著者

Akira Yokote Shinsuke Fujioka Nobutaka Takahashi Takayasu Mishima Yoshio Tsuboi

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.8934-21, (Released:2022-03-26)

参考文献数

15

被引用文献数

5

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We herein report a 71-year-old woman presented with a fever, arthralgia, general malaise and leg muscle stiffness following administration of the COVID-19 mRNA vaccine (Comirnaty, Pfizer-BioNTech). Laboratory findings showed an elevated C-reactive protein level and erythrocyte sedimentation rate. In addition, Gallium-67 scintigraphy demonstrated an increased uptake in multiple joints. Typing of HLA revealed the presence of the DRB1*0404/*0803 allele. These findings met the diagnostic criteria for polymyalgia rheumatica (PMR), and when we started steroid treatment, her symptoms improved rapidly. This patient developed PMR after receiving a COVID-19 mRNA vaccine (Comirnaty, Pfizer-BioNTech). This case is considered to be valuable, as the HLA-DRB1 allele was also confirmed.

著者

Akira Yokote Shinsuke Fujioka Nobutaka Takahashi Takayasu Mishima Yoshio Tsuboi

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.61, no.11, pp.1775-1777, 2022-06-01 (Released:2022-06-01)

参考文献数

15

被引用文献数

5

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We herein report a 71-year-old woman presented with a fever, arthralgia, general malaise and leg muscle stiffness following administration of the COVID-19 mRNA vaccine (Comirnaty, Pfizer-BioNTech). Laboratory findings showed an elevated C-reactive protein level and erythrocyte sedimentation rate. In addition, Gallium-67 scintigraphy demonstrated an increased uptake in multiple joints. Typing of human leukocyte antigen (HLA) revealed the presence of the DRB1*0404/*0803 allele. These findings met the diagnostic criteria for polymyalgia rheumatica (PMR), and when we started steroid treatment, her symptoms improved rapidly. This patient developed PMR after receiving a COVID-19 mRNA vaccine (Comirnaty, Pfizer-BioNTech). This case is considered to be valuable, as the HLA-DRB1 allele was also confirmed.

著者

Noriko HIRAO Takashi MORISHITA Kazuya SAITA Tomohiro TAKAGI Shinsuke FUJIOKA Tooru INOUE

出版者

The Japan Neurosurgical Society

雑誌

NMC Case Report Journal (ISSN:21884226)

巻号頁・発行日

vol.8, no.1, pp.445-450, 2021 (Released:2021-08-06)

参考文献数

15

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Dystonia is a movement disorder that has various treatment options. For primary dystonia, stereotactic procedures such as deep brain stimulation (DBS) have demonstrated favorable outcomes. For secondary dystonia, however, the treatment outcomes remain inconclusive, and the heterogeneous etiological background is considered to contribute to the poor outcomes of the disease. Here, we report a rare pediatric case of post-stroke focal dystonia treated with conventional radiofrequency ventro-oral (Vo) thalamotomy. The patient was an 11-year-old girl with secondary focal dystonia in her right hand. The dystonia was considered to result from a stroke lesion in the putamen due to vasculitis following varicella-zoster virus infection. We hypothesized that the infarction of the putamen resulted in hyperactivity in the thalamus, and, thus, performed a radiofrequency Vo thalamotomy. Markedly decreased muscle tone in her right hand was noted immediately after surgery. However, the improvement was temporary, as her symptoms returned to baseline level by the 6-month follow-up. Although the observed improvement was temporary in this case, our findings may elucidate the possible mechanisms of secondary focal dystonia. Further studies are needed to establish an effective surgical treatment for secondary focal dystonia.

著者

Nobutaka Takahashi Takayasu Mishima Shinsuke Fujioka Kohtarou Izumi Masahiro Ando Yujiro Higuchi Hiroshi Takashima Yoshio Tsuboi

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.62, no.15, pp.2253-2259, 2023-08-01 (Released:2023-08-01)

参考文献数

25

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Two patients, 48- and 50-year-old sisters, presented with a characteristic facial appearance with slowly progressive deafness and cerebellar ataxia starting in their 30s. Genetic testing identified compound heterozygous pathogenic variants in the ERCC6 gene: c.1583G>A (p.G528E) and c.1873T>G (p.Y625D). A diagnosis of Cockayne syndrome (CS) B type III was made. CS is usually diagnosed in childhood with well-defined facial characteristics and photosensitivity. This case report describes rare cases of adulthood CS with a primary presentation of slowly progressing deafness and cerebellar ataxia. CS should be considered in adults with characteristic facial and skin findings, deafness, and cerebellar ataxia.

著者

Shinji Ouma Jiro Fukae Shinsuke Fujioka Shosaburo Yamamoto Taku Hatano Asako Yoritaka Yasuyuki Okuma Ken-ichi Kashihara Nobutaka Hattori Yoshio Tsuboi

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.56, no.15, pp.1961-1966, 2017-08-01 (Released:2017-08-01)

参考文献数

22

被引用文献数

10 18

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Objective Parkinson's disease (PD) is a common, progressive, neurodegenerative disorder. With progression of PD, the wearing-off phenomenon occurs more frequently as a motor complication, decreasing the patient's quality of life. The aim of this study was to investigate the risk factors for the wearing-off phenomenon in Japanese PD patients. Methods All of the study participants were clinically diagnosed as having PD. Each patient was assessed for the wearing-off phenomenon based on the findings of clinical assessments and interviews that were conducted during a single visit. The risk factors for wearing-off were analyzed by univariate and multivariate logistic regression analyses. Results Wearing-off was observed in 101 of the 180 (56.1%) patients who were enrolled in this study. The multivariate logistic regression analysis revealed that the onset of PD at ≥69 years of age (odds ratio [OR], 0.22; 95% confidence interval [CI], 0.05-0.88; p=0.032), female sex (OR, 6.49; 95% CI, 2.34-17.99; p<0.001), catechol-O-methyltransferase (COMT) inhibitor treatment (OR, 19.59; 95% CI, 3.55-108.11; p<0.001) and a high daily levodopa dosage (≥600 mg/day) (OR, 7.69; 95% CI, 1.41-41.84; p=0.018) were independent predictive factors for wearing-off in Japanese PD patients. Conclusion Age at the symptomatic disease onset, female sex, COMT inhibitor treatment, and a high daily levodopa dose were associated with the occurrence of wearing-off in Japanese PD patients. Physicians need to consider the risk factors and carefully choose medications for PD patients to postpone the occurrence of this phenomenon for as long as possible.

著者

Yasunobu ARIKAWA Yusuke KATO Yuki ABE Shuto MATSUBARA Hidetaka KISHIMOTO Nozomi NAKAJIMA Alessio MORACE Akifumi YOGO Hiroaki NISHIMURA Mitsuo NAKAI Shinsuke FUJIOKA Hiroshi AZECHI Kunioki MIMA Shunsuke INOUE Yoshihide NAKAMIYA Kensuke TERAMOTO Masaki HASHIDA Shuji SAKABE

出版者

The Japan Society of Plasma Science and Nuclear Fusion Research

雑誌

Plasma and Fusion Research (ISSN:18806821)

巻号頁・発行日

vol.13, pp.2404009, 2018-02-15 (Released:2018-03-27)

参考文献数

18

被引用文献数

3

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A short and high-intensity neutron pulse can be produced efficiently by using photonuclear reactions caused by Bremsstrahlung hard X-rays in a lase-irradiated high-Z target. The efficient and repetitive neutron generation was demonstrated with the combination of 1 Hz, 0.5 J, 25 fs, 5 × 1019 W/cm2 laser pulses and a rotating tungsten disc targe. Here we applied double laser pulse irradiation scheme to increase the neutron generation efficiency. The first low-intensity laser pulse produces a long-scale under-critical-density plasma on the tungsten target surface prior to the second pulse irradiatio. High energy electrons above the ponderomotive scaling value are accelerated by the second hig-intensity pulse in the preformed plasm, this results in the increment of hard X-ray photons and photonuclear neutron. 3.5 × 104 neutron/pulse was obtained with optimized laser irradiation conditions.