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Internal Medicine

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https://www.readbyqxmd.com/read/27904129/gastrocolocutaneous-fistula-due-to-percutaneous-endoscopic-gastrostomy-placement
#1
Akira Kuriyama
No abstract text is available yet for this article.
2016: Internal Medicine
https://www.readbyqxmd.com/read/27904128/atypical-skin-rash-in-seronegative-secondary-syphilis
#2
Masanori Furuhata, Naoki Yanagisawa, Akihiko Suganuma
No abstract text is available yet for this article.
2016: Internal Medicine
https://www.readbyqxmd.com/read/27904127/hla-b52-positive-aortitis-with-antineutrophil-cytoplasmic-antibody-associated-vasculitis
#3
Kohei Karino, Michihito Kono
No abstract text is available yet for this article.
2016: Internal Medicine
https://www.readbyqxmd.com/read/27904126/recurrent-abdominal-arterial-aneurysm-rupture
#4
Masahiro Kashiura, Yuichi Hamabe
No abstract text is available yet for this article.
2016: Internal Medicine
https://www.readbyqxmd.com/read/27904125/use-of-corticosteroids-for-urinary-tuberculosis-patients-at-risk-of-developing-ureteral-obstruction
#5
Kosuke Matsui, Akitsugu Furumoto, Kojiro Ohba, Kota Mochizuki, Takeshi Tanaka, Masahiro Takaki, Konosuke Morimoto, Koya Ariyoshi
A 77-year-old man with urinary tuberculosis developed post renal anuria two days after starting an anti-tuberculosis drug regimen. He had bilateral hydronephrosis, and his right kidney was radiologically diagnosed to be non-functioning. A transurethral catheter was placed in the left ureter. No improvement in the ureteral stricture was noted during the initial three weeks of treatment; however, the stricture did thereafter improve after the commencement of oral prednisolone. In cases of urinary tuberculosis, ureteral stricture can deteriorate and result in ureteral obstruction during anti-tuberculosis treatment...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27904124/mycotic-aneurysm-caused-by-bacteroides-fragilis-in-an-elderly-immunosuppressed-patient
#6
Takahiko Fukuchi, Sadao Kawasaki, Hiroki Hayashi, Daisuke Koreeda, Takahiro Ashikawa
An 82-year-old Japanese man, who presented with a fever and abdominal pain, was admitted to our hospital. According to enhanced computed tomography images, the probable diagnosis was abdominal aortic mycotic aneurysm. Eight sets of blood cultures obtained from the patient were negative. Despite administering treatment with vancomycin and ceftriaxone, the aneurysm progressively enlarged. He underwent open debridement surgery and in situ replacement because of an aneurysmal rupture. Bacteroides fragilis was isolated from the tissue culture of the aortic wall...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27904123/posterior-reversible-encephalopathy-syndrome-with-extensive-deep-white-matter-lesions-including-the-temporal-pole
#7
Junichiro Ohira, Nobuyuki Mori, Shunsuke Kajikawa, Takeshi Nakamura, Tetsuya Arisato, Makio Takahashi
Posterior reversible encephalopathy syndrome (PRES) typically affects the posterior subcortical white matter. We report the case of a 55-year-old man with atypical PRES, who had malignant hypertension and renal dysfunction. Magnetic resonance imaging of the brain revealed extensive vasogenic edema in the deep white matter including the temporal pole, as well as in the brainstem and cerebellum. Antihypertensive therapy and hemodialysis contributed to both clinical and radiological improvement. Involvement of the deep white matter including the temporal pole, which is rarely affected in an ischemic stroke, should be recognized as a potential sign of PRES...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27904122/triptan-induced-reversible-cerebral-vasoconstriction-syndrome-two-case-reports-with-a-literature-review
#8
Yuji Kato, Takeshi Hayashi, Satoko Mizuno, Yohsuke Horiuchi, Masayuki Ohira, Norio Tanahashi, Masaki Takao
We encountered two patients with sumatriptan-induced reversible cerebral vasoconstriction syndrome (RCVS). The present patients were taking sumatriptan for the first time because they had been tentatively diagnosed with a migraine. On reviewing the literature, we found nine other cases of triptan-induced RCVS, predominantly among women aged 30 to 40 years. RCVS has been precipitated by triptan at the first ever use, after daily use, and even with long-term use at a normal dose. Patients with acute onset of severe headache should be thoroughly evaluated, and triptan should be administered appropriately...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27904121/sporadic-inclusion-body-myositis-manifesting-as-isolated-muscle-weakness-of-the-finger-flexors-three-years-after-disease-onset
#9
Yuichi Suwa, Naoki Suzuki, Temma Soga, Ryuhei Harada, Aya Shibui, Hiroshi Kuroda, Rumiko Izumi, Maki Tateyama, Ichiro Nakashima, Masahiro Sonoo, Masashi Aoki
Sporadic inclusion body myositis (sIBM) is a chronic progressive myopathy characterized by muscle weakness of both the quadriceps femoris and finger flexors. We herein present the case of a typical male patient with sIBM, which manifested as the isolated weakness of the finger flexors three years after the disease onset. We have identified several patients with sIBM in our cohort with muscle weakness of the flexors but not the quadriceps femoris. Examination of the flexor digitorum profundus muscle is important for the early and proper diagnosis of sIBM, even if a patient only presents with isolated finger flexor muscle weakness...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27904120/high-frequency-rtms-for-the-treatment-of-chronic-fatigue-syndrome-a-case-series
#10
Wataru Kakuda, Ryo Momosaki, Naoki Yamada, Masahiro Abo
Structural and functional abnormalities of the prefrontal cortex seem to correlate with fatigue in patients with chronic fatigue syndrome (CFS). We consecutively applied facilitatory high-frequency repetitive transcranial magnetic stimulation (rTMS) to the dorsolateral prefrontal cortex (DLPFC) of seven CFS patients over three days. Five patients completed the 3-day protocol without any adverse events. For the other two patients, we had to reduce the stimulation intensity in response to mild adverse reactions...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27904119/an-autopsy-case-of-amyotrophic-lateral-sclerosis-with-diaphragm-pacing
#11
Hisashi Ito, Tetsumasa Kamei, Sanae Odake, Masayuki Nakano, Riki Okeda, Shunsaku Kohriki, Jun Kawachi, Raymond P Onders, Fumihito Yoshii
Respiratory insufficiency is a critical problem in amyotrophic lateral sclerosis (ALS) patients. We herein present the case of an autopsied patient with sporadic ALS who underwent diaphragm pacing (DP). The pathology showed several localized adhesions with a markedly atrophied diaphragm. A marked loss of motor neurons with Bunina bodies and phosphorylated TDP-43 positive inclusions was found in the spinal cord and primary motor cortex. Mild hyalinization and a few multinucleated giant cells were present around the electrode tracks in the diaphragm...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27904118/acquired-factor-v-inhibitors-in-a-patient-with-end-stage-renal-disease
#12
Atsushi Kitazawa, Hideo Misawa, Katsuhiro Nagahori, Ryo Koda, Atsunori Yoshino, Shinya Kawamoto, Tetsuro Takeda
We report a case of acquired factor V inhibitors (AFVIs) in a patient with end-stage renal disease receiving warfarin therapy for atrial fibrillation. A 72-year-old Japanese man was admitted to our hospital complaining of tarry stools and abdominal pain. The laboratory findings revealed eosinophilia (52.1%), prolonged activated partial thromboplastin time (APTT) (98 s), PT (84 s), a factor V (FV) activity of <3%, and an FV inhibitor level of 6 Bethesda units/mL. After administration of prednisolone was started, his coagulation findings improved...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27904117/successful-cord-blood-stem-cell-transplantation-for-an-adult-case-of-chronic-active-epstein-barr-virus-infection
#13
Masuho Saburi, Masao Ogata, Takako Satou, Natsumi Yoshida, Kentaro Nagamatsu, Yuko Nashimoto, Yui Moroga, Kuniko Takano, Kazuhiro Kohno, Kuniaki Shirao
A 41-year-old man was referred to our hospital for treatment of anaplastic lymphoma kinase (ALK)-negative anaplastic large cell lymphoma. Chronic active Epstein-Barr virus (CAEBV) was diagnosed based on the findings of elevated EBV antibody titers and positive EBV-DNA in the peripheral blood, and cord blood stem cell transplantation (CBT) was performed. The EBV-DNA levels in the blood fell below the limit of detection. His lymphoma relapsed on Day 165 with the appearance of eruptions, which disappeared after the withdrawal of tacrolimus...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27904116/symptomatic-acute-pancreatitis-induced-by-nilotinib-a-report-of-two-cases
#14
Toshiki Yamada, Yasuhito Nannya, Masahito Shimizu, Mitsuru Seishima, Hisashi Tsurumi
Nilotinib is a selective tyrosine kinase inhibitor for the treatment of Philadelphia chromosome-positive leukemias. An elevation of the pancreatic enzyme level is one of the major adverse events associated with nilotinib, but whether or not nilotinib induces symptomatic pancreatitis remains to be elucidated. The cases of two chronic myeloid leukemia patients treated with nilotinib who developed symptomatic acute pancreatitis on the third and fifth day of nilotinib administration are herein presented. Since both patients had no other etiologies for pancreatitis, nilotinib was considered to be the causal agent...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27904115/two-young-women-with-left-sided-pneumothorax-due-to-thoracic-endometriosis
#15
Shungo Yukumi, Hideaki Suzuki, Masamitsu Morimoto, Hisayuki Shigematsu, Mikio Okazaki, Masahiro Abe, Sohei Kitazawa, Kenji Nakamura, Yoshifumi Sano
Pneumothorax associated with thoracic endometriosis (TE) generally occurs in women around 30 years old and it usually affects the right pleural cavity. We herein report two cases of TE associated with left-sided pneumothorax in young women. The prevalence of TE in younger patients may be underestimated if these cases are treated as spontaneous pneumothorax. Pneumothorax occurring in younger patients has not been reported to show laterality. TE-related or catamenial pneumothorax in young women must therefore represent a different clinical entity from the condition seen in older patients...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27904114/two-cases-of-proteinase-3-anti-neutrophil-cytoplasmic-antibody-pr3-anca-related-nephritis-in-infectious-endocarditis
#16
Kazuya Hirai, Naoto Miura, Masabumi Yoshino, Kanyu Miyamoto, Hironobu Nobata, Takuhito Nagai, Keisuke Suzuki, Shogo Banno, Hirokazu Imai
We herein report two cases of proteinase 3-anti-neutrophil cytoplasmic antibody (PR3-ANCA)-related nephritis in infectious endocarditis. In both cases, the patients were middle-aged men with proteinuria and hematuria, hypoalbuminemia, decreased kidney function, anemia, elevated C-reactive protein (CRP) levels, and PR3-ANCA positivity. Each had bacteremia, due to Enterococcus faecium in one and Streptococcus bovis in the other. One patient received aortic valve replacement therapy for aortic regurgitation with vegetation, and the other underwent tricuspid valve replacement therapy and closure of a ventricular septic defect to treat tricuspid regurgitation with vegetation...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27904113/fanconi-syndrome-associated-with-hyponatremia-in-two-patients-with-legionella-pneumonia
#17
Akihiro Ryuge, Yasuhiko Ito, Taishi Yamakawa, Hitoshi Tanaka, Hirotoshi Yasui, Shuko Mashimo, Kenshi Watanabe, Rie Nomura, Nobukazu Suganuma, Shoichi Maruyama
Legionella pneumophila is a cause of community-acquired pneumonia that is reported to induce electrolyte disorders, including hyponatremia, hypokalemia, and hypophosphatemia. We herein report two Japanese men with Legionella pneumonia and hyponatremia and hypophosphatemia. These findings were associated with an elevation of urinary low-molecular-weight tubular protein, including urinary β2-microglobulin, N-acetyl-β-D-glucosaminidase, the fractional excretion of phosphate and uric acid, and the presence of glycosuria and panaminoaciduria, suggesting that their electrolyte disorders had been caused by Fanconi syndrome...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27904112/a-renal-variant-of-fabry-disease-diagnosed-by-the-presence-of-urinary-mulberry-cells
#18
Homare Shimohata, Yujiro Ogawa, Hiroshi Maruyama, Kouichi Hirayama, Masaki Kobayashi
Fabry disease is a lysosomal storage disorder caused by a deficiency of α-galactosidase A. This disease is classified into two types, namely a classical and variant type. We herein present the case of a 36-year-old man who showed a renal variant of Fabry disease and was diagnosed at an early stage by the presence of mulberry cells. He had no history of general symptoms except for proteinuria. The presence of mulberry cells caused us to suspect Fabry disease and he was thereafter diagnosed to have a renal variant of Fabry disease based on the findings of a renal biopsy, a mutation analysis and a low level of α-galactosidase A activity...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27904111/restoration-of-the-hypothalamic-pituitary-adrenal-response-to-hypoglycemia-in-type-2-diabetes-by-avoiding-chronic-hypoglycemia
#19
Shin-Ichi Tsuda, Kazunori Konishi, Toshiki Otoda, Takako Nagai, Ai Takeda-Watanabe, Megumi Kanasaki, Munehiro Kitada, Atsushi Nakagawa, Makoto Nishizawa, Keizo Kanasaki, Daisuke Koya
An impaired ability to sense and respond to drug-induced hypoglycemia is a common and serious complication in diabetic patients. The hypothalamic-pituitary-adrenal (HPA) axis activity plays a critical role in the counterregulatory response to hypoglycemia. We herein report a case that experienced restoration of a blunted HPA axis by avoiding hypoglycemia with the use of the DPP-4 inhibitor sitagliptin.
2016: Internal Medicine
https://www.readbyqxmd.com/read/27904110/infected-aortic-aneurysm-mimicking-anti-proteinase-3-antineutrophil-cytoplasmic-antibody-associated-vasculitis
#20
Kenta Hachiya, Kazuaki Wakami, Atsuhiro Yoshida, Hisao Suda, Nobuyuki Ohte
We herein report an unusual case of an infected descending aortic pseudoaneurysm with luminal pathognomonic oscillating vegetation with serological findings and clinical features mimicking anti-proteinase 3-antineutrophil cytoplasmic antibody-associated vasculitis. The positive blood cultures and imaging findings, including a pseudoaneurysm and vegetations in the aorta, suggested the presence of an infected aortic aneurysm. The patient was successfully treated with antibiotics and endovascular aortic repair...
2016: Internal Medicine
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