihara Hiroshi  Nishioka Yasuhiko  Tobiume Makoto  Kagawa Kozo  Kawano Hiroshi  Sakaguchi Satoshi  Saijo Atsuro  Matsumoto Daisuke  Takizawa Hiromitsu  Morikawa Yuriko 

抄録:

A 67-year-old man was admitted to our hospital for massive pleural effusion. He had a history of mandibular gingival carcinoma treated with radiation therapy (RT). Based on the cytology findings of pleural effusion and a thoracoscopic pleural biopsy, we finally diagnosed him with radiation-associated angiosarcoma. Retrospective cell-block immunocytochemistry with pleural effusion also showed potential utility for the diagnosis. This case highlights the importance of considering the possibility of radiation-associated secondary cancer in patients with pleural effusion who have a history of RT.


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Superior Mesenteric Artery Syndrome Accompanied by Acute-onset Type 1 Diabetes Complicated with Graves' Disease: A Case Report CiNiiでみる

著者名:
Sue-Nagumo Mai  Matsumoto Shunichi  Yamada Eijiro  Nakajima Yasuyo  Yoshino Satoshi  Horiguchi Kazuhiko  Ishida Emi  Okada Shuichi  Yamada Masanobu 

抄録:

A 35-year-old man experienced general fatigue and could not eat solid food because of nausea and vomiting. His weight abruptly decreased from 49 to 45 kg after 2 weeks. A detailed examination indicated superior mesenteric artery syndrome (SMAS) accompanied by acute-onset type 1 diabetes complicated by Graves' disease, referred to as autoimmune polyglandular syndrome type 3A (APS3A). Although SMAS has a good prognosis, some cases require emergency surgery, especially when complicated by gastric perforation. In our case, APS3A and SMAS developed rapidly and at approximately the same time, resulting in a cycle of mutual exacerbation.


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A Rare Presentation of a Compression Fracture or a Typical Presentation of Lateral Cutaneous Nerve Entrapment Syndrome: A Diagnostic Error? CiNiiでみる

著者名:
Endo Takeshi  Watari Takashi 

抄録:

A 78-year-old woman complained of severe pain in the left costal region. Her body mass index was 23.1 kg/m2. Lateral cutaneous nerve entrapment syndrome (LACNES) was the suspected diagnosis because the affected area was 2×2 cm and positive for pinch sign. Seventeen days later, the patient again presented with complaints of lower back pain accompanied by back pain upon extending the spine. Magnetic resonance imaging of the spine showed a fracture of the vertebral body of T11. We herein discuss our errors in the diagnostic process and critical tactics for avoiding such errors in the future.


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A Young Patient with Microscopic Polyangiitis Requiring Hemodialysis with Complications of Repeated Episodes of Posterior Reversible Encephalopathy Syndrome Probably Due to Different Etiologies CiNiiでみる

著者名:
Asakawa Shinichiro  Fujigaki Yoshihide  Arai Shigeyuki  Kawagoe Mika  Ohata Chiaki  Ono Wataru  Murata Hiroshi  Tamura Yoshifuru  Uchida Shunya  Shibata Shigeru 

抄録:

A young woman with microscopic polyangiitis (MPA) requiring hemodialysis showed repeated posterior reversible encephalopathy syndrome (PRES) with spatiotemporal multiple lesions over a period of two months. The first PRES episode with confusion and the second PRES episode with vertigo and nausea were caused by MPA, hypertension and renal failure. These symptoms were improved by the reinforcement of MPA treatment and blood pressure management. The third PRES episode with nausea, headache, seizure and visual changes was induced by rituximab infusion and hypertension. The PRES was improved with blood pressure and convulsant management. These conditions are challenging to diagnose and treat.


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Polyomavirus-associated Primary Gastric Merkel Cell Carcinoma CiNiiでみる

著者名:
Yoshida Akira  Kuwamoto Satoshi  Kurumi Hiroki  Isomoto Hajime 

抄録:

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Slowly Progressive Male Alport Syndrome Evaluated by Serial Biopsy: Importance of Type IV Collagen Staining CiNiiでみる

著者名:
Sato Masayo  Mochizuki Toshio  Nitta Kosaku  Manabe Shun  Itabashi Mitsuyo  Horita Shigeru  Hirose Orie  Kawashima Moe  Nishida Miki  Kataoka Hiroshi  Taneda Sekiko 

抄録:

A slowly progressive middle-aged man initially diagnosed with thin basement membrane nephropathy based on extensive thinning of the glomerular basement membrane (GBM) was subsequently diagnosed with Alport syndrome (AS) by a serial renal biopsy eight years later. The ultrastructural analysis of the second biopsy indicated thickening and wrinkling with mild reticulation in the GBM, consistent with AS. However, a retrospective analysis of the first biopsy revealed mild attenuation of type IV collagen α5 chain staining, suggesting a potential diagnosis of AS, despite the lack of ultrastructural features of AS. We herein report the clinical usefulness of type IV collagen staining in the early diagnosis of AS.


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An Autopsy Confirmed Neuromyelitis Optica Spectrum Disorder with Extensive Brain White Matter Lesion and Optic Neuritis but Intact Spinal Cord, Clinically Mimicking a Secondary Progressive Multiple Sclerosis-like Course CiNiiでみる

著者名:
Azuma Fumika  Nokura Kazuya  Kako Tetsuharu  Yoshida Mari  Tatsumi Shinsui 

抄録:

A 57-year-old woman presented with optic neuritis with repeated clinical symptoms of focal demyelination of the cerebral white matter and brain stem for 14 years. At the end of the patient's course, the clinical signs mimicked secondary progressive multiple sclerosis, but whether it was caused by interferon administration or neuromyelitis optica spectrum disorders (NMOSD)-or a combination of both or others-was unclear. Histopathological findings indicated the etiology to be NMOSD, with no apparent plaque in spinal cord specimens. This case suggests that an accurate clinical diagnosis requires serum anti-aquaporin 4 antibody measurements as well as an autopsy examination.


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A Clinical Case of Insulinoma Presenting with Postprandial Hypoglycemia in a Patient with a History of Gastric Bypass Surgery CiNiiでみる

著者名:
Hayashida Ryosuke  Okada Haruka  Fukushima Noriyoshi  Yamada Tetsuya  Tsujino Motoyoshi  Tsuchiya Kyoichiro  Sekine Tetsuo  Momose Takashi  Sato Fuminori  Sakurada Maya  Nishida Kenji  Hayashi Tatsuya  Morita Yasuhiro 

抄録:

A 61-year-old man with a history of total gastrectomy for cancer with Roux-en-Y reconstruction showed severe postprandial hypoglycemia accompanied by endogenous hyperinsulinemia. Abdominal ultrasonography and contrast-enhanced computed tomography showed no abnormal findings in the pancreas. A selective arterial secretagogue injection test showed the marked induction of serum immunoreactive insulin when calcium was injected into the splenic artery. A pathological analysis following distal pancreatectomy with splenectomy revealed a pancreatic neuroendocrine microadenoma containing insulin-producing cells in the resected pancreas. This case highlights the importance of carefully evaluating refractory and severe hypoglycemia in patients with a history of gastric surgery to exclude insulinoma.


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A Case of Multiple Endocrine Neoplasia Type 1 with Functional Parathyroid Cysts CiNiiでみる

著者名:
Koyama Nobuyuki  Fujimori Minoru  Katsura Yoshiya  Nagase Terumasa  Kure Masahiko  Odaka Tomotada  Kogure Koichiro  Takeda Yukihisa  Ishii Tomoya  Narisawa Kenichiro  Fujita Tomoyuki 

抄録:

A 51-year-old woman was admitted because of hypercalcemia. Neck ultrasonography and computed tomography revealed the presence of parathyroid cysts on both sides. After primary hyperparathyroidism was diagnosed by technetium-99 m-methoxyisobutylisonitrile scintigraphy, the patient was successfully treated with total parathyroidectomy and autotransplantation. She also had a non-functioning pancreatic neuroendocrine tumor, prolactinoma, and adrenal tumors with subclinical Cushing's syndrome. Given these clinical features and her family history, multiple endocrine neoplasia type 1 (MEN1) was suspected, and germline DNA sequencing revealed a missense mutation (c.1013T > G, p.Leu338Pro) in exon 7 of MEN1. This case demonstrates the phenotypic and genetic diversity of MEN1.


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Intramuscular Bleeding Triggered by Disseminated Intravascular Coagulation with Enhanced Fibrinolysis in a Patient with Prostate Cancer: A Case Report CiNiiでみる

著者名:
Takada Eri  Adachi Seiji  Horibe Yohei  Shimizu Masahito 

抄録:

Disseminated intravascular coagulation (DIC) is the most frequent coagulation disorder associated with solid tumors, including prostate cancer. We herein report a 76-year-old man who suffered from intramuscular bleeding of the right gluteus maximus. Laboratory data showed a pattern of DICwith enhanced fibrinolysis, and a general examination led to the diagnosis of advanced prostate cancer with multiple bone metastases. To our knowledge, this is the first report describing intramuscular bleeding as an initial manifestation of prostate cancer with DIC with enhanced fibrinolysis.


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Thoracic Empyema Caused by Campylobacter rectus: A Case Report CiNiiでみる

著者名:
Matsumoto Ryoichi  Himeji Daisuke  Shiiba Ritsuya  Yamanaka Atsushi  Tanaka Gen-ichi  Sata Akira  Awano Shoji  Ogawa Hiroko  Ohkusu Kiyofumi 

抄録:

Campylobacter rectus is a campylobacterium considered to be a primary periodontal pathogen. Thus, C. rectus has rarely been isolated from extraoral specimens, especially in the thoracic region. We herein report a case of thoracic empyema in which Campylobacter infection was suspected after Gram staining of the pleural effusion, and C. rectus was isolated using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Fusobacterium nucleatum was also detected. Molecular identification was performed using polymerase chain reaction amplification and a sequencing analysis of the 16S rRNA gene. Estimation of the causative bacteria using Gram staining led to the proper culture and identification of the causative bacteria.


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Atypical Cogan's Syndrome Mimicking Giant Cell Arteritis Successfully Treated with Early Administration of Tocilizumab CiNiiでみる

著者名:
Hara Kazusato  Maeda Takahiro  Kawakami Atsushi  Umeda Masataka  Segawa Keiko  Akagi Midori  Endo Yushiro  Koga Tomohiro  Kawashiri Shin-ya  Ichinose Kunihiro  Nakamura Hideki 

抄録:

A 49-year-old Japanese man with a 2-month history of a fever, headache, and bilateral conjunctival hyperemia was admitted. His condition fulfilled the giant cell arteritis classification criteria (new headache, temporal artery tenderness, elevated ESR) and atypical Cogan's syndrome (CS) with scleritis and sensorineural hearing loss (SNHL). The interleukin (IL)-6 serum level was extremely high. Two weeks after his insufficient response of SNHL and scleritis to oral prednisolone, we administered tocilizumab (TCZ); rapid improvements in scleritis and SNHL occurred. Early IL-6 target therapy can help prevent irreversible CS-induced sensory organ damage.


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An Atypical Phenotype of Chronic Inflammatory Demyelinating Polyradiculoneuropathy Associated with Ocular Palsy, IgM-anti Ganglioside Antibody, and Fever-induced Recurrence CiNiiでみる

著者名:
Horiuchi Midori  Ikewaki Katsunori  Suzuki Kazushi  Kaida Kenichi  Hongo Yu  Yamazaki Keishi  Komuta Yukari  Kadoya Masato  Takazaki Hiroshi  Furuya Yuichiro  Mastui Taro  Sakamoto Naohiro 

抄録:

We herein report a case of recurrent multifocal, distal-dominant-sensorimotor neuropathy with ophthalmoplegia, IgM anti-GM1 antibody, and pyrexia-associated relapse. The patient developed sensory disturbance in her limbs after febrile disease at 50 years old. She had experienced several similar episodes and was admitted to the hospital at 56 years old. Based on a pathological study and electrophysiological findings consistent with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), maintenance IVIg therapy was administered and produced partial improvement with no relapse at one-year follow-up. Immunohistochemical studies suggested the presence of IgG (not IgM) anti-myelin antibodies. Chronic neuropathy with ophthalmoplegia and pyrexia-associated relapse may be a unique variant of CIDP.


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Complete Response Induced by Concurrent Chemoradiotherapy in a Patient with NUT Carcinoma: A Case Report CiNiiでみる

著者名:
Muramatsu Joji  Miyanishi Koji  Sakata Koh-Ichi  Kato Junji  Takada Kohichi  Sugita Shintaro  Tsuchiya Takaaki  Yamamoto Keisuke  Takagi Masaru  Murase Kazuyuki  Ameda Saki  Arihara Yohei 

抄録:

An 18-year-old man presented with sudden vision loss in his left eye. Magnetic resonance imaging revealed a tumor that had invaded the left optic nerve, originating from the left posterior ethmoid sinus. Immunohistochemical analyses identified positive staining for NUT protein in the nuclei of tumor cells. We diagnosed locally advanced NUT carcinoma (NC) and initiated concurrent chemoradiotherapy (CCRT), consisting of chemotherapy with vincristine, doxorubicin, and cyclophosphamide, alternating with ifosphamide and etoposide, plus radiation therapy. The patient achieved a complete response. CCRT can be a useful treatment option for adolescent and young-adult patients with locally advanced unresectable NC.


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Paget's Disease of the Skull CiNiiでみる

著者名:
Nakatsuji Yoshiyuki  Miyashita Midori  Kadoya Masumi  Nakatsuchi Yukio 

抄録:

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Acute Coronary Syndrome Developed in a 17-year-old boy with Sitosterolemia Comorbid with Takayasu Arteritis: A Rare Case Report and Review of the Literature CiNiiでみる

著者名:
Iyama Keita  Kawashiri Masa-aki  Kawakami Atsushi  Maemura Koji  Ikeda Satoshi  Koga Seiji  Yoshimuta Tsuyoshi  Kawano Hiroaki  Tsuji Sosuke  Ando Koji  Matsushima Kayoko  Tada Hayato 

抄録:

A 17-year-old boy with acute coronary syndrome was admitted to our hospital. He had xanthomas over his elbow and Achilles tendon and a high level of low-density lipoprotein cholesterol; therefore, his initial diagnosis was familial hypercholesterolemia. However, a genetic analysis revealed a compound heterozygous mutation in the ABCG5 gene with a high serum level of sitosterol, leading to the diagnosis of sitosterolemia. After lipid-lowering treatment, percutaneous coronary intervention was performed. Furthermore, a persistently high C-reactive protein level and images of large arteries led to a diagnosis of Takayasu arteritis. To our knowledge, this is the first case of sitosterolemia complicated by Takayasu arteritis.


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