Rheumatoid Arthritis and Vascular Failure - Rheumatoid Arthritis Is a Risk Factor for Cardiovascular Disease.
Authors: Oyama JI, Node K PMID: 31092770 [PubMed - in process] (Source: Internal Medicine)
Source: Internal Medicine - May 18, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

A Study of the Vascular Endothelial Function in Patients with Type 2 Diabetes Mellitus and Rheumatoid Arthritis.
This study is a retrospective study based on medical records. Differences in the reactive hyperemia index (RHI) among the groups and factors affecting the RHI in each group was analyzed. The vascular endothelial function was assessed by measuring the RHI using peripheral arterial tonometry. Patients The study subjects were 114 patients with non-functional thyroid tumors (healthy n=14), T2DM (T2DM n=64), and RA (RA n=36). Results The RHI was 2.29 in the control, 1.85 in the T2DM, and 1.83 in the RA group, with values lower in the T2DM and RA groups than in the control group (p=0.033) but not markedly different between the t...
Source: Internal Medicine - May 18, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Using Spontaneous Eye-blink Rates to Predict the Motor Status of Patients with Parkinson's Disease.
Conclusion Our study provides preliminary evidence regarding the utility of continuous EBR monitoring for the non-invasive evaluation of the motor status in patients with PD. PMID: 31092772 [PubMed - in process] (Source: Internal Medicine)
Source: Internal Medicine - May 18, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Lung Adenocarcinoma with Lynch Syndrome and the Response to Nivolumab.
Authors: Kawashima Y, Nishikawa S, Ninomiya H, Yoshida R, Takano N, Oguri T, Kitazono S, Yanagitani N, Horiike A, Ohyanagi F, Ishikawa Y, Nishio M Abstract Lynch syndrome is caused by mutations in mismatch repair genes that lead to microsatellite instability (MSI). An increased number of mutation-associated neoantigens have been observed in patients with high-frequency MSI (MSI-H) cancer; in addition, membranous programmed death ligand-1 (PD-L1) tends to be expressed at higher levels in MSI-H cancers than in microsatellite-stable cancers. MSI-H cancer patients are therefore considered to be susceptible to immune ch...
Source: Internal Medicine - May 18, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Advanced Pulmonary Hypertension Due to Congenital Double-shunt Successfully Treated with Surgical Repair and Up-front Combination Therapy.
Authors: Suto M, Matsumoto K, Kido S, Mori S, Nakayama K, Tanaka H, Inoue T, Emoto N, Okita Y, Hirata KI Abstract This case report concerns a 22-year-old woman with large patent ductus arteriosus and atrial septal defect. She was referred to our hospital because of exertional dyspnea and was revealed to have advanced pulmonary arterial hypertension (PAH) with a mean pulmonary arterial pressure (PAP) of 79 mmHg. Although both shunts had bidirectional flow, based on the results of acute pulmonary vasoreactive testing, one-stage surgical closure was performed followed by up-front combination therapy for post-operative...
Source: Internal Medicine - May 8, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Autoimmune Pulmonary Alveolar Proteinosis Diagnosed After Exposure to a Fire Extinguisher Containing Silica Powder: A Case Study.
Authors: Yorozuya T, Ikeda K, Chiba H, Saito A, Kuronuma K, Nishikiori H, Miyajima S, Takahashi M, Yoshikawa T, Takahashi Y, Taya T, Mori Y, Umeda Y, Otsuka M, Moriyama H, Takahashi H Abstract We herein report a case of autoimmune pulmonary alveolar proteinosis (PAP) diagnosed after one-time exposure to silica powder. Owing to the misuse of a silica-containing fire extinguisher and the inhalation of large amounts of its powder, the patient experienced prolonged cough and visited our hospital. The findings of chest computed tomography and surgical lung biopsy specimens led to the diagnosis of PAP. Interestingly, the...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Long-term Effects of Androgen Deprivation in a Patient with Spinal and Bulbar Muscular Atrophy - A Case Report with 14 Years of Follow-up.
Authors: Hijikata Y, Hashizume A, Yamada S, Ito D, Banno H, Suzuki K, Sobue G, Katsuno M Abstract Spinal and bulbar muscular atrophy (SBMA) is a progressive hereditary neuromuscular disease caused by the testosterone-dependent accumulation of pathogenic polyglutamine-expanded androgen receptor protein. A 41-year-old man with SBMA received the androgen deprivation agent leuprorelin acetate for 7 years in clinical trials and underwent castration following the trial. Suppression of testosterone levels for 14 years resulted in a slower disease progression, as measured prospectively with quantitative measurements, than ...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Posterior Reversible Encephalopathy Syndrome and Reversible Cerebral Vasoconstriction Syndrome after Rapid Blood Transfusion.
Authors: Saito K, Shimizu Y, Higuma M, Kubodera T, Wada Y Abstract We herein report a case of posterior reversible encephalopathy syndrome (PRES) and reversible cerebral vasoconstriction syndrome (RCVS) that occurred immediately after blood transfusion. A 64-year-old Japanese woman was diagnosed with liver cirrhosis due to hepatitis B 2 years ago. She was admitted to our hospital with hemorrhagic shock due to esophageal variceal rupture. She was hospitalized with rapid blood pumping transfusion, after which consciousness disorder appeared, and her blood pressure suddenly increased. Magnetic resonance imaging reveal...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Endoscopic Ultrasound-guided Drainage of a Mediastinal Abscess Caused by an Ingested Fish Bone.
Authors: Shibuya H, Ikehara H, Andoh K, Horii T, Moriyama M, Yamao K, Gotoda T Abstract Cases of foreign body ingestion are encountered relatively often in clinical settings; however, serious complications are rare. In such cases, mediastinal abscess due to esophageal perforation can become a life-threatening complication. Although highly invasive, surgery is often used as the first-line treatment. We herein report the case of a 65-year-old woman who presented with complaints of progressive odynophagia and dysphagia for 2 weeks following a fish meal. Enhanced cervicothoracic computed tomography demonstrated an enha...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

A Case of Exophiala dermatitidis Fungemia Diagnosed using Time-of-flight Mass Spectrometry during Chemotherapy for Malignant Lymphoma and Successful Treatment with Voriconazole.
Authors: Yoshida T, Tachita T, Fujinami H, Oshima Y, Sasaki H, Marumo Y, Narita T, Ito A, Ri M, Kusumoto S, Ishida T, Komatsu H, Iida S Abstract Infectious diseases, including those caused by fungi, remain important issues in patients receiving malignant lymphoma chemotherapy. We herein report a rare case of Exophiala dermatitidis fungemia during chemotherapy in a 67-year-old woman admitted to our hospital. She had a fever that could not be resolved despite antifungal therapy. Yeast-like fungi were detected in blood culture samples, but biochemical identification was difficult. E. dermatitidis, a black mold, was id...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

The Usefulness of Video Capsule Endoscopy in Evaluating Gastrointestinal Manifestations of Immunoglobulin A Vasculitis.
Conclusion VCE is very useful for confirming gastrointestinal involvement in IgAV and may be used to determine the timing of steroid therapy initiation. We recommend performing VCE when IgAV is suspected in patients with gastrointestinal symptoms. PMID: 30996162 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

A Case of Hemorrhagic Gastric Metastasis from Hepatocellular Carcinoma Successfully Treated Using Coil Embolization of the Left Gastric Artery.
Authors: Imai M, Ishikawa T, Okoshi M, Tomiyoshi K, Kojima Y, Horigome R, Nozawa Y, Sano T, Iwanaga A, Honma T, Nemoto T, Takeda K, Nishikura K, Ishihara N, Yoshida T Abstract A 62-year-old man initially underwent transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma (HCC). One year after the initial treatment, he developed anemia. Upper gastrointestinal endoscopy revealed irregularly elevated tumors in the lower anterior gastric body, which were diagnosed to be metastasis from HCC. Left gastric artery coil embolization was performed to prevent sustained bleeding, and his anemia par...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Clinical Safety and Efficacy of Secondary Prophylactic Pegylated G-CSF in Advanced Pancreatic Cancer Patients Treated with mFOLFIRINOX: A Single-center Retrospective Study.
Conclusions The scheduled administration of secondary prophylactic Peg G prolonged the progression-free survival in patients treated with mFFX. The combination therapy of Peg G and mFFX may be recommended in patients who exhibit grade 3-4 neutropenic events after prior mFFX cycles. PMID: 30996164 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Possibility of Cardio-renal Protection by Long-term Cardiac Rehabilitation in Elderly Patients with Cardiovascular Diseases.
Authors: Kitajima K, Fujimi K, Matsuda T, Fujita M, Kaino K, Teshima R, Ujifuku Y, Horita T, Sakamoto M, Arimura T, Shiga Y, Shiota E, Miura SI Abstract Objective Cardiac rehabilitation (CR) improves the mortality in patients with cardiovascular disease (CVD). Even in elderly patients with CVD, CR may improve the activities of daily living (ADL). Methods Eighty-eight outpatients over 65 years of age at the beginning of a CR program (baseline) at Fukuoka University Hospital who had CVD and could be followed-up for up to 5 years were enrolled. CVD included ischemic heart disease, postoperative valvular heart disease,...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Endoscopic Features and Diagnostic Procedures of Eosinophilic Gastroenteritis.
This study therefore evaluated the endoscopic findings of six patients with EGE. The diagnosis was confirmed based on gastrointestinal symptoms, pathological findings on biopsy, and the absence of other diseases. The site of the lesion was identified based on eosinophilic infiltration with ≥20 cells per high-power field during a pathological specimen analysis. Flattening of the small intestinal villi was observed in four patients; we believe that this may be a specific feature in the diagnosis of EGE. PMID: 30996166 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Atypical Endoscopic Findings of Rectal Perineurioma.
Authors: Negshi R, Sakai E, Ohata K PMID: 30996167 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

A Sporadic Case of Charcot-Marie-Tooth Disease Type 2 with Left Vocal Fold Palsy due to Mitofusin 2 Mutation.
Authors: Kanemaru K, Ogawa G, Mochizuki H, Nakazato M, Shiomi K Abstract A 33-year-old Japanese woman was referred for hoarseness. She had been diagnosed with Charcot-Marie-Tooth disease at age 3 and bilateral optic atrophy at age 15. Laryngoscopy revealed left vocal fold palsy. These findings suggested Charcot-Marie-Tooth disease type 2; the diagnosis was confirmed by a mitofusin 2 mutation analysis. Her symptoms remained stable for almost 10 years. Although vocal fold palsy and optic atrophy have been previously reported in patients with mitofusin 2 mutations, detailed clinical information and clinical course hav...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Electrocardiographic Criteria of Right Ventricular Hypertrophy in Patients with Chronic Thromboembolic Pulmonary Hypertension after Balloon Pulmonary Angioplasty.
Authors: Yokokawa T, Sugimoto K, Nakazato K, Misaka T, Oikawa M, Kobayashi A, Yoshihisa A, Yamaki T, Kunii H, Ishida T, Takeishi Y Abstract Background Chronic thromboembolic pulmonary hypertension (CTEPH) is a progressive disease that leads to right-sided heart failure with electrocardiographic abnormalities. There are only a few reports about the effects of balloon pulmonary angioplasty for CTEPH on the electrocardiographic criteria of right ventricular hypertrophy. Objective To determine the effect of balloon angioplasty on electrocardiography in patients with CTEPH. Methods We evaluated electrocardiograms in 19 ...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Management of Dysphagia in Patients with Parkinson's Disease and Related Disorders.
Authors: Umemoto G, Furuya H Abstract Various methods of rehabilitation for dysphagia have been suggested through the experience of treating stroke patients. Although most of these patients recover their swallowing function in a short period, dysphagia in Parkinson's disease (PD) and Parkinson-related disorder (PRD) degenerates with disease progression. Muscle rigidity and bradykinesia are recognized as causes of swallowing dysfunction, and it is difficult to easily apply the strategies for stroke to the rehabilitation of dysphagia in PD patients. Disease severity, weight loss, drooling, and dementia are important ...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Coexistence of Mixed Connective Tissue Disease and Familial Mediterranean Fever in a Japanese Patient: A Case Report.
Authors: Fujita Y, Asano T, Sato S, Furuya MY, Temmoku J, Matsuoka N, Kobayashi H, Watanabe H, Suzuki E, Koga T, Endo Y, Kawakami A, Migita K Abstract We herein report a Japanese patient with familial Mediterranean fever (FMF) who developed the clinical manifestations of mixed connective tissue disease (MCTD) and Sjögren's syndrome. The patient was a 36-year-old woman presenting with a periodic short-duration (2-3 days) fever and pleural pain. An MEFV gene analysis detected a complex allele mutation (P369S/R408Q) in exon 3 of the MEFV gene. Serological and clinical data showed the coexistence of MCTD and Sj&ou...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

A 29-year-old Woman with Recurrent Pregnancy-induced Hypertension Based on Vascular Compression of the Medulla Oblongata.
We present a report of a 29-year-old woman with non-dipper type refractory hypertension due to the vascular compression of the medulla oblongata. The patient was diagnosed with hypertension at 17 years of age and underwent emergency Caesarean section at 26 weeks of gestation during 2 pregnancies due to severe high blood pressure. We suspected medullary compression by the curved posterior inferior cerebellar artery as the cause of her intractable hypertension, and she underwent Jannetta's decompression surgery. After the surgery, her blood pressure swiftly decreased to almost within the normal range, and her blood pressure ...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Syphilitic Cervicitis with Cervical Cancer Presenting as Oropharyngeal Syphilis: A Case Report.
Authors: Ishimaru N, Kanzawa Y, Seto H, Kinami S Abstract We herein report a patient with syphilitic cervicitis and cervical cancer presenting as oropharyngeal syphilis. A 31-year-old Japanese woman with a history of unprotected vaginal and oral sex visited our hospital with right submandibular adenomas and erythema in the extremities. The fornix uteri was red, with a nodule noted. The rapid plasma reagin ratio was 1:3. She was diagnosed with syphilitic cervicitis and treated with amoxicillin for four weeks. Initial cervical cytology showed cells with mild nuclear enlargement, which was thought to be metaplasia ass...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Involvement of the Abducens Nucleus Results in Adduction Impairment of the Contralateral Eye.
Authors: Kobayashi Z, Numasawa Y PMID: 30996174 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Oligosecretory Primary Plasma Cell Leukemia with Atypical Morphological Abnormality.
Authors: Toriyama E, Imaizumi Y, Tsuruda K, Itonaga H, Sato S, Ando K, Sawayama Y, Hasegawa H, Hata T, Niino D, Yanagihara K, Miyazaki Y Abstract Plasma cell leukemia (PCL) is a rare variant of multiple myeloma. The detection of plasma cells in the peripheral blood and monoclonal protein in the serum or urine is important for the diagnosis of PCL. However, it is sometimes difficult to diagnose PCL in patients with atypical plasma cell morphology and/or those without detectable monoclonal protein. We herein report a case of oligosecretory PCL showing atypical morphology in leukemic cells with a convoluted nucleus an...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Diffusion Weighted Whole Body Imaging with Background Body Signal Suppression (DWIBS) Was Useful for the Diagnosis and Follow-Up of Giant Cell Arteritis.
Authors: Matsuoka H, Yoshida Y, Oguro E, Murata A, Kuzuya K, Okita Y, Teshigawara S, Yoshimura M, Isoda K, Harada Y, Kaminou T, Ohshima S, Saeki Y Abstract A 66-year-old woman with symptoms of fatigue and headache was diagnosed with giant cell arteritis (GCA). Fluorodeoxyglucose (FDG)-PET/computed tomography (CT) revealed the strong accumulation of FDG in the descending aorta, abdominal aorta, bilateral subclavian artery, and total iliac artery. Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) showed signal enhancement at the descending aorta and abdominal aorta. We repeated FDG...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

A Long-term Survival after Surgical Treatment for Atypical Aortic Coarctation Complicating Takayasu Arteritis with Inactive Disease at the Diagnosis: An Appropriately Treated Autopsy Case.
Authors: Yoshida M, Zoshima T, Hara S, Mizushima I, Fujii H, Yamada K, Sato Y, Harada K, Kawano M Abstract The number of Takayasu arteritis (TAK) cases being diagnosed at an advanced age has increased, including some who develop ischemic lesions without inflammation of the involved arteries long after the onset of TAK. However, few histopathological analyses of such patients without immunosuppressive therapy have been reported. We herein report a 92-year-old woman with atypical aortic coarctation complicating TAK who underwent bypass graft surgery and survived for 23 years without immunosuppressive therapy. Microsc...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Usefulness of Ustekinumab for Treating a Case of Myelodysplastic Syndrome-Associated Inflammatory Bowel Disease.
Authors: Kono M, Sakurai T, Okamoto K, Nagai T, Komeda Y, Kashida H, Minaga K, Kamata K, Takenaka M, Hagiwara S, Watanabe T, Nishida N, Enoki E, Inoue H, Matsumura I, Kudo M Abstract Autoimmune diseases including inflammatory bowel disease (IBD) occur in association with myelodysplastic syndrome (MDS). MDS-associated IBD frequently demonstrates a complicated course. We herein report the first case with MDS-associated IBD that was successfully treated with ustekinumab (UST), an anti-interleukin (IL) 12/23p40 monoclonal antibody. A 63-year-old man with a 7-year history of MDS was referred for examination of diarrhea,...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Acute Adrenal Insufficiency Precipitated by the Discontinuation of a Betamethasone and Dextrochlorpheniramine Combination: The Diagnostic Utility of an Echocardiographic Assessment of Systemic Vascular Resistance.
Authors: Mukai J, Mori S, Katsumori-Yoshimura Y, Takeshige R, Tabata T, Imada H, Hiroyuki S, Takahashi H, Takahashi Y, Hirata KI Abstract A 72-year-old woman with primary biliary cholangitis was admitted to our hospital with heart failure with a preserved ejection fraction. An accidental right ventricular perforation that occurred during an endomyocardial biopsy precipitated cardiogenic shock. Despite successful surgical treatment, she demonstrated progressive hemodynamic deterioration, which was resistant to the administration of high-dose catecholamines. She was diagnosed with acute adrenal insufficiency, which w...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Clinical Features, Pathological Features, and Treatment Outcomes of 22 Patients with Aggressive Adult T-cell Leukemia-lymphoma Treated with a Humanized CCR4 Antibody (Mogamulizumab) at a Single Institution during a 6-year Period (2012-2018).
Conclusion The present findings suggest that the CCR4 expression may be related to the mogamulizumab response, although no other significant predictive markers were identified in this study. Further studies will be needed in order to identify more markers related to the mogamulizumab response. PMID: 30996180 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Migraine-like Headache after Transseptal Puncture for Catheter Ablation: A Case Report and Review of the Literature.
Authors: Kato Y, Hayashi T, Kato R, Takao M Abstract Catheter ablation for atrial fibrillation creates an iatrogenic atrial septal defect by transseptal puncture, which may produce a transient right-to-left shunt. We encountered a 44-year-old man who presented with de novo migraine-like headache after cryoballoon ablation for atrial fibrillation. On reviewing the literature, we found additional cases in which migraine-like headache occurred within one week after the procedure and spontaneously within three months. We should recognize migraine-like headache as a potential complication of catheter ablation. PMID:...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Safety and Efficacy of Endoscopic Removal of Common Bile Duct Stones in Elderly Patients ≥90 Years of Age.
We examined the safety and efficacy of endoscopic stone removal for choledocholithiasis in elderly patients ≥90 years of age with native papilla and compared the outcomes with those in patients 75-89 years of age. Methods This multicenter retrospective study included 569 patients 75-89 years of age and 126 patients ≥90 years of age who had native papilla and underwent therapeutic endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis at 3 institutions in Japan between April 2012 and March 2018. The main outcomes assessed were the incidence of post-ERCP complications during hospitalization and o...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Renal Artery Stenting Recovered Renal Function after Spontaneous Renal Artery Dissection: A Case Report.
Authors: Aoki Y, Sakai Y, Kimura T, Yamaoka T, Maekawa S, Maekawa J, Sano M, Matsuno K, Ishibashi I Abstract Spontaneous renal artery dissection (SRAD) is a rare entity and the management of this disease has not been established. A 54-year-old man presented with severe flank pain, and contrast-enhanced computed tomography images suggested SRAD in his left renal artery. After two weeks of conservative treatment, stents were placed in the renal artery. The pre- and post-procedural renal function was independently assessed by renography. After stenting, his left renal function recovered from the renal failure pattern....
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Influenza Follicles.
Authors: Tomoda Y, Toya M, Kagawa S, Tanaka K PMID: 30996184 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Prevalence of Rapid Eye Movement-related Obstructive Sleep Apnea in Adult Narcolepsy.
This study aimed to examine the prevalence of REM-related OSA in narcolepsy patients. Methods From January 2013 to April 2018, 141 adult patients were diagnosed with narcolepsy using nocturnal polysomnography and the multiple sleep latency test. The prevalence of REM-related OSA in narcolepsy patients was retrospectively reviewed. Three criteria were used to determine REM-related OSA: Definition #1, an overall apnea-hypopnea index (AHI) ≥5 and AHI during REM (AHIREM)/AHI during non-rapid eye movement (NREM) (AHINREM) ≥2; Definition #2, an overall AHI ≥5 and AHIREM/AHINREM≥2 and AHINREM
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Acute-onset Autoimmune Hepatitis in a Patient with Selective Immunoglobulin M Deficiency.
Authors: Sano A, Inoue J, Kakazu E, Ninomiya M, Iwata T, Morosawa T, Takai S, Nakamura T, Masamune A Abstract Selective immunoglobulin M deficiency (SIGMD) is an uncommon primary immunodeficiency disorder. We herein report an SIGMD patient with autoimmune hepatitis. A 21-year-old Japanese man was transferred to our hospital because of acute liver dysfunction. His serum IgM level was low, whereas those of IgG and IgA were normal, indicating that he had SIGMD. We diagnosed him with acute-onset autoimmune hepatitis, and his liver function test findings gradually recovered with corticosteroid administration. Although S...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Proton-pump Inhibitor-induced Severe Hypomagnesemia and Hypocalcemia are Clinically Masked by Thiazide Diuretic.
Authors: Uehara A, Kita Y, Sumi H, Shibagaki Y Abstract 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 administrati...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Both Macro and Micro Filarial Treatment May be Necessary to Treat Hydrocele Due to a Wuchereria bancrofti Infection.
Authors: Fukuchi T, Sugawara H PMID: 30996188 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Erythema Migrans-Like Rash Mimicking Lyme Disease.
Authors: Fukushima K, Yanagisawa N, Kawabata H, Yajima K PMID: 30996189 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Pneumothorax and Pericardial-mediastinal Emphysema.
Authors: Suyama Y, Emoto K, Yukaya T, Osaki T PMID: 30996190 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Asymptomatic Gastric and Colonic Anisakiasis Detected Simultaneously.
Authors: Nakaji K, Kumamoto M, Wada Y, Nakae Y PMID: 30996191 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

The Addition of Prophylactic Antibiotics Can Achieve a Favorable Outcome.
Authors: Fukuchi T, Sugawara H PMID: 30996192 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

The Delayed Diagnosis of Thyroid Storm in Patients with Psychosis: A Report of Two Cases.
Authors: Ishihara Y, Sugawa T, Kaneko H, Hiroshima-Hamanaka K, Amano A, Umakoshi H, Tsuiki M, Kusakabe T, Satoh-Asahara N, Shimatsu A, Tagami T Abstract We herein report two cases of patients with thyroid storm with a delayed diagnosis due to psychosis. The patients were a 63-year-old woman with bipolar II disorder and a 37-year-old man with major depressive disorder. The psychoses in both patients were well controlled with medication. Although they both showed symptoms of thyrotoxicosis, the symptoms were ignored, presumably because the psychological manifestations of worsening of psychosis and thyroid storm are s...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

IgG4-related Periarteritis Successfully Diagnosed by an Alternative Prostate Biopsy: A Case Report.
Authors: Koda R, Tsuchida M, Iino N, Murata M, Inui K, Nakagawa Y, Nishiyama T, Ikeda Y, Hasegawa G, Oguma F, Narita I Abstract A 56-year-old man was referred to our facility after developing edema in his right leg. Enhanced computed tomography (CT) revealed a periarterial soft tissue mass surrounding the right iliac artery compressing the iliac vein. His elevated serum IgG4 level indicated IgG4-related disease (IgG4-RD). Both a percutaneous and surgical biopsy of this periarterial lesion proved challenging and were not pursued. A prostate biopsy, however, finally provided a histological diagnosis of IgG4-RD. Oral ...
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Tracheal Ulcers Associated with Anti-synthetase Syndrome.
Authors: Yamakawa H, Tsumiyama E, Sato S, Matsushima H PMID: 30996195 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Clinical and Genetic Study of the First Japanese FTDP-17 Patient with a Mutation of +3 in Intron 10 in the MAPT Gene.
This study may expand on the clinical and genetic findings for FTDP-17 with mutations in the MAPT gene. PMID: 30996196 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

The Authors' Reply to "The Addition of Prophylactic Antibiotics Can Achieve a Favorable Outcome".
The Authors' Reply to "The Addition of Prophylactic Antibiotics Can Achieve a Favorable Outcome". Intern Med. 2019 Apr 17;: Authors: Kaito S, Sekiya N, Najima Y, Sano N, Horiguchi S, Kakihana K, Hishima T, Ohashi K PMID: 30996197 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Author's Reply: Involvement of the Abducens Nucleus Results in Adduction Impairment of the Contralateral Eye.
Authors: Tsukita K, Sakamaki-Tsukita H, Suenaga T PMID: 30996198 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

The authors' reply to "Both Macro and Micro Filarial Treatment May be Necessary to Treat Hydrocele Due to a Wuchereria bancrofti Infection".
The authors' reply to "Both Macro and Micro Filarial Treatment May be Necessary to Treat Hydrocele Due to a Wuchereria bancrofti Infection". Intern Med. 2019 Apr 17;: Authors: Takaya S, Kutsuna S, Kato Y, Ohmagari N PMID: 30996199 [PubMed - as supplied by publisher] (Source: Internal Medicine)
Source: Internal Medicine - April 20, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Hashimoto's Encephalopathy Presenting with Smoldering Limbic Encephalitis.
Authors: Nagano M, Kobayashi K, Yamada-Otani M, Kuzuya A, Matsumoto R, Oita J, Yoneda M, Ikeda A, Takahashi R Abstract Hashimoto's encephalopathy (HE) is a steroid-responsive autoimmune encephalopathy associated with Hashimoto thyroiditis. We herein report a case of HE manifesting "smoldering" limbic encephalitis with persisting symptoms and abnormalities on examinations. Although our patient experienced partial clinical remission after treatment, hippocampal hypermetabolism on [18F] fluorodeoxyglucose positron emission tomography (FDG-PET) and subclinical seizures on video electroencephalography persiste...
Source: Internal Medicine - April 17, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Chronic Nodular Pulmonary Aspergillosis in a Patient with Rheumatoid Arthritis.
Authors: Ito Y, Tanigawa M, Takemura T, Iwamoto K, Nigi A, Sasano H, Itani H, Kondo S, Tokui T, Nakamura S, Miyazaki Y Abstract Chronic pulmonary aspergillosis, which features nodular lesions known as Aspergillus nodules, is a relatively uncommon disorder. We herein report a case of slowly progressing chronic multiple nodular pulmonary aspergillosis in a 59-year-old man with rheumatoid arthritis, dyspnea, and fatigue. One nodule was surgically resected. The surgical specimen featured central necrosis and was located adjacent to a respiratory bronchiole and pulmonary artery, without parenchymal invasion. Branching s...
Source: Internal Medicine - April 3, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research