著者

Yasunori Enomoto

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.53, no.7, pp.815-815, 2014 (Released:2014-04-01)

参考文献数

1

被引用文献数

1 1

著者

Shunichiro Hanai Takeo Sato Katsuya Nagatani Seiji Minota

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.53, no.5, pp.521-522, 2014 (Released:2014-03-01)

参考文献数

2

被引用文献数

5

著者

Wen-Cheng Liu Chih-Weim Hsiang Hsian-He Hsu Wei-Chou Chang

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.53, no.5, pp.523-523, 2014 (Released:2014-03-01)

参考文献数

2

著者

Satoshi Kutsuna Kayoko Hayakawa Norio Ohmagari

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.53, no.2, pp.167-168, 2014 (Released:2014-01-15)

参考文献数

2

被引用文献数

1

著者

Yasushi Ito Susumu Mitsutani

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.49, no.23, pp.2645-2646, 2010 (Released:2010-12-01)

参考文献数

1

著者

Ichiro WAKABAYASHI Kunihiro SAKAMOTO Hidehisa MASUI Sachiko YOSHIMOTO Akihisa KANAMARU Eizo KAKISHITA Hiroshi HARA Masashi SHIMO-OKA Kiyoyasu NAGAI

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.33, no.4, pp.198-203, 1994 (Released:2006-03-27)

参考文献数

22

被引用文献数

10 17

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A case control study was performed with 142 leukemia patients and 284 controls matched for age and sex. Occupation, birth order, past medical history, and drinking and smoking habits were compared in these two groups. Persons born first or fourth were found to have a higher incidence of leukemia. History of a fracture was one of the risk factors for acute leukemia, and a history of gastroduodenal ulcer was a risk factor for chronic leukemia. This may suggest that extensive exposure to X-rays in diagnosis and treatment is a risk factor for leukemia. There was a significant dose-response relationship between the amount of smoking and the incidence of acute nonlymphocytic leukemia, but not between the amount of alcohol consumption and the incidence of leukemia. Thus, smoking was one of the risk factors for acute leukemia.(Internal Medicine 33:198-203, 1994)

著者

Taiji Tsunemi Yuki Sakai Koichi Tsunoda Yasuhiro Irie Yoshiaki Wada

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.45, no.22, pp.1315-1317, 2006 (Released:2006-12-15)

参考文献数

9

被引用文献数

4 7

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The patient was hospitalized due to rapidly undulant fever and sore throat. Empirical antibiotic therapy was started, however, headache also occurred. Lumbar puncture disclosed polynuclear leukocyte-predominant pleocytosis indicating that the patient suffered from bacterial meningitis. The antibiotics therapy was increased, however, consciousness became impaired and erythema multiforme-like skin lesions appeared. T2-weighted brain magnetic resonance imaging showed high signal intensity in the brainstem. HLA testing revealed B54 and Cw1. The patient presented futures of Behçets disease at the same time as those of Sweets syndrome and it was difficult to distinguish between the two diseases. Administration of prednisolone showed remarkable effect.

著者

Shinji Abe Arata Azuma Hiroshi Mukae Takashi Ogura Hiroyuki Taniguchi Masashi Bando Yukihiko Sugiyama

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.51, no.12, pp.1487-1491, 2012 (Released:2012-06-15)

参考文献数

21

被引用文献数

23 88

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Objective The prognosis of idiopathic pulmonary fibrosis (IPF) patients with acute exacerbation (AE) is reported to be extremely poor. Several clinical studies suggest that direct hemoperfusion with polymyxin B-immobilized fiber (PMX) may have beneficial effects on AE in patients with interstitial pneumonia (IP). The aim of this multicenter retrospective analysis was to investigate whether PMX treatment could provide improvement of oxygenation and survival benefits in IPF patients with AE. Methods We conducted a retrospective study of 160 IP patients (including 73 IPF) with AE treated by PMX at 18 institutions in Japan. PMX treatment was carried out twice. The total hemoperfusion time of PMX treatment was, on average, 12 hours. Data concerning oxygenation on PMX treatment and survival after AE were collected and analyzed. Results In IPF patients with AE, arterial oxygen tension (PaO2)/inspiratory oxygen fraction (FiO2), (P/F) ratio was significantly improved at the end of the 2nd treatment with PMX (173.9±105.4 to 195.2±106.8 Torr, p=0.003). White blood cell count was significantly reduced at the end of the 2nd treatment (13,330±7,002 to 9,426±5,188 /mm3, p<0.001). These clinical changes were also observed on analysis of all 160 IP patients with AE. The one- and three-month survival rates of IPF patients after AE were 70.1% and 34.4%, respectively. Conclusion PMX treatment may improve oxygenation and survival in IPF patients with AE. Prospective, controlled trials of PMX treatment for IPF with AE are warranted to verify this potential benefit.

著者

Kazuki Sakakura Norio Takayashiki Yasuharu Tokuda Hiroaki Satoh

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.52, no.8, pp.925-925, 2013 (Released:2013-04-15)

参考文献数

2

被引用文献数

5

著者

Toru Naganuma Keigo Dote Masaya Kato Shota Sasaki Kentaro Ueda Yasuyuki Kono Yoshikazu Watanabe Masato Kajikawa Haruko Yokoyama

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.48, no.6, pp.433-436, 2009 (Released:2009-03-16)

参考文献数

17

被引用文献数

3

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A 65-year-old man who had undergone retropubic prostatectomy for prostate adenocarcinoma presented with sudden dyspnea and chest pain. Contrast-enhanced multi-slice computed tomography (MSCT) revealed thrombi in the left internal jugular vein (IJV) and in branches of the right pulmonary artery. Ultrasonography showed that the thrombus which occluded the left IJV was hypoechoic and mobile. After beginning anticoagulant therapy, he again presented with dyspnea and transient hypotension. MSCT and ultrasonography showed that the IJV thrombus had moved and caused a new embolism of the left pulmonary artery branch. This is a rare case of a patient who experienced non-catheter-related thrombosis of the IJV.

著者

Masafumi Seki Naruhiko Ikari Seigo Yamamoto Yuhki Yamagata Kosuke Kosai Katsunori Yanagihara Tomoyuki Kakugawa Shintaro Kurihara Koichi Izumikawa Yoshitsugu Miyazaki Yasuhito Higashiyama Yoichi Hirakata Takayoshi Tashiro Shigeru Kohno

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.45, no.22, pp.1323-1326, 2006 (Released:2006-12-15)

参考文献数

22

被引用文献数

11 24 11

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A 77 years old woman who had a bite with eschar on her left arm, was admitted to emergency ward in our hospital, because of high fever, severe malaise, skin eruption, and consciousness disturbance beginning 5 days previously. She was diagnosed as Japanese spotted fever by seropositive of Rickettsia japonica (R. japonica) antibody, and successfully treated with fluoroquinolone, after minocycline hydrochloride had been proven ineffective. R. japonica-specific DNA was detected by PCR from the tick: Haemaphysalis hystricis larvae collected from a mountainous location in Fukuoka, Japan where the patient had been bitten.

著者

Itaru Hayakawa Junwa Kunimatsu Riri Watanabe Kazuo Kubota Atsuto Yoshizawa

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.51, no.24, pp.3431-3434, 2012 (Released:2012-12-15)

参考文献数

27

被引用文献数

2 2 1

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The early diagnosis and treatment of Takayasu arteritis (TA) is crucial to prevent the devastating complications of vascular insufficiency. This report describes a patient with a persistent fever in whom carotid artery tenderness led to a diagnosis of TA. This case suggests that carotid artery tenderness is a useful physical finding that warrants 2-deoxy-2-[Fluorine-18] fluoro-D-glucose positron emission tomography/computed tomography to confirm a diagnosis of early TA.

著者

Hideyuki Nagakura Masanori Nishikawa Nobuko Kusano Mari Saito Satoshi Morita Takeshi Kaneko Yoshiaki Ishigatsubo

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.51, no.22, pp.3115-3118, 2012 (Released:2012-11-15)

参考文献数

27

被引用文献数

1 3

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Objective The aim of this study was to determine the epidemiological characteristics of never-smoking patients with non-small cell lung cancer (NSCLC) detected with clinic-based screening programs, focusing on clinical risk factors and survival. Methods The medical records of NSCLC patients (n=285) diagnosed at Fujisawa City Hospital between April 2000 and December 2010 with lesions that were originally detected with clinic-based screening programs in Fujisawa City were reviewed to identify the clinicopathological variables and survival outcomes. Results Of the 285 NSCLC patients, 95 (33.3%) were never-smokers. A comparison between the never-smoking and ever-smoking patients revealed that the never-smokers included a significantly greater proportion of women and patients with adenocarcinoma (86.3% vs. 12.6%: p<0.001 or 94.7% vs. 55.8%: p<0.001, respectively). The overall survival rate of the never-smoking patients was significantly superior to that of the ever-smokers (p=0.004). In addition to smoking status, factors found to be significantly associated with the overall survival rate in univariate analyses were gender, stage, histology and first line treatment. A multivariate analysis revealed smoking status to be an independent prognostic factor in addition to stage and first line treatment. Conclusion The differences in the clinicopathological factors and survival outcomes between never-smoking and ever-smoking patients with NSCLC detected with clinic-based screening programs suggest that persuading people to never start smoking is important.

著者

Kenichiro Yaita Masanari Komatsu Yusuke Oshiro Yukihiro Yamaguchi

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.51, no.18, pp.2645-2648, 2012 (Released:2012-09-15)

参考文献数

25

被引用文献数

3 7 1

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17-year-old man had been involved in a traffic accident. He underwent a bilateral craniotomy with artificial dura mater to remove bilateral acute subdural hematomas. Seven months later, a right cranioplasty was performed using frozen auto-bone, and he developed extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae meningitis and an epidural abscess. Since his general status was poor, we could not remove the foreign body (artificial dura mater). He was successfully treated with meropenem and chronic suppression with oral trimethoprim-sulfamethoxazole. By describing this case and the results of a review of the pertinent literature, we discuss the importance of ESBL-producing Klebsiella pneumoniae meningitis in posttraumatic/postoperative patients.

著者

Ismail Sari Levent Kebapcilar Ahmet Alacacioglu Oktay Bilgir Yasar Yildiz Ali Taylan Arif Yuksel Didem L. Kozaci

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.48, no.16, pp.1363-1368, 2009 (Released:2009-08-17)

参考文献数

28

被引用文献数

29 35 28

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Objective Endothelial dysfunction is present in ankylosing spondylitis (AS). However, the etiology of events is still unclear. The aim of the present study was to investigate whether there are abnormalities in nitric oxide (NO) metabolism and endothelin-1 (ET-1) in AS patients. Methods Subjects without any classical cardiovascular (CV) risk factors were studied. Fasting glucose, serum lipids, high sensitive CRP (hsCRP), ESR, asymmetric dimethylarginine (ADMA) and ET-1 were studied. Patients were also evaluated with the Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index, and the Bath Ankylosing Spondylitis Disease Activity Index. Results A total of 48 AS patients (38.6±10.6 years; 36M/12F) and 38 controls (36.4±11.1 years; 27M/11F) were studied. Acute phase reactants including hsCRP, and ESR were significantly increased in the patients group (p<0.05). Serum ADMA concentrations were also significantly higher in AS than in controls. Plasma levels of ET-1 did not differ between the groups (p>0.05). Comparison of three groups (conventional and anti-TNF treatment groups and controls) revealed that ADMA was significantly higher in the conventional treated AS than in controls. The levels of ADMA were not different between anti-TNF group and healthy subjects. Plasma ET-1 concentrations were similar between groups (p>0.05). Correlation analysis yielded significant correlations between ADMA, hsCRP, LDL cholesterol, HDL cholesterol and triglycerides (p<0.05). Conclusion The increased ADMA levels obtained in a group of relatively young AS patients who did not have classical CV risk factors suggest that NO metabolism is impaired in AS. On the other hand, anti-TNF treatments may have a beneficial effect on vascular function in AS.

著者

Hiroshi Yoneyama Masahisa Arahata Rie Temaru Shinji Ishizaka Shinji Minami

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.49, no.4, pp.289-292, 2010 (Released:2010-02-15)

参考文献数

4

被引用文献数

12 27

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Objective Our study was undertaken to determine the location of the tortuous intercostal artery in elderly patients by using 3D-CT angiography in order to prevent laceration during thoracentesis. Methods We evaluated the data of 3D-CT angiography of the intercostal artery in consecutive patients who had undergone contrast chest CT scan in our hospital from December 2007 to April 2008. We considered the "percent safe space" (the shortest lower rib-to-intercostal artery distance/the upper rib-to-lower rib distance) to be an index of safety that can be used to prevent laceration of the intercostal artery during thoracentesis. We measured this index at 3 points: the total site (5-10 cm lateral to the spine), the lateral site (9-10 cm lateral to the spine), and the medial site (5-6 cm lateral to the spine). Results We evaluated 33 cases (25 males and 8 females; mean age, 74.2 years). The mean percent safe space at the total site was 58.6%. The percent safe space at the total site tended to decrease with advancing age, but the correlation was low (p=0.0378, r=-0.3631). The percent safe space at the lateral site (mean, 79.8%) was significantly higher than that at the medial site (61.2%, p<0.0001). Conclusion We showed that the intercostal artery is tortuous and does not always lie along the inferior edge of the rib and that the percent safe space at the lateral site is significantly higher than that at the medial site in elderly patients.

著者

Yasuhiro Yamada Osamu Takahashi Sachiko Ohde Gautam A Deshpande Tsuguya Fukui

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.49, no.15, pp.1521-1526, 2010 (Released:2010-08-02)

参考文献数

16

被引用文献数

11 21

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Objective Physicians' attire is one important factor to enhance the physician-patient relationship. However, there are few studies that examine patients' preferences for physicians' attire in Japan. We sought to assess patients' preference regarding doctors' attire and to assess the influence of doctors' attire on patients' confidence in their physician. Furthermore, we examined whether patients' preferences would change among various clinical situations. Methods Employing a cross-sectional design, Japanese outpatients chosen over one week in October 2008 from waiting rooms in various outpatient departments at St. Luke's International Hospital, Tokyo, were given a 10-item questionnaire. A 5-point Likert scale was used to estimate patient preference for four types of attire in both male and female physicians, including semi-formal attire, white coat, surgical scrubs, and casual wear. In addition, a 4-point Likert Scale was used to measure the influence of doctors' attire on patient confidence. Patients Japanese outpatients consecutively chosen from waiting rooms at St. Luke's International Hospital in Tokyo for one week in October 2008. Results Of 2,272 outpatients enrolled, 1483 (67.1%) of respondents were women. Mean age of subjects was 53.8 years (SD 16.2 years). Respondents most preferred the white coat (mean rank: 4.18, SD: 0.75) and preferred casual attire the least (mean rank: 2.32, SD: 0.81). For female physicians, 1.4% of respondents ranked the white coat little/least preferred while 64.7% of respondents ranked casual wear little/least preferred. Among respondents who most preferred the white coat for physician attire, perceived hygiene (62.7%) and inspiring confidence (59.3%) were important factors for doctor's attire. Around 70% of all respondents reported that physicians' attire has an influence on their confidence in their physician. Conclusion This study confirms that Japanese outpatients prefer a white coat. Furthermore, this study strongly suggests that wearing a white coat could favorably influence patients' confidence in the relationship with their physician in all types of practice.

著者

Soichiro Nagao Yohei Yabuuchi Kosuke Tanaka Yoshiki Morihisa Takuya Kobayashi Shinsuke Akiyama Gensho Tanke Masaya Wada Shuko Morita Satoko Inoue Hiroshi Tei Daisuke Yamashita Tetsuro Inokuma

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.2857-23, (Released:2023-11-27)

参考文献数

28

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A 52-year-old man who had been using a proton pump inhibitor (PPI) and a potassium-competitive acid blocker (P-CAB) for 14 years underwent esophagogastroduodenoscopy and was found to have three neuroendocrine tumors (NETs) in the gastric body. Following detailed examinations, parietal cell dysfunction was excluded, and the NETs did not meet the criteria for the Rindi classification types I-III. The lesions were ultimately considered to be associated with the long-term use of the PPI and P-CAB. We performed endoscopic submucosal dissection of the lesions, with no recurrence or new lesions noted after discontinuation of the PPI and P-CAB.

著者

Kota Nishihama Chisa Inoue Kohei Nishikawa Yuko Okano Atsuro Takeshita Mei Uemura Taro Yasuma Toshinari Suzuki Ryuji Okamoto Corina N D'Alessandro-Gabazza Esteban C. Gabazza Yutaka Yano

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.2613-23, (Released:2023-10-27)

参考文献数

27

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A 42-year-old Japanese woman with end-stage renal failure due to hypertension presented with a systolic blood pressure of 160-200 mmHg despite treatment with 4 different antihypertensive agents. The plasma aldosterone concentration (PAC) and plasma renin activity (PRA) were elevated. Adrenal vein sampling suggested bilateral excessive aldosterone secretion, whereas adrenocortical scintigraphy showed right-dominant accumulation. Open bilateral nephrectomy and right adrenalectomy improved the systolic blood pressure, PAC, and PRA. A pathological examination revealed zona glomerulosa hyperplasia but not microaldosteronoma. This report shows that bilateral nephrectomy, not unilateral adrenalectomy, is a potentially effective treatment option for resistant hypertension with an elevated renin-angiotensin-aldosterone system in hemodialysis patients.

著者

Yuta Chiba Rie Kawakita Katsuya Mitamura Kenta Takahashi Tadaki Suzuki Kazuo Nakamichi Kenta Suzuki Asahiro Morishita Hideki Kobara Kazushi Deguchi Tsutomu Masaki

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.3023-23, (Released:2024-01-02)

参考文献数

12

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An 84-year-old Japanese woman presented with left hemiplegia 8 months after completing chemotherapy for mantle cell lymphoma. Brain magnetic resonance imaging (MRI) revealed a hyperintense lesion extending from the right parietal lobe to the left parietal lobe. Compared with these MRI results, 18F-THK5351 PET revealed more extensive accumulation. A brain biopsy showed progressive multifocal leukoencephalopathy (PML). Immunohistochemistry and John Cunningham virus (JCV) DNA-polymerase chain reaction indicated JCV infection. Therefore, a diagnosis of PML was made. 18F-THK5351 PET, indicative of activated astrocytes, clearly depicted PML lesions composed of reactive and atypical astrocytes. 18F-THK5351 PET may capture fresh progressive PML lesions better than MRI.