Internal medicine (Tokyo, Japan)最新文献_第9页

Intraventricular Dissecting Hematoma Diagnosed and Followed up by Multimodality Imaging: A Case Report. 脑室内夹层血肿的多模态影像学诊断与随访：1例报告。

Internal medicine (Tokyo, Japan) Pub Date : 2025-06-19 DOI: 10.2169/internalmedicine.5104-24

Tatsuya Nishikawa, Masaya Suzuki, Masayuki Tsukuda, Tomoyuki Tomikawa, Hibiki Kadohara, Motohiro Shingu, Akeo Hirai, Kenta Ishibashi, Mana Hiraishi, Toshinori Kajitani, Mitsuo Kinugasa, Yasutaka Hirayama, Koichi Tamita

引用次数: 0

Long-term Efficacy and Safety of Amifampridine Phosphate (Firdapse^®) in Japanese Patients with Lambert-Eaton Myasthenic Syndrome (LMS-005 Study). 磷酸氨福定（Firdapse®）在日本Lambert-Eaton肌无力综合征患者中的长期疗效和安全性（LMS-005研究）。

Internal medicine (Tokyo, Japan) Pub Date : 2025-06-19 DOI: 10.2169/internalmedicine.5363-25

Yuki Hatanaka, Madoka Mori-Yoshimura, Kimiaki Utsugisawa, Akira Tsujino, Nobuya Fujita, Ichiro Yabe, Yuko Igarashi, Masakatsu Motomura

{"title":"Long-term Efficacy and Safety of Amifampridine Phosphate (Firdapse®) in Japanese Patients with Lambert-Eaton Myasthenic Syndrome (LMS-005 Study).","authors":"Yuki Hatanaka, Madoka Mori-Yoshimura, Kimiaki Utsugisawa, Akira Tsujino, Nobuya Fujita, Ichiro Yabe, Yuko Igarashi, Masakatsu Motomura","doi":"10.2169/internalmedicine.5363-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5363-25","url":null,"abstract":"Objective To evaluate the efficacy and safety of amifampridine (3,4-diaminopyridine) phosphate in Japanese adults with Lambert-Eaton myasthenic syndrome (LEMS). Methods The LMS-005 study was an uncontrolled, single-blind (patient blinded), multicenter, one-year phase 3 clinical study. The administration of amifampridine phosphate was started at 15 mg/day, and the dose was increased every 3 to 4 days to determine the optimal dose for each patient. After 7 days of treatment with the optimal dose, efficacy was assessed by evaluating quantitative myasthenia gravis (QMG), subject global impression (SGI), and Clinical Global Impression-Improvement scale (CGI-I) scores. Patients Adult patients with LEMS were analyzed for safety (n=12, mean age±standard deviation [SD] of 61.1±14.6 years old) and efficacy (n=10, mean age±SD of 60.7±15.9 years old). Results In the efficacy population, the mean±SD (median [interquartile range]) QMG score was 13.2±3.1 (13.5 [11.0, 15.0]) at baseline and 8.0±2.7 (8.0 [6.0, 9.0]) at the end of the treatment period, with a mean±SD (median [interquartile range]) change of -5.2±2.8 (-5.5 [-7.0, -3.0]). All patients showed a decrease in the QMG score from baseline and experienced improvement in their LEMS symptoms. The SGI/CGI-I scores also improved. Efficacy was maintained until the end of the study. Five patients in the safety population experienced adverse drug reactions, the most common of which was dysesthesia (n=2). Conclusion This study revealed the long-term efficacy and tolerability of amifampridine phosphate in Japanese adults with LEMS.","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328413","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

Vonoprazan vs. Esomeprazole: Scarring Rate of Post-endoscopic Submucosal Dissection Ulcers in the Postoperative Stomach. 伏诺哌赞与埃索美拉唑：内镜下胃粘膜下夹层溃疡术后的瘢痕形成率。

Internal medicine (Tokyo, Japan) Pub Date : 2025-06-19 DOI: 10.2169/internalmedicine.5432-25

Kosuke Nomura, Yugo Suzuki, Yorinari Ochiai, Junnosuke Hayasaka, Yutaka Mitsunaga, Hiroyuki Odagiri, Satoshi Yamashita, Akira Matsui, Daisuke Kikuchi, Shu Hoteya

{"title":"Vonoprazan vs. Esomeprazole: Scarring Rate of Post-endoscopic Submucosal Dissection Ulcers in the Postoperative Stomach.","authors":"Kosuke Nomura, Yugo Suzuki, Yorinari Ochiai, Junnosuke Hayasaka, Yutaka Mitsunaga, Hiroyuki Odagiri, Satoshi Yamashita, Akira Matsui, Daisuke Kikuchi, Shu Hoteya","doi":"10.2169/internalmedicine.5432-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5432-25","url":null,"abstract":"Objective Proton pump inhibitors (PPIs) are ineffective in suppressing gastric acid secretion after prolonged exposure to an acidic environment in the stomach. In this study, we compared vonoprazan (VPZ) and PPI esomeprazole (EPZ) according to the rate of ulcer scarring after gastric endoscopic submucosal dissection (ESD) in the postoperative stomach, where food residues are often observed, and we investigated their effectiveness in clinical practice. Methods We compared 56 lesions treated with VPZ (20 mg) and 52 lesions treated with EPZ (20 mg) in the postoperative stomach and retrospectively evaluated the scarring rate of post-ESD ulcers at 8 weeks. ESD was performed in our hospital between January 2011 and May 2023. Results The post-ESD ulcer scarring rate after eight weeks was significantly higher in the VPZ group than in the EPZ group (83.9% vs. 57.7%, p<0.01). In the respective groups, the mean age was 72.8 and 70.8 years, food residual rate were 41.1% and 30.8%, the mean resection area was 770.0 and 1,282.4 mm2 (p<0.05), and the postoperative bleeding rates were 5.4% and 7.7%, respectively. There were no significant differences in sex, surgical procedure, diabetes status, or use of steroids, nonsteroidal anti-inflammatory drugs, or antithrombotic medications. An analysis using propensity scores to adjust for age, sex, surgical procedure, and resection area showed a significantly higher scarring rate in the VPZ group (odds ratio 2.65, p<0.05). Conclusion VPZ was associated with a significantly higher scarring rate for post-ESD ulcers in the postoperative stomach than EPZ.","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328420","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

Development of Severity Classification Criteria for Acute Neuro-Behçet's Disease. 急性神经behalet病严重程度分级标准的建立。

Internal medicine (Tokyo, Japan) Pub Date : 2025-06-12 DOI: 10.2169/internalmedicine.5496-25

Shunsei Hirohata, Hirotoshi Kikuchi, Tetsuji Sawada, Toshihiro Tono, Izumi Kawachi, Mitsuhiro Takeno

{"title":"Development of Severity Classification Criteria for Acute Neuro-Behçet's Disease.","authors":"Shunsei Hirohata, Hirotoshi Kikuchi, Tetsuji Sawada, Toshihiro Tono, Izumi Kawachi, Mitsuhiro Takeno","doi":"10.2169/internalmedicine.5496-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5496-25","url":null,"abstract":"Objective The Japanese Clinical Practice Guidelines for Behçet's Disease 2020 describe an algorithm for the diagnosis and treatment of acute neuro-Behçet's disease (ANB). However, they do not provide specific policies regarding which patients should be treated. We thus formulated severity classification criteria for ANB for use in clinical practice. Methods The treatment intensity score (TIS) was classified into five levels based on treatment details (e.g. glucocorticoid [GC] dosage). A retrospective analysis was conducted to determine the relationship between various endpoints and the TIS in patients with ANB. The endpoints were neurological symptoms, cerebrospinal fluid findings, brain magnetic resonance imaging (MRI) findings, GC dosage, recovery from symptoms, and recurrence of further attacks. Patients Sixty-one patients with ANB (37 men, 24 women, 40.8±1.6 years old [mean±standard error of the mean]) who met the international classification criteria for Behcet's disease were included. Results A higher TIS was significantly associated with worse recovery from acute attacks, indicating that the TIS reflected the severity. Furthermore, the TIS was significantly correlated with the presence of focal brain symptoms and MRI T2 high-intensity areas (any brain region or brainstem). Thus, the severity classification criteria for ANB (stage 1-4) were established according to the presence or absence of focal brain symptoms and MRI findings. Finally, higher stages in the criteria were significantly correlated with worse recovery from acute attacks and with higher doses of GC or immunosuppressant use. Conclusion These results indicate that the novel severity classification criteria may be useful in determining treatment strategies in clinical practice.","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278045","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

Varicella Zoster Virus Vasculopathy Leading to a Recurrent Cerebral Infarction: Differential Treatment Responses Between Stenosis and Occlusion. 水痘带状疱疹病毒血管病变导致复发性脑梗死：狭窄和闭塞的不同治疗反应。

Internal medicine (Tokyo, Japan) Pub Date : 2025-06-12 DOI: 10.2169/internalmedicine.5262-25

Hideyuki Shimizu, Kenichi Sakuta, Motohiro Okumura, Yasuyuki Iguchi

引用次数: 0

A Case of M232R Familial Creutzfeldt-Jacob Disease Challenging to Diagnose Due to the Absence of Characteristic Laboratory Findings. M232R家族性克雅氏病因缺乏特征性实验室结果而难以诊断1例

Internal medicine (Tokyo, Japan) Pub Date : 2025-06-12 DOI: 10.2169/internalmedicine.5585-25

Yoshiko Tanaka, Ken-Ichi Irie, Masashige Isogai, Tamon Koga, Shinichiro Mori, Takahisa Tateishi

引用次数: 0

Spontaneous Regression of a Pituitary Mass in Methotrexate-associated Lymphoproliferative Disorder. 甲氨蝶呤相关淋巴细胞增生性疾病中垂体肿块的自发性消退。

Internal medicine (Tokyo, Japan) Pub Date : 2025-06-12 DOI: 10.2169/internalmedicine.5294-25

Yuri Enomoto, Ryutaro Tanizaki, Yoshinori Nomura

引用次数: 0

A Case of Factor V Leiden Mutation Diagnosed After the Onset of DVT During Pregnancy in a Woman of Half-Japanese, Half-European Descent. 半日欧混血妇女妊娠期DVT发病后诊断为因子V Leiden突变1例

Internal medicine (Tokyo, Japan) Pub Date : 2025-06-12 DOI: 10.2169/internalmedicine.5419-25

Kazuhiro Shimizu, Masahiro Iwakawa, Yusuke Suzuki, Takeyoshi Murano

引用次数: 0

The reversed halo sign. 相反的光环符号。

Internal medicine (Tokyo, Japan) Pub Date : 2025-06-12 DOI: 10.2169/internalmedicine.5216-24

Daichi Noritomi, Takashi Kido, Noriho Sakamoto, Hiroshi Mukae

引用次数: 0

Mucosal Atrophy of the Fornix as an Important Endoscopic Finding for an Autoimmune Gastritis Diagnosis. 穹窿粘膜萎缩作为自身免疫性胃炎诊断的重要内镜发现。

Internal medicine (Tokyo, Japan) Pub Date : 2025-06-12 DOI: 10.2169/internalmedicine.5638-25

Kyoichi Adachi, Eiko Okimoto, Yuri Ebisutani, Yuko Matsubara, Rie Nakanishi, Honoka Taniguchi, Harumi Fujihara, Takashi Toda, Norihisa Ishimura, Shunji Ishihara

{"title":"Mucosal Atrophy of the Fornix as an Important Endoscopic Finding for an Autoimmune Gastritis Diagnosis.","authors":"Kyoichi Adachi, Eiko Okimoto, Yuri Ebisutani, Yuko Matsubara, Rie Nakanishi, Honoka Taniguchi, Harumi Fujihara, Takashi Toda, Norihisa Ishimura, Shunji Ishihara","doi":"10.2169/internalmedicine.5638-25","DOIUrl":"https://doi.org/10.2169/internalmedicine.5638-25","url":null,"abstract":"Objective This study investigated the significance of diagnosing an endoscopic atrophic pattern of the fornix in autoimmune gastritis (AIG). Materials Of 10,608 individuals (men/women: 6,551/4,057) who underwent an esophagogastroduodenal endoscopy (EGD) examination between April 2016 and March 2022 for a medical checkup, 80 patients (men/women: 34/46, mean age 58.7 years old) were diagnosed with AIG based on endoscopic findings and positivity for gastric autoantibodies. The mucosal atrophy pattern of the fornix shown in the endoscopic findings of AIG cases was divided into four classifications: none, patchy, wide-range, and whole. Results The number of AIG cases classified as none, patchy, wide-range, and whole was 9, 26, 14, and 31, respectively. Whole-fornix atrophy was frequently observed in Helicobacter pylori-uninfected cases, while the atrophic pattern was correlated with the area of remnant oxyntic mucosa in the gastric body. The serum levels of pepsinogen I and pepsinogen I/II ratio decreased, while the gastrin level increased in association with the enlarged atrophic area of the fornix. The pepsinogen I/II ratio was ≥3.0, in 70.8% of the cases, with a patchy pattern. Follow-up EGD findings obtained after the AIG diagnosis showed gradual progression of mucosal atrophy of the fornix, with such progression primarily observed in H. pylori-eradicated cases. Conclusion The degree of endoscopic atrophy of the fornix was correlated with AIG progression. Patchy atrophy pattern in the fornix may be helpful in the detection of AIG prior to oxyntic gland atrophy expansion.","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278046","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