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Internal Medicine

Takahiko Horiuchi
No abstract text is available yet for this article.
September 12, 2018: Internal Medicine
Jun Nakamura, Takao Nagashima, Yoichiro Akiyama, Seiji Minota
No abstract text is available yet for this article.
September 12, 2018: Internal Medicine
Shunsuke Kiuchi, Takanori Ikeda
Tolvaptan (TLV) is a diuretic agent administrated for heart failure (HF) only in Japan. Many clinical findings have been obtained from the accumulation of clinical experience, and the administration of TLV reportedly avoids causing a reduction in the renal function. In addition, TLV has been reported to exert effects other than diuresis. The early start of TLV after hospitalization shortens the length of the hospital stay, and continuous TLV after discharge extends the period until re-hospitalization of HF patients...
September 12, 2018: Internal Medicine
Masaki Mitobe, Keisuke Kawamoto, Takaharu Suzuki, Maiko Kiryu, Suguru Tamura, Ayako Nanba, Tatsuya Suwabe, Tomoyuki Tanaka, Kyoko Fuse, Yasuhiko Shibasaki, Masayoshi Masuko, Hiroaki Miyoshi, Koichi Ohshima, Hirohito Sone, Jun Takizawa
A 61-year-old woman exhibited right inguinal lymphadenopathy and right lower limb edema approximately 1 month prior to hospitalization. She was diagnosed with high grade B-cell lymphoma, and a lymph node biopsy and fluorescence in situ hybridization indicated MYC, BCL2, and BCL6 rearrangements (triple-hit lymphoma). She had progressive disease that was CD20-negative after two courses of R-CODOX-M/IVAC therapy. Subsequent EPOCH therapy was not effective. However, after two cycles of gemcitabine, dexamethasone, and cisplatin (GDP) therapy, she achieved a complete response and was able to undergo autologous peripheral blood stem cell transplantation...
September 12, 2018: Internal Medicine
Tsuyoshi Watanabe, Masamichi Yokoe, Yoshinori Noguchi
No abstract text is available yet for this article.
September 12, 2018: Internal Medicine
Tamio Okimoto, Yukari Tsubata, Mika Nakao, Takeshi Isobe
No abstract text is available yet for this article.
September 12, 2018: Internal Medicine
Manabu Hayashi, Kazumichi Abe, Masashi Fujita, Ken Okai, Atsushi Takahashi, Hiromasa Ohira
Hepatitis B virus (HBV) reactivation occasionally occurs long after immunosuppressive therapy. The characteristics of late HBV reactivation remain unclear. We herein present a case of HBV reactivation in a patient with nonalcoholic steatohepatitis (NASH) more than 3 years after rituximab-containing chemotherapy for diffuse large B-cell lymphoma. Increased transaminase levels, which were induced by NASH, were observed after chemotherapy and were alleviated with statin treatment. HBV reactivation was identified incidentally...
September 12, 2018: Internal Medicine
Daisuke Ueshima, Shunji Yoshikawa, Taro Sasaoka, Yu Hatano, Ken Kurihara, Yasuhiro Maejima, Mitsuaki Isobe, Takashi Ashikaga
Objectives The aim of this study was to assess the relationship between hypercholesterolemia (HC) and clinical events through a percutaneous coronary intervention (PCI) registry. Background HC is a well-known independent risk factor for long-term cardiovascular events after PCI. However, it has been reported to be associated with a lower risk of adverse events in patients with cancer or acute coronary syndrome. Methods We analyzed the relationship between HC and adverse events in patients treated with everolimus-eluting stents (EESs) through the Tokyo-MD PCI study (an all-comer, multicenter, observational registry)...
September 12, 2018: Internal Medicine
Kayo Misumi, Takeshi Ogo, Jin Ueda, Akihiro Tsuji, Sigefumi Fukui, Nao Konagai, Ryotaro Asano, Satoshi Yasuda
Pulmonary arterial hypertension (PAH) is a rare, devastating disease, characterized by elevated pulmonary arterial pressure due to pulmonary microvascular obstruction, which can result in heart failure and death. PAH can be associated with exposure to certain drugs or toxins. We herein report a case in which PAH developed in a patient with refractory ulcerative colitis (UC) during treatment with "Qing-Dai," a Chinese herbal medicine. The patient's PAH improved after the discontinuation of Qing-Dai...
September 12, 2018: Internal Medicine
Ryo Shoji, Yu Kono, Hiroto Furuhashi, Masanori Nakano, Yuichi Torisu
Foix-Chavany-Marie syndrome (FCMS) is a rare cortical type of pseudobulbar palsy characterized by the loss of voluntary control of the facial, pharyngeal, lingual, and masticatory muscles with preserved reflexive and autonomic functions. FCMS is generally associated with cerebrovascular diseases affecting the bilateral opercular regions. We herein report the clinical features of an 84-year-old right-handed Japanese man with FCMS due to a unilateral brain abscess. The patient' s symptoms were resolved after treating the brain abscess...
September 12, 2018: Internal Medicine
Ryosuke Imai, Ryo Nakatani, Hiroshi Nakaoka, Yutaka Tomishima, Torahiko Jinta, Naohiko Chonabayashi, Tomohide Tamura
Yellow nail syndrome (YNS) is a rare clinical syndrome characterized by a triad of yellow thick nail, lymphedema and respiratory diseases. We experienced 2 cases of YNS with diffuse panbronchiolitis (DPB)-like pulmonary manifestation. Since YNS might be hidden to those who have been diagnosed with DPB, physicians should be alert to recognize nail signs of YNS in case of DPB refractory to macrolide therapy. We hereby review previous case reports of YNS and discuss its pulmonary manifestations.
September 12, 2018: Internal Medicine
Nobuhiro Kanaji, Nariyasu Nakashima, Takuya Inoue, Emi Ibuki, Makiko Murota, Norimitsu Kadowaki
A 34-year-old Japanese woman exhibited a 35×25-mm solitary multiloculated mass shadow in the left lower lobe mimicking lung adenocarcinoma. On computed tomography, the mass resembled a lotus torus. A transbronchial lung biopsy and mediastinal lymph node biopsy led to the diagnosis of sarcoidosis. This lotus torus-like mass regressed spontaneously. This is the second reported case of pulmonary cavitary sarcoidosis with a 'lotus torus-like' appearance. We propose several findings regarding the lotus torus-like appearance by comparing the findings to those of lung adenocarcinoma...
September 12, 2018: Internal Medicine
Yosuke Hirakawa, Rika Miura, Yuji Sasaki, Yui Yoshida, Imari Mimura, Masaki Katsura, Yukako Shintani-Domoto, Makiko Ogawa, Akimasa Hayashi, Masaomi Nangaku
A 21-year-old woman was referred to our hospital because of proteinuria and hematuria. She had occasional flank pain. A renal biopsy was performed and revealed a thin basement membrane. Therefore, she was diagnosed with thin basement membrane disease. However, the frequency of her flank pain increased. Since her left kidney was slightly larger than the right, nutcracker syndrome (NCS) was suspected. Renal vein ultrasonography and venography were performed, and NCS was confirmed. Her hematuria was multifactorial, and NCS can go unnoticed if there is a comorbidity that also causes hematuria...
September 12, 2018: Internal Medicine
Yasumasa Hashimoto, Kenichi Komatsu, Tomokazu Nakagawa, Sadayuki Matsumoto
No abstract text is available yet for this article.
September 12, 2018: Internal Medicine
Satoshi Ito, Daisuke Kobayashi, Eriko Hasegawa, Chinatsu Takai, Tetsuya Nemoto, Hyunho Lee, Asami Abe, Hiroshi Otani, Hajime Ishikawa, Akira Murasawa, Ichiei Narita, Kiyoshi Nakazono
Objectives The present study was performed with the aim of analyzing the biological disease-modifying antirheumatic drug (bDMARD)-free (Bio-free) condition of adalimumab (ADA)-treated rheumatoid arthritis (RA) patients in a real-world setting. Methods ADA was used in the treatment of 130 (male, n=21; female, n=109 females) RA patients. Among them, 26 patients (20.0%) discontinued ADA due to a good response. We analyzed 20 patients who were followed up for more than 6 months after the discontinuation of ADA...
September 12, 2018: Internal Medicine
Fumio Tanaka, Kazunari Tominaga, Yoshiko Fujikawa, Tamami Morisaki, Koji Otani, Shuhei Hosomi, Yasuaki Nagami, Noriko Kamata, Koichi Taira, Akemi Nakano, Tatsuo Kimura, Hirokazu Yamagami, Tetsuya Tanigawa, Hiroyasu Morikawa, Shinya Fukumoto, Toshio Watanabe, Norifumi Kawada, Kazuto Hirata, Yasuhiro Fujiwara
Objective The association between functional dyspepsia (FD) and endoscopic findings has not been fully elucidated. Helicobacter pylori infection is considered a key factor in the pathophysiology of FD. The Kyoto Classification of Gastritis (KCG) was proposed in 2014 to evaluate endoscopic findings based on the H. pylori status. We investigated the endoscopic findings associated with FD according to the KCG. Methods This cross-sectional study included subjects who underwent esophagogastroduodenoscopy during a medical health check-up...
September 12, 2018: Internal Medicine
Yasuhiro Nakano, Fumio Otsuka
No abstract text is available yet for this article.
September 12, 2018: Internal Medicine
Yasunori Inoguchi, Bunji Kaku, Naotaka Kitagawa, Shoji Katsuda
A 52-year-old man with recurrent epistaxis and palpebral conjunctival telangiectasia visited our hospital for a follow-up checkup for gastrointestinal polyposis. At 48 years of age, he underwent Y-graft replacement for an abdominal aortic aneurysm. Arteriovenous malformation (AVM) was detected in his lungs, and a genetic test revealed an SMAD4 mutation. Eventually, he was diagnosed with juvenile polyposis-hereditary hemorrhagic telangiectasia (JP-HHT) syndrome. In addition, fatty degeneration of the left ventricle (LV) and a coronary aneurysm were detected...
September 12, 2018: Internal Medicine
Akio Kawabe, Kazuhisa Nakano, Hiroko Miyata, Ryo Shibuya, Atsuji Matsuyama, Takaaki Ogoshi, Yoshiya Tanaka
Chronic active Epstein-Barr virus (CAEBV) T-cell type infection, systemic form, is characterized by persistent infectious mononucleosis-like symptoms, high EBV DNA levels in the peripheral blood, organ damage, and a poor prognosis. The association between CAEBV and rheumatoid arthritis (RA) is unclear. We report a case of fatal CAEBV T-cell type infection in an RA patient undergoing treatment with cytotoxic T-lymphocyte-associated antigen 4 immunoglobulin fusion protein (abatacept, ABT). CAEBV can rapidly worsen in RA patients receiving ABT...
September 12, 2018: Internal Medicine
Koki Kosami, Tsuneaki Kenzaka
No abstract text is available yet for this article.
September 12, 2018: Internal Medicine
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