著者

Miya Andou Masaki Tominaga Ryuta Nishikomori Kenji Gotou Nobukazu Komatsu Masanobu Matsuoka Tomotaka Kawayama Tomoaki Hoshino

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.2350-23, (Released:2023-09-29)

参考文献数

10

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A 30-year-old man presented with oral candidiasis and a history of lung abscess. He experienced recurring oral and skin candidiasis in childhood but spent long periods without any infections. Therefore, immunodeficiency was suspected. T and B lymphocyte and natural killer cell counts as well as immunoglobulin levels were normal. Human immunodeficiency virus test results were negative. Therefore, we suspected chronic mucocutaneous candidiasis (CMC). The signal transducer and activator of transcription (STAT) mutation, the leading cause of CMC, was detected by exome sequencing. Most cases of STAT-1 mutations are diagnosed in childhood, but a few are diagnosed in adulthood because Candida infections may not be severe.

著者

Takayuki Toyama Tomotaka Kawayama Takashi Kinoshita Yohei Imamura Makoto Yoshida Koichiro Takahashi Kazuhiko Fujii Ikkou Higashimoto Tomoaki Hoshino

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0488-17, (Released:2018-09-12)

参考文献数

37

被引用文献数

9

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Objective This multicenter, cross-sectional, non-interventional trial aimed to investigate adherence barriers to inhaled medicines when compared with oral medicines in Japanese patients with chronic obstructive pulmonary disease (COPD) and asthma. Methods The self-reporting "Adherence Starts with Knowledge 20" (ASK-20) questionnaire was administered for adherence barriers of inhaled and oral medicines to outpatients with regular clinic attendance. Results Patients with COPD and asthma reported different adherence barriers to inhaled medicines. Independent adherence barriers (odds ratio [95% confidence interval]) to inhaled medicines relative to those for oral medicines among patients with COPD and asthma were those related to item Q8 ( "I know if I am reaching my health goals"; 2.49 [1.39-4.47]; p=0.0022) and item Q2 ( "I run out of my medicine because I do not get refills on time"; 2.69 [1.26-5.75]; p=0.0127), respectively. Among patients with poor adherence to only inhaled medicines, those with COPD and asthma recognized item Q3 ( "consuming alcohol and taking medicines"; 6.63 [1.27-34.7]; p<0.05) and item Q1 ( "forget to take medicines only sometimes"; 4.29 [1.83-10.0]; p<0.05), respectively, were recognized as independent adherence barriers to inhaled medicines. The total ASK-20 scores and total barrier counts in patients with poor adherence to inhaled medicines were significantly higher than in those without poor adherence among patients with asthma (p=0.0057) but not those with COPD (p>0.05). Conclusion These results will aid in personalizing education on adherence to inhaled medicines among patients with COPD and asthma.

著者

Masaki Okamoto Masaki Tominaga Shigeki Shimizu Chiyo Yano Ken Masuda Masayuki Nakamura Yoshiaki Zaizen Takashi Nouno Satoshi Sakamoto Mitsuru Yokoyama Tomotaka Kawayama Tomoaki Hoshino

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.56, no.24, pp.3323-3326, 2017-12-15 (Released:2017-12-15)

参考文献数

19

被引用文献数

11

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A 40-year-old female dental technician visited our hospital for the investigation of a chest X-ray abnormality. Chest computed tomography demonstrated centrilobular nodules and lung volume reduction, and her serum KL-6 level was elevated. A histological analysis of the specimens obtained on a surgical lung biopsy showed peribronchiolar fibrosis with pigmented macrophages and cholesterol clefts. An energy-dispersive X-ray analysis showed that these lung tissues contained some metals, including indium. The serum indium level was also elevated. We diagnosed this patient with pneumoconiosis caused by exposure to sandblasting certain dental metals. This is the first reported case of pneumoconiosis in a dental technician associated with exposure to indium.

著者

Shuwa Minami Tomotaka Kawayama Masao Ichiki Mamoru Nishiyama Yoshiko Sueyasu Rumi Gohara Masaharu Kinoshita Hideyuki Koga Tomoaki Iwanaga Hisamichi Aizawa

出版者

一般社団法人 日本内科学会

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.47, no.6, pp.503-509, 2008 (Released:2008-03-17)

参考文献数

21

被引用文献数

2 2

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Background There is insufficient evidence for the efficacy of a transdermal tulobuterol patch (TP), although combination therapy with bronchodilators is recommended for chronic obstructive pulmonary disease (COPD). Objective A randomized, controlled crossover study was conducted to evaluate the clinical efficacy and safety of the TP in 16 patients with COPD. Slow-release theophylline was used as a control drug. Methods Following a 2-week run-in period, patients were randomly allocated to two groups by the envelope method; they then received the TP and theophylline for 4 weeks each by the crossover method. Pulmonary function tests, peripheral blood examination, and electrocardiography were performed before and after each treatment period. Patients recorded in diaries their symptom scores, numbers of administrations of inhaled β2 agonists, and presence/absence of adverse reactions. Results Patients receiving TP exhibited significant improvement in the number and ease of sputum expectorations and in cough frequency score and wheezing severity score compared with baseline (p<0.05); the corresponding improvement in patients receiving theophylline was non-significant. Assessment of quality of life by the St. George's Hospital Respiratory Questionnaire revealed that treatment with TP was associated with significant improvement in symptoms, impact, and total scores compared with baseline (p<0.05); theophylline gave only a non-significant improvement in total score. Neither drug caused significant changes in the results of physiological examinations or in pulse or blood pressure. There was no difference in safety between the treatments. Conclusion Treatment of COPD patients with TP is more effective than with theophylline.