著者

高橋 和郎 北川 達也

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.65, no.3, pp.256-262, 1976

被引用文献数

1

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最近多発した浮腫を伴う急性多発性神経炎25例につき,発生頻度ならびに成因について検討した.年次別にみると昭和48年以後年ごとに多発する傾向があり,春から初秋にかけて発症することが多く,とくに若年男性に多い.食事は全例白米食で,強化米はなく,インスタント食品の多食,高糖質,低VB₁の清凉飲料水の多飲が目立つた.又発症時激しい運動をしているものが多かつた.詳細に検討した2症例において血中B₁濃度はやや低値,乳酸,ピルビン酸濃度はやや高値,平日ならびにB₁負荷時の尿中B₁排泄量は明らかな低値を示した.さらにB₁投与が特異的に症状改善をもたらす所などから,本症が脚気neuropathyであることを明らかにした.末梢神経は軸索変性を示し,とくに初期には特異な管状構造物が軸索内に多数出現した.有髄線維に比し,無髄線維の変化は軽度であつた.最近脚気が増加し始めたことは,本邦栄養食品に何らかの欠陥が生じ始めたことを示すものである.

著者

Fumio Terasaki Nobukazu Ishizaka

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.55, no.9, pp.1041-1042, 2016 (Released:2016-05-01)

参考文献数

22

被引用文献数

4 3

著者

Motohisa Yamamoto Tetsuya Tabeya Yoshiharu Masaki Chisako Suzuki Yasuyoshi Naishiro Keisuke Ishigami Hidetaka Yajima Yui Shimizu Mikiko Obara Hiroyuki Yamamoto Toshiaki Sugaya Hiroki Takahashi Kohzoh Imai Yasuhisa Shinomura

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.51, no.3, pp.325-328, 2012 (Released:2012-02-01)

参考文献数

22

被引用文献数

10 11

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A 58-year-old woman with a three-year progressive history of chronic arthritis, had become disabled due to general malaise and fever. Her laboratory data revealed hyperuricemia and elevated levels of C-reactive protein. Neither rheumatoid factor nor anti-citrullinated peptide antibodies were present. We diagnosed her with tophaceous gout with uric crystalline revealed by the arthrocentesis of the elbow. 99mTc scintigraphy also disclosed a significant uptake in the cervical spine. The CT of the patient's cervical spine revealed significant bone erosion and destruction. We diagnosed the cervical involvement of gout based on the exclusion of infections and sarcoidosis. Rheumatologists should be aware of this rare association.

著者

Hiroyoshi Iwata Makoto Kaneko Takao Wakabayashi Shinichiro Ueda

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.9338-22, (Released:2022-02-26)

参考文献数

5

被引用文献数

1

著者

Yoshiro Hadano Hajime Yoshii Michio Hayashi Hiroshi Oono Reiko Tanaka

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.54, no.9, pp.1141-1143, 2015 (Released:2015-05-01)

参考文献数

6

被引用文献数

1

---

Cryptococcus arboriformis (C. arboriformis) is a novel Cryptococcus species belonging to the genus Trichosporonales. This novel species was identified definitively in 2007 using D1/D2 26S ribosomal DNA gene sequencing. In this article, we present a rare case of central line-associated bloodstream infection caused by C. arboriformis with successful treatment of this infection.

著者

Jumpei Taniguchi Kei Nakashima Hiroyuki Ito Yu Tanaka Ayumu Otsuki Akihiro Shiroshita Michinori Yoshimi Norihiko Kubota Masahiro Aoshima

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.4624-20, (Released:2020-06-15)

参考文献数

24

---

Sarcoidosis is a multisystem granulomatous disease of unknown etiology and is pathologically characterized by non-caseating granulomas in the organs involved. We herein report a case of sarcoidosis in a Japanese woman with acute respiratory failure, diagnosed using endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) on the ventilator after intubation. Only a few cases of previously undiagnosed sarcoidosis presenting acute respiratory failure have been reported. It is important to be aware that undiagnosed sarcoidosis may present with acute respiratory failure. Therefore, EBUS-TBNA under mechanical ventilation may be useful for the immediate diagnosis of patients.

著者

Kei Endo Keisuke Kakisaka Yuji Suzuki Takayuki Matsumoto Yasuhiro Takikawa

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.56, no.22, pp.3019-3022, 2017-11-15 (Released:2017-11-15)

参考文献数

10

被引用文献数

5

---

An 82-year-old Japanese man visited our hospital with abdominal fullness accompanied by lower abdominal pain. He presented with small bowel obstruction due to multiple diospyrobezoars. The bezoars were successfully removed without any surgical intervention by the administration of Coca-Cola Zero through a long intestinal tube and subsequent endoscopic manipulation. Such a combination may be the treatment of choice for small bowel obstruction due to bezoars.

著者

Tomomi Kinoshita 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.54, no.15, pp.1955, 2015 (Released:2015-08-01)

参考文献数

6

被引用文献数

2 2

著者

Reina Kawamura Eiichiro Nagata Masako Mukai Yoichi Ohnuki Tomohiko Matsuzaki Kana Ohiwa Tomoki Nakagawa Mitsutomo Kohno Ryota Masuda Masayuki Iwazaki Shunya Takizawa

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.3357-3359, 2017-12-15 (Released:2017-12-15)

参考文献数

9

被引用文献数

27

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A 54-year-old woman with adenocarcinoma of the lung and lymph node metastasis experienced nystagmus and cerebellar ataxia 2 weeks after initiating nivolumab therapy. An evaluation for several autoimmune-related antibodies and paraneoplastic syndrome yielded negative results. We eventually diagnosed the patient with nivolumab-induced acute cerebellar ataxia, after excluding other potential conditions. Her ataxic gait and nystagmus resolved shortly after intravenous steroid pulse therapy followed by the administration of decreasing doses of oral steroids. Nivolumab, an immune checkpoint inhibitor, is known to induce various neurological adverse events. However, this is the first report of acute cerebellar ataxia associated with nivolumab treatment.

著者

Yoshinao Yazaki Kazuhiro Satomi Taishiro Chikamori

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.1645-1651, 2022-06-01 (Released:2022-06-01)

参考文献数

8

---

Objective The Lewis lead configuration is an alternative bipolar chest lead and it can help detect atrial activity. The utility of the Lewis lead to distinguish orthodromic atrioventricular reentrant tachycardia (AVRT) from typical atrioventricular nodal reentrant tachycardia (AVNRT) by visualizing the apparent retrogradely conducted P waves was investigated. Methods Forty-four patients with paroxysmal supraventricular tachycardia (PSVT) were included in this study. All patients had PSVT documented by an electrocardiogram (ECG) and underwent an electrophysiological study (EPS). During tachycardia, an ECG recording was performed using a Lewis lead with the electrode on the right aspect of the sternum at the second intercostal space instead of the right arm and the electrode on the fourth intercostal space instead of the left arm. The ECG parameters during tachycardia were compared between AVRT and AVNRT. Results Fourteen patients were diagnosed with AVRTs and 30 with typical AVNRTs on EPS. The positive P wave could be seen in the Lewis lead configuration in 9 of 14 patients with AVRTs and 21 of 30 patients with AVNRTs. P waves were more often visible in the Lewis lead configuration than in the standard leads (66% vs. 45%). The RP interval was significantly longer for AVRTs than for AVNRTs (88±17 vs. 154±34 ms, p<0.001), which yields 89% sensitivity and 71% specificity for distinguishing these 2 tachyarrhythmias with a cut-off point of 100 ms. Conclusion A Lewis lead configuration may help to make an accurate diagnosis among the reentrant supraventricular tachycardias prior to procedures, owing to its ability to locate P waves.

著者

Takeshi Numata Norihito Hida Kai Yazaki Naoki Arai Kyoko Ota Hidetoshi Yanai Takeo Endo

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.57, no.5, pp.707-711, 2018-03-01 (Released:2018-03-01)

参考文献数

23

被引用文献数

6

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A 39-year-old woman received a seasonal influenza vaccine in November 2015 and subsequently experienced malaise, low-grade fever, and chest discomfort. A chest X-ray performed 2 weeks after vaccination showed multiple nodular shadows in both lungs and ground-glass shadows in both lower lung fields. Her bronchoalveolar lavage fluid contained an unusually high number of lymphocytes, and a drug-induced lymphocyte stimulation test for seasonal influenza vaccine was positive. Transbronchial lung biopsy revealed the presence of granulomatous inflammation. Thereafter her abnormal chest shadow spontaneously improved. Based on these findings, the patient was diagnosed with drug-induced pneumonitis due to an influenza vaccine.

著者

Masayuki Ueda Marie Tsunogae Hiroshi Saito Takeya Suzuki Takahiro Ota

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.5621-20, (Released:2020-09-19)

参考文献数

14

被引用文献数

4

---

A 24-year-old female patient was admitted for a right frontal intracranial hematoma with an uncal herniation due to a ruptured arteriovenous malformation and therefore underwent emergency surgery. Neuroimaging revealed left-sided midbrain notching against the tentorium, indicating Kernohan's notch phenomenon. She denied experiencing any short-term neurological deficits but right-sided delayed hemiparkinsonism developed 18 months later. Dopamine transporter tracer uptake was severely reduced in the left striatum, suggesting nigrostriatal degeneration secondary to Kernohan's notch. Uncal herniations are potentially fatal, but surgery can save the patient's life and improve the functional outcomes. Clinicians should therefore be aware of delayed hemiparkinsonism as a rare complication of Kernohan's notch phenomenon.

著者

Shunsuke Ogata Yoshito Ishii Keiichiro Asano Erena Kobayashi Shun Kubota Keita Takahashi Yosuke Miyaji Yuichi Higashiyama Hideto Joki Hiroshi Doi Michiaki Koga Hideyuki Takeuchi Fumiaki Tanaka

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.1757-1760, 2022-06-01 (Released:2022-06-01)

参考文献数

9

被引用文献数

9

---

Guillain-Barré syndrome (GBS) has occasionally occurred in people who have received coronavirus disease 2019 (COVID-19) vaccines. Dysgeusia is rare symptom of GBS. We herein report a rare case of sensory ataxic GBS with dysgeusia just after the second dose of the Pfizer-BioNTech COVID-19 vaccine. Although autoantibodies against glycolipids were not detected, immunotherapy with intravenous immunoglobulin and methylprednisolone pulse therapy effectively ameliorated the symptoms. Our report suggests that the COVID-19 vaccine may induce various clinical subtypes of GBS, including a rare variant with sensory ataxia and dysgeusia.

著者

Shunsuke Yamada Kanako Yamada Hiroshi Nishida

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.2995, 2022-10-01 (Released:2022-10-01)

参考文献数

4

被引用文献数

3

著者

Atsuko Uehara Yohei Kita Hirofumi Sumi Yugo Shibagaki

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.58, no.15, pp.2201-2205, 2019-08-01 (Released:2019-08-01)

参考文献数

21

被引用文献数

8 12

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Hypomagnesemia, a side effect of proton-pump inhibitors (PPIs), can be asymptomatic. The presence of hypocalcemia or hypokalemia is indicative of hypomagnesemia; however, the concomitant use of PPIs and thiazide may mask hypocalcemia. A 79-year-old woman with a history of chronic heart failure and chronic kidney disease developed symptomatic hypocalcemia and hypomagnesemia. Five weeks earlier, she had developed thiazide-induced hyponatremia, so thiazide had been discontinued. Reviewing the patient's charts revealed that three discontinued thiazide administrations in the clinical course had unmasked hypocalcemia. Our case demonstrates that thiazide-induced hypercalcemia can be so prominent as to mask PPI-induced hypocalcemia and hypomagnesemia.

著者

Teruhisa Kinoshita Shoko Sahara Tomomi Amano Masashi Ito Takashi Sakakibara Norio Takimoto Yukari Osada Keisuke Oka

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.1141-22, (Released:2023-02-22)

参考文献数

14

被引用文献数

1

---

We herein report a case of peritoneal dialysis-associated peritonitis caused by Lysinibacillus sphaericus in a 40s-year-old patient. Treatment was initiated with intermittent intraperitoneal cefazolin and ceftazidime. Later, both peritoneal dialysate and blood cultures detected L. sphaericus, so the antibiotic was changed to ampicillin (ABPC). The patient was treated with a combination of intraperitoneal intermittent and intravenous ABPC for 7 days, followed by 14 days of amoxicillin. The patient experienced no adverse events and no recurrence for 30 days. The patient had four dogs, and the infection was deemed likely to have been caused by environmental contamination and inadequate catheter replacement.

著者

Yu Mizutani Shinichiro Kawamoto Michiko Takahashi Hisayo Doi Kumiko Wakida Satoko Tabuchi Masaaki Tanda Akihiro Soga Ruri Chijiki Hidetomo Takakura Koji Kawaguchi Ako Higashime Marika Watanabe Hiroya Ichikawa Sakuya Matsumoto Rina Sakai Hideaki Goto Keiji Kurata Seiji Kakiuchi Yoshiharu Miyata Kiyoaki Uryu Yumiko Inui Akihito Kitao Kimikazu Yakushijin Hiroshi Matsuoka Hironobu Minami

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.1314-22, (Released:2023-02-15)

参考文献数

41

被引用文献数

1

---

Objective High-dose chemotherapy with autologous hematopoietic stem cell transplantation (auto-HSCT) is an effective treatment option for relapsed and refractory aggressive malignant lymphoma. However, patients frequently experience treatment-induced gastrointestinal symptoms. Synbiotics, including live microorganisms and nondigestible food ingredients, reportedly ameliorate chemotherapy-induced mucosal damage. In this study, we assessed the efficacy and safety of synbiotics in patients undergoing auto-HSCT. Methods This randomized, double-blinded study included patients with malignant lymphoma eligible for auto-HSCT. The patients were randomly assigned to either a synbiotic group receiving Bifidobacterium longum (BB536) and guar gum or a placebo group receiving a placebo containing dextrin. The supplements were administered twice daily from the start of conditioning chemotherapy up to 28 days after auto-HSCT. The primary endpoint was the duration of total parenteral nutrition (TPN). Results In total, 12 patients were included and randomized. The median duration of TPN was 15 (range, 12-33) days in the synbiotic group and 17.5 (range, 0-32) days in the placebo group. The median duration of grade ≥3 diarrhea was shorter in the synbiotic group than in then placebo group (2.5 vs. 6.5 days), as was the duration of hospital stay (31.5 vs. 43 days). The oral intake and quality of life regarding diarrhea and anorexia improved in the synbiotic group after engraftment. Synbiotic infections, including bacteremia, were not observed. Conclusion Synbiotics may reduce gastrointestinal toxicity, thereby reducing nutritional problems and improving the quality of life of patients undergoing auto-HSCT, without severe adverse events.

著者

Toshio Naito

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0693-22, (Released:2022-09-06)

参考文献数

11

著者

高橋 和郎 田中 和子 西川 清方 米本 哲人

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.64, no.10, pp.1140-1152, 1975

被引用文献数

1

---

8例の特異な急性多発性神経炎について臨床的ならびに末梢神経の電顕的検討を行なつた.これらの症例は下肢の著しい浮腫,疼痛をもつて始まり,上行性の運動麻痺,駆幹あるいは四肢末端の知覚障害,深部反射の低下をみる.麻痺は顔面神経に及ぶことがあり,一般に四肢末端に強い。知覚障害は比較的軽い.発症は急性あるいは亜急性で時に寛解,増悪を示し,しばしば,発熱,白血球減少,血沈促進, CRP陽性, A/G比低下など感染,アレルギーを思わせる所見を有する.同時に著しい心拡大,心雑音,時に心電図異常を認める.心臓症状は多発性神経炎の回復に先立つて軽快する.神経症状はGuil1ain-Barré症候群に類似するが,脳脊髄液は細胞数増加を示すことが多いが蛋白量は正常である。末梢神経は軸索,髄鞘共に著しい障害を示し,軸索再生,髄鞘再生の像がみられ,障害は有髄線維に著しい.再生した細い無髄線維の著しい増加がみられる.筋は軽度の血管周囲性リンパ球浸潤を示すものがあるが,筋炎という程の所見ではなく,一般に神経原性萎縮を示す.いずれも男性で1973年から1974年にかけて発症し,近年多発する傾向がある.脚気にも類似するが,要因と思われるものが見出し難く,かつしばしば感染,アレルギーを思わせる所見を有する.

著者

Kiyoshi Shikino Tsutomu Mito Yoshiyuki Ohira Daiki Yokokawa Yota Katsuyama Takahiro Ota Eri Sato Yuta Hirose Shiho Yamashita Shingo Suzuki Kazutaka Noda Takanori Uehara Masatomi Ikusaka

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0085-22, (Released:2022-07-05)

参考文献数

39

被引用文献数

6

---

Objective Difficult patient encounters (DPEs) are defined as encounters with patients causing strong negative feelings in physicians. In primary care settings, DPEs account for approximately 15% of visits among outpatients. To our knowledge, this is the first epidemiological study of DPEs in Japan. Methods We conducted a survey of 8 physicians (5.0±2 years of clinical experience) who examined first-visit patients ≥15 years old with clinical symptoms at the Department of General Medicine in Chiba University Hospital and 4 community hospitals over a 2-month period since December 2015. Materials We evaluated 10-Item Difficult Doctor-Patient Relationship Questionnaire (DDPRQ-10) scores (DPE ≥31 points; non-DPE ≤30 points) and patient age, sex, and presence of psychological or social problems. Results The valid response rate was 98.9% (94/95) and 98.4% (189/192) in the university and community hospitals, respectively. The percentage of DPEs was 39.8% (37/93) and 15.0% (26/173) in the university and community hospitals, respectively; the percentage of DPEs was significantly higher at the university hospital than at the community hospitals (p<0.001). The proportion of patients with psychosocial problems was significantly higher in the DPE group than in the non-DPE group (93.7% vs. 40.4%, p<0.001). Conclusion Our findings were similar to those reported in primary care settings in other countries in community hospital outpatient and general internal medicine departments, where patients are mostly non-referrals, although the values were higher in university hospital general medicine departments, where patients were mostly referrals. Patients involved in DPEs have a high rate of psychological and social problems.