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Comparison of Clinical Outcomes Between Early and Delayed Percutaneous Coronary Intervention for the Culprit Lesion in Patients with Non-ST-Segment Elevation Myocardial Infarction.
IF 1 4区 医学
Internal Medicine Pub Date : 2025-03-29 DOI: 10.2169/internalmedicine.4805-24
Yae Ota, Kenichi Sakakura, Hiroyuki Jinnouchi, Yousuke Taniguchi, Kei Yamamoto, Takunori Tsukui, Masashi Hatori, Taku Kasahara, Yusuke Watanabe, Shun Ishibashi, Masaru Seguchi, Hideo Fujita
{"title":"Comparison of Clinical Outcomes Between Early and Delayed Percutaneous Coronary Intervention for the Culprit Lesion in Patients with Non-ST-Segment Elevation Myocardial Infarction.","authors":"Yae Ota, Kenichi Sakakura, Hiroyuki Jinnouchi, Yousuke Taniguchi, Kei Yamamoto, Takunori Tsukui, Masashi Hatori, Taku Kasahara, Yusuke Watanabe, Shun Ishibashi, Masaru Seguchi, Hideo Fujita","doi":"10.2169/internalmedicine.4805-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.4805-24","url":null,"abstract":"<p><p>Objective Immediate primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction is closely associated with better clinical outcomes. However, the optimal timing of PCI for the culprit lesion in non-ST-elevation myocardial infarction (NSTEMI) is not fully understood. The aim of this study was to compare clinical outcomes between patients with early and delayed PCI and to investigate whether early PCI within 24 hours of admission can improve long-term clinical outcomes in patients with NSTEMI. Methods This was a single-center, retrospective study. The primary endpoint was major adverse cardiovascular events (MACE), which was defined as the composite of all-cause death, non-fatal MI, and re-admission for heart failure. Results We included 816 patients with NSTEMI and divided them into an early PCI group (n=446) and a delayed PCI group (n=370). The median follow-up period was 856 days. The median age was lower in the early PCI group [73 (65-79) years] than in the delayed PCI group [76 (69-81)] (p<0.001). Shock at admission was more frequently observed in the early PCI group (11.9%) than in the delayed PCI group (3.2%) (p=0.001). The incidence of MACE in the delayed PCI group (40.8%) was higher than that in the early PCI group (28.5%) (P<0.001). However, a multivariate Cox hazard analysis revealed that early PCI was not associated with MACE after controlling for multiple confounding factors (HR 1.005, 95% CI 0.763-1.322, p=0.973). Conclusion The timing of PCI may not be important in hemodynamically stable patients with NSTEMI, as long as primary PCI is performed.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An Atypical Cystic Renal Mass in a Patient with IgG4-Related Kidney Disease: A Case Report.
IF 1 4区 医学
Internal Medicine Pub Date : 2025-03-29 DOI: 10.2169/internalmedicine.4691-24
Chisato Minezaki, Hiroki Uchida, Kouhei Todaka, Nobuchika Koumatsu, Jun Okita, Akiko Kudo, Takeshi Nakata, Akihiro Fukuda, Naoya Fukunaga, Noriko Uesugi, Hirotaka Shibata
{"title":"An Atypical Cystic Renal Mass in a Patient with IgG4-Related Kidney Disease: A Case Report.","authors":"Chisato Minezaki, Hiroki Uchida, Kouhei Todaka, Nobuchika Koumatsu, Jun Okita, Akiko Kudo, Takeshi Nakata, Akihiro Fukuda, Naoya Fukunaga, Noriko Uesugi, Hirotaka Shibata","doi":"10.2169/internalmedicine.4691-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.4691-24","url":null,"abstract":"<p><p>We herein report a case of IgG4-related kidney disease (IgG4-RKD) with an atypical cystic renal mass in a 73-year-old man. Computed tomography (CT) revealed diffuse renal enlargement and a cystic mass in the left kidney. Blood tests revealed elevated IgG and IgG4 levels. A renal biopsy led to the IgG4-RKD diagnosis. The cystic mass was deemed to be benign based on the clinical, imaging, and ultrasonography findings. No malignancy or abscess formation was noted. Both the renal function and IgG4 levels improved after steroid treatment; moreover, the mass shrunk, suggesting an IgG4-RKD etiology. Cystic renal masses with capsule formation should be considered in patients presenting with IgG4-RKD.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bucillamine-induced Yellow Nail Syndrome with Chylothorax: A Case Report.
IF 1 4区 医学
Internal Medicine Pub Date : 2025-03-29 DOI: 10.2169/internalmedicine.4935-24
Yukari Hisamoto, Yoriyuki Murata, Kazuki Matsuda, Koji Narikiyo, Taiga Kobayashi, Kosei Yonezawa, Keita Murakawa, Kazuki Hamada, Syuichiro Ohata, Toshiaki Utsunomiya, Yoshikazu Yamaji, Keiji Oishi, Maki Asami-Noyama, Nobutaka Edakuni, Tomoyuki Kakugawa, Tsunahiko Hirano, Kazuto Matsunaga
{"title":"Bucillamine-induced Yellow Nail Syndrome with Chylothorax: A Case Report.","authors":"Yukari Hisamoto, Yoriyuki Murata, Kazuki Matsuda, Koji Narikiyo, Taiga Kobayashi, Kosei Yonezawa, Keita Murakawa, Kazuki Hamada, Syuichiro Ohata, Toshiaki Utsunomiya, Yoshikazu Yamaji, Keiji Oishi, Maki Asami-Noyama, Nobutaka Edakuni, Tomoyuki Kakugawa, Tsunahiko Hirano, Kazuto Matsunaga","doi":"10.2169/internalmedicine.4935-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.4935-24","url":null,"abstract":"<p><p>Yellow nail syndrome (YNS), a rare condition characterized by thickened yellow nails, lymphedema, and respiratory manifestations, is rarely caused by bucillamine, an anti-rheumatic agent. Respiratory manifestations of YNS include chylothorax in 18.8%-22% of patients with pleural effusion. We herein report the first case of bucillamine-induced YNS with chylothorax. Lymphangiography revealed narrowing of the lymphatic vessels and stagnation of the lymphatic fluid, suggesting impaired lymphatic drainage. The chylothorax persisted despite the discontinuation of bucillamine. The present case illustrates that bucillamine can cause irreversible lymphatic impairment and chylothorax.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A case of Sjögren's syndrome with sensory neuronopathy and polyradiculoneuropathy.
IF 1 4区 医学
Internal Medicine Pub Date : 2025-03-29 DOI: 10.2169/internalmedicine.5188-24
Takumi Funakoshi, Minoru Yamada, Kazuna Ikeda, Kazuki Yokokawa, Tarou Saito, Reiko Tsuda, Naotoshi Iwahara, Syuuichirou Suzuki, Shin Hisahara
{"title":"A case of Sjögren's syndrome with sensory neuronopathy and polyradiculoneuropathy.","authors":"Takumi Funakoshi, Minoru Yamada, Kazuna Ikeda, Kazuki Yokokawa, Tarou Saito, Reiko Tsuda, Naotoshi Iwahara, Syuuichirou Suzuki, Shin Hisahara","doi":"10.2169/internalmedicine.5188-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.5188-24","url":null,"abstract":"<p><p>41-year-old female became difficulty walking due to sensory ataxia in the limbs and trunk. A diagnosis of Sjögren's syndrome was made on the results of positive anti-SS-A antibody and a lip gland biopsy. Nerve conduction studies indicated sensory neuronopathy. The symptoms improved following treatment with plasma exchange, intravenous immunoglobulin, and intravenous methylprednisolone. Nine months later, the patient's sensory ataxia worsened. Nerve conduction studies revealed the coexistence of sensory neuronopathy and polyradiculoneuropathy. The symptoms improved following treatment with intravenous cyclophosphamide and intravenous immunoglobulin. This case represents the first instance of sensory neuronopathy and polyradiculoneuropathy coexisting as Sjögren's syndrome related neuropathy.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Scoping Review of the Health Benefits of Stretching Exercises in Patients with Type 2 Diabetes Mellitus.
IF 1 4区 医学
Internal Medicine Pub Date : 2025-03-29 DOI: 10.2169/internalmedicine.4928-24
Tomoko Takamiya, Rokuro Ito, Junko Sasaki, Toshihiro Amagawa, Sawako Wakui, Yuko Odagiri, Ryo Suzuki
{"title":"Scoping Review of the Health Benefits of Stretching Exercises in Patients with Type 2 Diabetes Mellitus.","authors":"Tomoko Takamiya, Rokuro Ito, Junko Sasaki, Toshihiro Amagawa, Sawako Wakui, Yuko Odagiri, Ryo Suzuki","doi":"10.2169/internalmedicine.4928-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.4928-24","url":null,"abstract":"<p><p>This study aimed to clarify the current state of research on the effects of stretching exercises on the health of patients with type 2 diabetes mellitus (T2DM). A scoping review of the literature was conducted in December 2024, using four databases. Experimental and clinical studies were included if they compared stretching exercises with non-stretching exercises for T2DM-related health outcomes. The primary search terms used were \"diabetes mellitus, type 2,\" \"muscle stretching exercises,\" and \"range of motion, articular.\". Eleven studies met our inclusion criteria. Eight studies focused on blood glucose levels, one of which assessed the functional capacity. The remaining studies investigated plantar pressure, shoulder joint mobility/pain/disability, and fatigue, with one study addressing each outcome. This review indicates that stretching exercises may affect a variety of health parameters, including blood glucose regulation, in patients with T2DM but emphasizes the need for further high-quality research to determine their effectiveness.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Concurrent Pulmonary Sarcoidosis and Carcinomatous Lymphangitis.
IF 1 4区 医学
Internal Medicine Pub Date : 2025-03-29 DOI: 10.2169/internalmedicine.5277-25
Hisako Kushima, Yoshiaki Kinoshita, Masayo Yoshimura, Hiroshi Ishii
{"title":"Concurrent Pulmonary Sarcoidosis and Carcinomatous Lymphangitis.","authors":"Hisako Kushima, Yoshiaki Kinoshita, Masayo Yoshimura, Hiroshi Ishii","doi":"10.2169/internalmedicine.5277-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5277-25","url":null,"abstract":"","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Coronary Artery Spasm as a Contributor to Heart Failure: Lessons from Three Cases.
IF 1 4区 医学
Internal Medicine Pub Date : 2025-03-29 DOI: 10.2169/internalmedicine.5057-24
Ayami Naito, Takumi Toya, Akane Kawai, Kota Mizutani, Kazuhiko Kuinose, Yuji Nagatomo, Takeshi Adachi
{"title":"Coronary Artery Spasm as a Contributor to Heart Failure: Lessons from Three Cases.","authors":"Ayami Naito, Takumi Toya, Akane Kawai, Kota Mizutani, Kazuhiko Kuinose, Yuji Nagatomo, Takeshi Adachi","doi":"10.2169/internalmedicine.5057-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.5057-24","url":null,"abstract":"<p><p>Coronary artery spasm (CAS) is an underrecognized cause of heart failure, even in the absence of obstructive coronary artery disease. We report three cases of heart failure in which CAS was identified as the critical etiology. All patients exhibited symptoms of heart failure with nonobstructive coronary arteries, and CAS provocation testing confirmed epicardial spasm. In two cases, cardiac magnetic resonance imaging revealed ischemic patterns consistent with CAS-related injuries. Calcium channel blockers effectively stabilize the signs and symptoms related to heart failure. This series highlights CAS as a contributor to heart failure progression and emphasizes the importance of provocation testing and early tailored therapy for improving outcomes.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Serial Change of Perivascular Fat Attenuation Index in a Case of Spontaneous Coronary Artery Dissection Involving the Proximal Left Coronary Artery.
IF 1 4区 医学
Internal Medicine Pub Date : 2025-03-29 DOI: 10.2169/internalmedicine.5255-25
Shu Yoshihara, Taku Yaegashi, Masaki Matsunaga
{"title":"Serial Change of Perivascular Fat Attenuation Index in a Case of Spontaneous Coronary Artery Dissection Involving the Proximal Left Coronary Artery.","authors":"Shu Yoshihara, Taku Yaegashi, Masaki Matsunaga","doi":"10.2169/internalmedicine.5255-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5255-25","url":null,"abstract":"<p><p>The perivascular fat attenuation index (FAI) has been recognized as a cardiac computed tomography-based (CCT)-based biomarker of coronary inflammation. We report the case of a 47-year-old woman with acute spontaneous coronary artery dissection (SCAD) involving the proximal left coronary artery (LCA), who underwent FAI three times. The initial CCT scan revealed higher perivascular FAI values in the dissected LCA. The second CCT scan, performed 8 days later, showed persistence of a higher perivascular FAI value only in the left circumflex coronary artery, in which progression of stenotic severity and myocardial infarction formation were found. The persistence of a higher perivascular FAI may indicate disease deterioration in patients with SCAD.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Selective Intracoronary Injection of Nitrates was Effective for Contrast Media-induced Type I Kounis Syndrome After Treatment with Steroids and Antihistamines.
IF 1 4区 医学
Internal Medicine Pub Date : 2025-03-29 DOI: 10.2169/internalmedicine.5094-24
Tasuku Kurokawa, Aoi Takahata, Tadateru Iwayama, Toshiki Sasaki, Takeshi Niizeki, Masafumi Watanabe
{"title":"Selective Intracoronary Injection of Nitrates was Effective for Contrast Media-induced Type I Kounis Syndrome After Treatment with Steroids and Antihistamines.","authors":"Tasuku Kurokawa, Aoi Takahata, Tadateru Iwayama, Toshiki Sasaki, Takeshi Niizeki, Masafumi Watanabe","doi":"10.2169/internalmedicine.5094-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.5094-24","url":null,"abstract":"<p><p>A 77-year-old man presented for computed tomography (CT) with iodinated contrast for follow-up of gastric cancer. After contrast injection, the patient experienced cardiac arrest. A post-return spontaneous circulation electrocardiogram showed ST segment elevation in the inferior leads and V1-3. Since type I Kounis syndrome (KS) was suspected, corticosteroids and antihistamines were administered intravenously. Subsequently, coronary angiography (CAG) revealed coronary spasms, and selective intracoronary injection of nitrates successfully resolved each spasm. Strategic substitution of contrast media did not induce any additional allergic reactions. The optimal timing and preferred strategies for performing CAG in patients with KS were also discussed.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An Autopsy Case of Varicella-zoster Virus Uveitis Progressing to Vasculopathy with Multiple Cerebral Infarctions.
IF 1 4区 医学
Internal Medicine Pub Date : 2025-03-29 DOI: 10.2169/internalmedicine.4511-24
Hiroaki Ando, Yuichi Kawagashira, Jun-Ichi Niwa, Akio Akagi, Manabu Doyu
{"title":"An Autopsy Case of Varicella-zoster Virus Uveitis Progressing to Vasculopathy with Multiple Cerebral Infarctions.","authors":"Hiroaki Ando, Yuichi Kawagashira, Jun-Ichi Niwa, Akio Akagi, Manabu Doyu","doi":"10.2169/internalmedicine.4511-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.4511-24","url":null,"abstract":"<p><p>We herein report an autopsy case of multiple cerebral infarctions caused by varicella-zoster virus (VZV) vasculopathy. A 60-year-old man, previously diagnosed with VZV uveitis, subsequently developed cerebral infarction with multiple cerebral vessel stenoses. Based on the results of a polymerase chain reaction test of cerebrospinal fluid, the patient was diagnosed with VZV vasculopathy. Despite treatment with acyclovir and prednisolone, the vascular stenosis progressed and became complicated by extensive cerebral infarctions. Upon autopsy, inflammatory cell infiltration was pathologically observed in the vessel walls of the anterior and middle cerebral arteries, consistent with the magnetic resonance imaging findings.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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