著者

Rina Ando Hirotaka Iwaki Tomoaki Tsujii Masahiro Nagai Noriko Nishikawa Hayato Yabe Ikuko Aiba Kazuko Hasegawa Yoshio Tsuboi Masashi Aoki Kenji Nakashima Masahiro Nomoto on behalf of the Parkinson's Disease Safe Driving Study Group of Japan

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.9653-17, (Released:2018-02-28)

参考文献数

22

被引用文献数

4

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Objective We conducted a study to obtain information that could be used to provide Parkinson's disease (PD) patients with appropriate advice on safe driving. Methods Consecutive PD patients who visited our office were studied. Among these patients, those who had experienced driving after being diagnosed with PD were interviewed by neurologists and a trained nurse to investigate their previous car accidents, motor function, cognitive function, sleepiness, levodopa equivalent dose (LED), and emotional dysregulation. The rates of major car accidents before and after the onset of PD were compared. Results Fifteen patients had experienced a major car accident resulting in human injury or serious property damage since the onset of PD. When the rates of major car accidents before and after the onset of PD were compared, the ratio was 4.3 (95% CI 1.9-9.7). The incidence of accidents after the onset of PD was correlated with age, disease duration, LED, the cognitive function (MMSE, MoCA-J), but not the motor symptom score (UPDRS part III at the time of the study). The Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP) score was also higher in patients with major car accidents. Conclusion The severity of symptoms (Hoehn-Yahr classification), cognitive function, and disease duration were expected to be risk factors for car accidents. However, the motor symptom score (UPDRS part III) was not associated with the incidence of major car accidents. In addition to a low cognitive function and the severity of symptoms, the QUIP score might be an independent factor that can be referenced when advising PD patients to refrain from driving.

著者

Haruki Koike Ryoji Nishi Shohei Ikeda Yuichi Kawagashira Masahiro Iijima Naoki Atsuta Tomohiko Nakamura Masaaki Hirayama Hidenori Ogata Ryo Yamasaki Jun-ichi Kira Masahisa Katsuno Gen Sobue

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0455-17, (Released:2018-02-28)

参考文献数

27

被引用文献数

6 11

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We herein report a woman with chronic inflammatory demyelinating polyneuropathy (CIDP) in whom positivity for anti-neurofascin 155 antibodies was revealed 23 years after the onset of neuropathy. The patient initially reported numbness in the face at 50 years of age and subsequently manifested features compatible to typical CIDP. Steroid administration initiated at 54 years of age ameliorated her neuropathic symptoms. Although the nerve conduction indices at 59 years of age deteriorated, those at 68, 72, and 73 years of age showed a gradual recovery. The deterioration and subsequent restoration of compound muscle action potential amplitudes was the most dramatic, suggesting that a conduction block can be reversed earlier than other electrophysiological indices.

著者

Kazuhiro Ota Toshihisa Takeuchi Kouki Kodama Haruhiko Ozaki Satoshi Harada Yuichi Kojima Sadaharu Nouda Masahiro Goto Kazuhide Higuchi

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.57, no.3, pp.343-344, 2018-02-01 (Released:2018-02-01)

参考文献数

7

被引用文献数

1 3

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Although S-1 chemotherapy is used widely as postoperative adjuvant chemotherapy for gastric cancer, some patients experience diarrhea during treatment. The patient was a 39-year-old woman who underwent distal gastrectomy for gastric cancer and who had started S-1 chemotherapy as postoperative adjuvant chemotherapy 1 week before her presentation. She experienced severe diarrhea immediately after starting the course of S-1 tablets. Capsule endoscopy revealed severe S-1-induced enteritis with extensive mucosal injury in the ileum and red intestinal fluid due to the oozing of blood in the ileum. After reducing the dosage of S-1, her diarrhea became milder, and she was able to continue S-1 chemotherapy.

著者

Manabu Hayashi Kazumichi Abe Masashi Fujita Ken Okai Atsushi Takahashi Hiromasa Ohira

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.57, no.17, pp.2451-2458, 2018-09-01 (Released:2018-09-01)

参考文献数

32

被引用文献数

16

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Objective Hyponatremia is closely associated with the pathophysiology of cirrhosis. However, the association between the serum sodium level and the response to tolvaptan is unclear. This study evaluated the factors related to the tolvaptan response and the prognosis in cirrhosis patients with ascites and hyponatremia. Methods We retrospectively reviewed the clinical records of cirrhosis patients hospitalized for treatment with tolvaptan. The associations of patient baseline characteristics with the tolvaptan response after one week and of the characteristics after one-month tolvaptan treatment with the prognosis were analyzed. Results We analyzed 83 cirrhosis patients with ascites, including 34 patients with hyponatremia. The response rates to tolvaptan in patients with serum sodium <130 mEq/L, 130-135 mEq/L, and >135 mEq/L were 20%, 66%, and 58%, respectively (p=0.22). The serum sodium level was associated with the response to tolvaptan [odds ratio=1.18; 95% confidence interval (CI) =1.02-1.37; p=0.029]. In patients with hyponatremia, the serum sodium level after 1-month tolvaptan treatment was increased compared to baseline (132 mEq/L vs. 136 mEq/L, p=0.006), and an increasing serum sodium level was associated with a lower risk of mortality (hazard ratio=0.85; 95% CI=0.75-0.97; p=0.016). The survival rate was higher in patients with an increase in the serum sodium level after 1 month than in patients with a decreased serum sodium level (p=0.023). Conclusion Tolvaptan treatment was effective in cirrhosis patients with ascites and hyponatremia, but a low serum sodium level was associated with non-responsiveness to tolvaptan. An increased serum sodium level after one-month tolvaptan treatment may positively influence the mortality risk in cirrhosis patients with hyponatremia.

著者

Kiyohito Hayashi Taizo Tasaka Toshinori Kondo Yuichi Ishikawa Makoto Goto Yoshiko Matsuhashi Yoshito Sadahira Takashi Sugihara Wada Hideho

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0317-17, (Released:2018-08-24)

参考文献数

28

被引用文献数

5

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Werner syndrome (WS) confers a high risk of the development of neoplasias, including hematological malignancies, and curative treatment for these malignancies is difficult to achieve. A 44-year-old man with myelodysplastic syndrome was admitted to our hospital. He was diagnosed with mutation-proven WS. He underwent cord blood transplantation (CBT) following fludarabine, busulfan, and melphalan administration. A chimerism analysis of his marrow blood on day 62 showed a donor pattern >95%, which confirmed engraftment. The patient lived for 15 months while maintaining remission of MDS without treatment-related toxicity. Our case shows that CBT can be a treatment modality for WS patients with hematological malignancies.

著者

Taku Sugawa Takaaki Murakami Daisuke Yabe Riko Kashima Makiko Tatsumi Shinobu Ooshima Erina Joo Keiko Wada Atsushi Yoshizawa Toshihiko Masui Yuji Nakamoto Yuki Yamauchi Yuzo Kodama Yoshiki Iemura Masahito Ogura Akihiro Yasoda Nobuya Inagaki

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.1173-18, (Released:2018-08-10)

参考文献数

22

被引用文献数

11

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The delayed diagnosis of insulinoma remains a clinical issue. One of the main causes of such a delay is hypoglycemia unawareness. A 53-year-old woman fell unconscious during postprandial exercises. Flash glucose monitoring (FGM) systems revealed glucose profiles with fasting hypoglycemia, which facilitated the clinical diagnosis of insulinoma even though she was unaware of her hypoglycemia. The preoperative comparison of the blood glucose values provided by FGM with those obtained from capillary blood were consistent. Thus, FGM may have potential utility in revealing the presence of insulinoma-induced hypoglycemia.

著者

Yasuyoshi Shikama Jun-ichi Kitazawa Nobuo Yagihashi Osamu Uehara Yuuji Murata Nobuhisa Yajima Ryuichi Wada Soroku Yagihashi

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.49, no.5, pp.397-401, 2010 (Released:2010-03-01)

参考文献数

9

被引用文献数

43 111

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A 60-year-old woman diabetic patient presented with a subcutaneous mass in right lower abdominal quadrant where recombinant human insulin or insulin analogue had been injected for 16 years. Her diabetes has been insulin resistant with insufficient blood glucose control. The mass was extirpated under the suspicion of neoplasm but it was found to consist of diffuse deposition of eosinophilic amorphous materials mixed with inflammatory change. Congo-red staining demonstrated positive red color and yielded green birefringence by polarized microscopy. Pre-digestion with potassium permanganate was incomplete to quench positive Congo-red stains. Immunostains with insulin antibody were positive for this deposition but not so with amylin or AA or AL amyloid. Thus, the mass was considered to be localized amyloidosis composed of iatrogenic A-Ins type amyloid. Thus, the case suggested that her insulin resistance, i.e. refractoriness of insulin treatment, may be ascribed to poor penetration of injected insulin and human insulin itself or its analogue is amyloidogenic to form a local mass.

著者

Yasuharu Tokuda Masahiro Koizumi Gerald H. Stein Richard B. Birrer

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.48, no.7, pp.537-543, 2009 (Released:2009-04-01)

参考文献数

33

被引用文献数

6 10

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Objective To derive and validate a clinical prediction model with high sensitivity for differentiating aseptic meningitis (AM) patients from bacterial meningitis (BM) patients. Methods We developed the model using the derivation cohort in a community rural hospital in Okinawa and assessed its performance using the validation cohort in a metropolitan urban hospital in Tokyo. There were 66 (39.5%) and 5 (17.9%) adult patients with BM among the derivation (n=167) and the validation cohort (n=28), respectively. Recursive partitioning analysis was used to determine the important classification variables and to develop a sensitive model to safely exclude BM. Results The model produced high- and low-risk groups based on the following: 1) Gram stain, 2) CSF neutrophil percent ≤15%, 3) CSF neutrophil count ≤150 cells/mm3, and, 4) mental status change. Among the derivation cohort, there were 65 patients with BM in the high-risk group (n=76), while only one patient with BM was noted (sensitivity, 99%) in the low-risk group (n=91). Among the validation cohort, there were 5 patients with BM in the high-risk group (n=7), while no patient was classified with BM (sensitivity, 100%) in the low-risk group (n=21). Conclusion This simple and sensitive model might be useful to safely identify low-risk patients for BM who would not require antibiotic treatment.

著者

Satoshi Murao Takaaki Kiuchi

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.57, no.13, pp.1945-1946, 2018-07-01 (Released:2018-07-01)

参考文献数

2

被引用文献数

1

著者

Minami Taki Yoshio Shimojima Ayako Nogami Takuhiro Yoshida Michio Suzuki Koichi Imaoka Hiroki Momoi Norinao Hanyu

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.57, no.2, pp.273-277, 2018-01-15 (Released:2018-01-15)

参考文献数

10

被引用文献数

14

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Sepsis caused by a Capnocytophaga canis infection has only been rarely reported. A 67-year-old female with a past medical history of splenectomy was admitted to our hospital with fever and general malaise. She had been bitten by a cat. She showed disseminated intravascular coagulation and multi-organ failure because of severe sepsis. On blood culture, characteristic gram-negative fusiform rods were detected; therefore, a Capnocytophaga species infection was suspected. A nucleotide sequence analysis revealed the species to be C. canis, which was newly identified in 2016. C. canis may have low virulence in humans; however, C. canis with oxidase activity may cause severe zoonotic infection.

著者

Tetsuaki Shoji Hidenori Mizugaki Yasuyuki Ikezawa Megumi Furuta Yuta Takashima Hajime Kikuchi Houman Goudarzi Hajime Asahina Junko Kikuchi Eiki Kikuchi Jun Sakakibara-Konishi Naofumi Shinagawa Ichizo Tsujino Masaharu Nishimura

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.57, no.12, pp.1769-1772, 2018-06-15 (Released:2018-06-15)

参考文献数

17

被引用文献数

2

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This report describes the case of a 66-year-old man with non-small cell lung cancer and venous thromboembolism (VTE). Unfractionated heparin (UFH) was initially used to control VTE before chemotherapy. However, switching UFH to warfarin or edoxaban, a novel oral anticoagulant (NOAC), failed. Chemotherapy was then administered to control the tumor which was thought to have been the main cause of VTE, which had been treated by UFH. After tumor shrinkage was achieved by chemotherapy, we were able to successfully switch from UFH to edoxaban. Controlling the tumor size and activity enabled the use of edoxaban as maintenance therapy for VTE.

著者

Haruhi Yamada Yukiko Katsumori Miki Kawano Shumpei Mori Ryo Takeshige Jun Mukai Hiroshi Imada Hiroyuki Shimoura Hachidai Takahashi Tadasu Horai Yutaka Okita Ken-ichi Hirata

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.57, no.12, pp.1763-1767, 2018-06-15 (Released:2018-06-15)

参考文献数

12

被引用文献数

5

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A 73-year-old man, with congestive heart failure due to combined valvar disease, underwent curative surgery. Although the surgery was successful, his clinical course was eventful because of pulmonary complications, and he began to deteriorate mentally. Quetiapine was prescribed, which appeared to effectively settle his mental status. Following the administration of quetiapine, however, he developed acute kidney injury (AKI) that required continuous hemodiafiltration. Subsequent to discontinuation of quetiapine, his renal function gradually improved. Atypical antipsychotic drugs, including quetiapine, are frequently used to treat delirium in elderly patients in the intensive-care setting. This case highlights a potential risk of quetiapine-related AKI.

著者

Yutaka Shimada Makoto Fujimoto Tatsuya Nogami Hidetoshi Watari Hideyuki Kitahara Hiroki Misawa Yoshiyuki Kimbara Kei-ichiro Kita

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.57, no.12, pp.1733-1740, 2018-06-15 (Released:2018-06-15)

参考文献数

26

被引用文献数

11

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A 67-year-old woman experiencing coughing visited a clinic and was prescribed drugs, including shosaikoto extract, for 4 days. She subsequently suffered from liver injury, but her condition improved after the discontinuation of all medications. Approximately 1 year later, she experienced fatigue, consulted another clinic, and received saikokeishikankyoto extract for 21 days. She subsequently suffered liver injury again. Both shosaikoto and saikokeishikankyoto contain Scutellariae Radix. This case is thought to be one of recurrent drug-induced liver injury caused by the incidental readministration of a Kampo formula containing Scutellariae Radix. An awareness of adverse drug events caused by Kampo formulas, especially those containing Scutellariae Radix, is essential.

著者

Masaki Okamoto Masaki Tominaga Shigeki Shimizu Chiyo Yano Ken Masuda Masayuki Nakamura Yoshiaki Zaizen Takashi Nouno Satoshi Sakamoto Mitsuru Yokoyama Tomotaka Kawayama Tomoaki Hoshino

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.56, no.24, pp.3323-3326, 2017-12-15 (Released:2017-12-15)

参考文献数

19

被引用文献数

11

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A 40-year-old female dental technician visited our hospital for the investigation of a chest X-ray abnormality. Chest computed tomography demonstrated centrilobular nodules and lung volume reduction, and her serum KL-6 level was elevated. A histological analysis of the specimens obtained on a surgical lung biopsy showed peribronchiolar fibrosis with pigmented macrophages and cholesterol clefts. An energy-dispersive X-ray analysis showed that these lung tissues contained some metals, including indium. The serum indium level was also elevated. We diagnosed this patient with pneumoconiosis caused by exposure to sandblasting certain dental metals. This is the first reported case of pneumoconiosis in a dental technician associated with exposure to indium.

著者

片桐 秀樹

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.98, no.5, pp.1127-1133, 2009-05-10

参考文献数

12

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個体全身の代謝を調節するには,臓器間の代謝情報のやり取りが必須であり,肥満や糖尿病は,この臓器間連絡が破綻した状態とも言える.最近我々は,自律神経系,特に求心路がこの臓器間の代謝情報連絡に重要な役割を果たしていることを見出した.まず,脂肪組織からの求心性神経シグナルが,食欲を調節していること,次に,肝からの神経ネットワークが,過栄養時に基礎代謝を亢進させ,肥満を予防する機能を果たしていること,さらに,肝からの別の神経ネットワークが,膵β細胞増殖を惹起することを明らかにした.これらは食欲,エネルギー消費,インスリン分泌といった,エネルギー代謝・糖代謝の中心を制御するものであり,この機構に介入することにより,体重調節や膵β細胞再生といった肥満や糖尿病の治療につながる成果を得ている.またこのことは,末梢組織での代謝状況を,脳が随時把握し,全身の代謝を統御しているという新しい概念を示すものである.<br>

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

vol.57, no.18, pp.2607-2612, 2018-09-15 (Released:2018-09-15)

参考文献数

56

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

Yuko Iwashita Masaki Ohya Satoko Kunimoto Yu Iwashita Toru Mima Shigeo Negi Takashi Shigematsu

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0108-17, (Released:2018-05-18)

参考文献数

25

被引用文献数

11

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Objective This report presents a part of a survey pertaining to drug burden in maintenance hemodialysis patients in Japan. Methods A patient-reported questionnaire-based survey was conducted from September to November 2016 in six regions in Japan. Patients or Materials A total of 700 patients (50-79 years old) on maintenance hemodialysis for >3 years and members of the Japan Association of Kidney Disease Patients (JAKDP) were provided with the questionnaire. They were randomly selected using stratified sampling according to patient distribution observed from the Japanese Society for Dialysis Therapy Renal Data Registry (JSDT JRDR). Results A total of 524 (74.9%) patient questionnaires were evaluated (mean [standard deviation; SD] age, 66.6 [7.2] years; males, 63.4%; dialysis vintage, 16.9 [9.1] years). Patients' age, gender, and regional distribution were similar to the JSDT JRDR. They were taking an average (SD) of 16.4 (8.34) and 16.3 (8.55) oral medications/day on dialysis and nondialysis days, respectively. A majority of the patients were taking ≥10 oral medications/day on dialysis (75.1%) and nondialysis (74.4%) days, with phosphate binders being the most taken (7.0 tablets/day). A similar proportion (74.4%, 72.9%, respectively) was taking ≥6 different types of oral medications/day. Most patients were taking oral medications 3 (31%, 33%), 4 (24%, 22%), and ≥5 times (31%, 30%) a day, respectively. The drug burden was similar on dialysis and nondialysis days and did not vary with dialysis vintage. Conclusion The number, type, and frequency of oral medications in maintenance hemodialysis patients are high in Japan. The proportion of phosphate binders was highest among the prescription medications.

著者

今西 康二

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.70, no.7, pp.984-991, 1981

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中枢神経感染症の髄液細胞の形態と機能について検索し,疾病の病態および鑑別診断に役立つか否かについて検討した.独自に考案した浮遊細胞収集法は細胞の回収率,形態保存ともに良好であつた.細胞組成では小リンパ球はウイルス性髄膜炎で,マクロファージは非感染性神経疾患で,多核球は化膿性髄膜炎で,髄膜剥離細胞は結核性髄膜炎でそれぞれ優位であつた. lysosomal enzyme (acid-phosphatase, β-galactosidase)はマクロファージ系細胞で活性がみられ,種々の疾患で陽性であつたが,特に化膿性および結核性髄膜炎で高活性を示し臨床経過とよく相関していて補助診断価値があつた.また非感染性神経疾患にも活性がみられ, lysosomal enzymeは感染症に特異的なものではなかつた. nitroblue tetrazolium還元はマクロファージ系細胞および多核球でみられた.髄液細胞ではむしろマクロファージ系細胞により還元能の亢進を認め,その還元能の程度は中枢神経感染症の病勢とよく相関していた.また髄液細胞のNBT還元能は定量的にも測定可能であつた.多核球よりマクロファージ系細胞にこより還元能があることから,多核球が多く出現する病態の少ない中枢神経疾患においてマクロファージ系細胞でのNBT還元能の解析は,疾病の病態を知る上で重要と思われた.

著者

Osamu RIKITAKE Takanobu SAKEMI Yasuji YOSHIKAWA Yoshiro NAGANO Teruo WATANABE

出版者

The Japanese Society of Internal Medicine

雑誌

Japanese Journal of Medicine (ISSN:00215120)

巻号頁・発行日

vol.28, no.4, pp.523-526, 1989 (Released:2006-03-27)

参考文献数

21

被引用文献数

9 15

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A 57-year-old woman who had had renal amyloidosis with nephrotic syndrome for five years was found to have the Fanconi syndrome and monoclonal lambda light-chain proteinuria. The amyloidosis of this patient was of primary type on the basis of the permanganate-resistent amyloid, the presence of monoclonal light-chain proteinuria, and the absence of clinical and histologic evidence of multiple myeloma. To best of our knowledge, this is the first case report in which primary amyloidosis with monoclonal lambda light-chain proteinuria was accompanied by adult Fanconi syndrome.

著者

Daijun Kirigaya Takeo Nakayama Tatsuro Ishizaki Shunya Ikeda Toshihiko Satoh

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.50, no.22, pp.2793-2800, 2011 (Released:2011-11-15)

参考文献数

31

被引用文献数

13 33

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Objective The aim of this study was to evaluate the adherence of guidelines for the management and treatment of glucocorticoid-induced osteoporosis, and to investigate whether it is associated with factors such as age, gender, glucocorticoid dose, physician specialty, and size of facility. Methods This was a cross-sectional study utilizing administrative data from a database of health insurance claims (2004-2007); 2,368 patients who received glucocorticoid treatment for≥90 days were extracted. The guideline adherence was determined by evaluations based on glucocorticoid prescription dose, prescription of anti-osteoporosis drugs, and whether or not bone mineral density was measured. Results Overall proportion of guideline adherence was 23.3%. In cases in which the equivalent dose of prednisolone was<5 mg/d and≥5 mg/d, the adherence was 8.3% and 30.5% respectively. Factors correlating with low adherence included young age, male gender, and lower glucocorticoid doses. Surgery and otolaryngology specialties had lower adherence than internal medicine. Smaller clinical facilities had lower adherence than larger facilities. Conclusion The adherence of guidelines for the management and treatment of glucocorticoid-induced osteoporosis is still low, and improvements in treatment quality can be expected through education of patient groups and medical care providers with large deviations from the guidelines.