著者

Katsuhito Ihara Shotaro Naito Tomokazu Okado Tatemitu Rai Yutaro Mori Takayuki Toda Shinichi Uchida Sei Sasaki Noriaki Matsui

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.54, no.1, pp.49-54, 2015 (Released:2015-01-01)

参考文献数

16

被引用文献数

2 3

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A 33-year-old Japanese woman at 40 weeks gestation visited the maternity hospital after imminent labor had begun. After the delivery, persistent bleeding developed resulting in hemorrhagic shock. Although the hemorrhage was eventually controlled, hepatic and renal dysfunction occurred, leading to acute kidney injury (AKI). The patient's clinical presentation was suggestive of amniotic fluid embolism (AFE). We subsequently initiated continuous renal replacement therapy (RRT) for AKI. The patient's condition improved, she discontinued RRT, and her renal function recovered. We herein report a patient who successfully recovered from AKI caused by AFE.

著者

Yuhko KANEKO Tohru OGIHARA Hiroto TAJIMA Fumio MOCHIMARU

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.40, no.9, pp.945-947, 2001 (Released:2006-03-27)

参考文献数

5

被引用文献数

21 27

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We describe a 27-year-old woman with disseminated intravascular coagulation and shock due to amniotic fluid embolism after Caesarean section who responded well to continuous hemodiafiltration (CHDF) therapy. The effectiveness of CHDF in treating amniotic fluid embolism is also discussed.(Internal Medicine 40: 945-947, 2001)

著者

Yusuke Konta Eiichiro Saito Koji Sato Kyohei Furuta Kenichiro Miyauchi Akiko Furukawa Hiroshi Sato Tae Yamamoto

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.61, no.21, pp.3239-3243, 2022-11-01 (Released:2022-11-01)

参考文献数

18

被引用文献数

7

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We herein report a case of acute kidney injury (AKI) due to tubulointerstitial nephritis (TIN) after starting empagliflozin in a diabetic patient. The patient developed stage 1 AKI with proteinuria and elevated tubulointerstitial markers. A renal biopsy showed acute TIN with lymphocytic infiltration into the interstitium. The patient's renal function improved after discontinuation of empagliflozin and steroid administration. Sodium-glucose cotransporter 2 (SGLT2) inhibitor-induced AKI has been reported, but the underlying mechanism remains unclear, potentially because few patients with SGLT2-inhibitor-induced AKI have undergone a renal biopsy. We report the present case in the hope that it will help clarify the mechanism.

著者

Yasutaka Tsujimoto Yohei Kanzawa Naoto Ishimaru Saori Kinami

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.7948-21, (Released:2021-10-19)

参考文献数

2

被引用文献数

1

著者

Sho Nakakubo Keisuke Kamada Yu Yamashita Junichi Nakamura Munehiro Matsumoto Hiroshi Horii Kazuki Sato Daisuke Morinaga Masaru Suzuki Nanase Okazaki Emi Takakuwa Yoshihiro Matsuno Satoshi Konno

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.9016-21, (Released:2022-03-05)

参考文献数

22

被引用文献数

3

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We present three cases with an atypical clinical course of organizing pneumonia (OP) secondary to COVID-19. Three patients were discharged with satisfactory improvement after standard steroid therapy for COVID-19. Shortly after the completion of treatment, the patients experienced a flare-up of symptoms. Imaging results showed new lesions in the lungs. Transbronchial lung cryobiopsy showed histological findings consistent with OP in all cases. Steroids were administered, and a good therapeutic response was observed. This report is the first to describe pathologically confirmed OP that developed after recovery from COVID-19. Careful follow-up is advisable for patients who have recovered from COVID-19.

著者

Mio Masuda Osamu Tomonaga

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.60, no.24, pp.3879-3888, 2021-12-15 (Released:2021-12-15)

参考文献数

44

被引用文献数

1

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Objective The stress brought on by changes in social conditions due to COVID-19 is diverse. However, there have been no studies examining the relationship between the type of stress felt by an individual due to such changes in social conditions and the degree of change in HbA1c, prompting us to conduct this study. Methods We conducted a collaborative study at two diabetes clinics. A total of 1,000 subjects responded to the questionnaire. Data on HbA1c and body weight before and after the declaration of the state of emergency were collected. Results We conducted a questionnaire on some stressors, but when comparing the two groups with respect to whether or not they felt stress from each item, only "school closures for children," seemed to be associated with a significant difference in the amount of change in HbA1c. In the stressed group, i.e. the group of parents who experienced stress due to their children's schools being closed, the HbA1c value changed from 7.30±0.78 to 7.30±1.13 (p=0.985). By contrast, in the unstressed group, the HbA1c value significantly decreased from 7.28±0.98 to 7.06±0.85 (p<0.001). In addition, as a result of comparing the amount of change between the 2 groups, a significant decrease was observed in the unstressed group compared with the stressed group (p=0.032). There was no significant difference in body weight change between the two groups. Conclusion Stress that cannot be avoided by one's own will, such as school closures for children, may affect glycemic control.

著者

Yoshiro Hadano Mika Tsukahara Kenta Ito Jun Suzuki Ichiro Kawamura Hanako Kurai

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.51, no.22, pp.3193-3195, 2012 (Released:2012-11-15)

参考文献数

10

被引用文献数

37 42

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Raoultella ornithinolytica is a Gram-negative aerobic bacillus reclassified in the new genus from the Klebsiella species based on new genetic approaches; however, human infections caused by R. ornithinolytica are rare. We herein report three cases of R. ornithinolytica bacteremia associated with biliary tract infections in cancer patients. R. ornithinolytica can be a causative pathogen of biliary tract infection in cancer patients.

著者

Kazumasa Oura Takashi Yamaguchi Taro Suzuki Mao Yamaguchi Oura Ryo Itabashi Tetsuya Maeda

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.9316-22, (Released:2022-08-10)

参考文献数

15

被引用文献数

1

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Several case reports of patients with both moyamoya syndrome (MMS) and antiphospholipid syndrome (APS) have been published. However, the relationship between MMS and APS has not been clarified. We herein report a patient with MMS who had an ischemic stroke with rapid worsening of stenosis of the middle cerebral artery associated with APS. The patient was triple-positive for antiphospholipid antibodies. Patients with MMS complicated by APS should be closely followed up with vascular imaging.

著者

Yu Ito Nobuyasu Awano Fumiya Uchiyama Minoru Inomata Naoyuki Kuse Mari Tone Kohei Takada Kazushi Fujimoto Yutaka Muto Shogo Sagisaka Kenro Maki Ryuta Yamashita Akinori Harada Jun-ichi Nishimura Munehiro Hayashi Takehiro Izumo

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.7422-21, (Released:2021-08-24)

参考文献数

20

被引用文献数

1 4

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In hospitalized coronavirus disease 2019 (COVID-19) patients, anticoagulation therapy is administered to prevent thrombosis. However, anticoagulation sometimes causes bleeding complications. We herein report two Japanese cases of severe COVID-19 in which spontaneous muscle hematomas (SMH) developed under therapeutic anticoagulation with unfractionated heparin. Although the activated partial prothrombin time was within the optimal range, contrast-enhanced computed tomography (CECT) revealed SMH in the bilateral iliopsoas muscles in both cases, which required emergent transcatheter embolization. Close monitoring of the coagulation system and the early diagnosis of bleeding complications through CECT are needed in severe COVID-19 patients treated with anticoagulants.

著者

Hiroki Mizuno Naoki Sawa Akinari Sekine Noriko Inoue Yuki Oba Daisuke Ikuma Masayuki Yamanouchi Eiko Hasegawa Tatsuya Suwabe Hisanori Suzuki Junichi Hoshino Yoshifumi Ubara

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.9624-22, (Released:2022-05-31)

参考文献数

12

被引用文献数

1

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A 79-year-old man was admitted with a compression fracture of the first lumbar vertebra. His alkaline phosphatase (ALP) level was 35 IU/L, and his dual energy X-ray absorptiometry T score was -3.7 standard deviations, indicating osteoporosis. A genetic analysis showed a mutation of the alkaline phosphatase biomineralization-associated gene encoding tissue-nonspecific alkaline phosphatase. Hypophosphatasia-related osteoporosis was diagnosed. Alendronate, teriparatide, and minodronate were administered in that order. The ALP level increased during teriparatide use. A bone biopsy performed after three years of teriparatide treatment showed that cancellous bone was adynamic. In cortical bone, tetracycline double-labeling indicates enhanced bone formation. Teriparatide may thus be a viable treatment option even in patients with hypophosphatasia.

著者

Kimitoshi Kubo Noriko Kimura Soichiro Matsuda Momoko Tsuda Katsuhiro Mabe Mototsugu Kato

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.59, no.4, pp.507-511, 2020-02-15 (Released:2020-02-15)

参考文献数

8

被引用文献数

4 8

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To date, no cases of vonoprazan-associated gastric mucosal redness have been reported, and its endoscopic and pathological features remain largely unclear. We report four cases of vonoprazan-associated gastric mucosal redness. In all cases, esophagogastroduodenoscopy (EGD) demonstrated linear or spotty redness that newly appeared in the greater curvature of the middle gastric body after the initiation of vonoprazan, which disappeared after its discontinuation. A tissue biopsy taken from the gastric mucosa with redness revealed inflammatory cell infiltration, parietal cell protrusions (PCPs), and oxyntic gland dilatation. To our knowledge, this is the first report describing the endoscopic and pathological features of vonoprazan-associated gastric mucosal redness.

著者

Harumi Morioka Kiyoko Murata Tatsuki Sugisawa Mari Shibukawa Junya Ebina Masahiro Sawada Sayori Hanashiro Junpei Nagasawa Masaru Yanagihashi Takehisa Hirayama Masayuki Uchi Kiyokazu Kawabe Satoru Ebihara Yoshitaka Murakami Takashi Nakajima Osamu Kano

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.61, no.10, pp.1479-1484, 2022-05-15 (Released:2022-05-15)

参考文献数

28

被引用文献数

4

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Objective To assess the long-term effects of hybrid assistive limb (HAL) treatment on gait in patients with amyotrophic lateral sclerosis (ALS). Methods Three courses of treatment with HAL were administered to three women with ALS. Each course had a four- to five-week duration, during which the treatment was performed nine times, with a rest period of at least two months between each course. Gait ability (2-minutes-walk and 10-m-walk tests), ALS Functional Rating Scale-Revised, and respiratory function tests were performed before and after each treatment course. Patients Patients diagnosed with ALS, according to the updated Awaji criteria, by board-certified neurologists in the Department of Neurology and Department of Rehabilitation Medicine, Toho University Omori Faculty of Medicine between January and December 2019 were recruited. Results The average time from the start to the end of the 3 courses was 319.7±33.7 days. A multiple regression analysis was performed for the 2-minutes-walk and 10-m-walk tests, using the baseline value, each participant's ID, and time point as covariates. Changes after each course were considered outcomes. Following the 3 treatment courses, the 2-minutes walk distance improved by 16.61 m (95% confidence interval, -9.33-42.54) compared with the baseline value, but this improvement was not statistically significant (p=0.21). However, cadence significantly improved by 1.30 steps (95% confidence interval, 0.17-2.42; p=0.02). Conclusion Long-term, repetitive HAL treatments may help patients with ALS maintain their gait.

著者

Yutaka Shimada

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.61, no.1, pp.29-35, 2022-01-01 (Released:2022-01-01)

参考文献数

21

被引用文献数

2 16

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This review summarizes the adverse effects of Kampo medicines. These adverse effects in terms of immunoallergic reactions include interstitial pneumonia, liver injury, allergic cystitis, and drug eruption. Many cases of interstitial pneumonia, liver injury, and allergic cystitis associated with Kampo formulas have been reported to be caused by formulas containing Scutellariae Radix (Scutellaria root, ogon). The known adverse effects linked to overdose of Kampo formulas include pseudoaldosteronism [caused by Glycyrrhizae Radix (licorice, kanzo)], sympathomimetic symptoms [caused by Ephedrae Herba (ephedra, mao)], aconite poisoning [caused by Aconiti Tuber (processed aconite root, bushi and uzu)], and diarrhea [caused by Rhei Rhizoma (rhubarb, daio)]. In recent years, mesenteric phlebosclerosis caused by the long-term administration of Gardeniae Fructus (gardenia fruit, sanshishi) has also been reported. It is necessary to consider these potential adverse effects when prescribing Kampo medicines in clinical practice.

著者

藤枝 憲二

出版者

The Japanese Society of Internal Medicine

雑誌

日本内科学会雑誌 (ISSN:00215384)

巻号頁・発行日

vol.91, no.4, pp.1172-1178, 2002-04-10

著者

Tomohiro Kaneko Sakiko Miyazaki Takuma Koike Azusa Murata Ryoko Morimoto Kuniaki Hirose Kazuhisa Takamura Daisuke Endo Atsushi Amano Tohru Minamino

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.8176-21, (Released:2021-10-19)

参考文献数

14

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Atypical Shone's complex is a rare congenital anomaly involving a left-sided obstructive lesion of two or three cardiovascular levels. A 70-year-old man with dyspnea on exertion was diagnosed with severe aortic stenosis (AS) with a bicuspid valve, complicated by severe aortic coarctation (CoA) and a double-orifice mitral valve. He underwent surgery for AS and CoA in one session. It is important to search for complicated malformations, even in cases of bicuspid aortic valve found in old age.

著者

Masahiro Saito Tomoyuki Koike Yasuaki Abe Kenichiro Nakagawa Takeshi Kanno Xiaoyi Jin Waku Hatta Kaname Uno Naoki Asano Akira Imatani Fumiyoshi Fujishima Atsushi Masamune

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.60, no.3, pp.391-396, 2021-02-01 (Released:2021-02-01)

参考文献数

14

被引用文献数

15

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We herein report the first case of foveolar-type gastric adenocarcinoma that developed after the initiation of vonoprazan (VPZ). A 51-year-old man had heartburn at the first visit and reflux esophagitis endoscopically, so he started taking VPZ. An approximately 5-mm-sized reddish polyp with a raspberry-like morphology was detected at the anterior wall of the upper body of the stomach 156 weeks after starting maintenance therapy with VPZ 10 mg/day. It was diagnosed as foveolar-type gastric adenocarcinoma based on a biopsy. Another approximately 4-mm-sized foveolar-type gastric adenocarcinoma was also detected at the posterior wall of the middle body of the stomach.

著者

Motohiro Shingu Naoto Ishimaru Jun Ohnishi Shimpei Mizuki Yohei Kanzawa Kei Kawano Takahiro Nakajima Nobuya Sano Saori Kinami

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.6186-20, (Released:2021-05-22)

参考文献数

21

被引用文献数

4

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Hemolytic anemia is a rarely occurring manifestation of native valve infective endocarditis. We herein report an afebrile patient with hemolytic anemia caused by Cardiobacterium hominis endocarditis. A 60-year-old Japanese man had a history of aortic root replacement and the gradual onset of general fatigue. He had hemolytic anemia. Blood cultures detected C. hominis. A transthoracic echocardiogram showed aortic valve vegetation and periannular abscess with perforation of the non-coronary cusp. Intravascular hemolysis recovered after antimicrobial therapy, surgical removal of the vegetation and abscess, and aortic valve replacement. Subacute endocarditis should be considered if patients develop hemolytic anemia with signs of chronic inflammation without a fever.

著者

Takahiro Matsuo Osamu Takahashi Kazuyo Kitaoka Hiroko Arioka Daiki Kobayashi

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.5872-20, (Released:2020-12-07)

参考文献数

52

被引用文献数

20

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Objectives We examined the prevalence of burnout among resident doctors and its relationship with specific stressors. Methods We conducted a nationwide, online, cross-sectional survey in Japan with 604 resident doctors in 2018-2019. Participants and Materials Participants completed the Maslach Burnout Inventory-General Survey to evaluate burnout and provided details of their individual factors and working environmental factors. Chi-square tests and t-tests were conducted for categorical and continuous variables, respectively. The association between burnout and resident-reported causes of stress, ways of coping with stress, number of times patient-safety incidents were likely to occur, and individuals who provide support when in trouble was analyzed using logistic regression analyses after controlling for confounding variables. Results A total of 28% met the burnout criteria, 12.2% were exhausted, 2.8% were depressed, and 56.9% were healthy. After adjusting for sex, postgraduate years, type of residency program, marital status, number of inpatients under residents' care, number of working hours, number of night shifts, number of days off, and resident-reported causes of stress-excessive paperwork (odds ratio [OR]: 2.24, 95% confidence interval [CI]: 1.32-3.80), excessive working hours (OR: 2.75, 95% CI: 1.24-6.04), low autonomy (OR: 3.92, 95% CI: 2.01-7.65), communication problems at the workplace (OR: 2.24, 95% CI: 1.05-4.76), complaints from patients (OR: 6.62, 95% CI: 1.21-36.1), peer competition (OR: 2.22, 95% CI: 1.25-3.93), and anxiety about the future (OR: 2.13, 95% CI: 1.28-3.56)-were independently associated with burnout. The burnout group had more reported patient-safety incidents that were likely to occur per year (>10) (OR: 2.65, 95% CI: 1.01-6.95) and a lack of individuals who could provide support when in trouble (OR: 1.83, 95% CI: 1.01-3.34) than the non-burnout group. Conclusions This study described the prevalence of burnout among residents who responded to our survey. We detected an association between burnout and resident-reported causes of stress, patient-safety incidents, and a lack of individuals who provide support when in trouble. Further interventional studies targeting ways to reduce these concerns are warranted.

著者

久保 明美 垣田 時雄 高木 敦司 松永 隆 外林 秀紀 岡村 康彦

出版者

The Japanese Society of Internal Medicine

雑誌

日本内科学会雑誌 (ISSN:00215384)

巻号頁・発行日

vol.77, no.4, pp.506-509, 1988

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気温20~22°C,湿度55~62%,風力1.5m,天候晴というさほど高温多湿ではない条件下に,体熱の放散が妨げられて発症した熱中症3例につき報告した.症例は24~26才の男性,警察学校生で,警備装備品を着装して3~4km駆け足を行ない,意識消失,転倒した. 1例は当日入院,急性胃粘膜病変を呈し,翌日以降に高度の肝機能障害を認めた. 2例は翌日入院でともに高度の肝機能障害を呈し,うち1例は腎不全,播種性血管内凝固症候群をきたして血液透析,血漿交換にて救命しえた.熱中症を発症した場合は,たとえ発症時の症状が軽度であっても適切な加療と経時的な肝機能,腎機能の検索を行なうことが必要と考える.

著者

Yu Kurahara Yoshinobu Matsuda Kazunari Tsuyuguchi Akihiro Tokoro

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.9013-21, (Released:2022-02-26)

参考文献数

15

被引用文献数

4

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Objective The incidence and clinical importance of delirium in COVID-19 have not yet been fully investigated. The present study reported the prevalence of delirium in patients with COVID-19 and identified the factors associated with delirium and mortality. Methods We performed an observational, retrospective study of patients diagnosed with COVID-19 at the Kinki-Chuo Chest Medical Center. Univariate and multivariate logistic regression analyses were used to explore delirium risk factors. Patients or Materials All consecutive patients diagnosed with COVID-19 at the Kinki-Chuo Chest Medical Center. Results We identified 600 patients [median age: 61.0 (interquartile range: 49.0-77.0) years old], of whom 61 (10.2%) developed delirium during their stay. Compared with patients without delirium, these patients were older (median age 84.0 vs. 56.0 years old, p <0.01) and had more comorbidities. Based on a multivariate analysis, age, dementia, severe disease, and lactate dehydrogenase (LDH) levels were independent risk factors for developing delirium. For every 1-year increase in age and 10-IU/L increase in LDH, the delirium risk increased by 10.8%-12.0% and 4.6%-5.7%, respectively. There were 15 (24.6%) in-hospital deaths in the group with delirium and 8 (1.6%) in the group without delirium (p <0.01). Delirium was associated with an increased mortality. Conclusion Delirium in patients with COVID-19 is prevalent and associated with poor clinical outcomes in Japan. Despite difficulties with COVID-19 patient care during the pandemic, physicians should be aware of the risk of delirium and be trained in its optimal management.