Nagoya Journal of Medical Science最新文献_第2页

Fever of unknown origin as the primary manifestation of extrapulmonary sarcoidosis with bone marrow involvement: a rare clinical scenario. 病因不明的发热是肺外结节病累及骨髓的主要表现：一种罕见的临床情况。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2026-05-01 DOI: 10.18999/nagjms.88.2.355

Svetlana Rachina, Leonid Dvoretsky, Igor Stepanyan, Olga Ivleva, Olesya Levendyuk, Gayrat Kiyakbaev, Elza Rakhmatullina, Daria Strelkova

{"title":"Fever of unknown origin as the primary manifestation of extrapulmonary sarcoidosis with bone marrow involvement: a rare clinical scenario.","authors":"Svetlana Rachina, Leonid Dvoretsky, Igor Stepanyan, Olga Ivleva, Olesya Levendyuk, Gayrat Kiyakbaev, Elza Rakhmatullina, Daria Strelkova","doi":"10.18999/nagjms.88.2.355","DOIUrl":"10.18999/nagjms.88.2.355","url":null,"abstract":"Isolated bone marrow involvement in sarcoidosis is a rare condition, mostly manifested by cytopenia, hypercalcemia and/or hypercalciuria. We present the case of a 48-year-old man with a prolonged fever meeting the criteria for fever of unknown origin, in whom a suspicion of sarcoidosis only emerged after non-necrotizing granulomas were identified in the bone marrow, one year after the onset of the disease. The patient exhibited only mild anemia, moderate leukocytosis, thrombocytosis, and increased erythrocyte sedimentation rate, C-reactive protein levels. Other potential causes of fever of unknown origin and bone marrow non-necrotizing granulomas were ruled out. Although serum angiotensin-converting enzyme levels were elevated, they did not reach diagnostic thresholds. The diagnosis of sarcoidosis was confirmed by newly detected intra-abdominal lymphadenopathy on computed tomography and whole-body 18F-fluorodeoxyglucose positron emission tomography with computed tomography, along with the presence of multiple sarcoid-type non-necrotizing granulomas in the intra-abdominal lymph nodes. Treatment with prednisolone normalized the patient's body temperature, improved laboratory-inflammatory profile, and enhanced the patient's quality of life. In cases where fever of unknown origin is present and sarcoidosis is suspected, a bone marrow biopsy may be considered, even in the absence of cytopenia, hypercalcemia, or hypercalciuria.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"88 2","pages":"355-360"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680876","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

Coefficient of variation of R-R intervals during deep breathing as a risk marker of orthostatic blood pressure decline in patients with Type 2 diabetes mellitus. 深呼吸时R-R间隔的变异系数作为2型糖尿病患者直立性血压下降的危险标志。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2026-05-01 DOI: 10.18999/nagjms.88.2.258

Qingbo Zhang, Mariko Sugiyama, Yu Liu, Naoko Matsuzawa, Mikiko Kojima, Keiko Furuta, Aya Kawaguchi, Yuko Shige, Ayano Osawa, Yaeko Terada, Ryoichi Banno, Akiko Yamamoto, Akiko Fujii, Hiroshi Arima, Etsuko Fujimoto, Yukari Takeno

{"title":"Coefficient of variation of R-R intervals during deep breathing as a risk marker of orthostatic blood pressure decline in patients with Type 2 diabetes mellitus.","authors":"Qingbo Zhang, Mariko Sugiyama, Yu Liu, Naoko Matsuzawa, Mikiko Kojima, Keiko Furuta, Aya Kawaguchi, Yuko Shige, Ayano Osawa, Yaeko Terada, Ryoichi Banno, Akiko Yamamoto, Akiko Fujii, Hiroshi Arima, Etsuko Fujimoto, Yukari Takeno","doi":"10.18999/nagjms.88.2.258","DOIUrl":"10.18999/nagjms.88.2.258","url":null,"abstract":"Diabetic orthostatic hypotension, associated with cardiovascular autonomic neuropathy, can be assessed using the coefficient of variation of the R-R interval (CVRR). We investigated whether CVRR during deep breathing could serve as a risk indicator for orthostatic blood pressure decline in patients with type 2 diabetes. This study included 88 hospitalized patients aged 51.5-71.4 years with type 2 diabetes undergoing diabetes education or glycemic control. Blood pressure changes during postural transitions were measured using a non-invasive beat-to-beat blood pressure monitoring device. Participants were divided into two groups based on CVRR values measured at rest and during deep breathing, using a cutoff of 2%. Blood pressure changes during postural transitions were compared. At rest, no significant differences in systolic or diastolic blood pressure changes were observed between the autonomic dysfunction group (CVRR ≤ 2%, n = 42) and the non-autonomic dysfunction group (CVRR >2%, n = 46; p > 0.05). However, during deep breathing, patients with CVRR ≤ 2% (n = 20) exhibited significantly greater decreases in systolic blood pressure at 0-30, 31-60, 61-90, 91-120, and 151-180 seconds after standing (p < 0.05). These findings suggest that a CVRR below 2% during deep breathing serves as a risk indicator for orthostatic systolic blood pressure decline in patients with type 2 diabetes.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"88 2","pages":"258-273"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680830","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

Hypoxemia with atelectasis during clazosentan therapy after subarachnoid hemorrhage: a potential effect of suppressed hypoxic pulmonary vasoconstriction. 蛛网膜下腔出血后克唑森坦治疗期间低氧血症伴肺不张：抑制低氧肺血管收缩的潜在作用。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2026-05-01 DOI: 10.18999/nagjms.88.2.364

Daisuke Yamazaki, Asuka Nakamura, Mana Wakabayashi, Yota Suzuki, Kohei Kanaya, Tetsuyoshi Horiuchi

{"title":"Hypoxemia with atelectasis during clazosentan therapy after subarachnoid hemorrhage: a potential effect of suppressed hypoxic pulmonary vasoconstriction.","authors":"Daisuke Yamazaki, Asuka Nakamura, Mana Wakabayashi, Yota Suzuki, Kohei Kanaya, Tetsuyoshi Horiuchi","doi":"10.18999/nagjms.88.2.364","DOIUrl":"10.18999/nagjms.88.2.364","url":null,"abstract":"Clazosentan, a selective endothelin-A (ET-A) receptor antagonist, is used to prevent cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH). Although pulmonary edema and fluid retention are recognized adverse effects, hypoxemia associated with atelectasis has not been described. Endothelin-1 contributes to hypoxic pulmonary vasoconstriction (HPV), which preserves ventilation-perfusion (V/Q) matching by diverting blood flow from poorly ventilated regions; pharmacologic ET-A blockade may attenuate HPV, increasing intrapulmonary shunt and impairing oxygenation. We report a man in his 60s with aneurysmal SAH (World Federation of Neurosurgical Societies [WFNS] I, Fisher 3) who underwent clipping surgery and postoperative clazosentan infusion (10 mg/h, standard Japanese dosage). On day 7 of infusion, hypoxemia (SpO2 < 90% room air) developed; on day 8, arterial blood gas showed PaO2 62.5 mmHg with a PaO2/FiO2 (P/F) ratio of 109. Chest computed tomography (CT) demonstrated right lower-lobe atelectasis without pulmonary edema or pleural effusion, and echocardiography showed normal cardiac function. Clazosentan was discontinued and corticosteroid therapy initiated, after which oxygenation improved and the atelectasis resolved. The patient was extubated on day 18 and discharged with good neurological recovery. This case illustrates a plausible mechanism whereby ET-A receptor blockade suppresses HPV, exacerbating V/Q mismatch in the presence of segmental atelectasis. Improvement after drug withdrawal supports this association. Clinicians should recognize that hypoxemia during clazosentan therapy may occur independently of fluid overload and warrants early respiratory evaluation.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"88 2","pages":"364-369"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680844","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

Sestrin2 alleviates age-related hearing loss through mediating PINK1/Parkin related mitophagy. Sestrin2通过介导PINK1/Parkin相关的有丝分裂减轻年龄相关性听力损失。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2026-05-01 DOI: 10.18999/nagjms.88.2.297

Liwen Wang, Yuenong Jiao, Tianqi Nie, Linlan Jiang, Shuyi Gao, Jinyu Wang

{"title":"Sestrin2 alleviates age-related hearing loss through mediating PINK1/Parkin related mitophagy.","authors":"Liwen Wang, Yuenong Jiao, Tianqi Nie, Linlan Jiang, Shuyi Gao, Jinyu Wang","doi":"10.18999/nagjms.88.2.297","DOIUrl":"10.18999/nagjms.88.2.297","url":null,"abstract":"Age-related hearing loss (ARHL) is closely linked to mitochondrial dysfunction in cochlear hair cells; however, its molecular regulation remains unclear. Sestrin2 (SESN2), a stress-inducible protein crucial for regulating energy metabolism, has not been comprehensively studied in the context of ARHL. To investigate SESN2's role, cochlea-specific SESN2 overexpression and knockout mouse models were established via adeno-associated virus 9 (AAV9) delivery through posterior semicircular canal injection. These models, combined with an H2O2-induced accelerated-aging paradigm and H2O2-treated House Ear Institute-organ of Corti 1 (HEI-OC1) cellular oxidative injury system, were systematically evaluated using auditory brainstem response (ABR), immunofluorescence (IF), mitochondrial membrane potential assays, western blotting, and other methods. Analysis of ARHL mouse cochleae revealed downregulation of SESN2 in hair cells, accompanied by mitochondrial membrane disruption and increased apoptosis. In aged mice, SESN2 overexpression significantly improved low-frequency hearing thresholds (p < 0.01). Mechanistically, SESN2 reduced oxidative stress, restored mitochondrial function, and suppressed excessive PTEN-induced putative kinase 1 (PINK1)-Parkin-mediated mitophagy, thereby maintaining mitochondrial quality control. This study is the first to show that SESN2 protects against ARHL through a tripartite cascade: antioxidant defense, mitochondrial functional restoration, and dynamic mitophagy regulation. These findings highlight SESN2's pivotal role in auditory preservation and identify it as a promising new therapeutic target for age-related hearing deterioration.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"88 2","pages":"297-311"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680819","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 a new device to measure arterial stiffness and its reliability, and its potential to detect history of cardiovascular events in patients with chronic kidney disease. 一种测量动脉硬度的新装置的开发及其可靠性，以及它在检测慢性肾脏疾病患者心血管事件史方面的潜力。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2026-05-01 DOI: 10.18999/nagjms.88.2.326

Yuki Takeda, Sawako Kato, Junfeng Wang, Masahiko Ando, Takeo Matsumoto, Yasuko Yoshida, Hiroshi Masuda, Shoichi Maruyama

{"title":"Development of a new device to measure arterial stiffness and its reliability, and its potential to detect history of cardiovascular events in patients with chronic kidney disease.","authors":"Yuki Takeda, Sawako Kato, Junfeng Wang, Masahiko Ando, Takeo Matsumoto, Yasuko Yoshida, Hiroshi Masuda, Shoichi Maruyama","doi":"10.18999/nagjms.88.2.326","DOIUrl":"10.18999/nagjms.88.2.326","url":null,"abstract":"Atherosclerosis, which leads to cardiovascular disease (CVD), can progress without any symptoms. To prevent CVD, it is important to detect atherosclerotic lesions early and assess their severity. Atherosclerosis evaluation for primary prevention is a preferable non-invasive diagnostic tool. In this study, a new device was developed to measure arterial stiffness. This new device measures the pressure-volume relationship during avascularization and the upper arm release process, similar to an automatic blood pressure monitor. The proportionality coefficient between pressure and volume was calculated from this curve; the larger the proportionality coefficient, the greater the arterial stiffness. Using this device, the arterial stiffness index (ASI), standard arteriosclerosis indices, cardio-ankle vascular index (CAVI), ankle-brachial pressure index (ABI), and pulse wave velocity (PWV) were measured in 97 patients with chronic kidney disease and investigated the associations between ASI and these arteriosclerosis indices, as well as CVD history. A positive correlation was observed between ASI and PWV (P = 0.04); however, ABI and CAVI showed no correlation with ASI when analyzed using multiple regression, adjusting for age, sex, smoking, diastolic pressure, and serum creatinine. Furthermore, ASI was related to CVD history by an odds ratio of 1.03 (95% CI, 1.01-1.06) using logistic regression analysis adjusted for age, sex, smoking, and diastolic pressure, whereas CAVI, PWV, and ABI showed no relation to CVD history. ASI measured by our device is easier to measure than indices by devices in everyday use and was the only index to identify actual atherosclerotic disease events.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"88 2","pages":"326-338"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680909","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

Keratotic macules and plaques with mild erythema in deficiency of interleukin 36 receptor antagonist cases with monoallelic pathogenic variants of IL36RN. 白细胞介素36受体拮抗剂缺乏伴IL36RN单等位致病变异体的角化斑和斑块伴轻度红斑。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2026-05-01 DOI: 10.18999/nagjms.88.2.370

Michiya Omi, Takuya Takeichi, Kana Tanahashi, Hidesada Adachi, Takeshi Kambara, Yoshinao Muro, Masashi Akiyama

引用次数: 0

Novel fixative solutions with superior preservation of structure and antigenicity are suitable for optical clearing, tissue staining, and flow cytometry. 新型固定液具有优良的结构保存和抗原性，适用于光学清除、组织染色和流式细胞术。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2026-05-01 DOI: 10.18999/nagjms.88.2.182

Kumiko Fujieda, Kazuhiro Furuhashi, Kenshi Watanabe, Yuriko Sawa, Akihito Tanaka, Tomohiro Kawazoe, Akiko Owaki, Keita Hattori, Chikao Onogi, Eri Koshi-Ito, Yu Watanabe, Shoichi Maruyama

{"title":"Novel fixative solutions with superior preservation of structure and antigenicity are suitable for optical clearing, tissue staining, and flow cytometry.","authors":"Kumiko Fujieda, Kazuhiro Furuhashi, Kenshi Watanabe, Yuriko Sawa, Akihito Tanaka, Tomohiro Kawazoe, Akiko Owaki, Keita Hattori, Chikao Onogi, Eri Koshi-Ito, Yu Watanabe, Shoichi Maruyama","doi":"10.18999/nagjms.88.2.182","DOIUrl":"10.18999/nagjms.88.2.182","url":null,"abstract":"Fixation of tissues and cells is an essential step in histological analysis; however, structural deformation and fluorescence signal attenuation caused by fixatives often pose challenges. This study aimed to evaluate the performance of a newly developed fixative, the FM Fix, by comparing it with conventional fixation methods in tissue staining, optical clearing, and flow cytometry analysis. FM Fix demonstrated staining properties comparable to those of standard fixatives and showed superiority with respect to tissue structure retention. Optical clearing allowed the visualization of fluorescent signals at greater depths. In flow cytometry using green fluorescent protein (GFP)-expressing cells, FM Fix minimized the loss of GFP fluorescence, preserved cell membrane integrity, and maintained cell size. Furthermore, the staining quality of human renal biopsy samples was equivalent to that of 10% neutral buffered formalin (NBF). These findings suggest that FM Fix has excellent structural preservation, fluorescence retention, and antigen preservation properties, making it broadly applicable for histological evaluation and quantitative cellular analysis.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"88 2","pages":"182-193"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680853","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

Knacks and pitfalls of retroperitoneal sarcoma surgery, part 2: practical tumor resection in Nagoya University. 腹膜后肉瘤手术的技巧与陷阱，第二部分：名古屋大学实用肿瘤切除术。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2026-02-01 DOI: 10.18999/nagjms.88.1.12

Yukihiro Yokoyama, Masaki Sunagawa

{"title":"Knacks and pitfalls of retroperitoneal sarcoma surgery, part 2: practical tumor resection in Nagoya University.","authors":"Yukihiro Yokoyama, Masaki Sunagawa","doi":"10.18999/nagjms.88.1.12","DOIUrl":"10.18999/nagjms.88.1.12","url":null,"abstract":"This article provides a detailed account of the practical techniques and precautions regarding the surgical resection of retroperitoneal sarcoma (RPS). As there is no standardized procedure for RPS surgery, the operative approach must be flexible, depending on tumor location and extent. Stepwise dissection from multiple directions is emphasized, as well as decision-making regarding combined resection of adjacent organs, such as the intestine, pancreas, kidney, liver, and adrenal gland. Strategies for managing tumor-associated feeding arteries and drainage veins to minimize intraoperative bleeding are also discussed. Nephrectomy is recommended when the tumor invades the renal hilum or adjacent structures; however, kidney preservation is considered whenever possible. The paper also addresses the extent of resection required, noting that in retroperitoneal liposarcoma, compartmental fat tissue removal is often preferred over strict margin-based resection, considering the high rate of microscopic infiltration. Distinguishing well-differentiated from dedifferentiated components is partially achievable using imaging and intraoperative findings. Given the complexity of these procedures, multidisciplinary collaboration and the anesthesiologist's understanding of the surgical strategy are essential. This comprehensive overview highlights the technical depth and adaptability required for large RPS resections.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"88 1","pages":"12-23"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934208","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

A case of reconstruction for triple-negative metaplastic breast cancer that enlarged rapidly during neoadjuvant immunochemotherapy. 新辅助免疫化疗期间迅速扩大的三阴性化脓性乳腺癌重建1例。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2026-02-01 DOI: 10.18999/nagjms.88.1.157

Kazuhiro Toriyama, Souji Yoshimura, Ryota Nakamura, Yumi Wanifuchi-Endo, Tatsuya Toyama

{"title":"A case of reconstruction for triple-negative metaplastic breast cancer that enlarged rapidly during neoadjuvant immunochemotherapy.","authors":"Kazuhiro Toriyama, Souji Yoshimura, Ryota Nakamura, Yumi Wanifuchi-Endo, Tatsuya Toyama","doi":"10.18999/nagjms.88.1.157","DOIUrl":"10.18999/nagjms.88.1.157","url":null,"abstract":"We report a case of reconstruction for triple-negative metaplastic breast cancer that rapidly enlarged during neoadjuvant immunochemotherapy, requiring semi-emergency surgery. A 47-year-old female with metaplastic carcinoma (cT2N0M0, stage IIA) received pembrolizumab, paclitaxel, and carboplatin in a neoadjuvant fashion. Rapid tumor enlargement and axillary lymph node swelling occurred during the first cycle of immunochemotherapy, necessitating semi-emergency surgery to prevent tumor rupture (cT4bN1M0, stage IIIB). Right mastectomy with partial pectoralis major muscle resection and axillary lymph node dissection were performed, exposing the ribs and sternum. Reconstruction utilized an internal mammary artery perforator flap with caudal rotation-advancement, followed by meshed skin grafting. Despite partial epidermal necrosis, wound closure was achieved after 3 weeks. Chemotherapy resumed 4 weeks after surgery; radiation therapy was initiated 4.5 months later. The patient remains disease-free 18 months after surgery. To our knowledge, mastectomy with pectoralis major resection and internal mammary artery perforator flap reconstruction for a triple-negative metaplastic breast cancer that had rapidly progressed during neoadjuvant therapy has not been previously reported.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"88 1","pages":"157-161"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934929","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

Inguinal bladder hernia with bilateral hydronephrosis: a case report of urodynamic and functional recovery assessments. 腹股沟膀胱疝合并双侧肾积水：尿动力学和功能恢复评估1例报告。

IF 0.9 4区医学

Nagoya Journal of Medical Science Pub Date : 2026-02-01 DOI: 10.18999/nagjms.88.1.138

Kaichi Sugihara, Hisae Nishii, Shun Takai, Yuto Ohara, Koya Morishita, Yoshie Moriya, Yoko Yoshikawa, Osamu Kamihira, Masanori Nomiya

{"title":"Inguinal bladder hernia with bilateral hydronephrosis: a case report of urodynamic and functional recovery assessments.","authors":"Kaichi Sugihara, Hisae Nishii, Shun Takai, Yuto Ohara, Koya Morishita, Yoshie Moriya, Yoko Yoshikawa, Osamu Kamihira, Masanori Nomiya","doi":"10.18999/nagjms.88.1.138","DOIUrl":"10.18999/nagjms.88.1.138","url":null,"abstract":"We report a case of a 50-year-old man referred to our department with a marked inflammatory response and severe renal dysfunction. Computed tomography scans revealed an inguinal bladder hernia with bilateral hydronephrosis. A urethral catheter was placed to relieve urinary retention, and antimicrobial therapy was initiated for pyelonephritis. Despite adequate urine output, renal function improved only partially, and hydronephrosis persisted. Further imaging and intraoperative findings confirmed that the hernia sac was adjacent to the bladder and the bilateral lower ureters, which were significantly stretched and displaced. Firm adhesions between the bladder and the hernia sac necessitated meticulous dissection to restore normal anatomy. Surgical repair of the inguinal hernia successfully repositioned the bladder. Although morphological upper urinary tract dilation persisted postoperatively, a mercaptoacetyltriglycine 3 renal scan demonstrated no evidence of functional obstruction, indicating improved ureteral patency. A urodynamic study (UDS) revealed significantly decreased bladder compliance, likely due to chronic displacement and compression within the scrotum, which impaired the detrusor function. The patient gradually regained spontaneous voiding after urethral catheter removal and initiation of clean intermittent catheterization. Follow-up UDS confirmed a substantial improvement in bladder compliance, indicating functional recovery. Follow-up imaging indicated the resolution of bilateral hydronephrosis and improvement of renal function. This case emphasizes the importance of recognizing lower ureteral entrapment in cases of bladder hernia and demonstrates that bladder dysfunction due to chronic displacement can be reversed by timely surgical intervention.","PeriodicalId":49014,"journal":{"name":"Nagoya Journal of Medical Science","volume":"88 1","pages":"138-148"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934938","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