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A Case of Urinary Retention Triggered by Urethritis in Olanzapine-induced Diabetic Ketoacidosis. 奥氮平所致糖尿病酮症酸中毒并发尿道炎尿潴留1例。
Internal medicine (Tokyo, Japan) Pub Date : 2025-07-17 DOI: 10.2169/internalmedicine.5880-25
Hideyuki Murakami, Kazuaki Norita, Akihiro Ikeda
{"title":"A Case of Urinary Retention Triggered by Urethritis in Olanzapine-induced Diabetic Ketoacidosis.","authors":"Hideyuki Murakami, Kazuaki Norita, Akihiro Ikeda","doi":"10.2169/internalmedicine.5880-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5880-25","url":null,"abstract":"<p><p>A 58-year-old woman with schizophrenia was transported to our hospital by ambulance due to impaired consciousness. At the time of the examination, the patient had significant abdominal distension and diabetic ketoacidosis associated with urinary retention. Although the symptoms improved with the insertion of a urinary catheter and glycemic control, the involvement of the antipsychotic olanzapine was considered the background to the pathophysiology of this case. We herein report the relationship between antipsychotic drugs, diabetic ketoacidosis, and urinary retention along with a literature review.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hepatic Ectopic Adrenal Gland in a Patient with Hepatitis C Virus Who Achieved a Sustained Virological Response: A Case Report. 实现持续病毒学应答的丙型肝炎患者肝肾上腺异位：一例报告。
Internal medicine (Tokyo, Japan) Pub Date : 2025-07-17 DOI: 10.2169/internalmedicine.5655-25
Mariya Kawanishi, Akitoshi Douhara, Koji Ishida, Masato Nakatsuji, Noriyuki Hamato, Daisuke Hokuto, Masahiro Tsutsumi, Toshiya Nakatani
{"title":"Hepatic Ectopic Adrenal Gland in a Patient with Hepatitis C Virus Who Achieved a Sustained Virological Response: A Case Report.","authors":"Mariya Kawanishi, Akitoshi Douhara, Koji Ishida, Masato Nakatsuji, Noriyuki Hamato, Daisuke Hokuto, Masahiro Tsutsumi, Toshiya Nakatani","doi":"10.2169/internalmedicine.5655-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5655-25","url":null,"abstract":"<p><p>Hepatic ectopic adrenal glands are rare and can mimic hepatocellular carcinoma (HCC). We herein report a 60-year-old woman with a history of chronic hepatitis C who achieved a sustained virological response. A 23-mm hepatic lesion was detected and initially diagnosed as HCC. However, laparoscopic resection and histopathology confirmed the presence of an ectopic adrenal gland. Given the location of the posterior liver, a biopsy is challenging. Adrenal scintigraphy may aid in the diagnosis and reduce the need for invasive procedures. As more cases are reported, improved imaging-based diagnoses may facilitate noninvasive identification of hepatic ectopic adrenal glands, avoiding unnecessary surgical intervention.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Subclinical Myocardial Involvement Evaluated by Cardiac Magnetic Resonance Imaging in a Patient with Anti-Ro52/SS-A Antibody-positive Sjögren's Disease Complicated with Polymyositis. 抗ro52 /SS-A抗体阳性Sjögren病患者合并多发性肌炎的心脏磁共振成像评估亚临床心肌损害
Internal medicine (Tokyo, Japan) Pub Date : 2025-07-17 DOI: 10.2169/internalmedicine.5500-25
Kiichi Sugito, Masashi Uchikawa, Shinya Asatani, Masahiro Nishihara, Yosuke Nagasawa, Hirotake Inomata, Masako Tsukamoto, Hitomi Kobayashi, Noboru Kitamura, Hideki Nakamura, Yasuo Okumura
{"title":"Subclinical Myocardial Involvement Evaluated by Cardiac Magnetic Resonance Imaging in a Patient with Anti-Ro52/SS-A Antibody-positive Sjögren's Disease Complicated with Polymyositis.","authors":"Kiichi Sugito, Masashi Uchikawa, Shinya Asatani, Masahiro Nishihara, Yosuke Nagasawa, Hirotake Inomata, Masako Tsukamoto, Hitomi Kobayashi, Noboru Kitamura, Hideki Nakamura, Yasuo Okumura","doi":"10.2169/internalmedicine.5500-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5500-25","url":null,"abstract":"<p><p>A 52-year-old woman with myalgia, anti-aminoacyl tRNA synthetase, anti-SS-A/Ro52 antibody positivity, and elevated creatine kinase levels was admitted to our hospital. She was diagnosed with Sjögren's disease (SjD) complicated by polymyositis (PM). No chest symptoms were observed. Although her electrocardiogram and echocardiogram findings were normal, cardiac magnetic resonance imaging (CMRI) revealed myocardial edema and fibrosis with late gadolinium enhancement, elevated extracellular volume, and elevated T2 values. After treatment with prednisolone, the myalgia and CMRI abnormalities improved. This case suggests that CMRI may be useful for the detection and treatment of subclinical myocardial damage in patients with SjD complicated by PM.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Acute Kidney Injury Secondary to Aortic Dissection Following Transcatheter Aortic Valve Implantation: Perspectives from Nephrologists. 经导管主动脉瓣植入术后继发于主动脉夹层的急性肾损伤：肾内科医生的观点。
Internal medicine (Tokyo, Japan) Pub Date : 2025-07-17 DOI: 10.2169/internalmedicine.5904-25
Ryo Tajima, Ryo Koyama, Mikihiro Suzuki, Suguru Takayama, Toshiya Yoshida, Takahiko Kai, Masashi Koga, Masahiko Yazawa
{"title":"Acute Kidney Injury Secondary to Aortic Dissection Following Transcatheter Aortic Valve Implantation: Perspectives from Nephrologists.","authors":"Ryo Tajima, Ryo Koyama, Mikihiro Suzuki, Suguru Takayama, Toshiya Yoshida, Takahiko Kai, Masashi Koga, Masahiko Yazawa","doi":"10.2169/internalmedicine.5904-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5904-25","url":null,"abstract":"<p><p>Aortic dissection (AD) is a rare but serious complication of transcatheter aortic valve implantation (TAVI) and should be considered in the differential diagnosis of acute kidney injury (AKI). We herein report an older man who developed AKI secondary to Stanford type B AD after transfemoral TAVI. Non-contrast computed tomography (CT) revealed inward displacement of the calcified intima, which is a key early finding. Contrast-enhanced CT confirmed AD extending to the renal artery. As endovascular intervention was not feasible, conservative management was selected. Nephrologists should recognize AD as an important cause of AKI following TAVI and carefully assess CT images for early subtle signs.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Japanese Encephalitis: Characteristic Imaging in Substantia Nigra, Thalamus, and Basal Ganglia. 日本脑炎：黑质、丘脑和基底神经节的特征性影像。
Internal medicine (Tokyo, Japan) Pub Date : 2025-07-17 DOI: 10.2169/internalmedicine.5832-25
Kazumasa Sekiguchi, Jun Sawada, Yuhei Anan, Shigeru Fujimoto
{"title":"Japanese Encephalitis: Characteristic Imaging in Substantia Nigra, Thalamus, and Basal Ganglia.","authors":"Kazumasa Sekiguchi, Jun Sawada, Yuhei Anan, Shigeru Fujimoto","doi":"10.2169/internalmedicine.5832-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5832-25","url":null,"abstract":"","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Solitary Fused Pelvic Kidney with Limb Agenesis. 孤立融合盆腔肾伴肢体发育不全。
Internal medicine (Tokyo, Japan) Pub Date : 2025-07-17 DOI: 10.2169/internalmedicine.6002-25
Mana Kashiwagi, Hiroki Kobayashi, Yoshihiro Nakamura, Masanori Abe
{"title":"Solitary Fused Pelvic Kidney with Limb Agenesis.","authors":"Mana Kashiwagi, Hiroki Kobayashi, Yoshihiro Nakamura, Masanori Abe","doi":"10.2169/internalmedicine.6002-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.6002-25","url":null,"abstract":"","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Spinal Dural Arteriovenous Fistula Revealed by Heavily T2-weighted Sequences. 重t2加权序列显示的硬脊膜动静脉瘘。
Internal medicine (Tokyo, Japan) Pub Date : 2025-07-17 DOI: 10.2169/internalmedicine.5719-25
Takahiro Makino, Kazuki Machino, Kyosuke Takasaka, Ikuo Kamitsukasa
{"title":"Spinal Dural Arteriovenous Fistula Revealed by Heavily T2-weighted Sequences.","authors":"Takahiro Makino, Kazuki Machino, Kyosuke Takasaka, Ikuo Kamitsukasa","doi":"10.2169/internalmedicine.5719-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5719-25","url":null,"abstract":"","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","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 Hepatic Cyst Infection in a Hemodialysis Patient with Autosomal Dominant Polycystic Kidney Disease Complicated by Non-symptomatic Caroli Disease. 常染色体显性多囊肾病合并无症状Caroli病的血液透析患者肝囊肿感染1例
Internal medicine (Tokyo, Japan) Pub Date : 2025-07-17 DOI: 10.2169/internalmedicine.5486-25
Ayaka Hane, Tatsuya Suwabe, Yuki Oba, Shigekazu Kurihara, Hiroki Mizuno, Hisashi Kamido, Hisashi Sugimoto, Noriko Inoue, Akinari Sekine, Masayuki Yamanouchi, Kiho Tanaka, Eiko Hasegawa, Takehiko Wada, Naoya Mirisada, Kandai Nozu, Naoki Sawa, Yoshifumi Ubara
{"title":"A Case of Hepatic Cyst Infection in a Hemodialysis Patient with Autosomal Dominant Polycystic Kidney Disease Complicated by Non-symptomatic Caroli Disease.","authors":"Ayaka Hane, Tatsuya Suwabe, Yuki Oba, Shigekazu Kurihara, Hiroki Mizuno, Hisashi Kamido, Hisashi Sugimoto, Noriko Inoue, Akinari Sekine, Masayuki Yamanouchi, Kiho Tanaka, Eiko Hasegawa, Takehiko Wada, Naoya Mirisada, Kandai Nozu, Naoki Sawa, Yoshifumi Ubara","doi":"10.2169/internalmedicine.5486-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5486-25","url":null,"abstract":"<p><p>An 84-year-old woman undergoing hemodialysis for autosomal dominant polycystic kidney disease (ADPKD) was admitted for refractory hepatic cyst infection. Magnetic resonance cholangiopancreatography and contrast-enhanced computed tomography revealed a concurrent complication of Caroli disease, diagnosed by cystic dilatation of the intrahepatic bile duct and a central dot sign in the vicinity of the infected liver cyst. However, there was no traffic between the infected liver cyst and dilated bile duct, and the cyst drainage procedure was curative. In cases where both diseases were combined, it was suggested that two infections, cyst and biliary tract infections, could occur.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Utility and Safety of Decortication Using Medical Thoracoscopy under Local Anesthesia Performed by Respiratory Physicians in Patients with Acute Pleural Empyema: A Single-center Retrospective Study. 呼吸内科医生在局麻下应用医用胸腔镜对急性胸膜脓胸患者进行去皮术的有效性和安全性：一项单中心回顾性研究
Internal medicine (Tokyo, Japan) Pub Date : 2025-07-17 DOI: 10.2169/internalmedicine.5728-25
Koki Nakashima, Takayuki Azuma, Masayuki Sato, Kazunari Igarashi, Tamotsu Ishizuka
{"title":"Utility and Safety of Decortication Using Medical Thoracoscopy under Local Anesthesia Performed by Respiratory Physicians in Patients with Acute Pleural Empyema: A Single-center Retrospective Study.","authors":"Koki Nakashima, Takayuki Azuma, Masayuki Sato, Kazunari Igarashi, Tamotsu Ishizuka","doi":"10.2169/internalmedicine.5728-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5728-25","url":null,"abstract":"<p><p>Objective Acute pleural empyema, defined as empyema diagnosed within three months of the onset, frequently affects patients with poor general health and often poses challenges for invasive treatments requiring general anesthesia. In addition, the number of respiratory surgeons was insufficient and unevenly distributed across urban base and core hospitals in Japan. Therefore, safe and effective therapeutic procedures that physicians can perform are required. Methods We retrospectively analyzed 28 patients with acute pleural empyema who underwent decortication using medical thoracoscopy under local anesthesia (DMT-LA) in our department. All procedures were performed by respiratory physicians at our institution. The \"success\" of DMT-LA was defined by meeting all of the following criteria: (i) absence of residual clinically significant pleural effusion, (ii) resolution of clinical signs of sepsis, (iii) normalization of serum C-reactive protein (CRP) levels and white blood cell counts, (iv) no requirement for additional interventions, and (v) maintenance of these conditions for at least one month following antibiotic treatment. Results Of the 28 patients, 21 met the criteria for success, yielding a success rate of 75.0%. Patients in the failure group were more likely to have an Eastern Cooperative Oncology Group-performance status of >3, stage III empyema, and high median serum CRP levels than those in the success group. Adverse events were observed in only one patient (3.4%) and involved prolonged sedative effects. Conclusions DMT-LA is a safe and effective therapeutic procedure that can be performed by respiratory physicians and provides a viable treatment option for acute pleural empyema, particularly in facilities without respiratory surgeons.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cold Forceps Polypectomy with Jumbo Forceps for Foveolar-type Gastric Adenoma with a Raspberry-like Appearance in an Outpatient Setting. 冷钳大钳息肉切除术治疗具有覆盆子样外观的小窝型胃腺瘤。
Internal medicine (Tokyo, Japan) Pub Date : 2025-07-17 DOI: 10.2169/internalmedicine.5659-25
Junnosuke Hayasaka, Daisuke Kikuchi, Kei Kouno, Yutaka Takazawa, Shu Hoteya
{"title":"Cold Forceps Polypectomy with Jumbo Forceps for Foveolar-type Gastric Adenoma with a Raspberry-like Appearance in an Outpatient Setting.","authors":"Junnosuke Hayasaka, Daisuke Kikuchi, Kei Kouno, Yutaka Takazawa, Shu Hoteya","doi":"10.2169/internalmedicine.5659-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5659-25","url":null,"abstract":"<p><p>The optimal endoscopic treatment for foveolar-type gastric tumors with raspberry-like appearance remains unclear. A 51-year-old man underwent endoscopic treatment for a 4-mm foveolar-type gastric tumor with a raspberry-like appearance. Because the patient preferred outpatient treatment, resection was performed using cold forceps polypectomy with jumbo forceps. Both the gross and pathological margins were negative, and the tumor was successfully resected without complications. This case suggests that cold forceps polypectomy with jumbo forceps may be a suitable and minimally invasive treatment for small foveolar-type gastric tumors with a raspberry-like appearance.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","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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