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https://www.readbyqxmd.com/read/29321442/acquired-von-willebrand-syndrome-due-to-aortic-valve-stenosis-in-a-case-with-antiphospholipid-antibody
#1
Hiroaki Tanaka, Yurie Nagai, Chihiro Kuwabara, Ryo Shimizu, Akihide Umeki, Tetsufumi Yamamoto
Acquired von Willebrand syndrome (AVWS) is a bleeding disorder caused by an acquired deficiency of von Willebrand factor (vWF). Some patients with AVWS show a low bleeding tendency and are diagnosed by the presence of a mild prolongation of activated partial thromboplastin time (APTT) preoperatively. Another cause of APTT prolongation is the presence of antiphospholipid antibody (aPL). We experienced a case of AVWS due to aortic valve stenosis in a patient with aPL in whom aortic valve replacement surgery was successful with vWF replacement...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29321441/diabetes-mellitus-prevents-an-improvement-in-the-serum-albumin-level-during-interferon-free-sofosbuvir-based-therapy-for-chronic-hepatitis-c-patients-a-multi-institutional-joint-study
#2
Akira Kawano, Hirohisa Shigematsu, Koichiro Miki, Yasunori Ichiki, Chie Morita, Kimihiko Yanagita, Kazuhiro Takahashi, Kazufumi Dohmen, Hideyuki Nomura, Hiromi Ishibashi, Shinji Shimoda
Objective Interferon-free regimens of direct-acting antiviral agents have improved the treatment response for chronic hepatitis C virus (HCV) infection, and improvement in the serum albumin level during interferon-free therapy has been reported. The aim of this study was to identify the factors that influence the improvement in the serum albumin level in patients receiving interferon-free antiviral therapy. Methods This retrospective, multicenter study consisted of 471 Japanese patients with chronic hepatitis and compensated liver cirrhosis infected with HCV who completed 12-week interferon-free sofosbuvir (SOF)-based therapy (SOF plus ledipasvir for genotype 1 [n=276] and SOF with ribavirin for genotype 2 [n=195])...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29321440/an-overview-of-kidney-disease-following-hematopoietic-cell-transplantation
#3
Minoru Ando
Hematopoietic stem cell transplantation (SCT) recipients are exposed to a large amount of anti-cancer drugs, immunosuppressors, and irradiation during the peri-SCT period. Thus, they have to overcome serious adverse events related to unavoidable but toxic procedures, including organ disorders. In particular, acute kidney injury (AKI) is one of the most critical complications, because it influences the mortality of patients. A few patients who survive AKI may develop nephrotic syndrome, and precedent AKI is also closely associated with chronic and progressive loss of the renal function in post-SCT patients...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29321439/the-association-of-bite-instability-and-comorbidities-in-elderly-people
#4
Susumu Itakura, Masaaki Miyata, Atsushi Kuroda, Manabu Setoguchi, Atsushi Kusumoto, Daisuke Hokonohara, Mitsuru Ohishi
Objective The purpose was to evaluate the association between bite instability and comorbidities, comprehensive geriatric evaluations, or disabilities in elderly people. Methods A dentist examined the oral function, such as the bite stability, number of teeth, and the use of dentures, in 119 patients (93 women, mean age: 86.7±7.8) in 2 nursing homes for the elderly. The association between the oral function and the prevalence of diseases, including hypertension, diabetes mellitus, and dementia, was analyzed...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29321438/vogt-koyanagi-harada-disease-associated-with-influenza-a-virus-infection-a-case-report
#5
Nozomu Yoshino, Ai Kawamura, Akira Ishii, Katsuyuki Yoshida, Tamami Watanabe, Takeshi Yamashita, Takahiko Fukuchi, Fumihiko Toyoda, Akihiko Kakehashi, Hitoshi Sugawara
We herein report a case of a 31-year-old Japanese man who simultaneously had a positive influenza A virus antigen test result and Vogt-Koyanagi-Harada disease (VKHD), demonstrated by both diffuse multiple early hyperfluorescent points on fluorescein fundus photography and serous retinal detachments on optical coherence tomography. He had meningitis. It was difficult to determine whether the main cause of meningitis was influenza A or VKHD. After initial treatment with peramivir for influenza A and then methylprednisolone pulse with subsequent corticosteroid therapy for VKHD, his symptoms improved gradually...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29321437/esophageal-granular-cell-tumors-can-be-differentiated-from-leiomyomas-using-endoscopic-ultrasonography
#6
Masaya Iwamuro, Takehiro Tanaka, Hiromitsu Kanzaki, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada
Objective Although esophageal granular cell tumors have been reported to present as hypoechoic tumors, we noticed that their echogenicity is similar to that of the submucosal layer. We investigated the sonographic features of esophageal granular cell tumors and the diagnostic accuracy of the features. Methods Seven patients with esophageal granular cell tumors who underwent endoscopic ultrasonography were retrospectively reviewed. Thirteen patients with esophageal leiomyoma were selected as historical control subjects...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29321436/necrotizing-sarcoid-granulomatosis-with-natural-resolution-after-a-surgical-lung-biopsy
#7
Takayuki Shibata, Koichiro Takahashi, Masaru Uchida, Fumio Yamasaki, Michihiro Kawashima, Naoko Sueoka-Aragane
Necrotizing sarcoid granulomatosis (NSG) is a rare disease that is diagnosed based on pathological findings. We herein report the case of a 27-year-old man who had multiple nodular shadows in bilateral lung fields on chest radiography and elevated levels of C-reactive protein (CRP). The pathological evaluation of a lung biopsy specimen showed the infiltration of lymphocytes, granulomas with necrosis and granulomatous angiitis. He was therefore diagnosed with NSG. He has been followed without treatment, as his fever and CRP levels decreased immediately after the surgical lung biopsy...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29321435/chronic-expanding-hematoma-on-the-chest-wall-after-mastectomy
#8
Ryusuke Ookura, Go Sakai, Norifumi Nishida
No abstract text is available yet for this article.
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29321434/tricuspid-and-mitral-valve-regurgitation-with-bi-fascicular-block-following-a-horse-kick
#9
Tomoki Kokubun, Masayoshi Oikawa, Yasuhiro Ichijo, Yoshiyuki Matsumoto, Tetsuro Yokokawa, Kazuhiko Nakazato, Yoshiyuki Sato, Shinya Takase, Hiroharu Shinjo, Hitoshi Yokoyama, Hitoshi Suzuki, Shu-Ichi Saitoh, Yasuchika Takeishi
A 40-year-old man was transferred to our hospital following an isolated horse kick injury to the anterior chest wall. The case showed bi-fascicular block, severe tricuspid valve regurgitation due to ruptured chordae tendineae of the anterior leaflet, moderate mitral valve regurgitation due to prolapse of mitral anterior leaflet, and hypokinetic motion of the inferior septal wall. Both tricuspid and mitral insufficiency were completely repaired by a surgical operation. Fortunately, these injuries were not fatal in this case, but the comprehensive assessment of cardiac damage and careful observation are important for managing patients with cardiac injury...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29321433/a-case-of-cv2-crmp5-antibody-related-paraneoplastic-optic-neuropathy-associated-with-small-cell-lung-cancer
#10
Masanori Nakajima, Ayumi Uchibori, Yuki Ogawa, Tai Miyazaki, Yaeko Ichikawa, Kimihiko Kaneko, Toshiyuki Takahashi, Ichiro Nakashima, Hirokazu Shiraishi, Masakatsu Motomura, Atsuro Chiba
A 61-year-old woman who had smoked for 40 years developed subacute dizziness, ataxic gait, opsoclonus, and right visual impairment. She had right optic disc swelling and optic nerve gadolinium enhancement on magnetic resonance imaging. She had small-cell lung cancer (SCLC), with CV2/collapsin response mediator protein (CRMP) 5 and HuD antibodies in her serum and cerebrospinal fluid. She was diagnosed with paraneoplastic optic neuropathy (PON) accompanied by paraneoplastic opsoclonus-ataxia syndrome. Her symptoms improved after removing the SCLC...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29321432/acute-onset-autoimmune-hepatitis-in-a-young-woman-with-type-1-diabetes-mellitus
#11
Satoshi Takai, Jun Inoue, Takayuki Kogure, Eiji Kakazu, Masashi Ninomiya, Tomoaki Iwata, Teruyuki Umetsu, Takuya Nakamura, Akitoshi Sano, Tooru Shimosegawa
Autoimmune hepatitis (AIH) and type 1 diabetes mellitus (T1DM) are thought to be induced by autoimmunity, but their coexistence has rarely been reported. We herein report a case in which a patient with T1DM developed acute-onset AIH. A 26-year-old woman, who had been diagnosed with T1DM in childhood, was transferred to our hospital because of acute liver failure of unknown etiology. The administration of corticosteroids including steroid pulse therapy was effective. Based on the histological finding of massive centrilobular necrosis and a good response to steroid therapy, we diagnosed the patient with acute-onset AIH...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29321431/self-reported-slower-eating-is-associated-with-a-lower-salt-intake-a-population-based-cross-sectional-study
#12
Minako Wakasugi, Junichiro James Kazama, Ichiei Narita
Objective Evidence suggests that the eating rate is positively associated with the body weight and blood pressure. Furthermore, people who are overweight or obese tend to have higher salt intakes than those of normal weight. To investigate whether or not the eating rate is also associated with the salt intake, a cross-sectional study was conducted using health examination survey data collected in 2014 from 7,941 residents of Sado City, Niigata, Japan. Methods The eating rates were evaluated using a questionnaire; 11...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29321430/new-onset-takayasu-s-arteritis-as-acute-myocardial-infarction
#13
Yusuke Ishiyama, Kazuo Eguchi, Katsuaki Yokota, Tomokazu Ikemoto, Kazuomi Kario
We herein report the case of a 25-year-old Japanese woman with left-main-trunk acute myocardial infarction (LMT-AMI). She had cardiogenic shock, so emergency percutaneous intervention was performed. Intravascular ultrasound of LMT-AMI showed that the three-layered structure of the intima, tunica media, and adventitia was not clearly visible, and the vessel was concentrically thickened; unstable plaque and calcification were not seen. AMI is rarely seen in young women, but Takayasu's arteritis is one major cause...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29321429/early-combination-therapy-with-corticosteroid-and-nucleoside-analogue-induces-rapid-resolution-of-inflammation-in-acute-liver-failure-due-to-transient-hepatitis-b-virus-infection
#14
Keiichi Fujiwara, Shin Yasui, Yuuki Haga, Masato Nakamura, Yutaka Yonemitsu, Makoto Arai, Tatsuo Kanda, Shigeto Oda, Osamu Yokosuka, Naoya Kato
Objective Patients with acute hepatitis B sometimes develop acute liver failure (ALF), which has a poor prognosis. The efficacy of nucleoside analogue (NA) monotherapy for ALF due to transient hepatitis B virus infection (HBV-ALF) remains controversial. Further investigations are necessary in nations with a shortage of donor livers for liver transplantation. In the present study, we aimed to clarify the efficacy of combination therapy with corticosteroid (CS) and NA in the treatment HBV-ALF. Patients We examined the clinical and biochemical features of 19 patients with HBV-ALF who were treated in the early stage of the disease between 2000 and 2015...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29321428/synchronous-occurrence-of-mycosis-fungoides-diffuse-large-b-cell-lymphoma-and-acute-myeloid-leukemia-a-report-of-two-cases
#15
Junichi Miyatake, Hiroaki Inoue, Kentarou Serizawa, Yasuyoshi Morita, J L Espinoza, Hirokazu Tanaka, Takahiro Shimada, Yoichi Tatsumi, Takashi Ashida, Itaru Matsumura
Patients with mycosis fungoides (MF), the most common subtype of primary cutaneous T-cell lymphoma, have an increased risk of developing secondary malignancies. We herein report two rare cases of MF concurring with diffuse large B cell lymphoma (B lymphoid lineage) and acute myeloid leukemia (myeloid lineage) in two otherwise healthy elderly patients. Potential etiologic factors, including the impact of the therapy-associated inflammatory response on the development of secondary tumors in patients with MF, are discussed...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29321427/cardiac-sarcoidosis-concomitant-with-large-vessel-aortitis-detected-by-18f-fluorodeoxyglucose-positron-emission-tomography
#16
Yoshihiro Higuchi, Yasutaka Kimoto, Rika Tanoue, Tomotake Tokunou, Kenichiro Tomonari, Toyoki Maeda, Takahiko Horiuchi
We herein report a case of concurrent cardiac sarcoidosis and large-vessel aortitis detected by 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) and followed up during immunosuppressive therapy. After high-dose prednisolone administration (1 mg/kg), serial FDG-PET showed that almost all of the abnormal FDG uptake in the heart and extracardiac region, including the abdominal to bilateral iliac arteries, had been disappeared. During the tapering of prednisolone, additive methotrexate therapy was needed to treat the recurrence of cardiac sarcoidosis...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29321426/percutaneous-coronary-intervention-for-a-patient-with-left-main-coronary-compression-syndrome
#17
Ryutaro Ikegami, Kazuyuki Ozaki, Takuaya Ozawa, Satoru Hirono, Masahiro Ito, Tohru Minamino
Left main coronary compression syndrome rarely occurs in patients with severe pulmonary hypertension. A 65-year-old woman with severe pulmonary hypertension due to an atrial septal defect suffered from angina on effort. Cardiac computed-tomography and coronary angiography revealed considerable stenosis of the left main coronary artery (LMA) caused by compression between the dilated main pulmonary artery trunk and the sinus of valsalva. Stenting of the LMA under intravascular ultrasound imaging was effective for the treatment of angina...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29321425/elevation-of-plasmin-%C3%AE-2-plasmin-inhibitor-complexes-in-patients-with-al-amyloidosis
#18
Kanji Miyazaki, Kenshi Suzuki
No abstract text is available yet for this article.
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29321424/a-case-of-anti-musk-antibody-positive-myasthenia-gravis-successfully-treated-with-outpatient-periodic-weekly-blood-purification-therapy
#19
Kentaro Deguchi, Kosuke Matsuzono, Yumiko Nakano, Syoichiro Kono, Kota Sato, Shoko Deguchi, Katsuyuki Tanabe, Nozomi Hishikawa, Yasuyuki Ota, Toru Yamashita, Kiyoe Ohta, Masakatsu Motomura, Koji Abe
A 37-year-old man with anti-muscle-specific tyrosine kinase (MuSK) antibody-positive myasthenia gravis (MG) presented with subacute progressive dysphagia and muscle weakness of the neck and bilateral upper extremities. Conventional immune-suppressive treatments and high-dose intravenous immunoglobulin were ineffective. He then displayed repeated exacerbations and remissions over the course of two years, despite two to four sessions of plasma exchange (PE) every two months. The patient was successfully treated with outpatient periodic weekly blood purification therapy with alternative PE and double-filtration plasmapheresis using an internal shunt...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29321423/constrictive-pericarditis-as-a-long-term-undetermined-etiology-of-ascites-and-edema
#20
Takahiro Kamio, Eiji Hiraoka, Kotaro Obunai, Hiroyuki Watanabe
Constrictive pericarditis (CP) is defined as impedance to diastolic filling caused by a fibrotic pericardium. The diagnosis of CP is a clinical challenge and requires a high index of clinical suspicion. The signs and symptoms of CP include fatigue, edema, ascites, and liver dysfunction. These can be mistakenly diagnosed as primary liver disease. We present the case of a 69-year-old woman with a 7-year history of leg edema and a 2-year history of ascites who was initially diagnosed with cryptogenic liver cirrhosis and was finally diagnosed with CP...
January 11, 2018: Internal Medicine
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