著者

Koichi Soga Junichi Sakagami Osamu Handa Hideyuki Konishi Naoki Wakabayashi Nobuaki Yagi Minoru Yamada Satoshi Kokura Yuji Naito Toshikazu Yoshikawa Naoki Arizono

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.50, no.4, pp.325-327, 2011 (Released:2011-02-15)

参考文献数

13

被引用文献数

3 6

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We present the case of a patient who was referred to our hospital after she reported having passed a long, whitish object per rectum. Accordingly, capsule endoscopy was performed using the PillCam® SB video capsule. A tapeworm of the species Diphyllobothrium nihonkaiense was detected; it appeared to be freely floating and unfolded in the jejunum and sometimes tangled or irregularly folded in the ileum. The stretching of the strobila by strong peristalsis in the ileum may have resulted in the separation of the caudal portion of the strobila, which descended into the colon and was eventually passed per rectum.

著者

Shotaro Ide Noriho Sakamoto Shintaro Hara Atsuko Hara Tomoyuki Kakugawa Yoichi Nakamura Yoji Futsuki Koichi Izumikawa Yuji Ishimatsu Katsunori Yanagihara Hiroshi Mukae

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.56, no.1, pp.79-83, 2017-01-01 (Released:2017-01-01)

参考文献数

20

被引用文献数

4

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Although pneumothorax has been reported to be a major pulmonary adverse event in patients treated with pazopanib, a multikinase inhibitor, drug-induced interstitial lung disease (DILD) has not been reported. A 74-year-old Japanese man who received pazopanib for the treatment of femoral leiomyosarcoma and lung metastasis presented with dyspnea and fatigue. He had mild interstitial pneumonia when pazopanib treatment was initiated. Chest computed tomography revealed progressive bilateral ground-glass opacity (GGO) and traction bronchiectasis. We diagnosed DILD due to pazopanib. The patient's pazopanib treatment was interrupted and a steroid was administered. The symptoms and GGO were improved with treatment. Physicians should be aware of DILD due to pazopanib in patients with pre-existing interstitial lung disease.

著者

Jin Imai Takayoshi Suzuki Marie Yoshikawa Makiko Dekiden Hirohiko Nakae Fumio Nakahara Shingo Tsuda Hajime Mizukami Jun Koike Muneki Igarashi Hiromasa Yabe Tetsuya Mine

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.55, no.23, pp.3441-3444, 2016-12-01 (Released:2016-12-01)

参考文献数

20

被引用文献数

5

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Dyskeratosis congenita (DC) is a rare inherited disease in which the telomere complex cannot be maintained. Shortened telomeres can cause a number of clinical conditions. We herein report a case of unrelated bone marrow transplantation due to aplastic anemia associated with DC. The patient died of uncontrollable refractory intestinal bleeding. Three cases of DC with life-threatening hemorrhaging after transplantation have been reported; however, the bleeding origin could not be determined. Our case is the only patient in which a gastrointestinal bleeding point, jejunal multiple angioectasia, was determined.

著者

Akio Chikata Satoru Sakagami Naomi Kanamori Chieko Kato Wataru Omi Takahiro Saeki Hideo Nagai Soichiro Usui Kenichi Nakajima Masayuki Takamura

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.54, no.17, pp.2185-2189, 2015 (Released:2015-09-01)

参考文献数

11

被引用文献数

1 5

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A 75-year-old man with a 120-bpm tachycardia and typical atrial flutter was admitted. Echocardiography showed a dilated left ventricle with anterior and apical wall akinesia. Tachycardia was terminated with cavotricuspid isthmus ablation. Multiple imaging findings revealed a woven coronary artery anomaly (WCAA) in the left anterior descending artery. Stress myocardial perfusion imaging was performed after ablation in the sinus rhythm and revealed stress-induced ischemia and a fixed low uptake in the WCAA territory. WCAA is generally regarded as a benign condition; however, compromised blood flow within the anomaly, caused by tachycardia-related diastolic shortening, may induce ischemia.

著者

野村 憲一

出版者

一般社団法人 日本内科学会

雑誌

日本内科学会雑誌 (ISSN:00215384)

巻号頁・発行日

vol.97, no.7, pp.1561-1567, 2008 (Released:2012-08-02)

参考文献数

16

被引用文献数

1 1

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染色体・遺伝子検査は,悪性リンパ腫の診断に有用である.遺伝子検査は,良悪性の鑑別に用いる.免疫グロブリン遺伝子,あるいはT細胞レセプター遺伝子の再構成はサザンブロッティングで検出する.染色体異常は,組織診断に重要なエビデンスとなる.染色体解析は,通常,G染色法で行う.SKYやFISHを併用することで,より詳細な情報を得ることも可能である.染色体・遺伝子検査は,治療法の選択や予後の推定にも有用である.

著者

日野原 重明

出版者

一般社団法人 日本内科学会

雑誌

日本内科学会雑誌 (ISSN:00215384)

巻号頁・発行日

vol.91, no.11, pp.3147-3149, 2002-11-10 (Released:2008-06-12)

参考文献数

3

著者

Makoto Nakao Hideki Muramatsu Tetsushi Takahashi Shunsuke Niwa Yusuke Kagawa Ryota Kurokawa Kazuki Sone Yuki Uozumi Misako Ohkusu Katsuhiko Kamei Hiroshi Koga

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.55, no.20, pp.3021-3024, 2016-10-15 (Released:2016-10-15)

参考文献数

17

被引用文献数

9

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A 39-year-old man presented to our hospital with a four-week history of headache and a two-week history of low-grade fever. Chest X-rays showed a tumor of approximately 50 mm in size in the right lower field. A histopathological examination of a transbronchial lung biopsy specimen from the right S9/10 revealed numerous fungal elements that appeared as encapsulated yeast with clear halos. Gadolinium-enhanced brain magnetic resonance images showed multiple cerebral nodules. Cryptococcus gattii (Genotype VGIIa) was isolated from the bronchial lavage and cerebrospinal fluid specimens. The patient was an immunocompetent Japanese man who had not recently traveled to a C. gattii-endemic area.

著者

Jun Yamanouchi Takaaki Hato Sanshiro Shiraishi Kazuto Takeuchi Yoshihiro Yakushijin Masaki Yasukawa

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.55, no.20, pp.3035-3038, 2016-10-15 (Released:2016-10-15)

参考文献数

15

被引用文献数

1 11

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Vancomycin-induced thrombocytopenia is a rare adverse reaction that may be overlooked because no specific diagnostic test is currently available. We herein report a patient with vancomycin-induced immune thrombocytopenia who was diagnosed by the detection of vancomycin-dependent anti-platelet antibody with flow cytometry. An IgG antibody in the patient's serum reacted with platelets only in the presence of vancomycin. Severe thrombocytopenia gave rise to life-threatening gastrointestinal bleeding, which was quickly resolved after effective platelet transfusion following the cessation of vancomycin administration. This report suggests that the flow cytometric test is useful for the differential diagnosis of thrombocytopenia and platelet transfusion should be performed after the cessation of vancomycin administration.

著者

Toshinari Yagi Tomoko Sakamoto Keiko Nakai Masami Tanizawa Toyoko Okabe Noriko Hoshikawa Miku Kohatada Fumika Kitagawa Ritsuko Hanya Michiyo Kotani

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.55, no.17, pp.2393-2399, 2016-09-01 (Released:2016-09-01)

参考文献数

8

被引用文献数

5

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Objective A significant number of Japanese cancer patients refuse to have central venous (CV) ports implanted. The aim of this study is to investigate the experiences of patients prior to and after CV port implantation, as well as their expectations regarding the use of CV ports. Methods This study was carried out at Osaka Medical Center for Cancer and Cardiovascular Diseases from October 20, 2014, to January 16, 2015. Data were collected using a questionnaire developed by the researchers, and various statistical analyses were performed. Results Among the 50 patients who participated in this study, the CV port was implanted due to poor venous access in 18 (36%). The proportion of patients who were anxious before the port implantation was significantly higher among the patients in whom CV ports were implanted due to poor venous access than among those in whom CV ports were implanted for other reasons. All patients exhibited high satisfaction levels, regardless of the reason for CV port implantation. CV port-related discomfort was most commonly associated with seat belts. Conclusion The patients exhibited high satisfaction levels regardless of the reason for CV port implantation. However, the patients that exhibited poor venous access often experienced anxiety before the implantation of the port, so it is important to provide such patients with sufficient information prior to port implantation. In order to improve the quality of life of patients with CV ports, medical staff should give special consideration to discomfort experienced by patients that are wearing seat belts.

著者

Minemori Watanabe Chikako Asai Kota Ishikawa Atsushi Kiyota Tatsuhiro Terada Satoshi Kono Hiroaki Miyajima Ataru Okumura

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.15, pp.1581-1585, 2010 (Released:2010-08-02)

参考文献数

24

被引用文献数

3 10

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Aceruloplasminemia is a rare autosomal recessive disease first reported by Miyajima et al. (Neurology 37: 761-767, 1987); it is clinically characterized by diabetes mellitus, retinal degeneration and neurological abnormalities, such as cerebellar ataxia, extrapyramidal signs and dementia. Aceruloplasminemia is caused by mutations in the ceruloplasmin gene, which results in the absence of serum ceruloplasmin and iron overload in the brain, liver, pancreas and other organ tissues. However, little is known about endocrine diseases associated with aceruloplasminemia. We report herein a case of aceruloplasminemia accompanied by central diabetes insipidus and hypothalamic hypothyroidism.

著者

Noriko OHARA Ichiro KOMIYA Keishi YAMAUCHI Hiromi OHTSUKA Yoshitaka NAGASAWA Teiji TAKEDA Nobuyuki TAKASU

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.32, no.1, pp.60-62, 1993 (Released:2006-03-27)

参考文献数

9

被引用文献数

4 7

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Carney's complex is composed of myxoma, spotty pigmentation and endocrine overactivity. A 27-year-old male was diagnosed to have Carney's complex on the basis of intense spotty pigmentations on his face, soles and palms, and bilateral adrenal nodular hyperplasia on computed tomography scanning (CT) and magnetic resonance imaging (MRI). Total bilateral adrenectomy was done; histological findings were compatible with primary pigmented adrenocortical disease (PPNAD). Recently, his sister and one of his brothers were suspected to have Carney's complex with PPNAD. We report the first familial case of Carney's complex with PPNAD and spotty pigmentations in Japan.(Internal Medicine 32: 60-62, 1993)

出版者

一般社団法人 日本内科学会

雑誌

日本内科学会雑誌 (ISSN:00215384)

巻号頁・発行日

vol.103, no.2, pp.News2-News2, 2014-02-10 (Released:2015-02-10)

著者

Masashi Yamanouchi Yuki Uehara Hirohide Yokokawa Tomohiro Hosoda Yukiko Watanabe Takayoshi Shiga Akihiro Inui Yukiko Otsuki Kazutoshi Fujibayashi Hiroshi Isonuma Toshio Naito

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.21, pp.2471-2475, 2014 (Released:2014-11-01)

参考文献数

26

被引用文献数

4 24

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Objective The causes of fever of unknown origin (FUO) vary depending on the region and time period. We herein present a study of patients with classic FUO where we investigated differences based on patient background factors, such as age and causative diseases, and changes that have occurred over time. Methods We extracted and analyzed data from the medical records of 256 patients ≥18 years old who met the criteria for classic FUO and were hospitalized between August, 1994 and December, 2012. Results The median age of the patients was 55 years (range: 18-94 years). The cause of FUO was infection in 27.7% of the patients (n=71), non-infectious inflammatory disease (NIID) in 18.4% (47), malignancy in 10.2% (26), other in 14.8% (38), and unknown in 28.9% (74). The most common single cause was human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (n=17). NIID and malignancy were more common in patients ≥65 years old than in patients <65 years old. During 2004-2012, compared to 1994-2003, infections and "other" causes were decreased, whereas NIID, malignancy, and unknown causes were increased. Conclusion FUO associated with HIV/AIDS is increasing in Japan. In addition, as in previous studies in Japan and overseas, our study showed that the number of patients in whom the cause of FUO remains unknown is increasing and exceeds 20% of all cases. The present study identified diseases that should be considered in the differential diagnosis of FUO, providing useful information for the future diagnosis and treatment of FUO.

出版者

一般社団法人 日本内科学会

雑誌

日本内科学会雑誌 (ISSN:00215384)

巻号頁・発行日

vol.103, no.8, pp.News8-News8, 2014-08-10 (Released:2015-08-10)

出版者

一般社団法人 日本内科学会

雑誌

日本内科学会雑誌 (ISSN:00215384)

巻号頁・発行日

vol.102, no.8, pp.News8-News8, 2013-08-10 (Released:2014-08-10)

著者

Lale Ozisik Mine Durusu Tanriover Esen Saka

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.55, no.10, pp.1393-1396, 2016 (Released:2016-05-15)

参考文献数

16

被引用文献数

1 13

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Drug rash with eosinophilia and systemic symptoms (DRESS) is a severe drug hypersensitivity reaction characterized by rash, fever and multi-organ failure. Limbic encephalitis (LE) is a rare disorder characterized by cognitive dysfunction with memory disturbance, seizures and psychiatric symptoms. We herein present an unusual case of DRESS syndrome due to lamotrigine with reactivation of Epstein-Barr virus, which developed autoimmune LE and syndrome of inappropriate antidiuretic hormone secretion. Discontinuation of lamotrigine, administration of methylprednisolone and intravenous immunoglobulin led to improvement. The LE in this case might have been caused by an autoimmune inflammatory mechanism associated with DRESS syndrome.

出版者

一般社団法人 日本内科学会

雑誌

日本内科学会雑誌 (ISSN:00215384)

巻号頁・発行日

vol.104, no.5, pp.News5-News5, 2015-05-10 (Released:2016-05-10)

著者

Fu-Sheng Fang Zhi-Bing Li Chun-Lin Li Hui Tian Jian Li Xiao-Ling Cheng

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.3109-3113, 2012 (Released:2012-11-15)

参考文献数

17

被引用文献数

3 11

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Objective To investigate the influence of glycemic variability on the HbA1c level in elderly male patients with type 2 diabetes (T2DM). Methods The 24-h glucose profiles were obtained using a continuous glucose monitoring system in 291 elderly male type 2 diabetic patients. The relationship between the glycemic variability and HbA1c level was assessed in these patients. Results The mean amplitude of glycemic excursions (MAGE) in patients with HbA1c ≥7.0% was significantly higher than in patients with HbA1c <7.0% (4.33±1.67 vs. 3.48±1.46 mmol/L, p<0.001). A simple (Pearson's) correlation analysis indicated that the MAGE was significantly correlated with the HbA1c (r=0.229, p<0.001). Compared with the lowest quartile, the highest quartile of the MAGE was associated with a significantly increased risk of having a HbA1c ≥7.0% after multiple adjustments (p for trend <0.001). Conclusion The glycemic variability had a significant influence on the HbA1c level in elderly male patients with T2DM. The present data suggests that patients with higher glycemic variability might have higher HbA1c levels.

著者

宮田 典幸 坂本 竜一 堤 絵里子 塩塚 奈那 前田 麻木 武藤 敏孝 田邉 真紀人 高月 浩 澄井 俊彦 岡嶋 泰一郎

出版者

一般社団法人 日本内科学会

雑誌

日本内科学会雑誌 (ISSN:00215384)

巻号頁・発行日

vol.101, no.3, pp.769-772, 2012 (Released:2013-04-11)

参考文献数

10

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脾摘後患者では液性免疫障害により敗血症,その重症化のリスクが高い.症例は64歳女性.45歳時に特発性血小板減少性紫斑病に対し脾摘.肺炎球菌ワクチンは未接種.悪寒,発熱を自覚した翌日に上下肢の紫斑が出現.その翌日当科受診し,肺炎球菌感染,DICの所見を認めた.既往歴から脾臓摘出後重症感染症による敗血症,電撃性紫斑をきたしたものと診断.ペニシリン大量投与,DIC治療にて救命しえたが,左膝表皮,右第3・5趾先端は壊死し,植皮,切断を要した.

著者

伊勢 孝之 高木 恵理 岩瀬 俊 楠瀬 賢也 山口 浩司 八木 秀介 山田 博胤 添木 武 若槻 哲三 佐田 政隆

出版者

一般社団法人 日本内科学会

雑誌

日本内科学会雑誌 (ISSN:00215384)

巻号頁・発行日

vol.104, no.6, pp.1175-1179, 2015-06-10 (Released:2016-06-10)

参考文献数

8

被引用文献数

1

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心臓サルコイドーシスの標準的治療はステロイドであるが,ステロイドを投与中であっても再燃を認めることも多く,またステロイドの多岐にわたる副作用も問題となることが多い.症例は70歳代,女性.心臓サルコイドーシスの診断でプレドニンを維持量5 mg/日で加療されていた.定期検査で施行した心電図で陰性T波,前壁心尖部に新規の左室壁運動異常を認めた.FDG-PET,Gaシンチグラフィーで壁運動異常部位に一致して集積を認め,心臓サルコイドーシスの再燃と判断した.本症例では,ステロイドの副作用として糖尿病,肥満,白内障などを認めており,ステロイド増量が躊躇され,メトトレキサートの併用を開始した.メトトレキサート開始後,特に副作用を認めず,心電図ならびに左室壁運動異常の改善が認められた.ステロイド投与で再燃を認める心臓サルコイドーシス症例にはメトトレキサート併用も考慮すべきであると考えられた.