Internal Medicine最新文献

{"title":"Superficial Primary Malignant Melanoma of the Esophagus Detected and Treated at Stage 0.","authors":"Yuzo Toyama, Ryuji Nagahama, Yu Kodama, Izumi Kaieda, Shinjiro Sakai, Gen Maeda, Hidemitsu Nishizawa, Shingo Asahara, Yuji Mizokami","doi":"10.2169/internalmedicine.2454-23","DOIUrl":"10.2169/internalmedicine.2454-23","url":null,"abstract":"<p><p>The patient was a 79-year-old male. At three years and eight months after his initial presentation, upper gastrointestinal endoscopy revealed a black-flattened elevated lesion in the middle third of the esophagus, which was diagnosed as malignant melanoma on biopsy. No lymph node or distant metastasis was found. A diagnosis of cT1bN0M0 Stage I was thus made. We performed a robot-assisted, minimally invasive esophagectomy and D2 dissection. The postoperative diagnosis was pT1a-MM, N0, M0, vascular invasion+, stage 0. The patient was recurrence-free for 14 months after surgery. We presume that an aggressive biopsy diagnosis is important for the early detection of malignant melanoma.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"3049-3053"},"PeriodicalIF":1.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140206806","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}

{"title":"Predictive Factors of Unexpected Hospitalization within Six Months of Undergoing Percutaneous Coronary Intervention in Patients with Chronic Coronary Disease.","authors":"Tetsuo Furukawa, Isamu Mizote, Tatsuya Shiraki, Daisuke Nakamura, Mayu Nishio, Naoki Fukushima, Takashi Kitao, Kensuke Yokoi, Masahiro Kumada, Motoaki Kitagawa, Kunihiko Nagai, Kiyoshi Kume, Keiji Hirooka, Tsutomu Nakagawa, Tohru Ohama, Mitsuyoshi Takahara, Shungo Hikoso, Yasushi Sakata","doi":"10.2169/internalmedicine.3929-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.3929-24","url":null,"abstract":"<p><p>Background Recent guidelines recommend dual antiplatelet therapy (DAPT) for six months following percutaneous coronary intervention (PCI) in patients with chronic coronary disease, as unexpected hospitalization can trigger DAPT discontinuation. This study evaluated the predictive factors for unexpected hospitalization within six months after PCI in patients with chronic coronary disease. Methods This prospective multicenter study included 412 patients who underwent PCI for chronic coronary disease. Unexpected hospitalization was defined as a prolonged hospital stay, unscheduled readmission, and all-cause mortality. The predictive factors for unexpected hospitalization within six months post-PCI were evaluated using the Cox regression model. Results The rate of unexpected hospitalization 6 months after PCI was 10.8%±1.5%. Unexpected hospitalizations due to bleeding events accounted for 12.1% (n=5/41), whereas non-bleeding readmissions accounted for 87.9% (n=36/41). A multivariable analysis revealed that the number of Academic Research Consortium for High Bleeding Risk (ARC-HBR) major criteria met [adjusted hazard ratio (HR), 1.55; 95% confidence interval (CI), 1.05-2.29; P=0.026], body weight (adjusted HR, 2.44; 95% CI 1.33-4.49; P=0.004), and presence of diabetes mellitus (adjusted HR, 1.94; 95% CI 1.09-3.47; P=0.025) were independent risk factors for unexpected hospitalization. Among the major ARC-HBR criteria, oral anticoagulant use (adjusted HR, 2.39; 95% CI, 1.14-5.02, P=0.021) and active malignancy (adjusted HR, 3.85; 95% CI, 1.47-10.05; P=0.006) were significantly associated with unexpected hospitalization after adjusting for a low body weight and diabetes mellitus. Conclusions The majority of unexpected hospitalizations after PCI in patients with chronic coronary disease are attributed to non-bleeding causes. The assessment using major ARC-HBR criteria in these patients not only addresses bleeding risks but also underscores its predictive value in conjunction with a low body weight and diabetes mellitus for the prediction of unexpected hospitalization.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619776","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}

{"title":"A Case of Severe Fever with Thrombocytopenia Syndrome and Acute Gastric Mucosal Lesions Confirmed Using Esophagogastroduodenoscopy.","authors":"Koki Kitagawa, Mitsuhiro Kitani, Tetsuro Saito, Naoto Yoshitake, Shogo Shirota","doi":"10.2169/internalmedicine.4416-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.4416-24","url":null,"abstract":"<p><p>Severe fever with thrombocytopenia syndrome (SFTS) is known to cause gastrointestinal hemorrhaging; however, few reports have so far specified the site of the hemorrhaging or lesion characteristics. A 79-year-old man was admitted to the hospital with fever, anorexia, and diarrhea which was suspected to be due to gastroenteritis. On day 2, the patient developed hematemesis. Esophagogastroduodenoscopy revealed an acute gastric mucosal lesion. Further physical examination revealed an eschar, and the blood test was positive for SFTS virus nucleic acid. This case suggests that SFTS-associated gastrointestinal hemorrhage may be caused by acute gastritis. SFTS should therefore be considered in cases with fever, gastrointestinal symptoms, and thrombocytopenia.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619682","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}

{"title":"Acute Severe Colitis after mRNA Coronavirus Disease 2019 Vaccination: A Case Report.","authors":"Akira Nakanishi, Sakuma Takahashi, Tomoki Inaba, Eriko Yasutomi, Hugh Shunsuke Colvin, Koichi Izumikawa, Shigenao Ishikawa, Masaki Wato, Midori Ando, Satoko Nakamura","doi":"10.2169/internalmedicine.4224-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.4224-24","url":null,"abstract":"<p><p>A 74-year-old woman developed acute severe colitis after receiving her sixth mRNA vaccine against coronavirus disease-2019 (COVID-19). On the day after vaccination, she experienced bloody diarrhea, abdominal pain, and high-grade fever. Laboratory tests revealed leukocytosis and increased C-reactive protein. Contrast-enhanced computed tomography revealed bowel wall thickening with a reduced contrast effect within the colon, in addition to ascites. Sigmoidoscopy revealed extensive sloughing of the mucosa. Her symptoms and laboratory findings improved immediately after the initiation of prednisolone therapy. Pre-discharge total colonoscopy revealed mucosal repair in most of the colon. Clinicians should acknowledge that severe acute colitis can occur after COVID-19 vaccination.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619692","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}

{"title":"Enlargement of Gastric Hyperplastic Polyps Arising from Helicobacter heilmannii sensu strico-infected Mucosa after the Successful Eradication of Helicobacter pylori and the Long-Term Use of a Proton Pump Inhibitor.","authors":"Masayuki Kurimoto, Hajime Honjo, Saki Yoshida, Natsuki Okai, Yasuo Otsuka, Yasuhiro Masuta, Sho Masaki, Ken Kamata, Kosuke Minaga, Osamu Maenishi, Masatoshi Kudo, Tomohiro Watanabe","doi":"10.2169/internalmedicine.4230-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.4230-24","url":null,"abstract":"<p><p>Helicobacter pylori eradication is effective for the regression of gastric hyperplastic polyps (GHPs). We report a case which demonstrated an enlargement of GHPs after H. pylori eradication. The patient, who received long-term proton-pump inhibitor (PPI) therapy, lived with a dog, a natural host of Helicobacter heilmanii sensu stricto. Gastric colonization with Helicobacter heilmannii s.s. was observed after H. pylori eradication, thus suggesting the involvement of non-H. pylori Helicobacter species (NHPHs) infection for the enlargement of GHPs, in addition to the proliferative effects of PPI use on the gastric epithelium. Screening for NHPHs may be necessary in dog lovers to avoid paradoxical responses to H. pylori eradication.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619702","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}

{"title":"A case of duodenal adenocarcinoma with a gastric phenotype demonstrating a rapidly progressive course.","authors":"Sho Matsuyama, Akihisa Fukuda, Nobukazu Agatsuma, Masahito Hoki, Takahiro Utsumi, Hiroshi Seno","doi":"10.2169/internalmedicine.4004-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.4004-24","url":null,"abstract":"<p><p>We herein report a rare case of duodenal adenocarcinoma with a rapidly progressive course. Esophagogastroduodenoscopy revealed Brunner's gland hyperplasia in the bulbs of the duodenum three years prior to this presentation. Two years earlier, gastric foveolar metaplasia had been observed in the bulbs. One year earlier, the lesion had increased slightly in size. At this time, the lesion had markedly increased in size, and the duodenum was circumferentially stenotic due to the mass. Pathologically, he was diagnosed with duodenal adenocarcinoma with a gastric-dominant immunophenotype and he died two months later. Although extremely rare, we should keep in mind that duodenal tumors with a gastric phenotype may sometimes progress rapidly within a short period of time.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619680","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}

{"title":"Bacteremia and meningitis caused by penicillin-resistant Streptococcus pneumoniae serotype 35B successfully treated with ceftriaxone combined with vancomycin followed by linezolid: A case report.","authors":"Mifumi Tomioka, Kiwamu Nakamura, Shaoqing Duan, Kazuaki Matsumoto, Takahiro Shindo, Keisuke Hoshi, Mika Nagao, Fuminari Oshima, Yasuka Hara, Yoshiyuki Namai","doi":"10.2169/internalmedicine.3904-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.3904-24","url":null,"abstract":"<p><p>We herein report a case of bacterial meningitis and bacteremia in a 3-month-old boy caused by Streptococcus pneumoniae serotype 35B multidrug resistance. Intravenous ampicillin was administered on admission. However, when pneumococcal meningitis was suspected, the antibiotic treatment was changed to ceftriaxone (CTRX) and vancomycin (VCM). However, owing to difficulties in achieving sufficient serum trough levels of VCM, this treatment was again switched to linezolid (LZD). The patient recovered without complications after 16 days of CTRX and LZD treatment. This case suggests that LZD is a viable treatment option for bacterial meningitis.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619697","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}

{"title":"Reply to the Letter.","authors":"Ryo Wada, Masaya Shinohara, Hideki Koike, Rine Nakanishi, Tadashi Fujino, Takanori Ikeda","doi":"10.2169/internalmedicine.4615-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.4615-24","url":null,"abstract":"","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619778","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}

{"title":"How to Treat Persistent Atrial Fibrillation in Patients with Dextrocardia and Situs Inversus.","authors":"Naoya Kataoka, Teruhiko Imamura","doi":"10.2169/internalmedicine.4378-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.4378-24","url":null,"abstract":"","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619713","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}

{"title":"A Case of Anti-OJ Antibody-positive Antisynthetase Myopathy Diagnosed after Pulmonary Embolization.","authors":"Yu Nakanishi, Hirofumi Watanabe, Yoshihiro Tsuyuki, Mako Tsuyuki, Shinji Kakumoto, Masaaki Abe, Kosuke Hamai","doi":"10.2169/internalmedicine.4201-24","DOIUrl":"https://doi.org/10.2169/internalmedicine.4201-24","url":null,"abstract":"<p><p>Idiopathic inflammatory myopathies, such as dermatomyositis, are implicated as possible risk factors for venous thromboembolism. We herein report the first known case of a 50-year-old woman who presented to our hospital with a fever, chest pain, and elevated creatine kinase levels and was ultimately diagnosed with pulmonary embolism and anti-OJ antibody-positive antisynthetase myopathy. Dermatomyositis may increase the risk of venous thromboembolism, including pulmonary embolism. However, only a few cases of pulmonary embolism developing before the diagnosis of inflammatory myositis have been reported. Idiopathic inflammatory myopathy should be considered as a differential diagnosis when creatine kinase levels are elevated in patients with pulmonary embolism.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619674","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}