著者

Kentaro Okubo Hisako Okubo Yuji Kamijo Makoto Higuchi

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.50, no.18, pp.2057, 2011 (Released:2011-09-15)

被引用文献数

1 3

著者

Nagaaki Katoh Ko-ichi Tazawa Wataru Ishii Masayuki Matsuda Shu-ichi Ikeda

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.47, no.12, pp.1133-1138, 2008 (Released:2008-06-16)

参考文献数

21

被引用文献数

11 21

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We report a patient with myeloma-associated systemic AL amyloidosis who showed chronic polyarthralgia as the main symptom. The clinical picture was similar to that of rheumatoid arthritis with regard to symmetrical swelling with tenderness in multiple joints, but inflammatory reactions were almost normal and autoantibodies were negative. He was diagnosed as having systemic AL amyloidosis based on deposition of κ-light chain-immunoreactive amyloid in biopsied tissue and Bence Jones protein in serum and urine. Magnetic resonance imaging and bone scintigraphy suggested this disease as the cause of the polyarthralgia. Systemic AL amyloidosis may be important in the differential diagnosis of chronic polyarthralgia.

著者

Masayuki Amano Taro Shimizu

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0495-17, (Released:2018-05-18)

参考文献数

57

被引用文献数

67

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Mondor's disease (MD) is a rare disease that manifests with a palpable cord-like induration on the body surface. In general, MD is a self-limited, benign thrombophlebitis that resolves in four to eight weeks without any specific treatment. Cases of MD can be roughly categorized into three different groups based on the site of the lesion as follows: original MD of the anterolateral thoracoabdominal wall, penile MD with dorsum and dorsolateral aspects of the penis, and axillary web syndrome with mid-upper arm after axillary surgery. The diagnosis of MD is rather straightforward and based on a physical examinations. However, some case occur "secondary" with another underlying disease, including malignancy, a hypercoagulative state, and vasculitis. Therefore, it is critical to identify MD precisely, evaluate any possible underlying disease, and avoid any unnecessary invasive tests or treatment. In this paper, we comprehensively review the clinical characteristics of MD.

著者

Yasutaka Tajima Hiroaki Yaguchi Yasunori Mito

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.57, no.6, pp.873-876, 2018-03-15 (Released:2018-03-15)

参考文献数

8

被引用文献数

6

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To date, the only instance of tick-borne encephalitis (TBE) in Japan was reported from the southern part of Hokkaido Island in 1993; no other cases have been reported since then. We herein report the first case of TBE reported in the central part of Hokkaido Island, and describe the fatal clinical course of a patient who presented with meningoencephalomyelitis, which partly involved the nerve root. Magnetic resonance imaging (MRI) of the patient's cranium and spine revealed characteristic central nervous system involvement. Our case report is extremely relevant to efforts to protect public health and for precautions against TBE pandemics.

著者

都築 甚之助

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.2, pp.728-741, 1914

著者

SAITOH Makoto HASEGAWA Junichi TAKAMI Tom HOSHIO Akira MIYAKODA Hiroyuki KOTAKE Hiroshi MASHIBA Hiroto TSUTSUMI Sadao KATSUBE Yoshio

出版者

The Japanese Society of Internal Medicine

雑誌

Japanese Journal of Medicine (ISSN:00215120)

巻号頁・発行日

vol.30, no.4, pp.333-337, 1991

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An 80-year-old man with Ebstein's anomaly and ductus arteriosus aneurysm is reported. He was admitted with bradycardiac atrial fibrillation and right ventricular failure. For the control of brady-arrhythmia, a permanent pacemaker was implanted. Two-dimensional echocardiogram revealed distal displacement of the septal tricuspid valve. Aortography and computed tomography showed ductus arteriosus aneurysm. This is the first report of the association of Ebstein's anomaly and non-patent ductus arteriosus aneurysm.

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

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.100, no.5, pp.1388-1390, 2011-05-10

参考文献数

7

被引用文献数

1 2

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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.<br>

著者

涌井 秀樹 山下 純一 大渕 宏道 吉田 廣作 中本 安 三浦 亮

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.75, no.6, pp.788-791, 1986

被引用文献数

1

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症例は16才の女子高校生で修学旅行中に一過性の黒色尿を生じたため入院した.尿潜血反応は強陽性であつたが赤血球沈渣はみられなかつた.血清ビリルビン, LDH, GOT値の上昇と血清ハプトグロビン値の減少を認めた. Coombs試験, Ham試験, sugar water試験は陰性で赤血球浸透圧脆弱試験は正常であつた.運動負荷試験を行なつた.黒色尿は生じなかつたが血管内溶血の所見を得た.修学旅行後は通常の学校生活に戻つたが黒色尿はみられていない.以上より修学旅行中の長距離歩行によるmarch hemoglobinuriaと診断された.本邦報告例では圧倒的に青年男子の運動選手,特に剣道選手にみられるので,本症例はきわめてまれな例である.

著者

石川 裕一 宮城 匡彦 松本 知子 渡邊 奈津子 東條 靖 廣井 直樹 久保木 幸司 芳野 原 坪田 貴也 吉原 克則

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.97, no.10, pp.2552-2554, 2008-10-10

参考文献数

4

被引用文献数

1

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34歳,女性,7月に起立困難で入院.心エコーにて著明な右心不全を認め,急激に呼吸状態の増悪を来たした.スワンガンツカテーテルにて全身血管抵抗低下を伴った高心拍出性心不全の所見を呈し衝心脚気と診断.フルスルチアミン投与したところ24時間以内に循環動態の改善が認められた.衝心脚気の原因として本人が2月から始めた健康食品ダイエットが原因と考えられた.現在では稀な疾患ではあるが,短期間で重症化し致命的な経過を辿る事がある為,注意が必要であると考える.<br>

著者

齋藤 大雅

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.7, pp.517-523, 1919

著者

前防 昭男 松森 正温 森脇 優司 中野 孝司 山出 渉 安室 芳樹 鍋島 健治 波田 寿一 東野 一彌

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.74, no.4, pp.457-461, 1985

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ビルハルツ住血吸虫症は,血尿を主訴とする寄生虫疾患で,アフリカや中近東などの熱帯地方がその流行地である.今回,我々は,世界旅行中,熱帯地方滞在の際に感染したと考えられるビルハルツ住血吸虫症を経験したので報告する.患者は33才の日本人男性. 1976年より世界旅行に出発,アフリカ,東南アジア,アメリカ大陸などを旅行していた. 1983年1月,メキシコ滞在中に血尿に気づくも放置していた.同年5月,日本へ帰国後も血尿持続し,精査のため入院.尿沈渣にて多数の赤血球および寄生虫卵を認め,その虫卵よりビルハルツ住血吸虫症と診断した.血液学的には好酸球増加および血清IgEの高値を認めた.また,膀胱粘膜の生検にて粘膜内にも虫卵を認めた.治療として酒石酸アンチモン剤を投与し尿中の虫卵が陰性化し退院した.本症は,流行地では2000万~3000万人もの患者が存在してるにもかかわらず,本邦ではほとんど認めることのできないまれな輸入寄生虫疾患であるが,海外渡航が頻繁に行なわれるようになつた現在,特に本疾患流行地に滞在していた場合には,血尿を認めた時には鑑別すべき疾患の一つになりえる.

著者

藤木 直人 田代 邦雄

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.90, no.4, pp.58-62, 2001-04-10

参考文献数

5

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群発頭痛は他の慢性頭痛と比べると比較的稀な頭痛である.このため医療側の認知度が低く,正しい診断を受けるまでに時間がかかることがしばしばある.症状は非常に特徴的であり,この疾患の診療の経験があれば,典型例では診断は比較的容易であるともいえる.治療面での進歩が今後期待されており,この頭痛の存在を患者側にも医療側にも広く認知してもらうことが,診断のために最も重要と考えられる.

著者

川崎 晃一 上野 道雄 尾前 照雄 松岡 緑

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.69, no.10, pp.1293-1298, 1980

被引用文献数

4

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収縮期(SBP)ならびに拡張期(DBP)血圧,口内温(Temp)および脈拍(PR)の日周(cir-cadian),月周(circatrigintan)および年周リズム(circannual rhythm)を検出するために, 1健康女性(34才)の1日4回(起床時,昼食前,夕食前,就寝前), 1年間にわたる自己測定値をコサイナー法を用いて分析した. DBP, Temp, PRの推計学的に有意な日周,月周および年周リズムならびにSBPの有意な日周リズムが検出された. 1年間を通じてSBP, DBPのメサー(余弦曲線の基線)は115.2±0.2(SE)/85.4±0.2mmHgであり, TempとPRのそれは36.04±0.01°C, 79.8±0.2/分であつた.日周リズムの頂点位相はそれぞれ7:08(SBP), 10:40(DBP), 17:00(Temp)および18:48(PR)に検出された.また月周リズムの頂点位相は月経開始後7日目(SBP), 8日目(DBP), 22日目(Temp), 19日目(PR)に,年周リズムのそれは1月10日(SBP), 12月1日(DBP), 12月4日(Temp)および11月23日(PR)に検出された.日周リズムを1カ月毎に検出すると, SBPとDBPの頂点位相は冬季では3:00すぎに,夏季では午後遅く認められ,季節的変動が大きかつた.しかしTempとPRの頂点位相は1年を通じて著しい変動はなかつた.今回分析し得た諸変数の自己測定はたとえ1日4回の測定頻度であつても日周リズムから年周リズムまでのリズム分析に有用であつた.またこの成績はリズム分析を行なうことによつてより適切で,より効果的な治療を行なうために,個人個人の高血圧治療に"chronotherapy"が適用されうることを示唆する.

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.

著者

Takamichi Kanbayashi Shunsuke Kobayashi Yuki Hatanaka Jun Shimizu Masahiro Sonoo

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.62, no.22, pp.3397-3400, 2023-11-15 (Released:2023-11-15)

参考文献数

14

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Grip myotonia can be a clue for the diagnosis of myotonic disorders. However, several clinical conditions cause delayed finger opening mimicking grip myotonia. We herein report a 44-year-old man with idiopathic inflammatory myopathy who presented with delayed finger opening resembling grip myotonia. The delayed finger opening differed from grip myotonia given the absence of the warm-up phenomenon and percussion myotonia, relative sparing of the thumb extension, and pronounced weakness of the extensor digitorum. Focusing on the extension of the thumb and other fingers may aid in the differentiation between delayed finger opening and true grip myotonia.