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Hepatocellular Carcinoma Arising Adjacent to Antiphospholipid Syndrome-associated Hepatic Infarction in a Non-cirrhotic Liver. 非肝硬化肝脏抗磷脂综合征相关性肝梗死附近发生的肝细胞癌。
IF 1.1 4区 医学
Internal Medicine Pub Date : 2025-10-01 Epub Date: 2025-03-22 DOI: 10.2169/internalmedicine.5081-24
Yuriko Kusumi, Takumu Hasebe, Manami Hayashi, Yuki Kamikokura, Shin Otake, Hidemi Hayashi, Yu Ota, Shunsuke Nakajima, Kazunobu Aso, Koji Sawada, Mishie Tanino, Mikihiro Fujiya
{"title":"Hepatocellular Carcinoma Arising Adjacent to Antiphospholipid Syndrome-associated Hepatic Infarction in a Non-cirrhotic Liver.","authors":"Yuriko Kusumi, Takumu Hasebe, Manami Hayashi, Yuki Kamikokura, Shin Otake, Hidemi Hayashi, Yu Ota, Shunsuke Nakajima, Kazunobu Aso, Koji Sawada, Mishie Tanino, Mikihiro Fujiya","doi":"10.2169/internalmedicine.5081-24","DOIUrl":"10.2169/internalmedicine.5081-24","url":null,"abstract":"<p><p>A man in his 70s with antiphospholipid syndrome (APS) presented with a hepatic mass. Initial imaging suggested hepatic infarction, as the liver tumor markers were normal, and coagulation tests indicated a hypercoagulable state. Three years later, follow-up imaging revealed tumor enlargement, leading to a biopsy-confirmed hepatocellular carcinoma diagnosis. Transarterial embolization was performed followed by lenvatinib therapy. The patient achieved complete response with no recurrence for over eight months. This case highlights the potential of APS to contribute to liver carcinogenesis in non-cirrhotic patients and illustrates the need for individualized treatment strategies.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2839-2845"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Small Intestinal Bacterial Overgrowth in a Healthy Female Patient Caused by Long-term Oral Proton Pump Inhibitor Administration. 健康女性长期口服质子泵抑制剂致小肠细菌过度生长1例。
IF 1.1 4区 医学
Internal Medicine Pub Date : 2025-10-01 Epub Date: 2025-04-05 DOI: 10.2169/internalmedicine.4376-24
Koichi Soga, Sotaro Yamada, Yuto Suzuki, Yumi Kusano, Ikuhiro Kobori, Yasumi Katayama, Masaya Tamano
{"title":"Small Intestinal Bacterial Overgrowth in a Healthy Female Patient Caused by Long-term Oral Proton Pump Inhibitor Administration.","authors":"Koichi Soga, Sotaro Yamada, Yuto Suzuki, Yumi Kusano, Ikuhiro Kobori, Yasumi Katayama, Masaya Tamano","doi":"10.2169/internalmedicine.4376-24","DOIUrl":"10.2169/internalmedicine.4376-24","url":null,"abstract":"<p><p>Small-intestinal bacterial overgrowth (SIBO) causes gastrointestinal symptoms. Proton pump inhibitors (PPIs) are commonly used for acid peptic diseases; however, their long-term use can alter the gut microbiota, resulting in adverse effects. We herein report the case of a 26-year-old Japanese woman with SIBO caused by prolonged PPI use. After switching to a H2 receptor antagonist, her symptoms and blood test results improved. This case highlights the need to understand the pathogenesis of SIBO and also the risks associated with prolonged PPI use.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2852-2857"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Venous Thromboembolism with Double Left Common Iliac Veins. 静脉血栓栓塞伴双左髂总静脉。
IF 1.1 4区 医学
Internal Medicine Pub Date : 2025-09-15 Epub Date: 2025-03-08 DOI: 10.2169/internalmedicine.5252-25
Takao Konishi, Sakae Takenaka, Toshiyuki Nagai, Toshihisa Anzai
{"title":"Venous Thromboembolism with Double Left Common Iliac Veins.","authors":"Takao Konishi, Sakae Takenaka, Toshiyuki Nagai, Toshihisa Anzai","doi":"10.2169/internalmedicine.5252-25","DOIUrl":"10.2169/internalmedicine.5252-25","url":null,"abstract":"","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2809-2810"},"PeriodicalIF":1.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How to Prevent Left Atrial Thrombus Formation Following TEER in Patients with Prior Left Atrial Appendage Occlusion. 如何预防既往左房附件闭塞患者TEER后左房血栓形成。
IF 1.1 4区 医学
Internal Medicine Pub Date : 2025-09-15 Epub Date: 2025-03-08 DOI: 10.2169/internalmedicine.5125-24
Nobuyuki Fukuda, Teruhiko Imamura
{"title":"How to Prevent Left Atrial Thrombus Formation Following TEER in Patients with Prior Left Atrial Appendage Occlusion.","authors":"Nobuyuki Fukuda, Teruhiko Imamura","doi":"10.2169/internalmedicine.5125-24","DOIUrl":"10.2169/internalmedicine.5125-24","url":null,"abstract":"","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2815"},"PeriodicalIF":1.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of Clinical Outcomes Between Early and Delayed Percutaneous Coronary Intervention for the Culprit Lesion in Patients with Non-ST-segment Elevation Myocardial Infarction. 非st段抬高型心肌梗死患者罪魁祸首病变早期与延迟经皮冠状动脉介入治疗的临床效果比较
IF 1.1 4区 医学
Internal Medicine Pub Date : 2025-09-15 Epub 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":"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 (hazard ratio 1.005, 95% confidence interval 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":"2699-2707"},"PeriodicalIF":1.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508638/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Disseminated Nocardiosis in Idiopathic CD4 Lymphocytopenia: A Rare Case and Literature Review. 特发性CD4淋巴细胞减少伴播散性诺卡菌病：一例罕见病例及文献回顾。
IF 1.1 4区 医学
Internal Medicine Pub Date : 2025-09-15 Epub Date: 2025-03-29 DOI: 10.2169/internalmedicine.4984-24
Nayuta Seto, Takayuki Suzuki, Takahiko Fukuchi, Momori Honjo, Shinya Watanabe, Longzhu Cui, Hitoshi Sugawara
{"title":"Disseminated Nocardiosis in Idiopathic CD4 Lymphocytopenia: A Rare Case and Literature Review.","authors":"Nayuta Seto, Takayuki Suzuki, Takahiko Fukuchi, Momori Honjo, Shinya Watanabe, Longzhu Cui, Hitoshi Sugawara","doi":"10.2169/internalmedicine.4984-24","DOIUrl":"10.2169/internalmedicine.4984-24","url":null,"abstract":"<p><p>Nocardiosis typically affects immunocompromised patients; however, the clinical characteristics of idiopathic CD4 lymphocytopenia (ICL) remain poorly understood. A 64-year-old patient was diagnosed with ICL following disseminated nocardiosis, including bacteremia, pneumonia, knee arthritis, and brain abscess. The patient underwent trimethoprim-sulfamethoxazole therapy with frequent dose adjustments based on the renal function, ranging from 2 to 12 single-strength tablets daily over 5 months of hospitalization. While he had a 1-year uneventful course of lifelong prophylaxis, he experienced prolonged recovery in physical activity. A literature review highlighted the life-threatening nature of nocardiosis in ICL, underscoring the importance of a timely diagnosis and tailored management strategies.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2797-2803"},"PeriodicalIF":1.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Status Epilepticus Caused by Tick-borne Encephalitis. 蜱传脑炎致癫痫持续状态1例报告。
IF 1.1 4区 医学
Internal Medicine Pub Date : 2025-09-15 Epub Date: 2025-03-22 DOI: 10.2169/internalmedicine.4773-24
Kazuhiro Horiuchi, Shuntaro Nakamura, Kazuki Yamada, Kazuya Mitsuhashi, Kei Watari, Kazuma Tamiya, Hiroki Yamaguchi, Shintaro Kobayashi
{"title":"Status Epilepticus Caused by Tick-borne Encephalitis.","authors":"Kazuhiro Horiuchi, Shuntaro Nakamura, Kazuki Yamada, Kazuya Mitsuhashi, Kei Watari, Kazuma Tamiya, Hiroki Yamaguchi, Shintaro Kobayashi","doi":"10.2169/internalmedicine.4773-24","DOIUrl":"10.2169/internalmedicine.4773-24","url":null,"abstract":"<p><p>We herein report a rare case of a 78-year-old Japanese man who developed refractory status epilepticus due to tick-borne encephalitis (TBE). The patient initially presented with left-sided hemiplegia and loss of consciousness. Initial diagnostic tests could not identify the cause of the encephalomyelitis, leading to a preliminary diagnosis of autoimmune encephalomyelitis. Despite treatment with corticosteroids and plasma exchange, the patient experienced status epilepticus, which required multiple antiseizure medications. TBE viral antibodies were eventually detected, confirming the diagnosis. Despite the treatment, the patient remained critically ill. Clinicians should consider TBE in the differential diagnosis of encephalitis of unknown origin associated with status epilepticus.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2784-2789"},"PeriodicalIF":1.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cutaneous Arteritis Complicated by Crohn's Disease. 一例克罗恩病并发皮肤动脉炎病例
IF 1.1 4区 医学
Internal Medicine Pub Date : 2025-09-15 Epub Date: 2025-03-15 DOI: 10.2169/internalmedicine.5052-24
Takao Nagashima, Hiroki Yabe, Naoka Umemoto, Satohiro Matsumoto, Hisashi Oshiro
{"title":"Cutaneous Arteritis Complicated by Crohn's Disease.","authors":"Takao Nagashima, Hiroki Yabe, Naoka Umemoto, Satohiro Matsumoto, Hisashi Oshiro","doi":"10.2169/internalmedicine.5052-24","DOIUrl":"10.2169/internalmedicine.5052-24","url":null,"abstract":"<p><p>Cutaneous arteritis (CA) is a rare cutaneous manifestation of Crohn's disease. A 50-year-old woman with a 15-year history of CA was admitted to our hospital with a fever, abdominal pain, and hematochezia. Based on these symptoms and increased C-reactive protein levels, systemic vasculitis was considered. However, emergency colonoscopy revealed multiple longitudinal ulcers throughout the colon, thus suggesting Crohn's disease. Prednisolone (60 mg/day) was administered intravenously. A histopathological examination of the biopsied colonic mucosa revealed epithelioid granulomas, which confirmed the diagnosis of Crohn's disease. Because the systemic evolution of CA is rare, other comorbidities should be considered when patients with CA experience systemic manifestations.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2794-2796"},"PeriodicalIF":1.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development of Adult T-Cell Leukemia/Lymphoma During Treatment with PD-L1 Inhibitor for Lung Cancer. PD-L1抑制剂治疗肺癌期间成人t细胞白血病/淋巴瘤的发展
IF 1.1 4区 医学
Internal Medicine Pub Date : 2025-09-15 Epub Date: 2025-03-08 DOI: 10.2169/internalmedicine.5114-24
Hikari Fujioka, Kentaro Kikuchi, Takumi Nakahara, Satoshi Yoshioka, Rina Kawai, Maki Kajitani, Mana Ishizuka, Masaya Akiyama, Yutaro Tanaka, Ayako Kobayashi, Ken Sato, Kennosuke Karube, Goh Tanaka, Tadashi Kohyama
{"title":"Development of Adult T-Cell Leukemia/Lymphoma During Treatment with PD-L1 Inhibitor for Lung Cancer.","authors":"Hikari Fujioka, Kentaro Kikuchi, Takumi Nakahara, Satoshi Yoshioka, Rina Kawai, Maki Kajitani, Mana Ishizuka, Masaya Akiyama, Yutaro Tanaka, Ayako Kobayashi, Ken Sato, Kennosuke Karube, Goh Tanaka, Tadashi Kohyama","doi":"10.2169/internalmedicine.5114-24","DOIUrl":"10.2169/internalmedicine.5114-24","url":null,"abstract":"<p><p>Advancements in immunotherapy, the phenomenon of hyperprogression in cancer patients, have garnered increasing attention. We herein report a case of acute adult T-cell leukemia/lymphoma (ATL) that developed after administration of the programmed death-ligand1 inhibitor durvalumab in a patient with lung cancer. Although the patient was a carrier of human T-cell leukemia virus type 1 (HTLV-1), this was unknown prior to durvalumab treatment. HTLV-1 bZIP factor was detected in formalin-fixed lymph node tissue, confirming the diagnosis of ATL. Our findings suggest a potential association between immune checkpoint inhibition and ATL development in HTLV-1 carriers.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2760-2763"},"PeriodicalIF":1.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Successful Transvaginal Endoscopic Ultrasound-guided Pelvic Abscess Drainage. 经阴道超声内镜引导下盆腔脓肿引流成功1例。
IF 1.1 4区 医学
Internal Medicine Pub Date : 2025-09-15 Epub Date: 2025-03-08 DOI: 10.2169/internalmedicine.4448-24
Yoshitaka Ando, Makoto Motegi, Toshiyuki Sakurai, Masayuki Saruta
{"title":"Successful Transvaginal Endoscopic Ultrasound-guided Pelvic Abscess Drainage.","authors":"Yoshitaka Ando, Makoto Motegi, Toshiyuki Sakurai, Masayuki Saruta","doi":"10.2169/internalmedicine.4448-24","DOIUrl":"10.2169/internalmedicine.4448-24","url":null,"abstract":"<p><p>Endoscopic ultrasound-guided pelvic abscess drainage (EUS-PAD) has emerged as a viable alternative to percutaneous drainage. However, reports of this method are limited to procedures associated with transrectal access. We herein present the first case of successful transvaginal EUS-PAD in a 22-year-old female who developed a pelvic abscess after undergoing a cesarean section. An ultrasound endoscope was inserted transvaginally to visualize the abscess. Puncture and dilation were performed and a 7 Fr endoscopic nasobiliary drainage tube was put in place. The patient showed a rapid improvement after the procedure and was discharged without any complications. This case report highlights the efficacy and safety of transvaginal EUS-PAD as a viable option for performing pelvic abscess drainage.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2723-2727"},"PeriodicalIF":1.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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