著者

Kosuke Matsuzono Yoshinori Mita Goro Imai Shigeru Fujimoto

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.1236-22, (Released:2023-03-22)

参考文献数

14

被引用文献数

1

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Rivastigmine is a highly effective drug for treating Alzheimer's disease. However, its addiction can be fatal, so proper use of this transdermal drug is needed. We herein report an 85-year-old woman with Alzheimer's disease who inappropriately placed rivastigmine patches on the back of her neck. She suffered from acute cholinergic syndrome, hypersalivation, anorexia, dyspnea, and vomiting. These symptoms disappeared when the improper use of rivastigmine patches was ceased. This case serves as a warning to physicians and pharmacists of the risk associated with the improper placement of rivastigmine patches.

著者

Hideyuki Imai Hiroto Nishikawa Asami Suzuki Eriko Kodama Tatsuya Iida Kentaro Mikura Mai Hashizume Yasuyoshi Kigawa Rie Tadokoro Chiho Sugisawa Kei Endo Toru Iizaka Fumiko Otsuka Shoichiro Nagasaka

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.61, no.19, pp.2899-2903, 2022-10-01 (Released:2022-10-01)

参考文献数

23

被引用文献数

1 8

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A 54-year-old man had been drinking approximately 1.2 L of soy milk (equivalent to approximately 310 mg of isoflavones) per day for the previous 3 years. He then developed erectile dysfunction and gynecomastia. On an examination in our department in May, blood tests showed low gonadotropin and testosterone levels, indicative of secondary hypogonadism. He stopped drinking soy milk on his own in June of that year. When he was admitted in August, blood tests showed an improved gonadal function. Secondary hypogonadism caused by the excessive intake of isoflavones in soy milk was diagnosed. In men, an excessive intake of isoflavones may cause feminization and secondary hypogonadism.

著者

Kensuke Kitsugi Kazuhito Kawata Moe Matsumoto Masahiro Umemura Tomohiko Hanaoka Maho Yamashita Shingo Takatori Jun Ito Kazuyoshi Ohta Takeshi Chida Hidenao Noritake Takafumi Suda

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0315-22, (Released:2022-09-06)

参考文献数

48

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A 59-year-old woman presented to our hospital with liver dysfunction. Imaging revealed multiple lesions in the liver. The patient was diagnosed with peliosis hepatis using percutaneous and laparoscopic biopsies. However, her condition worsened with the appearance of new, obvious mass-forming lesions. Therefore, she underwent a second percutaneous biopsy of these lesions and was diagnosed with hepatic angiosarcoma. Her condition progressed rapidly, and she died two weeks after the diagnosis. Diagnosis of hepatic angiosarcoma in the early stages is difficult. It should be noted that hepatic angiosarcoma may be associated with the development of peliosis hepatis.

著者

Masaya Iwamuro Takehiro Tanaka Sakiko Kuraoka Kenta Hamada Makoto Abe Yoshiyasu Kono Hiromitsu Kanzaki Seiji Kawano Yoshiro Kawahara Hiroyuki Okada

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.61, no.13, pp.1931-1938, 2022-07-01 (Released:2022-07-01)

参考文献数

16

被引用文献数

4

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Objective This study aimed to determine the prevalence and endoscopic features of zinc acetate dihydrate tablet-associated gastric lesions. Methods We retrospectively examined the endoscopic features of 47 patients taking zinc acetate dihydrate tablets who underwent esophagogastroduodenoscopy. Results Gastric mucosal alterations, including redness, erosions, ulcers, and adhesion of the white coat, were observed in 29 of 47 patients (61.7%). Among patients with gastric lesions (group A), there was a significantly higher percentage of symptomatic patients in comparison to patients without lesions (group B) (65.5% vs. 22.2%; p<0.01). The background characteristics of the two groups did not differ to a statistically significant extent. On esophagogastroduodenoscopy, mucosal redness (n=27, 93.1%), erosions (n=26, 90.0%), adhesion of the white coat (n=25, 86.2%), and ulcers (n=9, 31.0%) were observed. None of the 19 patients who previously underwent esophagogastroduodenoscopy had gastric lesions before starting zinc acetate dihydrate. Esophagogastroduodenoscopy was performed after the cessation of zinc acetate dihydrate intake in six patients, and revealed the resolution of gastric lesions. Conclusion Gastric lesions were observed in 29 of 47 patients who were taking zinc acetate dihydrate tablets. The most common endoscopic findings were mucosal redness (93.1%), erosions (90.0%), adhesion of the white coat (86.2%), and ulcers (31.0%). Although the exact pathogenesis is uncertain, we believe that understanding the unique manifestations of this gastric lesion will help physicians manage adverse events in patients taking zinc acetate dihydrate tablets.

著者

Mizuki Asako Hitomi Matsunaga Kazumasa Oka Shuji Ueda

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.9598-22, (Released:2022-05-31)

参考文献数

2

被引用文献数

3

著者

Toshinaru Kawakami Kazuyuki Yahagi Masahiro Sekiguchi Taiki Ishizawa Hideaki Nonaka Naoto Setoguchi Yusuke Watanabe Masaaki Nakase Yu Horiuchi Masahiko Asami Hitomi Yuzawa Kota Komiyama Jun Tanaka Jiro Aoki Kengo Tanabe

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.61, no.9, pp.1371-1374, 2022-05-01 (Released:2022-05-01)

参考文献数

10

被引用文献数

4

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We herein report a case of acute myocarditis possibly related to the second dose of an mRNA-coronavirus disease 2019 vaccine in a 45-year-old woman with no remarkable medical history. She had a fever for one week following the second dose of the mRNA-1273 severe acute respiratory syndrome coronavirus 2 vaccine. One week later, she presented with chest pain and electrocardiogram changes. Her serum troponin levels were elevated upon admission. Echocardiography showed segmental wall motion abnormalities of the apex, apical portion of the anterior and inferior walls. The findings of cardiac magnetic resonance imaging were consistent with acute myocarditis.

著者

Chiaki Yanagihara Teru Kumagi Tatsuro Tasaka Yuta Watanabe Tamami Kono Kiyotaka Ohshima Akiyoshi Ogimoto

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.8479-21, (Released:2021-11-06)

参考文献数

15

---

We herein report two cases of potentially life-threatening arrhythmia due to hyperkalemia triggered by the excessive consumption of "Hoshi-Imo" (dried sweet potato). Both patients with chronic renal disease on renin-angiotensin-aldosterone system inhibitors presented at the emergency room with non-specific symptoms. Electrocardiograms revealed potentially life-threatening arrhythmia due to hyperkalemia in both cases: sinus arrest with a ventricular escape rhythm, tall and peaked T waves; and a widened QRS complex in a nearly sine-wave configuration without discernible P wave. Both patients fully recovered after intensive care for hyperkalemia. Physicians should recognize the excessive consumption of "Hoshi-Imo" may lead to the development of life-threatening arrhythmia, especially in patients with risk factors for hyperkalemia.

著者

Hiroe Sato Noriaki Iino Riuko Ohashi Takako Saeki Tomoyuki Ito Maki Saito Yutaka Tsubata Suguru Yamamoto Shuichi Murakami Takeshi Kuroda Yoshinari Tanabe Junichi Fujisawa Takehiro Murai Masaaki Nakano Ichiei Narita Fumitake Gejyo

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.51, no.4, pp.425-429, 2012 (Released:2012-02-15)

参考文献数

24

被引用文献数

6 14 2

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Hypogammaglobulinemia is a reduction or absence of immunoglobulin, which may be congenital or associated with immunosuppressive therapy. In addition to infectious diseases, autoimmune diseases have also been reported in patients with hypogammaglobulinemia. A 26-year-old man with hypogammaglobulinemia had multiple joint pain and swelling with erosive changes in the proximal interphalangeal joint of the right middle finger on X-ray film, mimicking rheumatoid arthritis (RA). As polyarthritis remained after immunoglobulin replacement therapy and there was no finding indicating any infection at that time, a diagnosis of RA was made. Prednisolone and etanercept were started. However, his polyarthritis did not improve and he developed meningitis and massive brain ischemia. Finally, a diagnosis of disseminated Mycoplasma hominis infection was made. The differential diagnosis of polyarthritis in patients with hypogammaglobulinemia should strictly exclude Mycoplasma infection by culture with special media or longer anaerobic culture, and molecular methods for mycoplasma.

著者

Yuki Kataoka Shunkichi Ikegaki Daisuke Kato Toshihiko Takada Yasushi Tsujimoto Sho Sasaki Sei Takahashi

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.2312-18, (Released:2019-03-28)

参考文献数

21

被引用文献数

3

---

Objective To describe the clinical research support systems in Japanese board certification programs of internal medicine and to assess the relationship between these support systems and the scholarly activities of residents. Methods In 2018, a 26-item web questionnaire was mailed to 542 points of contact of hospitals listed as certified residency programs of internal medicine in order to obtain information about the presence of a research support system and scholarly activity from 2016. We used hospital characteristic data from the Japanese Diagnostic Procedure Combination database, a national inpatient database, and the annual report of the Japanese Society of Internal Medicine. Results A total of 228 hospitals (42%) responded to the survey. There were regular research lectures in 129 hospitals (57%), protected time (time to perform research during working hours) in 53 hospitals (23%), research consultations in 175 hospitals (77%), regular journal clubs in 213 hospitals (77%), regular research conferences in 151 hospitals (66%), data warehouses in 139 hospitals (61%), and financial research support from the hospital budget in 140 hospitals (61%). A multivariate analysis showed that none of the research support systems were related to the number of conference presentations. In contrast, protected time (odds ratio [OR] 3.66, 95% confidence interval [CI] 1.43-9.39) and regular research conferences (OR 2.20, 95% CI 1.14-4.23) were related to the presence of clinical research presentations in scientific conferences hosted by residents. Conclusion Protected time and regular research conferences were related to the scholarly activity of residents in Japanese teaching hospitals.

著者

Tomoharu Ishikawa Muneto Tatsumoto Katuhiro Maki Minoru Mitsui Hiroshi Hasegawa Koichi Hirata

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.2206-18, (Released:2019-02-01)

参考文献数

33

被引用文献数

9

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Objectives Sound hypersensitivity is highly comorbid with migraine headaches. To elucidate the pathogenic mechanism of migraine attacks, we must first identify the types of everyday environmental sounds they perceive as unpleasant and clarify the acoustic properties of such sounds. This study aimed to clarify the true nature of "noise," i.e. everyday sounds perceived as unpleasant by migraineurs, by evaluating their subjective comfort/discomfort in response to several sounds commonly heard in everyday life. Methods Participants were presented with 20 environmental sounds they would likely hear daily. Subjects rated the pleasantness/unpleasantness of each stimulus using a nine-step scale. Patients We recruited 50 adults with migraine headaches (46 women, 4 men) and 50 healthy controls (35 women, 15 men). Results Migraineurs provided statistically significantly lower (more unpleasant) ratings to ambulance sirens, police car sirens, and railroad crossing bells than did controls. Our analysis also investigated the acoustic characteristics associated with higher rating gaps between the two groups. Greater divergence in ratings for the same stimulus was associated with less power (smaller amplitude envelope) and slower temporal variation in signals in the 400-Hz band. Conclusion We identified specific signal components associated with different subjective (un) pleasantness scores between migraineurs and healthy adults, which may lead to the elucidation of the pathogenic mechanism underlying migraine attacks triggered by sound.

著者

Nayu Tamura Takafumi Obara Taihei Yamada Tsuyoshi Nojima Shunsuke Nakamura Yasuhiro Koide Makoto Takaoka Hiromichi Naito Atsunori Nakao

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.61, no.12, pp.1913-1916, 2022-06-15 (Released:2022-06-15)

参考文献数

13

被引用文献数

3

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Prolonged vitamin C deficiency can result in numerous metabolic abnormalities like impaired tissue repair and defective collagen synthesis. This case report describes a middle-age Japanese man presenting painful purpura on his lower limbs, severe anemia, and altered consciousness. The patient had been eating a selective diet lacking in vegetables and fruits since childhood. A serum analysis demonstrated a low level of vitamin C. The patient was treated with vitamin supplementation and psychological intervention. Scurvy is an under-considered illness with a favorable prognosis if diagnosed early while it is still sporadically encountered in some patients with malabsorption or malnutrition even in modern times.

著者

Akira Yokote Shinsuke Fujioka Nobutaka Takahashi Takayasu Mishima Yoshio Tsuboi

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.61, no.11, pp.1775-1777, 2022-06-01 (Released:2022-06-01)

参考文献数

15

被引用文献数

7

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We herein report a 71-year-old woman presented with a fever, arthralgia, general malaise and leg muscle stiffness following administration of the COVID-19 mRNA vaccine (Comirnaty, Pfizer-BioNTech). Laboratory findings showed an elevated C-reactive protein level and erythrocyte sedimentation rate. In addition, Gallium-67 scintigraphy demonstrated an increased uptake in multiple joints. Typing of human leukocyte antigen (HLA) revealed the presence of the DRB1*0404/*0803 allele. These findings met the diagnostic criteria for polymyalgia rheumatica (PMR), and when we started steroid treatment, her symptoms improved rapidly. This patient developed PMR after receiving a COVID-19 mRNA vaccine (Comirnaty, Pfizer-BioNTech). This case is considered to be valuable, as the HLA-DRB1 allele was also confirmed.

著者

Tomohiro Nakayama Yutaka Kozu

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0414-22, (Released:2022-11-30)

参考文献数

22

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Familial Mediterranean fever (FMF) is an inherited autoinflammatory disease associated with the MEFV gene. FMF is common in Mediterranean peoples but not highly recognized in Japan. We herein report two cases of Japanese FMF patients who were diagnosed by genetic testing for the MEFV gene during the Coronavirus disease 2019 (COVID-19) pandemic. Both patients presented with symptoms similar to COVID-19, which delayed the definitive diagnosis. Patients with a confirmed diagnosis of FMF may be eligible for physical, emotional, and financial benefits. Therefore, the COVID-19 pandemic highlights the importance of differentiating the diagnosis by genetic testing.

著者

Daisuke Miyagishima Masanori Inoue Kaori Kinjo Kentaro Fujimoto Hiromasa Suzuki Kaoru Sugimura Michio Kubota Akihiko Nakagawa Yasuharu Kikuchi Masami Shinozaki Hajime Fujimoto

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.9181-21, (Released:2022-04-23)

参考文献数

35

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Shiitake mushrooms are edible mushrooms popular in East Asian cuisine. We herein report a 69-year-old man with abdominal distension and vomiting after ingesting several pieces of sautéed Shiitake mushrooms. Abdominal computed tomography (CT) revealed ring-shaped and crescent-shaped low-density objects (−100 to −300 Hounsfield units) in the ileum. Based on the specific shapes and CT numbers of the foreign bodies, he was diagnosed with small bowel obstruction due to Shiitake mushrooms. After conservative treatment, he passed four pieces of Shiitake mushrooms. Despite the rarity, the condition can be diagnosed before exploratory surgery by careful and detailed interpretation of CT findings.

著者

Takuto Shonai Fumihiko Kimura Junichi Watanabe

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.9177-21, (Released:2022-03-19)

参考文献数

22

被引用文献数

8

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We herein report two cases of coronavirus disease 2019 (COVID-19) vaccine-induced immune thrombocytopenia (ITP). A 69-year-old Japanese man developed severe thrombocytopenia after COVID-19 vaccination. He had oral bleeding and hemoptysis but no thrombotic symptoms. He improved rapidly with oral prednisolone therapy. A 34-year-old Japanese woman had generalized purpura after COVID-19 vaccination. Her platelet count improved rapidly after treatment with prednisolone and eltrombopag. The occurrence of two cases of ITP after COVID-19 vaccination at a single institution suggests that there could be more such undiagnosed cases, especially cases of mild secondary ITP.

著者

Toshimasa Hayashi Yosuke Miura Hiroki Kawabata

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0432-17, (Released:2018-03-30)

参考文献数

1

被引用文献数

1

著者

渡辺 彰 名村 正伸 金谷 法忍 大家 他喜雄 林 守源

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.76, no.9, pp.1409-1413, 1987

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症例は26才男性で,急性左心不全で入院した.心電図は心室内伝導傷害と前側壁心筋梗塞の所見を示した. CPKは最高10470IUに上昇し, LDHは6620IUに上昇した.入院第51病日に心臓カテーテル検査を施行した.左室造影では心筋収縮能はび漫性に低下していた.選択的冠動脈造影では左冠動脈主幹部に長さ1.6cmの辺縁が平滑な50%の狭窄を認めた.また,前下行枝に長さ2.8cmにわたり冠動脈内陰影欠損を認めた.血中ウイルス学的検査でムンプスウイルス抗体価が有意に変動した.発症1年後の右室心内膜心筋生検から心筋炎と診断した.以上より,冠動脈病変を呈したムンプスウイルス心筋炎と診断し,冠動脈病変の病因として冠動脈炎が考えられた.

著者

Shinichi Matsuzaki Hiroyuki Kamiya Ichiro Inoshima Yasutaka Hirasawa Osamu Tago Masashi Arai

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.81-86, 2022-01-01 (Released:2022-01-01)

参考文献数

29

被引用文献数

1 12

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A 65-year-old man experienced cough and shortness of breath 3 days after receiving the first dose of the Pfizer-BioNTech coronavirus disease 2019 (COVID-19) vaccine. Chest X-ray revealed bilateral infiltrates, and the desaturation deteriorated rapidly. The symptoms and radiographic abnormalities rapidly improved after the initiation of corticosteroid therapy. Intradermal testing of the Pfizer-BioNTech COVID-19 vaccine showed a delayed positive reaction. Based on these findings, the patient was diagnosed with COVID-19 vaccine-induced pneumonitis. The timing of the onset of pneumonitis after vaccination and the results of intradermal testing suggest that Type IV hypersensitivity against COVID-19 vaccine may have been responsible for this clinical condition.

著者

Kazuaki Aoki Shungo Yamamoto Kentaro Tochitani

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.9469-22, (Released:2022-04-23)

参考文献数

2

被引用文献数

7

著者

Yasutaka Mochizuka Masato Kono Mineo Katsumata Ryutaro Hirama Masayuki Watanuki Yuiko Oshima Kenichiro Takeda Akari Tsutsumi Hideki Miwa Yoshihiro Miki Dai Hashimoto Noriyuki Enomoto Yutaro Nakamura Takafumi Suda Hidenori Nakamura

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.7533-21, (Released:2021-07-30)

参考文献数

18

被引用文献数

3

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A 67-year-old man was admitted to our hospital with cough and fatigue. He had had long-term exposure to silica due to cement processing. Chest computed tomography showed bilateral centrilobular nodules, and hilar and mediastinal lymphadenopathy with calcification, suggesting chronic silicosis. Within a few months, these nodules enlarged, and bilateral patchy consolidations appeared. A lung biopsy revealed sarcoid-like granulomas with birefringent particles under polarized light without malignancy or infection. He was diagnosed with silicosis-associated sarcoid-like granulomatous lung disease, rather than sarcoidosis, according to the clinicopathological findings. His pulmonary manifestations improved after the discontinuation of silica exposure and combination therapy of corticosteroid and azathioprine.