Journal of Nippon Medical School最新文献

Delayed Diagnosis of Painless Thyroiditis in an Adolescent Presenting with Aggression and Disruptive Behavior Initially Attributed to Worsening of a Psychiatric Disorder. 最初因精神障碍恶化而出现攻击和破坏行为的青少年被延迟诊断为无痛性甲状腺炎》（Delayed Diagnosis of Painless Thyroiditis in an Adolescent Presenting with Aggression and Disruptive Behavior Initially Attributed to Worseening of a Psychiatric Disorder）。

IF 1.2 4区医学

Journal of Nippon Medical School Pub Date : 2025-07-02 Epub Date: 2024-06-18 DOI: 10.1272/jnms.JNMS.2025_92-302

Yutaka Furuta, Takahiro Masuoka, Ryuichiro Narishige, Amane Tateno

{"title":"Delayed Diagnosis of Painless Thyroiditis in an Adolescent Presenting with Aggression and Disruptive Behavior Initially Attributed to Worsening of a Psychiatric Disorder.","authors":"Yutaka Furuta, Takahiro Masuoka, Ryuichiro Narishige, Amane Tateno","doi":"10.1272/jnms.JNMS.2025_92-302","DOIUrl":"10.1272/jnms.JNMS.2025_92-302","url":null,"abstract":"Painless thyroiditis, which is rare in children, exhibits the characteristic sequence of hyperthyroidism, including aggressive and disruptive behaviors. Unlike subacute thyroiditis or Graves' disease, painless thyroiditis is challenging to diagnose because of its mild symptoms and minimal or absent physical findings. Moreover, aggressive and disruptive behaviors in children with psychiatric disorders may be misconstrued as exacerbation of underlying symptoms. The present patient was a 16-year-old male with adjustment disorder who presented to a pediatric psychiatric clinic for assessment of irritability. After 4 months, he developed aggressive and disruptive behaviors that prompted initiation of risperidone but without improvement. After 1 month, he reported palpitations and dyspnea. His neck was supple and non-tender without thyroid enlargement. Thyroid studies revealed elevated free T4 and T3 levels and suppressed thyroid-stimulating hormone level, suggesting hyperthyroidism. A radioactive iodine uptake test revealed a barely visible thyroid gland, consistent with thyroiditis. Painless thyroiditis, without thyroid tenderness, was diagnosed. We describe a case of painless thyroiditis in an adolescent patient with aggressive and disruptive behaviors that were initially attributed to worsening of an underlying adjustment disorder. Even when minimal or no signs of hyperthyroidism are present, painless thyroiditis should be considered in the differential diagnosis of children with aggressive and disruptive behaviors. Awareness of potential anchoring bias is also recommended to prevent its delayed diagnosis of such behaviors.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":"296-299"},"PeriodicalIF":1.2,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428333","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}

引用次数: 0

New-Onset Schizophrenia in an Adolescent after COVID-19. 一名青少年在服用 COVID-19 后新发精神分裂症。

IF 1.2 4区医学

Journal of Nippon Medical School Pub Date : 2025-07-02 Epub Date: 2024-06-18 DOI: 10.1272/jnms.JNMS.2025_92-301

Masatsugu Ishii, Kakusho C Nakajima-Ohyama, Hayato Saito, Tomoyuki Ohya, Shotaro Uchiyama, Mizuho Takahashi, Masanori Sakamaki, Akihiro Watanabe, Jun-Ichi Inoue, Tetsuro Sekine, Amane Tateno, Yasuhiro Kishi

{"title":"New-Onset Schizophrenia in an Adolescent after COVID-19.","authors":"Masatsugu Ishii, Kakusho C Nakajima-Ohyama, Hayato Saito, Tomoyuki Ohya, Shotaro Uchiyama, Mizuho Takahashi, Masanori Sakamaki, Akihiro Watanabe, Jun-Ichi Inoue, Tetsuro Sekine, Amane Tateno, Yasuhiro Kishi","doi":"10.1272/jnms.JNMS.2025_92-301","DOIUrl":"10.1272/jnms.JNMS.2025_92-301","url":null,"abstract":"Schizophrenia develops during adolescence. Maternal infections during the fetal period increase the incidence of schizophrenia in children, which suggests that the pathogenesis involves neuroinflammation. Here, we report a case of new-onset schizophrenia in a 16-year-old boy after COVID-19. After developing COVID-19, he entered a catatonic state 4 days later and was hospitalized. Benzodiazepines alleviated his catatonia, but hallucinations and delusions persisted. Encephalitis and epilepsy were excluded by magnetic resonance imaging (MRI), encephalography, and cerebrospinal fluid examination. Psychosis persisted after the virus titer declined and the inflammatory response subsided. Moreover, the patient exhibited delusions of control-a Schneider's first-rank symptom. Schizophrenia was diagnosed, and olanzapine improved his symptoms. He had a brief history of insomnia before COVID-19 but his symptoms did not satisfy the ultra-high-risk criteria. However, COVID-19 may have facilitated development of schizophrenia through neuroinflammation and volume reduction in the gray matter of the right medial temporal lobe. This case demonstrates that infectious diseases in adolescents should be carefully managed, to prevent schizophrenia.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":"287-295"},"PeriodicalIF":1.2,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428337","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}

引用次数: 0

Use of Tocilizumab to Treat Arthritis Associated with Mixed Connective Tissue Disease Complicated by Ovarian Teratoma: A Case Report. 使用托西珠单抗治疗卵巢畸胎瘤并发混合结缔组织病相关关节炎：病例报告。

IF 1.2 4区医学

Journal of Nippon Medical School Pub Date : 2025-07-02 Epub Date: 2024-06-18 DOI: 10.1272/jnms.JNMS.2025_92-303

Haruka Ota, Toru Igarashi, Ryosuke Matsui, Hikaru Takeshita, Koji Hashimoto, Masaki Miyao, Norio Motoda, Tsubasa Takahashi, Jun Hayakawa, Makoto Migita, Yasuhiko Itoh

{"title":"Use of Tocilizumab to Treat Arthritis Associated with Mixed Connective Tissue Disease Complicated by Ovarian Teratoma: A Case Report.","authors":"Haruka Ota, Toru Igarashi, Ryosuke Matsui, Hikaru Takeshita, Koji Hashimoto, Masaki Miyao, Norio Motoda, Tsubasa Takahashi, Jun Hayakawa, Makoto Migita, Yasuhiko Itoh","doi":"10.1272/jnms.JNMS.2025_92-303","DOIUrl":"10.1272/jnms.JNMS.2025_92-303","url":null,"abstract":"Mixed connective tissue disease (MCTD) is characterized by mixed features of systemic lupus erythematosus, systemic sclerosis, and polymyositis/dermatomyositis and is rare in children. Here, we report a case of MCTD in a 10-year-old girl who presented at our hospital with arthralgia, Raynaud's phenomenon, and fatigue. Blood tests were positive for anti-U1-ribonucleoprotein (RNP) antibodies and for rheumatoid factors (RFs) IgG-RF and anti-galactose-deficient IgG. Levels of myogenic enzymes and hypergammaglobulinemia were elevated. Macrophages were prominent in bone marrow, with scattered phagocytic macrophages. MCTD was diagnosed based on the patient's symptoms and laboratory findings. Methylprednisolone pulse therapy combined with oral tacrolimus was administered, which led to resolution of symptoms. Three months after pulse therapy, arthralgia worsened and methotrexate was administered. Arthralgia improved but did not resolve. Magnetic resonance imaging performed to investigate the hip pain revealed a mature ovarian teratoma, which was surgically removed. Because the pain persisted and interfered with her daily life, she was treated with tocilizumab for joint pain relief, which decreased the pain level. Tocilizumab is a candidate for additional treatment of juvenile idiopathic arthritis-like arthritis associated with childhood-onset MCTD.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":"300-304"},"PeriodicalIF":1.2,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428338","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}

引用次数: 0

Accurate Diagnosis of Familial Mediterranean Fever Improved Quality of Life for a Patient and Her Family: A Case Report. 家族性地中海热的准确诊断改善了患者及其家庭的生活质量：一个病例报告。

IF 1.2 4区医学

Journal of Nippon Medical School Pub Date : 2025-06-26 DOI: 10.1272/jnms.JNMS.2025_92-610

Mami Kurihara, Toru Igarashi, Ryu Ishii, Hanako Tajima, Jun Hayakawa, Makoto Migita

{"title":"Accurate Diagnosis of Familial Mediterranean Fever Improved Quality of Life for a Patient and Her Family: A Case Report.","authors":"Mami Kurihara, Toru Igarashi, Ryu Ishii, Hanako Tajima, Jun Hayakawa, Makoto Migita","doi":"10.1272/jnms.JNMS.2025_92-610","DOIUrl":"https://doi.org/10.1272/jnms.JNMS.2025_92-610","url":null,"abstract":"Periodic fever syndrome is diagnosed on the basis of duration of fever, associated symptoms, and blood and genetic test results. During a 6-month period, a 3-year-old girl experienced monthly fever (39°C) episodes persisting 5 to 12 days and two episodes of ankle arthralgia and skin rash during fever. No abdominal or chest pain was noted. Blood tests performed at the time of fever revealed elevated CRP levels and blood sedimentation rates. Urinalysis and bone marrow examination results were unremarkable. Genetic testing for hereditary autoinflammatory disease syndromes showed E84K MEFV gene mutations. After diagnosing atypical familial Mediterranean fever, oral colchicine alleviated the febrile attacks and improved family quality of life. Fever, arthralgia, and skin rash disappeared after oral colchicine, which is effective for atypical familial Mediterranean fever. During the 6 months before the diagnosis, periodic fever disrupted the daily lives of the entire family. The patient was absent from nursery school during fever. The patient's illness affected her mother's health. The mother was concerned about her child's unknown fever, which resulted in depression and the need for psychiatric medication. Colchicine resolved the febrile episodes, and resolution of the patient's symptoms alleviated her mother's depression. This case shows that genetic testing for periodic fever syndrome can improve family quality of life.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509602","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}

引用次数: 0

Circulatory Management with Impella Assistance During Off-Pump Coronary Artery Bypass Grafting for Cardiogenic Shock: A Report of Two Cases. 心源性休克非体外循环冠状动脉旁路移植术中叶轮辅助循环管理2例报告。

IF 1.2 4区医学

Journal of Nippon Medical School Pub Date : 2025-06-26 DOI: 10.1272/jnms.JNMS.2025_92-609

Makiko Yamamoto, Yuka Ino, Keisuke Mori, Yuji Maruyama, Yosuke Ishii, Masashi Ishikawa, Atsuhiro Sakamoto

{"title":"Circulatory Management with Impella Assistance During Off-Pump Coronary Artery Bypass Grafting for Cardiogenic Shock: A Report of Two Cases.","authors":"Makiko Yamamoto, Yuka Ino, Keisuke Mori, Yuji Maruyama, Yosuke Ishii, Masashi Ishikawa, Atsuhiro Sakamoto","doi":"10.1272/jnms.JNMS.2025_92-609","DOIUrl":"https://doi.org/10.1272/jnms.JNMS.2025_92-609","url":null,"abstract":"The combination of initial Impella therapy, Impella-supported coronary artery bypass grafting (ISCAB), and postoperative Impella therapy providing antegrade perfusion in myocardial infarction can prove effective. We investigated strategies for Impella stabilization in ISCAB, particularly during peripheral circumflex branch anastomosis. Case 1 was a 70-year-old man treated with an Impella 2.5, followed by urgent ISCAB on the day of hospitalization, for a left main trunk lesion. Use of an apical suction device to position the heart to expose an obtuse marginal branch caused Impella obstruction by applying suction to the left ventricular wall, interrupting revascularization; however, one revascularization was achieved. Case 2 was a 79-year-old man treated with an Impella CP for a three-vessel lesion until ISCAB 4 days later. The Impella was stabilized with appropriate positioning by adjusting the bed angle, minimal heart compression with a deep pericardial stitch without pulling on the cardiac apex, and sufficient preload, even during posterolateral branch anastomosis. Four revascularizations were eventually achieved. Multiple innovations to prevent Impella contact with the left ventricle as described herein improve ISCAB safety, particularly during peripheral circumflex branch anastomosis.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509603","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}

引用次数: 0

Debranching Thoracic Endovascular Aortic Repair (TEVAR) for Thoracoabdominal Aortic Dissecting Aneurysm Involving the Visceral Arteries: A Case Report. 胸腹主动脉夹层动脉瘤累及内脏动脉的去分支胸血管内主动脉修复术（TEVAR）一例报告。

IF 1.2 4区医学

Journal of Nippon Medical School Pub Date : 2025-06-26 DOI: 10.1272/jnms.JNMS.2026_93-401

Anna Tsuji, Naoto Miyagi, Aiko Hirayama, Tomohiro Murata, Ryosuke Amitani, Hitomi Ueda, Hiromasa Yamashita, Takashi Sasaki, Yuji Maruyama, Yasuo Miyagi, Jiro Honda, Yosuke Ishii

{"title":"Debranching Thoracic Endovascular Aortic Repair (TEVAR) for Thoracoabdominal Aortic Dissecting Aneurysm Involving the Visceral Arteries: A Case Report.","authors":"Anna Tsuji, Naoto Miyagi, Aiko Hirayama, Tomohiro Murata, Ryosuke Amitani, Hitomi Ueda, Hiromasa Yamashita, Takashi Sasaki, Yuji Maruyama, Yasuo Miyagi, Jiro Honda, Yosuke Ishii","doi":"10.1272/jnms.JNMS.2026_93-401","DOIUrl":"https://doi.org/10.1272/jnms.JNMS.2026_93-401","url":null,"abstract":"Surgical repair of thoracoabdominal aortic aneurysms (TAAA) is a complex procedure that is associated with marked morbidity and mortality. Endovascular TAAA repair, initially reserved for patients at high risk, has yielded promising results and is performed on an increasing range of patients. This case report describes a hybrid approach-a combination of endovascular and open repair-for a patient with high-risk TAAA after aortic dissection. A 79-year-old man had undergone aortic replacement for chronic aortic dissection 20 years previously. His saccular TAAA, extending from the Th12 level to the renal artery origin, demonstrated progressive enlargement (56-60 mm) on computed tomography (CT) scans and compressed the celiac artery. In light of the patient' s age and thoracotomy history, a hybrid repair strategy involving total debranching thoracic endovascular aortic repair (TEVAR) with four-branch abdominal reconstruction was selected to minimize surgical risk. The surgery was performed via a midline abdominal incision. Bypass surgery was first performed using a quadrant artificial graft to restore left renal, right renal, superior mesenteric, and common hepatic artery blood flow. The celiac artery was coiled, and TEVAR was completed. Intraoperative contrast and postoperative CT showed no endoleak and a patent debranching graft. The patient recovered without complications and was discharged 10 days postoperatively. The findings for the present hybrid procedure indicate that debranching TEVAR is less invasive and yields better outcomes than open aortic replacement, particularly for patients at high risk.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509604","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}

引用次数: 0

Melanoma Metastasis to the Left Breast: A Case Report. 黑色素瘤左乳转移1例报告。

IF 1.2 4区医学

Journal of Nippon Medical School Pub Date : 2025-06-26 DOI: 10.1272/jnms.JNMS.2026_93-102

Megumi Sano, Keiko Yanagihara, Mio Yagi, Koji Nagata, Hiroyuki Takei

引用次数: 0

Isolated Prosopagnosia Caused by Damage to the Right Inferior Longitudinal Fasciculus: A Case Report. 右下纵筋膜受损导致的孤立性嗜眠症：病例报告。

IF 1.2 4区医学

Journal of Nippon Medical School Pub Date : 2025-05-21 Epub Date: 2024-06-18 DOI: 10.1272/jnms.JNMS.2025_92-202

Harumi Morioka, Masaru Yanagihashi, Mikito Toda, Takanori Ikeda, Masafumi Mizuno, Masaaki Hori, Kouhei Kamiya, Osamu Kano

引用次数: 0

Large first branchial cyst extending into the parapharyngeal space: A case report. 第一鳃裂大囊肿伸入咽旁间隙1例。

IF 1.2 4区医学

Journal of Nippon Medical School Pub Date : 2025-03-22 DOI: 10.1272/jnms.JNMS.2025_92-601

Takeshi Matsunobu, Takaomi Kurioka, Kimihiro Okubo

引用次数: 0

Aggravation of Pre-existing Cervical Spondylotic Myelopathy with Limb Paralysis Following Lumbar Puncture: A Case Report. 腰椎穿刺后原有脊髓型颈椎病伴肢体瘫痪加重1例报告。

IF 1.2 4区医学

Journal of Nippon Medical School Pub Date : 2025-03-22 DOI: 10.1272/jnms.JNMS.2025_92-602

Akiko Yamazaki, Masahiro Mishina, Masanori Sakamaki, Takehiko Nagao, Kazumi Kimura

引用次数: 0