著者

Minako Wakasugi Junichiro James Kazama Ichiei Narita

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.8, pp.903-910, 2015 (Released:2015-04-15)

参考文献数

20

被引用文献数

1 20

---

Objective In Japan, reducing the consumption of miso soup and Japanese pickles, both traditional Japanese dishes, is recommended in order to decrease dietary salt intake. With the Westernization of dietary habits, however, these dishes are now consumed less frequently, and thus a reduction in their effect on sodium intake is suspected. This study examined cross-sectional associations between the frequency of intake of miso soup and Japanese pickles and the estimated 24-hour urine sodium excretion using data obtained from health examination surveys conducted in 2013 in Sado City, Japan. Methods The level of daily salt intake was estimated based on spot urine sodium and creatinine measurements. The frequency of intake of miso soup and Japanese pickles was determined using a self-reported questionnaire. Multiple linear regression models were used to assess associations. Results Among a total of 8,821 participants (3,956 men; age range, 19-97 years), the mean daily salt intake was 9.4 g/day. The frequency of intake of miso soup and Japanese pickles increased with age and was associated with the level of daily salt intake (p for trend <0.0001). A linear regression model analysis adjusted for age, sex, body mass index, hypertension, diabetes, hypercholesterolemia and chronic kidney disease revealed that daily salt intake was associated with the frequency of intake of miso soup (p<0.0001) and Japanese pickles (p<0.0001) in all age groups, except those ≥80 years of age. Conclusion These findings suggest that reducing the consumption of miso soup and Japanese pickles may be an effective approach for decreasing the level of dietary salt intake in the general Japanese population, although not in octogenarians or nonagenarians.

著者

関原 久彦

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.81, no.4, pp.490-493, 1992-04-10 (Released:2008-06-12)

参考文献数

13

---

リファンピシン,フェノバルビタール,フェニトイン,エフェドリンなどの薬物は,コルチゾールや合成糖質コルチコイドの肝臓ミクロゾームに存在する代謝酵素の活性を上昇させるため,これらの薬物を併用した場合,コルチゾールや糖質コルチコイド薬の血中半減期は短縮し,クリアランスは増加する.その結果,急性副腎不全や糖質コルチコイド薬の治療効果の減弱が起こる.従って,これらの薬物を併用する場合には,充分注意する必要がある.

著者

Hideharu Hagiya Yuto Haruki Taeko Uchida Tomoko Wada Sumiko Shiota Tomoharu Ishida Hiroko Ogawa Tomoko Murase Fumio Otsuka

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.1, pp.73-78, 2016 (Released:2016-01-01)

参考文献数

33

被引用文献数

1 2

---

A 68-year-old man with persistent bacteremia accompanying a large iliopsoas abscess, vertebral osteomyelitis, discitis and central venous port infection caused by methicillin-resistant Staphylococcus aureus (MRSA) was admitted to our hospital. During the course of treatment, the emergence of a daptomycin (DAP)-resistant MRSA strain was confirmed; the minimum inhibitory concentration was 1 to 2 μg/mL for vancomycin and more than 1 μg/mL for DAP. Although the bacterial cell wall was not significantly thickened, an increased positive surface charge and single-nucleotide polymorphism within mprF have been confirmed in DAP-resistant strains. Still rare, but clinicians need to be cautious of the emergence of DAP-resistant MRSA during treatment.

著者

榊原 博樹

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.85, no.2, pp.227-233, 1996-02-10 (Released:2008-06-12)

参考文献数

5

被引用文献数

2 5

---

アスピリン喘息はアラキドン酸シクロオキシゲナーゼ阻害をトリガーにして発症する.アスピリンだけではなく,すべての非ステロイド性抗炎症薬が喘息発作を惹起する.アスピリン喘息の頻度は成人の通年性喘息の9.8%と推定できる.ただし,病歴から診断できるのは60%の症例である.診断を確定するためには負荷試験が必要である.コハク酸エステル型ステロイド薬が喘息を誘発したり増悪させたりすることがある.

著者

名和田 新

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.81, no.4, pp.501-505, 1992-04-10 (Released:2008-06-12)

参考文献数

4

---

多毛症(hirsutism)はアンドロゲン〔DHEA-(S), androstenedione, testosterone〕の過剰又は末梢でのアンドロゲン感受性の増大により,女性が男性性毛を生じる事を言い,その背景には重篤な疾患を含め,多くの疾患が存在する事が明らかにされつつある.その病因を解明し診断法を確立する事は,その治療法の選択の上からも極めて重要である.各種ステロイドホルモンのRIAの確立に伴う成人多毛症の病因,診断治療の最近の進歩について概説する.

著者

Marcelo M. Serra Bruno L. Ferreyro Oscar Peralta Ezequiel Levy Yeyati Natalia Causada Calo Teresa Garcia-Botta Diego Andresik Martín Rabellino Ricardo Garcia-Mónaco

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.21, pp.2745-2748, 2015 (Released:2015-11-01)

参考文献数

13

被引用文献数

4

---

Hereditary hemorrhagic telangiectasia (HHT) usually presents in association with pulmonary arteriovenous malformations (PAVMs). In addition, the incidence of venous thromboembolism tends to be increased in these patients. A 74-year-old female with HHT presented with cyanosis and hypoxemia. Contrast-enhanced multislice computed tomography (MSCT) revealed two left PAVMs and one in the right upper lobe. Both left PAVMs were treated with embolotherapy. Follow-up MSCT revealed an incidental pulmonary embolism in the right pulmonary branches. Deep venous thrombosis was confirmed and anticoagulation was initiated. Follow-up MSCT revealed the resolution of thromboembolism. Finally, embolotherapy was performed. This case illustrates the chronic adaptation to hypoxemia and adds further evidence to the relative safety of anticoagulation treatment in these patients.

著者

岩崎 泰正 橋本 浩三

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.4, pp.747-751, 2008 (Released:2012-08-02)

参考文献数

16

被引用文献数

3 1

---

ACTH単独欠損症は下垂体前葉ホルモン6種類のうちACTHのみの分泌障害により副腎不全を来す疾患である.近年報告例が増加しており,決して稀な疾患ではない.また不全型(潜在型)の例も存在することから,全身倦怠感などの症状に加え低血糖,低ナトリウム血症,好酸球増多傾向など副腎不全を疑わせる所見を認めた場合には負荷試験で下垂体・副腎系の予備能を評価することが望ましい.

著者

市川 誠一

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.98, no.11, pp.2747-2753, 2009 (Released:2012-08-02)

参考文献数

8

被引用文献数

1

---

世界では,いまだHIV感染の予防とHIV治療へのアクセスが十分でないことから,毎日,6,800人がHIVに新たに感染し,5,700人がAIDSにより死亡している.わが国においても,男性同性愛者や滞日外国人などHIV感染対策が脆弱な層においてHIV感染症が広がっており,これらの層に対するHIVや性感染症の情報の入手が容易となる環境,HIV感染リスクやそれに伴う相談,検査,医療などの支援環境を構築する対策が必要である.HIV感染症は,未だ公衆衛生上重大な課題である.

著者

多田 智洋 中田 潤 菅原 浩仁 西沢 慶太郎 須永 大介 佐藤 健司 福眞 隆行 北 宏之 中田 智明 老松 寛

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.3, pp.738-740, 2014-03-10 (Released:2015-03-10)

参考文献数

4

被引用文献数

1 2

---

心室細動の原因となるQT延長症候群は,器質的疾患や薬剤による影響で起こることが知られている.急性心筋梗塞に対する経皮的ステント留置術後,選択的再取り込み阻害薬(SSRI),プロトンポンプ阻害薬(PPI)の内服にてQT延長を起こし,心室細動となった症例(40代,男性)を経験した.抗血小板療法に加えたPPIによる薬物相互作用により,SSRIによるQT延長効果が増強され,心室細動を誘発したと思われた.

著者

Satoshi Kutsuna Hiroki Kawabata 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.54, no.6, pp.691-691, 2015 (Released:2015-03-15)

参考文献数

1

被引用文献数

1

著者

Shinichi Nishi Naofumi Imai Kazuhiro Yoshita Yumi Ito Mitsuhiro Ueno Takako Saeki

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.2, pp.147-153, 2015 (Released:2015-01-15)

参考文献数

27

被引用文献数

7

---

Objective Ultrastructural studies of IgG4-related kidney disease (IgG4-RKD) characterized by tubulointerstitial nephritis (TIN) are limited in previous reports due to the rarity of the condition. In the present report, we performed ultrastructural examinations and assessed the pathogenesis of this disease. Patients Clinicopathological studies were conducted in eight patients diagnosed with IgG4-RKD. Routine light, immunofluorescence and electron microscopy examinations and immunohistochemical assessments of IgG4 were performed using renal biopsy samples. Results Hypocomplementemia, positive anti-nuclear antibodies and eosinophilia were confirmed in more than half of the cases. Electron dense deposits (EDDs) were frequently found in the glomeruli and interstitium. The rate of deposition was 62.5% in both mesangial areas and Bowman's capsule. EDDs were frequently detected on the tubular basement membrane (TBM) (87.5% of patients). The interstitium also contained EDDs on collagen fibers in 87.5% of the cases and on basement membrane-like materials in areas of fibrosis in 37.5% of the cases. The creatinine clearance levels were significantly lower in the patients with the latter pattern. Meanwhile, the rate of immunoglobulin and/or complement deposition on the TBM was observed in less than 37.5% of patients, and these findings were not entirely coincident with the cases of EDDs on the TBM. Conclusion EDDs are frequently found in the glomeruli and interstitium in patients with IgG4-RKD; however, immunohistological studies do not provide evidence that IgG4-RKD involves TIN with immune complex nephropathy. The presence of interstitial EDDs may be related to the progression of interstitial fibrosis in the setting of IgG4-RKD.

著者

Yao-Min Hung Chin-Chang Cheng Shue-Ren Wann Shoa-Lin Lin

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.4, pp.431-434, 2015 (Released:2015-02-15)

参考文献数

13

被引用文献数

5

---

Pulmonary arterial hypertension (PAH) is a frequent complication of connective tissue diseases, such as systemic sclerosis, systemic lupus erythematosus and rheumatoid arthritis. However, the occurrence of PAH in a patient with ankylosing spondylitis (AS) has not been previously reported with a detailed clinical description in the English literature. We herein report the first case of AS associated PAH in a 27-year-old Taiwanese man with a chief complaint of intermittent palpitations lasting for two years. To the best of our knowledge, this is the first reported case of AS associated with PAH with a detailed clinical description and findings of right heart catheterization published in the English literature.

著者

Hiroshi Arima Yutaka Oiso

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.19, pp.2043-2047, 2010 (Released:2010-10-01)

参考文献数

17

被引用文献数

4 20 8

---

Background and objective We previously reported that baclofen, a GABAB agonist, reduces body weight in obese mice. In this clinical study, we examined the possibility that baclofen might serve as an effective therapeutic agent for obesity in humans. Methods Seven women and three men ranging from 25-51 years of age and 31.3-41.0 kg/m2 body mass index were included in the study. Baclofen, which was started at a dose of 15 mg/day and increased to 30 mg/day in 10 days, was administered for 12 weeks. Results Administration of baclofen for 12 weeks significantly decreased both body weight (baseline: 93.30 ± 9.80 kg, 12 weeks: 91.70 ± 10.30 kg) and waist circumference (baseline: 107.9 ± 9.0 cm, 12 weeks: 105.6 ± 10.0 cm). Serum leptin levels, which possibly reflect the amount of adipose stores, were also decreased significantly by the treatment. On the other hand, there were no significant changes in the blood pressure or metabolism of glucose and lipid. No adverse effects were observed. Conclusion Although the anti-obesity effects of baclofen in the present study were mild, this pilot study suggests the possibility that baclofen might serve as a new anti-obesity drug in humans.

著者

宮地 秀樹 小谷 英太郎 岡崎 怜子 吉川 雅智 松本 真 遠藤 康実 中込 明裕 草間 芳樹 磯部 光章 新 博次

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.100, no.5, pp.1388-1390, 2011 (Released:2013-04-10)

参考文献数

7

被引用文献数

2 2

---

症例は21歳,女性.不明熱のため各種精査を行うも原因を同定できず.骨病変精査目的で施行したFDG-PET/CTにて大動脈弓部に異常集積を認め,早期の高安動脈炎と診断した.狭窄閉塞,拡張病変が明らかでない早期高安動脈炎の早期診断は現在のガイドラインでは困難である.しかし高安動脈炎は若年女性に好発し,重篤な心血管合併症が生じることからFDG-PET/CTによる早期診断が重要と考え報告する.

著者

Junwa Kunimatsu 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.52, no.14, pp.1659-1659, 2013 (Released:2013-07-15)

参考文献数

2

著者

Ying Wen Ying Zhou Wen Wang Yu Wang Xu Lu Cui Ming Sun Wei Cui Jing Liu Wen Qing Geng Hong Shang Pei Liu

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.2455-2461, 2014 (Released:2014-11-01)

参考文献数

29

被引用文献数

2 7

---

Objective Short-term mortality rates remain high among critically ill human immunodeficiency virus-1 (HIV-1) patients though long-term mortality rates have dropped. Baseline risk factors for short-term mortality have not yet been determined in China. In this paper, we herein describe clinical characteristics, laboratory findings, causes of clinical deterioration, and risk factors associated with mortality among HIV-1 patients within six months after hospital admission. Methods We carried out a prospective study of hospitalized patients in advanced stages of HIV infection. These patients started antiretroviral therapy three or four weeks after admission. Follow-up was conducted for a period of six months. We used a multivariate logistic-regression analysis to identify risk factors associated with mortality. Results A total of 141 patients met our inclusion criteria. The mean age was 41 years. Fever and weight loss were the most common clinical manifestations of advanced HIV disease. Oral candidiasis, tuberculosis, cytomegaloviremia, and pneumocystis pneumonia were the most common opportunistic infections. Significantly decreased CD4+ T-cell counts, hypoalbuminemia, anemia, hyponatremia, as well as elevated C-reactive protein (CRP) and glutamic alanine transaminase levels were common laboratory test abnormalities. The mortality rate was 21.3%. The patients who died were more likely than the survivors to have low CD4+ T-cell counts as well as low creatinine, hemoglobin, albumin, and serum sodium levels while also having longer intervals of fever and higher CRP levels. A multivariate analysis demonstrated that the independent risk factors for mortality were active tuberculosis [odds ratio (OR): 2.681; 95% confidence interval (CI), 1.006-7.142; p=0.049], hyponatremia (OR: 3.027; 95% CI, 1.238-7.401; p=0.015), and being at clinical stage 4 (as defined by the World Health Organization) (OR: 9.492; 95% CI, 1.200-75.065; p=0.033) within the first six months of admission. Conclusion Special consideration should be given to patients who have active tuberculosis, are at clinical stage 4, and present with hyponatremia upon admission as these were found to be important factors associated with mortality within six months of hospital admission in HIV-1 patients.

著者

Hironori Uruga Takeshi Fujii Atsuko Kurosaki Shigeo Hanada Hisashi Takaya Atsushi Miyamoto Nasa Morokawa Sakae Homma Kazuma Kishi

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.12, pp.1317-1323, 2013 (Released:2013-06-15)

参考文献数

25

被引用文献数

23 110

---

Objective Pulmonary tumor thrombotic microangiopathy (PTTM) is a unique, rare and fatal form of pulmonary arterial tumor embolism. The aim of this study was to evaluate the clinical characteristics and pathological and immunohistochemical findings of PTTM. Methods Autopsy records dated between January 1983 and May 2008 in our hospital were reviewed, and those of patients who died from pulmonary tumor embolism resulting from malignant neoplasm were retrieved. The relevant tissue slides were reevaluated and examined immunohistochemically to confirm the diagnosis. Results Among 2,215 consecutive autopsy cases of carcinoma, 30 patients (1.4%) were diagnosed with definitive PTTM. The common symptom was progressive dyspnea. A hypercoagulative state was observed in all measured cases (n = 21). The chest computed tomography findings (n = 6) included consolidation, ground-glass opacity, small nodules and a tree-in-bud appearance. Perfusion scans were performed in seven patients, six of whom demonstrated multiple small defects. The median survival time after the initiation of oxygen supplementation was nine days. The most frequent primary site was the stomach (n = 18 ; 60%) , and the most frequent histological type was adenocarcinoma (28/30 ; 93.3%) . The immunohistochemical findings for tumor cells located within the tumor emboli were positive for vascular endothelial growth factor (28/29 ; 96.6%) and tissue factor (29/29 ; 100%). Conclusion Clinicians should suspect PTTM in cancer patients who exhibit acute worsening respiratory insufficiency accompanied by a hypercoagulative state without embolism in major pulmonary arteries. The PTTM patients evaluated in our study had very poor prognoses. Vascular endothelial growth factor and tissue factor may play important roles in PTTM.

著者

Taku Ogawa Masatoshi Sato Shinsuke Yonekawa Chiyo Nakagawa Kenji Uno Kei Kasahara Koichi Maeda Mitsuru Konishi Keiichi Mikasa

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.10, pp.1131-1135, 2013 (Released:2013-05-15)

参考文献数

21

被引用文献数

5 6

---

Aminoglycosides are useful antimicrobial agents for treating infective endocarditis; however, they occasionally cause troublesome side effects, such as nephrotoxicity and ototoxicity. We herein report a case of infective endocarditis caused by Enterococcus faecalis that was treated successfully with continuous infusion of ampicillin without adjunctive aminoglycosides. The serum ampicillin concentrations were higher than the minimal inhibitory concentration for the target strain. Although the use of ampicillin monotherapy is currently avoided because double β-lactam therapy is reportedly more effective, continuous penicillin administration remains an effective therapeutic choice for treating infective endocarditis.

著者

Shintaro Akiyama Tsunao Imamura Tetsuo Tamura Yuko Koizumi Rikako Koyama Kazuo Takeuchi Goro Watanabe

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.2489-2492, 2014 (Released:2014-11-01)

参考文献数

9

被引用文献数

2 7

---

Ursodeoxycholic acid (UDCA) is often used to treat cholesterol gallstones. UDCA makes cholesterol stones soluble, thereby improving biliary emptying. Conversely, however, UDCA can also form stones via an unknown mechanism, as shown in a few previous reports of cholangitis caused by the formation of UDCA stones in the common bile duct (CBD). We herein report four cases of recurrent cholangitis resulting from UDCA stones. The withdrawal of UDCA administration was highly effective in these patients. The details of these four cases suggest that clinicians must rethink the indications for UDCA treatment in cases in which cholangitis caused by CBD stones frequently recurs over a short period of time.

著者

Yuichi Tashiro Tsuneo Yamazaki Shun Nagamine Yuji Mizuno Adachi Yoshiki Koichi Okamoto

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.19, pp.2245-2250, 2014 (Released:2014-10-01)

参考文献数

14

被引用文献数

9

---

We herein describe a case of a 38-year-old man with familial hemiplegic migraine with a T666M mutation in the electrical potential-dependent calcium ion channel (CACNA1A) gene. His migraine was accompanied by hemiparesis and impaired consciousness. Brain magnetic resonance imaging revealed abnormalities in the right cortical hemisphere. Single-photon emission computed tomography demonstrated a decrease in iomazenil uptake and an increase in 99mTc-ethyl cysteinate dimer uptake at the ipsilateral site. Positron emission tomography showed a decrease in 18F-fluorodeoxyglucose uptake in the same area, which later showed atrophic changes. The patient's brain atrophy ceased after treatment with sodium valproate. This case suggests that the progression of brain atrophy can be prevented with adequate prophylaxis.