Acute Pulmonary Hypertension Crisis after Adalimumab Reduction in Rheumatoid Vasculitis.
Authors: Yamasaki G, Okano M, Nakayama K, Jimbo N, Sendo S, Tamada N, Misaki K, Shinkura Y, Yanaka K, Tanaka H, Akashi K, Morinobu A, Yokozaki H, Emoto N, Hirata KI Abstract Rheumatoid vasculitis is a rare etiology for pulmonary hypertension (PH) in patients with connective tissue disease. We encountered a case of acute PH crisis in a case with rheumatoid vasculitis eight months after undergoing adalimumab reduction. Since no repetition of arthralgia occurred after the adalimumab reduction, we decided to not increase the dose of adalimumab. However, hemodynamic collapse thereafter developed and even though steroid ...
Source: Internal Medicine - February 19, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Answer Found in a Blowing Sound: Amphoric Breathing Due to Cyst Formation in Pulmonary Adenocarcinoma.
Authors: Saraya T, Fujiwara M, Mikura S, Fukuda N, Ishii H, Takizawa H Abstract A 51-year-old woman presented with dyspnea that had progressed over the previous year. On a physical examination, harsh, hollow breath sounds with a high-pitched timbre, termed "amphoric breathing", were identified during inspiration and expiration. Chest radiography and thoracic computed tomography performed over the previous three years revealed an enlarging cyst in the right lung arising from an area of consolidation. Pulmonary adenocarcinoma (T4 N0 M1a, stage IV) was diagnosed and considered a possible cause of the cyst, r...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Non-aneurysmal Subarachnoid Hemorrhaging: A Rare Cause of Death in a Patient with Multiple System Atrophy.
Authors: Kinoshita H, Ayaki T, Maki T, Goda N, Yoshizawa A, Takahashi R Abstract Sudden death as a result of multiple system atrophy (MSA) is usually attributed to vocal cord paralysis or disruption of breathing owing to the degeneration of the brainstem respiratory centers. However, the exact pathophysiology of sudden death is still unclear. In addition, specific causes of sudden death are not always investigated by an autopsy. We herein report a patient with MSA and non-aneurysmal subarachnoid hemorrhaging, which is believed to be a rare cause of death in this setting. Without an autopsy, our case would likely ha...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Anterior Cutaneous Nerve Entrapment Syndrome Possibly Triggered by Oral Contraceptives.
Authors: Omura D, Obika M, Iwamuro M, Nagao S, Nada T, Matsuzaki T, Kondo Y, Otsuka F Abstract We herein report a teenage girl who had been taking oral contraceptive pills for three months and complained of left lower abdominal pain that had continued for two months. A physical examination indicated anterior cutaneous nerve entrapment syndrome (ACNES), although no abnormality was found in various biochemical and imaging examinations. The pain was only transiently ameliorated by trigger-point injection, and neurectomy surgery was eventually effective. Sex steroids can be involved in the progress of local tissue edem...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Temporal Changes on 123I-Iomazenil and Cerebral Blood Flow Single-photon Emission Computed Tomography in a Patient with Anti-N-methyl-D-aspartate Receptor Encephalitis.
Authors: Kasahara H, Sato M, Nagamine S, Makioka K, Tanaka K, Ikeda Y Abstract A 45-year-old man was admitted due to tonic seizures, aphasia, disturbance of consciousness, and abnormal behavior. Because cerebral magnetic resonance imaging findings were normal and mild cerebrospinal fluid (CSF) pleocytosis was observed, autoimmune encephalitis was suspected. The presence of anti-N-methyl-D-aspartate (NMDA) receptor antibodies in the CSF was subsequently confirmed. 123I-Iomazenil and cerebral blood flow single photon emission computed tomography (SPECT) revealed an abnormal uptake in the left frontotemporal region. M...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Benefits of a Nationwide Palliative Care Education Program on Lung Cancer Physicians.
Authors: Inoue A, Yamaguchi T, Tanaka K, Sakashita A, Aoe K, Seki N, Hagiwara K Abstract Introduction The early integration of palliative care into standard cancer treatment has become a global standard. The Palliative care Emphasis program on symptom management and Assessment for Continuous medical Education (PEACE) has been conducted in Japan, and previous studies have reported that the PEACE workshop was able to improve various palliative care skills of participants. However, whether or not the effects of the program are long-lasting and if the program consequently changed physicians' practice with regard to lun...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Methotrexate-associated Lymphoproliferative Disorder: A Rare Differential Diagnosis of Wheezes.
Authors: Ujino M, Miyoshi S, Sugimoto N, Arai H, Ota Y, Sasajima Y, Kawamura M, Nagase H, Yamaguchi M, Ohta K Abstract A 70-year-old woman was admitted for the evaluation of wheezes and a nodular lesion in the left lung field. She had been diagnosed with rheumatoid arthritis at 45 years of age and was continuously treated with methotrexate (MTX) at 8 mg/week. Bronchoscopic aspiration histology of a hilar lymph node suggested a lymphoproliferative disorder (LPD). After discontinuation of MTX, the lung nodule and wheezes disappeared. Although wheezes are not a usual manifestation of LPD, her clinical course clearly d...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Beneficial Effect of Osimertinib Readministration in Non-small-cell Lung Cancer Harboring an EGFR Mutation With a History of Acquired Resistance to Osimertinib.
Authors: Makimoto G, Ohashi K, Senoo S, Hotta K, Maeda Y, Kiura K Abstract We herein report a case of the beneficial effect of osimertinib readministration in non-small-cell lung cancer (NSCLC) harboring an epidermal growth factor receptor (EGFR) mutation. A 69-year-old non-smoking woman was diagnosed with advanced NSCLC harboring an EGFR ex19 deletion and T790M. She was treated with osimertinib for two years but eventually acquired resistance. After 1.5 years of salvage chemotherapies, osimertinib was re-administered. She has been effectively and safely treated with osimertinib readministration for over 10 months....
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

A Reversible Gastric Uptake of Bone Scintigraphy in a Patient with Hypercalcemia.
Authors: Fukasawa H, Ide S, Kaneko M, Ishibuchi K, Niwa H, Yasuda H, Furuya R Abstract Hypercalcemia is a severe complication in cases of vitamin D intoxication that can result in metastatic calcification. We herein report a female case with hypercalcemia due to eldecalcitol administration associated with the increased uptake of technetium-99mhydroxymethylene diphosphonate (99mTc-HMDP) as the bone-scanning agent in the stomach. A histologic assessment using biopsy specimens identified metastatic calcification of the stomach. After the normalization of serum calcium levels, the gastric uptake of 99mTc-HMDP disappear...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

A Phase II Study of Tailored-dose S-1 Plus Carboplatin Followed by Maintenance S-1 for Advanced Squamous Cell Lung Cancer: OSAKA-LCSG 1102.
Conclusions Tailored-dose S-1 plus carboplatin followed by maintenance S-1 is an effective and feasible treatment for advanced squamous cell NSCLC. PMID: 30713297 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

A Case of Spontaneous Regression of Recurrent Undifferentiated Carcinoma of the Endometrium.
Authors: Ishii T, Takayama S, Abe M, Kuroda H, Tanaka J, Numata T, Kikuchi A, Ohsawa M, Kaneko S, Saito N, Arita R, Itakura Y Abstract We herein report a very rare case of spontaneous regression of recurrent undifferentiated carcinoma of the endometrium. An 80-year-old woman had undergone total hysterectomy with bilateral adnexectomy for undifferentiated carcinoma of the endometrium. The cancer recurred locally 10 months after surgery and then metastasized to the lung and liver. After she and her family elected to receive supportive care without active treatment, the local recurrences dramatically decreased, and th...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

The Early Initiation of Extracorporeal Life Support May Improve the Neurological Outcome in Adults with Cardiac Arrest Due to Cardiac Events.
Conclusion The early initiation of ECLS (within 46 minutes) might be associated with a favorable neurological outcome for patients with rCA caused by cardiac events. PMID: 30713299 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Diffuse Alveolar Hemorrhaging with Hypertensive Emergency: A Rare but Important Cause of Hemoptysis.
Authors: Suzuki A, Nakagawa N, Maruyama K, Matsuki M, Hasebe N Abstract Hypertensive emergency, which occurs even in young adults, induces systemic organ damage and results in a poor prognosis. We herein report the case of a 27-year-old man who developed alveolar hemorrhaging with hypertensive emergency. He presented with bloody sputum, renal failure, and extremely high blood pressure (200/128 mmHg). Chest computed tomography revealed diffuse bilateral alveolar infiltrates suggestive of diffuse alveolar hemorrhaging. After intensive therapy with anti-hypertensive drugs, the alveolar hemorrhaging disappeared. Renal ...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

The Incidence of Nonmalignant Diseases among Patients with Suspected Carcinoma of Unknown Primary Site.
Conclusions The incidence of nonmalignant diseases among patients with suspected CUP was 46 out of 830 patients in our institution. It is important to perform a thorough pathological examination in the CUP diagnostic workup. To confirm a diagnosis, some patients may need to visit specialized institutions, especially those with liver and bone lesions. PMID: 30713301 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Rapidly Progressing Pituitary Mass in B-cell Lymphoma.
Authors: Morita S, Ariyasu H, Ohiwa T, Akamizu T PMID: 30713302 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Posterior Interosseous Nerve Palsy Caused by A Ganglion.
Authors: Yokote A, Fujioka S, Ishiko T, Tsuboi Y PMID: 30713303 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Levofloxacin-associated Encephalopathy with Severe Hyperventilation.
Authors: Sugiura M, Shibata K, Saito S, Nishimura Y, Sakura H Abstract A 64-year-old woman with no previous mental illness took a single 500 mg tablet of levofloxacin for cystitis. Two hours later, she developed psychosis with involuntary movement and severe hyperventilation with respiratory alkalosis. Cranial magnetic resonance imaging findings were unremarkable, and an electroencephalogram revealed no epileptiform discharge. Her symptoms improved on the third day after levofloxacin was discontinued. Levofloxacin-associated encephalopathy with psychotic features is a rare adverse event. Disturbance of GABAergic in...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Peliosis Hepatis Due to Corticosteroid in Systemic Lupus Erythematosus.
Authors: Kimura M, Aizawa A, Miyauchi S, Hasuike S, Umekita K PMID: 30713305 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Bronchial Thermoplasty for Severe Asthma With Mucus Hypersecretion.
Authors: Nagano N, Iikura M, Ito A, Miyawaki E, Hashimoto M, Sugiyama H Abstract Bronchial thermoplasty, which delivers thermal radiofrequency to the bronchial wall, is an effective therapy for patients with severe persistent uncontrolled asthma. We herein report the case of a 47-year-old man who underwent bronchial thermoplasty for uncontrolled severe asthma. After bronchial thermoplasty, his asthma control, asthma-related quality of life, and pulmonary function improved. Furthermore, a histologic examination of transbronchial biopsy specimens revealed a decrease in goblet cell hyperplasia and the smooth muscle ma...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Successful Treatment of Acute Chest Syndrome with Manual Exchange Transfusion in a Patient with Sickle Beta+-thalassemia.
Authors: Kawahara A, Morioka T, Otani Y, Kanno K, Edahiro T, Fukushima N, Nagasaka S, Housai M, Kakimoto M, Tsuji N, Asano S, Kikuchi Y, Kobayashi T, Miyamori D, Ishida R, Kimura K, Kishikawa N, Mizooka M, Ichinohe T, Tazuma S Abstract Acute chest syndrome (ACS), characterized by fever, respiratory symptoms, and new pulmonary infiltration, is a serious complication of sickle cell disease (SCD). Regardless of the etiology, the conventional treatment options for ACS include empirical antibiotic therapy, the administration of analgesics, and red cell transfusion. The indications and methods of red cell transfusion are...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Atypical Familial Mediterranean Fever Complicated with Gastrointestinal Amyloidosis Diagnosed Due to Paroxysmal Arthralgia and Intractable Diarrhea, Successfully Treated with Tocilizumab.
Authors: Aikawa E, Shimizu T, Koga T, Endo Y, Umeda M, Hori T, Irie J, Kuroda K, Eguchi M, Okamoto M, Tsuji S, Takatani A, Igawa T, Sumiyoshi R, Kawashiri SY, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Origuchi T, Kawakami A Abstract A 53-year-old man with recurrent episodes of large joint pain and a low-grade fever at irregular intervals for 16 years developed right knee and ankle arthralgia, watery diarrhea, and abdominal pain. Following an ileum and colon biopsy, he was diagnosed with gastrointestinal amyloidosis. We suspected familial Mediterranean fever (FMF) based on his history and administered colchicine; ...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Adrenomedullin: A Novel Therapy for Intractable Crohn's Disease with a Loss of Response to Infliximab.
Authors: Ashizuka S, Kuroishi N, Nakashima K, Inatsu H, Kita T, Kitamura K Abstract A 35-year-old man with refractory Crohn's disease showed a loss of response to infliximab after requiring treatment with infliximab at 10 mg/kg together with steroid to maintain remission. His symptoms recurred, and colonoscopy showed extensive active ulcers in the colon. Adrenomedullin therapy was started in addition to the conventional infliximab therapy. A few days after, his symptoms went into remission. Endoscopy at 2 and 7 weeks revealed significant mucosal remission without steroid therapy. Adrenomedullin promoted mucosal hea...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

A Questionnaire Survey on the Sequence of Events prior to Undergoing Colonoscopy: The Influence of the Behavioral Response after a Fecal Occult Blood Test on the Early Detection of Colorectal Cancer.
Conclusion These results suggested that colonoscopy should be performed immediately for patients with positive FOB test results due to their association with colorectal cancer and the possible detection of cancer at an early stage. PMID: 30713310 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Bilateral Pleuritis as the Initial Symptom of Systemic Lupus Erythematosus: A Case Series and Literature Review.
Authors: So C, Imai R, Tomishima Y, Nishimura N Abstract We documented four cases of systemic lupus erythematosus (SLE) presenting with pleuritis as the initial disease manifestation. The diagnosis was challenging because, atypically, all patients were elderly and 3 of the 4 patients were men. Furthermore, SLE pleuritis, characterized by lymphocytic pleural effusion and high ADA activity, is difficult to differentiate from tuberculous pleurisy. A detailed physical examination, blood tests, and urinalysis are therefore indispensable to ensure an accurate diagnosis. We also reviewed the previously published case repo...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Salt Loading Aggravates the Relationship between Melatonin and Proteinuria in Patients With Chronic Kidney Disease.
Conclusion Salt loading aggravates the relationship between melatonin secretion and albuminuria or proteinuria. PMID: 30713312 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Pembrolizumab-induced Ocular Myasthenia Gravis with Anti-titin Antibody and Necrotizing Myopathy.
Authors: Onda A, Miyagawa S, Takahashi N, Gochi M, Takagi M, Nishino I, Suzuki S, Oishi C, Yaguchi H Abstract A 73-year-old man developed diplopia after the administration of pembrolizumab for lung adenocarcinoma. He had ptosis and external ophthalmoplegia without general muscle weakness. Serum CK levels were elevated. Although autoantibodies to acetylcholine receptor and muscle-specific kinase, the edrophonium test, and the repetitive nerve stimulation test were all negative, anti-titin autoantibody was positive, leading to the diagnosis of myasthenia gravis (MG). Muscle pathology showed necrotizing myopathy with ...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Recurrence of Pulmonary Arteriovenous Malformation With Non-tuberculous Mycobacteria Infection Caused by Perfusion from the Pulmonary Artery and Bronchial Artery After Coil Embolization.
Authors: Kasai H, Toshihiko S, Kobayashi T, Okamura R, Oota M, Harada N, Wada Y, Oota S, Yoshino I, Nakatani Y, Tatsumi K Abstract Recurrence of an embolized pulmonary arteriovenous malformation (PAVM) is common after coil embolization. A 23-year-old woman who had undergone multiple instances of transcatheter coil embolization was admitted with hypoxia and hemoptysis. A PAVM in the left S6 was found to be recanalized by reperfusion through the pulmonary and bronchial arteries. The left S6 was partially resected; the specimen contained necrotic granulomas and non-tuberculous mycobacteria (NTM) around the PAVM. Clini...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

An Adult Case of Pulmonary Artery Sling Accompanied by Tracheobronchomalacia.
We present an adult case of PA sling accompanied by tracheobronchomalacia found in a 49-year-old woman with a history of recurrent pneumonia. Computed tomography of the chest showed that the left lung was nourished by two aberrant PAs. Bronchoscopy demonstrated achondroplasia of the trachea and the right bronchus, which we speculate to have resulted in their stenosis. The recurrent pneumonia was attributable to these tracheobronchial structural abnormalities; we therefore stress the importance of focusing on the anatomic abnormalities in such cases. PMID: 30713315 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Cardiotoxicity of Carfilzomib in Two Japanese Patients with Relapsed Multiple Myeloma.
Authors: Ikoma T, Saotome M, Sano M, Suwa K, Naruse Y, Ohtani H, Urushida T, Nagata Y, Ono T, Maekawa Y Abstract Although multiple myeloma (MM) had been an incurable hematological malignancy with a poor prognosis, recent advances in novel anti-neoplastic agents, including carfilzomib (a proteasome inhibitor), have improved the prognosis. We herein report two cases of congestive heart failure in patients treated with carfilzomib. Although there are some reports on the cardiotoxicity of carfilzomib, to our knowledge, this is the first report on the cardiac involvement of carfilzomib in Japanese MM patients. We review...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Acute Bilateral Oculomotor Nerve Palsy in an Adult Patient with Neisseria meningitidis.
Authors: Senda J, Adachi T, Tago M, Mori M, Imai H, Ogawa Y, Kawaguchi K Abstract A 69-year-old woman was admitted to our hospital with a fever, dizziness, and headache caused by Neisseria meningitidis. After ceftriaxone was administered, she suddenly developed bilateral oculomotor nerve palsy. Intra-orbital magnetic resonance imaging using appropriate sequences revealed that her bilateral third intracranial nerves were enlarged and enhanced. She achieved complete recovery by two months after additional short-term treatment with intravenous immunoglobulin and methylprednisolone. Although intracranial nerve disorder...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Endobronchial Manifestation of Methotrexate-induced Lymphoproliferative Disorder.
Authors: Ikeue T, Kawachi H, Yoshida H, Tanaka E, Noguchi S, Fukao A, Terashita S, Tajiri T, Horikawa S, Sugita T Abstract Lymphoproliferative disorders can occur in patients with autoimmune disorders who undergo long-term methotrexate therapy (MTX-LPD). Although the manifestations of MTX-LPD are diverse, little attention is paid to endobronchial involvement. We herein describe two patients with MTX-LPD who presented with parenchymal pulmonary tumors and endobronchial involvement of LPD; one had lymphomatoid gramulomatosis and the other LPD. The patients had no tumors adjacent to the endobronchial lesions. The endo...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Severe In-stent Calcification in a 17-year-old Bare-metal Stent.
Authors: Kudo A, Ishikawa T, Hayakawa F, Taguchi I PMID: 30713319 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Clinically Infrequent Arcanobacterium haemolyticumBacteremia Complicated by Foot Decubitus Ulcer: An Educational Reminder for Primary Care Physicians.
Authors: Takamura N, Tada K, Ishioka H, Gomi H Abstract An 81-year-old Japanese man with no history of diabetes mellitus was admitted to our hospital for a fever with a new ulcerative lesion on the left heel. Blood cultures on admission grew Arcanobacterium haemolyticum in aerobic bottles. He was therefore diagnosed with A. haemolyticum bacteremia and osteomyelitis complicated with foot decubitus ulcer. He was successfully treated with intravenous antibiotic therapy and debridement of the left heel. Our case and literature review show that it is important to recognize that A. haemolyticum is a systemic causative pa...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Syphilitic Rash in a non-HIV Female Patient.
Authors: Yanagisawa N PMID: 30713321 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Different Effects on Fluid Distribution between Tolvaptan and Furosemide in a Liver Cirrhosis Patient with Chronic Kidney Disease.
Authors: Nagayama I, Masuda T, Nakagawa S, Murakami T, Ohara K, Matsuoka R, Kobayashi T, Maeshima A, Akimoto T, Saito O, Muto S, Nagata D Abstract A 73-year-old man with liver cirrhosis and advanced chronic kidney disease was admitted to our hospital due to bilateral lower leg edema and appetite loss. Furosemide to treat fluid retention markedly decreased extracellular water compared with intracellular water, but the addition of tolvaptan equally decreased both with a greater diuretic response than furosemide alone. Furthermore, tolvaptan administration increased the plasma colloid osmotic pressure, which might fac...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Pulmonary Nocardiosis Caused by Nocardia exalbida in a Patient with Lung Cancer and Radiation Pneumonitis: A Case Report and Literature Review.
We report a case of Nocardia exalbida (N.exalbida)-induced pneumonia in a 70-year old Japanese man with lung cancer and radiation pneumonitis. He initially received doripenem (1.5 g/day) for pneumonia treatment, and N.exalbida was identified by a clone library analysis of bronchoalveolar lavage fluid obtained from the pneumonia lesion. The doripenem dosage was therefore increased to 3.0 g/day with adjunctive trimethoprim/sulfamethoxazole, and his pneumonia improved. N. exalbida is susceptible to antibiotics; thus, in nocardiosis, N. exalbida infection might be associated with a good response to treatment, although its clin...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Identification of Everyday Sounds Perceived as Noise by Migraine Patients.
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. PMID: 30713324 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

A Case of Desquamative Esophageal Lesions, Most Likely Due to Celecoxib.
Authors: Kajihara Y PMID: 30713325 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Recent Updates on the Relationship between Cancer and Autoimmune Pancreatitis.
Authors: Okamoto A, Watanabe T, Kamata K, Minaga K, Kudo M Abstract Autoimmune pancreatitis (AIP) is now considered a pancreatic manifestation of a newly proposed disease condition, IgG4-related disease (IgG4-RD). IgG4-RD is characterized by enhanced IgG4 antibody responses and multiple organ involvements. Recent epidemiological studies have addressed the incidence of cancer in patients with AIP and/or IgG4-RD. Surprisingly, a significant number of AIP patients were detected with cancer at or within one year of the diagnosis of AIP. Furthermore, around 50% of all cancers detected in AIP patients comprised mainly 3 ...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Osteomalacia and Fanconi Syndrome Induced by Adefovir.
Authors: Matsuoka N, Uchida HA, Hara Y, Matsuda H PMID: 30713327 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Effect of Age on Effectiveness of Vonoprazan in Triple Therapy for Helicobacter pylori Eradication.
Conclusion The inclusion of vonoprazan increased the success rate of first-line eradication therapy; however, the advantage was reduced with aging and remained unclear in elderly patients. PMID: 30713328 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Autoimmune Pancreatitis Exhibiting Pancreatic Duct Wall Thickening.
Authors: Azuma S, Kurita A, Yazumi S PMID: 30713329 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Circadian Rhythm and CKD: Is Melatonin a Key Player or Bi-player?
Authors: Nagasawa Y, Hasuike Y, Kuragano T, Ishihara M PMID: 30713330 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Acute Infectious Purpura Fulminans Caused by Klebsiella oxytoca.
Authors: Tsubouchi N, Tsurukiri J, Numata J, Sano H PMID: 30713331 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

A Catastrophic Case of Idiopathic Cholesterol Crystal Embolism with Multiple Lethal Complications: A Labyrinth Underneath the Diagnosis of Skin Ulcers in Chronic Kidney Disease Patients.
Authors: Kumakura S, Nakamichi T, Suzuki N, Yamakage S, Ishikawa A, Fujikura E, Sato S, Aoki T, Musha H, Kikuchi K, Nagasawa T, Sato H, Ito S, Miyazaki M Abstract A 66-year-old man was admitted to our hospital because of multiple refractory skin ulcers. Based on his severe systemic arterial calcification and severe calcium-phosphate imbalance due to severe kidney dysfunction, we initially considered calciphylaxis. However, a skin biopsy provided a diagnosis of cholesterol crystal embolization. Although we initiated hemodialysis, steroid treatment, and low-density lipoprotein-cholesterol apheresis, he died of multip...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

A Pitfall of Treatment with Tosufloxacin for Pneumonia That Might Be Lung Tuberculosis.
Authors: Fujishima N, Komiya K, Matsunaga N, Usagawa Y, Yamasue M, Hashinaga K, Umeki K, Nureki SI, Ando M, Matsunaga T, Kadota JI Abstract Tosufloxacin, which is not used to treat Mycobacterium tuberculosis, is a fluoroquinolone recommended for pneumonia when the possibility of tuberculosis infection cannot be excluded. In the present case, symptoms and chest infiltrative shadow initially improved by tosufloxacin. Therefore, we regarded this patient as having general pneumonia and did not perform follow-up chest X-ray until the infiltrates had completely disappeared. However, a few weeks later, the symptoms and th...
Source: Internal Medicine - January 16, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

The authors' reply to "Bone marrow biopsy is mandatory for a diagnosis of essential thrombocythemia".
The authors' reply to "Bone marrow biopsy is mandatory for a diagnosis of essential thrombocythemia". Intern Med. 2019 Jan 10;: Authors: Kato Y, Nagamine Y, Hayashi T, Takao M PMID: 30626803 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - January 12, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Obturator Artery Pseudoaneurysm.
Authors: Akaba T, Takeyama K, Hara H, Tamaoki J PMID: 30626804 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - January 12, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

A computed tomographic assessment of tracheostomy tube placement in patients with chronic neurological disorders: The prevention of tracheoarterial fistula.
Authors: Tateyama M, Konno M, Takano R, Chida K, Rikimaru H, Chida K Abstract Background Tracheoarterial fistula (TAF) is a rare but devastating complication of tracheostomy caused by pressure necrosis from the elbow, tip, or over-inflated cuff of the tracheostomy tube. The incidence of TAF is reportedly higher in patients with neurological disorders than in those without such disorders. Objective To evaluate the incidence of and factors contributing to the misalignment of tracheostomy tubes in bedridden patients with chronic neurological disorders. Methods We retrospectively assessed three-dimensionally reconstruc...
Source: Internal Medicine - January 12, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Huge Hepatocellular Carcinoma Treated with Radical Hepatectomy after Drug-eluting Bead Transarterial Chemoembolization.
Authors: Fujita M, Okai K, Hayashi M, Abe K, Takahashi A, Kimura T, Kenjo A, Marubashi S, Hashimoto Y, Ohira H Abstract We performed split drug-eluting bead transarterial chemoembolization (DEB-TACE) in a patient with huge unresectable hepatocellular carcinoma and multiple intrahepatic metastases. However, TACE was discontinued at the fourth application because the tumor was fed by the cholecystic artery. As most intrahepatic metastases disappeared following DEB-TACE, the patient was able to undergo radical hepatectomy, and has maintained a complete response. DEB-TACE enables cancer treatment without reducing the l...
Source: Internal Medicine - January 12, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research