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Efficacy of Pharmacotherapy for Seasonal Influenza in Young and Middle-aged Adults: A Systematic Review and Network Meta-analysis Intern. Med. (IF 1.2) Pub Date : 2024-03-18 Nao Hanaki, Ryoto Sakaniwa, Takuhiro Moromizato, Jun Miyata, Keiko Ishimura, Midori Noguchi, Hiroyasu Iso
Background Seasonal influenza affects healthcare demand. However, the efficacy of anti-influenza drugs, particularly among young patients at a low risk of complications, has rarely been evaluated. Therefore, we evaluated the efficacy of anti-influenza drugs against seasonal influenza in healthy young and middle-aged adults. Methods A systematic review and network meta-analysis were conducted. The Cochrane
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Safety and Effectiveness of Elotuzumab in Japanese Patients with Relapsed/Refractory Multiple Myeloma: A Post-marketing Surveillance Study Intern. Med. (IF 1.2) Pub Date : 2024-03-18 Fumiya Kaneko, Hiroshi Suzuka, Tomoaki Yoshino, Ryosuke Hinosugi
Objective Elotuzumab plus lenalidomide and dexamethasone (ELd) was approved in Japan in 2016 for the treatment of relapsed/refractory multiple myeloma (RRMM). This post-marketing surveillance study evaluated the safety and effectiveness of ELd in RRMM patients during routine clinical practice in Japan. Methods Elotuzumab safety was assessed by evaluating adverse drug reactions (ADRs), and effectiveness
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The Epidemiology of Circulating Respiratory Pathogens During the COVID-19 Pandemic Intern. Med. (IF 1.2) Pub Date : 2024-03-18 Haruka Imai, Jun Suzuki, Shota Takahashi, Daishi Shimada, Makiko Yoshida, Shiro Endo, Mitsuo Kaku
Objective To survey the epidemiology of respiratory pathogens during the COVID-19 pandemic using multiplex polymerase chain reaction (PCR). Methods Specimens were assayed using multiplex nested PCR. Patients and Materials Specimens were obtained from outpatients who presented with symptoms of upper respiratory tract infection and asymptomatic outpatients who had contact with patients with SARS-CoV-2
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The Movement Disorder Society Criteria: Its Clinical Usefulness in Multiple System Atrophy Intern. Med. (IF 1.2) Pub Date : 2024-03-18 Monami Tarisawa, Masaaki Matsushima, Akihiko Kudo, Ken Sakushima, Yasuhiro Kanatani, Naoki Nishimoto, Jun Sawada, Takeshi Matsuoka, Shin Hisahara, Haruo Uesugi, Naoya Minami, Kazuya Sako, Asako Takei, Akiko Tamakoshi, Norihiro Sato, Hidenao Sasaki, Ichiro Yabe, HoRC-MSA study group
Objective In 2022, Wenning et al. proposed the Movement Disorder Society Criteria (MDS Criteria) for the Diagnosis of Multiple System Atrophy (MSA). These criteria were expected to provide useful alternatives to the second consensus statement. We examined trends in these diagnostic criteria. Methods We used patient data registered with the Hokkaido Rare Disease Consortium for Multiple System Atrophy
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A Case of a Patient with Calpainopathy Carrying Compound Heterozygous Mutations of a de novo Pathogenic Variant of c.1333G>A and a Novel Variant of c.1331C>T in CAPN3 Intern. Med. (IF 1.2) Pub Date : 2024-03-18 Shogo Komaki, Akatsuki Kubota, Kazuto Katsuse, Asuka Kitamura, Meiko Maeda, Takashi Matsukawa, Nobuyuki Eura, Yoshihiko Saito, Ichizo Nishino, Tatsushi Toda
Calpainopathy is primarily an autosomal recessive inherited myopathy; however, dominantly inherited cases with a pathogenic variant of c.1333G>A have been reported. A 13-year-old Japanese girl presented with toe walking and elevated serum creatine kinase levels. Genetic panel testing revealed compound heterozygosity for c.1333G>A and a novel variant of c.1331C>T in CAPN3, leading to a diagnosis of
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Detailed Lipid Profiles and Lipid-related Residual Risk after 12-week 10 mg Rosuvastatin Treatment for Acute Myocardial Infarction Intern. Med. (IF 1.2) Pub Date : 2024-03-18 Yuki Kondo, Masaru Ishida, Takenori Ishisone, Masanobu Niiyama, Takuya Osaki, Yuki Matsumoto, Yuko Maegawa, Kenta Sasaki, Ryo Ninomiya, Yuji Takahashi, Yu Ishikawa, Takumi Kimura, Yudai Shimoda, Munetaka Morikawa, Hidenori Saito, Tomonori Itoh, Yoshihiro Morino
Objective We aimed to reveal detailed on-treatment lipid profiles, lipid-related surrogate markers, and factors predicting failure to achieve the guideline-recommended lipid management goal following guideline-recommended statin treatment in Japanese patients with acute myocardial infarction (AMI). Methods and Results Sixty AMI patients who underwent coronary intervention and had received rosuvastatin
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Tyrosine Kinase Inhibitor-induced Cerebrovascular Occlusion Presenting with Moyamoya Disease-like Stenosis of the Circle of Willis Intern. Med. (IF 1.2) Pub Date : 2024-03-11 Takuya Terakawa, Yuya Hayasaka, Yuka Umeki, Mako Ikeda, Yoshiki Matsuoka, Masanari Mizuki, Shogo Matsui, Wataru Nakahara, Hitomi Matsunaga, Shayne Morris, Takeo Nishida, Takayuki Sakaki, Takeshi Yoshimoto, Shuji Ueda
Vascular occlusive events are notable adverse effects of tyrosine kinase inhibitors (TKIs), which are promising treatments for chronic myeloid leukemia (CML). We herein report the case of a patient with CML who developed cerebrovascular occlusion of the circle of Willis during TKI treatment. Our patient did not meet the diagnostic criteria for moyamoya disease due to the insignificant development of
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Hypopituitarism due to CNS Aspergillus Infection Intern. Med. (IF 1.2) Pub Date : 2024-03-11 Shogo Funakoshi, Mitsuru Nishiyama, Masahiro Komori, Masamitsu Hyodo, Yu Kawanishi, Tetsuya Ueba, Shimpei Fujimoto, Yoshio Terada
A 59-year-old man was admitted to our hospital with hyponatremia. An endocrine examination indicated panhypopituitarism, and magnetic resonance imaging revealed a mass-like lesion in the pituitary gland. Sinus endoscopy revealed a fungal mass in the sphenoid sinus, and the patient was diagnosed with hypopituitarism due to aspergillosis of the central nervous system (CNS). The patient's hyponatremia
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Fusion Imaging Objectively Demonstrates Improved Pancreas Visualization through Manipulation Techniques: A Prospective Interventional Study Intern. Med. (IF 1.2) Pub Date : 2024-03-11 Kazuya Matsumoto, Suguru Kakite, Takaaki Sugihara, Eijiro Yamashita, Kenichi Miyoshi, Takumi Onoyama, Soichiro Kawata, Yuichiro Ikebuchi, Yohei Takeda, Hiroki Koda, Taro Yamashita, Naoyuki Yamaguchi, Masahiko Koda, Hajime Isomoto
Objective Abdominal ultrasonography (AUS) is used to screen for abdominal diseases owing to its low cost, safety, and accessibility. However, the detection rate of pancreatic disease using AUS is unsatisfactory. We evaluated the visualization area of the pancreas and the efficacy of manipulation techniques for AUS with fusion imaging. Methods Magnetic resonance imaging (MRI) volume data were obtained
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Mild Encephalopathy/Encephalitis with Reversible Splenial Lesions after Amphetamine and Opioid Use Intern. Med. (IF 1.2) Pub Date : 2024-03-11 Youichi Yanagawa, Hiroki Nagasawa, Noriko Torizawa, Ikuto Takeuchi
A 47-year-old woman with a history of substance abuse, depression, and insomnia experienced a collapse. Upon arrival at the hospital, the patient displayed low systolic blood pressure, confusion, dehydration, and renal failure. Urine tests confirmed an amphetamine and opioid overdose. Her condition fluctuated with reduced consciousness, myoclonic movements, fever, and suspected psychogenic seizures
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Pegylated-liposomal Doxorubicin-induced Glomerular Thrombotic Microangiopathy Intern. Med. (IF 1.2) Pub Date : 2024-03-11 Shingo Yokoyama, Kota Kakeshita, Teruhiko Imamura, Tomoko Shima, Hayato Fujioka, Hidenori Yamazaki, Tsutomu Koike, Koichiro Kinugawa
Pegylated liposomal doxorubicin (PLD) has emerged as a recent innovation within the realm of antineoplastic agents, distinguished by its incorporation of doxorubicin within the liposomal bilayer. Given the low risk of cardiotoxicity, the clinical use of PLD has been expanding. We encountered a patient who underwent extended PLD therapy for recurrent malignancy and subsequently developed PLD-associated
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Japanese Mucuna pruriens (Hasshou beans) Showed Fast-acting and Long-lasting Effects in Parkinson's Disease Intern. Med. (IF 1.2) Pub Date : 2024-03-11 Mayumi Sakata, Katsuichi Miyamoto, Jinsoo Koh, Yasuhiro Nagashima, Tomoyoshi Kondo, Hidefumi Ito
Objective Mucuna pruriens (MP) is a legume whose seeds contain levodopa (LD), which has potential therapeutic effects against Parkinson's disease (PD). However, further research is needed to thoroughly evaluate its efficacy and safety for treating this condition. In this study, we analyzed the pharmacokinetics of MP grown in Japan and investigated its mechanism of action in PD. Methods MP seeds ground
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A Case of Tick-borne Disease with Yezo Virus and Borrelia miyamotoi Coinfection Intern. Med. (IF 1.2) Pub Date : 2024-03-11 Keiko Suzuki, Satoshi Suzuki, Hiroki Yamaguchi, Yasutaka Kakinoki
Yezo virus is a novel virus transmitted by tick bites that causes fever with thrombocytopenia. To date, two reports have been published on patients with Yezo virus infection. However, the clinical characteristics of Yezo virus infection remain unclear. A patient who presented with fever, fatigue, headaches, and muscle pain and was admitted to our hospital. The patient had thrombocytopenia, leukopenia
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Relationship between the Tortuosity of the Extracranial Internal Carotid and Vertebral Arteries on Magnetic Resonance Imaging/Angiography and Vascular Risk Factors in a Japanese Population Intern. Med. (IF 1.2) Pub Date : 2024-03-11 Takayuki Katayama, Kae Takahashi, Osamu Yahara, Issei Matuura, Yasuyuki Fukuda, Shin-ichi Kawasaki, Kenji Kuroda, Takashi Kimura, Jun Sawada
Objective We aimed to investigate the relationship between tortuosity of the extracranial internal carotid artery (ICA) or vertebral artery (VA) and vascular risk factors among residents of Asahikawa, northeast Japan. Methods We retrospectively surveyed participants of "brain dock" medical brain checkups, which involved magnetic resonance imaging and angiography. We measured the tortuosity of the ICA
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A Case of Hereditary Coproporphyria in which the Patient's Course Improved after the Discontinuation of Givosiran Intern. Med. (IF 1.2) Pub Date : 2024-03-11 Nobuaki Ozaki, Yuri Hayashi, Atsushi Kiyota
Hereditary coproporphyria (HCP) is caused by a partial deficiency of coproporphyrinogen oxidase during heme biosynthesis. Givosiran is approved for the treatment of acute hepatic porphyria. We herein report the case of a 47-year-old woman with HCP. Monthly givosiran administration improved her subjective symptoms and reduced her δ-aminolevulinic acid (ALA) and porphobilinogen (PBG) levels to the normal
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Tapeworm Infection Diagnosed after Campylobacter jejuni-induced Enteritis Intern. Med. (IF 1.2) Pub Date : 2024-03-11 Sotaro Ozaka, Ryusuke Soma, Haruhiko Takahashi, Yuta Shimomori, Masahide Fukuda, Koshiro Tsutsumi, Yuka Hirashita, Kensuke Fukuda, Ryo Ogawa, Kazuhiro Mizukami, Yomei Kagoshima, Nozomi Sachi, Naganori Kamiyama, Hideo Hasegawa, Takashi Kobayashi, Masaaki Kodama, Kazunari Murakami
A 35-year-old man with fever and diarrhea visited our hospital because of white string-like fecal excretion. Based on a morphological examination of the excreted object, a Diphyllobothrium infection was suspected. Additionally, Gram staining of a fecal sample revealed Campylobacter infection. After the intraduodenal administration of meglumine/diatrizoate sodium, the tapeworm was excreted. A polymerase
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Nivolumab-induced Thrombotic Thrombocytopenic Purpura in Patients with Gastric Tube Cancer Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Yuya Yoshida, Sakura Toriyabe, Hiroo Imai, Keiju Sasaki, Yuki Kasahara, Kota Ouchi, Ken Saijo, Koichi Onodera, Chikashi Ishioka
Recently, immune checkpoint inhibitors (ICIs) have been used to treat several cancer types. ICIs have been reported to cause a wide variety of immune-related adverse events, including endocrine, neurologic, gastrointestinal, and cutaneous disorders. Thrombotic thrombocytopenic purpura (TTP) is an autoimmune hematologic disorder characterized by the presence of autoantibodies against a disintegrin and
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Successful Treatment of Rosai-Dorfman Disease with Cutaneous Involvement and Arthritis with Methotrexate and Infliximab Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Koji Suzuki, Mitsuhiro Akiyama, Yasushi Kondo, Katsuya Suzuki, Yuko Kaneko
Rosai-Dorfman disease (RDD) is a rare histiocytic proliferative disorder characterized by lymphadenopathy and extra-nodal manifestations. Some patients with RDD require systemic treatment, but there is no consensus on the treatment strategy owing to its extreme rarity. Overexpression of tumor necrosis factor α (TNF-α) has been reported in lesions of patients with RDD and is thought to be involved in
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Endoscopic and Histological Gastritis in University Students with Helicobacter pylori Infection Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Shotaro Okanoue, Hiroyuki Sakae, Kenji Yokota, Takehiro Tanaka, Yuka Obayashi, Makoto Abe, Yoshiyasu Kono, Hiromitsu Kanzaki, Masaya Iwamuro, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Yanai, Hiroyuki Okada
Objective Although the characteristics of Helicobacter pylori infection have been extensively reported, there is a lack of consensus regarding its characteristics in young adults. The present study examined the endoscopic and histological characteristics of young adults who underwent eradication therapy for H. pylori infection. Methods We examined the H. pylori infection status of first-year students
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A Reduction in the Number of Hospitalized Cases of Acute Meningitis during the COVID-19 Pandemic in Japan Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Tetsuya Akaishi, Kunio Tarasawa, Kiyohide Fushimi, Chiharu Ota, Sumireko Sekiguchi, Tetsuji Aoyagi, Nobuo Yaegashi, Masashi Aoki, Kenji Fujimori
Objective The changes in the prevalence of acute meningitis during the coronavirus disease 2019 (COVID-19) pandemic remain unclear. This study aimed to compare the prevalence of acute meningitis before and during the COVID-19 pandemic in Japan. Methods We retrospectively reviewed the Japanese nationwide administrative medical payment system database, Diagnosis Procedure Combination (DPC), from 2016
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A Case of Unresectable Combined Hepatocellular-cholangiocarcinoma Treated with Combination Therapy Consisting of Durvalumab Plus Tremelimumab Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Shinji Unome, Kenji Imai, Takao Miwa, Tatsunori Hanai, Atsushi Suetsugu, Koji Takai, Natsuko Suzui, Tatsuhiko Miyazaki, Masahito Shimizu
Combined hepatocellular cholangiocarcinoma is a rare and challenging primary liver malignancy that lacks any established standard treatments for unresectable cases. We herein present the first known case of a 49-year-old woman diagnosed with unresectable combined hepatocellular-cholangiocarcinoma, who underwent novel chemotherapy involving durvalumab plus tremelimumab combination therapy. The treatment
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Small Insulinoma Followed-up as an Indolent Pancreatic Tumor: A Case Report Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Hiroki Sato, Shozaburo Fujii, Tetsuhiro Okada, Hidemasa Kawabata, Yuki Kamikokura, Mikihiro Fujiya
A woman in her 60s presented with a small pancreatic head tumor. Imaging studies revealed a 13-mm well-defined pancreatic head tumor. A neuroendocrine neoplasm was suspected, and the patient opted for observation at that time. After 8 months, the patient began experiencing sweating while fasting, and blood tests during regular follow-up visits showed hypoglycemia. Hypoglycemia was induced during fasting
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Ovarian Microcystic Stromal Tumor with Significant Nestin Expression: A Unique Case Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Bao Wu, Chongming Wu, Dandan Li, Zhanmin Yang, Ying Liu, Hai-Xia Zhang, Hong-Wu Xin, Yuqin Bai
Ovary microcystic stromal tumor (MCST) is an extremely rare subtype of sex cord-stromal neoplasm, and only 57 cases have been reported. We herein report a unique case of ovarian MCST with positive nestin expression in a 39-year-old Chinese woman. The tumor showed microcystic stromal histological structures and characteristically expressed the CD10, WT-1, and Ki67 proteins. A molecular analysis identified
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Clinical Benefits of Targeting Treatable Traits in Asthma and Chronic Obstructive Pulmonary Disease Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Yuko Morishima, Nobuyuki Hizawa
Asthma and chronic obstructive pulmonary disease (COPD) have long been debated regarding their similarities and differences in clinical presentation and pathology. There has also been a discussion about how common therapeutics should be used differently for each disease. Traditionally, a "one size fits all" stepwise treatment has been chosen based on the severity of each case after categorizing the
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Endoscopic Findings of 'Salmon Roe-like Nodular Lesions' in a Case of Severe Disseminated Strongyloidiasis in a Foreign Resident in Japan Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Keigo Kobayashi, Yasuhiro Umekawa
A Southeast Asian man in his 30s residing in Japan developed severe disseminated strongyloidiasis during long-term steroid therapy. Initially misdiagnosed as gastroenteritis, his condition was later identified as strongyloidiasis by fecal smears and endoscopy. An endoscopic examination revealed salmon roe-like nodular lesions, indicating an advanced stage. Despite treatment, the patient died of the
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Cardiomyopathy with an LMNA Genetic Variant Affecting Three Consecutive Generations: A Case Series Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Naoko Ogawa, Hidekazu Kondo, Yumi Ishii, Kazuki Mitarai, Kumiko Akiyoshi, Hiroko Niwa, Koichi Kato, Minoru Horie, Seiko Ohno, Naohiko Takahashi
We report the case of a family afflicted with cardiac laminopathy who showed atrial fibrillation (AF) and complete atrioventricular block across three generations. Implantable cardioverter defibrillators (ICDs) implantation, or cardiac resynchronization therapy (CRT) were delivered to the three patients (proband; 61 years old, proband's mother: 84 years old, and proband's daughter; 38 years old) to
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Paraneoplastic Cerebellar Degeneration Leading to an Early Diagnosis of Peritoneal Serous Papillary Carcinoma Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Tsutomu Yasuda, Jun Shimizu, Toji Miyagawa, Yuri Tsutsumi, Takeshi Iwatsubo, Shoji Tsuji
A 77-year-old female with a subacute progression of ataxia and serum anti-Yo antibodies was suspected to have paraneoplastic cerebellar degeneration (PCD). An examination of an underlying cancer showed no abnormality in the gynecological organs, but the findings did show a mass in the Douglas fossa. The mass was resected and diagnosed as stage IIB peritoneal serous papillary carcinoma (PSPC), a rare
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The Body Mass Index as a Determinant of Acute Ischemic Location in Mild Non-cardioembolic Stroke Patients Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Junya Aoki, Kazumi Kimura, on behalf of the ADS investigator
Objective Although the body mass index (BMI) is considered a meaningful parameter for evaluating obesity, the association between the BMI and acute non-cardioembolic stroke remains unclear. We investigated how the BMI was related to patients' background, type of infarction, and infarction location in patients with non-cardioembolic stroke using an acute dual study (ADS) cohort. Methods The ADS trial
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Association between an early revascularization strategy and major cardiac events based on left ventricular dyssynchrony in patients at intermediate risk of major cardiac events using the J-ACCESS risk model Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Yudai Tanaka, Shunichi Yoda, Katsunori Fukumoto, Takumi Hatta, Keiichiro Kuronuma, Yasuyuki Suzuki, Naoya Matsumoto, Yasuo Okumura
Objective This retrospective study aimed to investigate the association between therapeutic strategies and the development of major cardiac events (MCEs) in intermediate-risk patients by using the J-ACCESS risk model in combination with the stress phase bandwidth (SPBW), an index of left ventricular dyssynchrony. Methods Patients were followed-up for three years to confirm their prognosis. Based on
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Vibrio fluvialis Bacteremia in an Immunocompetent Patient with Acute Cholangitis Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Tomoko Takezawa, Naohisa Matsunaga, Atsushi Miki, Toshihiko Arizumi, Atsushi Tanaka, Fuyu Ito, Shoji Kawachi
Vibrio fluvialis is a bacterium that can be found in both seawater and freshwater, and it is responsible for causing gastroenteritis and cholangitis. V. fluvialis bacteremia has rarely been reported. We report a case of V. fluvialis bacteremia due to cholangitis in an immunocompetent adult who was exposed to seawater regularly as a sushi chef. The increased risk of V. fluvialis entry into the body
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Evidence of tosufloxacin deposition in the kidneys of a patient presenting with crystal nephropathy Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Yuuki Ito, Noriko Mori, Ken Matsuo, Satoshi Tanaka, Kiyoshi Mori, Nao Kobayashi, Hajime Mizuno, Kenichiro Todoroki, Kojiro Nagai
Tosufloxacin tosilate is classified as a new quinolone antibacterial agent, which has been reported to cause crystal nephropathy. However, the origin of these crystal deposits has not yet been elucidated. We encountered a case of renal failure that progressed slowly owing to crystal-forming interstitial nephritis after long-term exposure to tosufloxacin. Mass spectrometry of the renal specimens revealed
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Sporadic Late-onset Nemaline Myopathy Associated with Sjögren's Syndrome: A Case Report. Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Tsuyoshi Hamaguchi, Ichizo Nishino, Yasuki Hirano, Nobuaki Uchida, Michiyo Fujita-Nakata, Megumi Nakanishi, Tomoyuki Sakai, Masato Asahina
We report the case of a 46-year-old female patient who developed a subacute progression of axial and proximal muscle weakness. Laboratory findings revealed mildly elevated serum creatine kinase levels. No monoclonal gammopathy was detected. A muscle biopsy revealed that she had nemaline myopathy. Serological tests and a lip biopsy revealed Sjögren's syndrome (SjS). We diagnosed her as having sporadic
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An Autopsy Case of COVID-19 with New Diffuse Pulmonary Ossification Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Taisuke Nakagawa, Yasuaki Kotetsu, Katsumi Takizawa, Michihiro Yoshimi, Isamu Okamoto, Shohei Takata
We present the case of a 61-year-old man who developed Coronavirus disease 2019 (COVID-19) and died during treatment for relapsing polychondritis. The patient was intubated and treated with steroid pulse therapy, remdecivir, antibacterial agents, baricitinib, and tocilizumab. However, his respiratory condition worsened, and he died 108 days after disease onset. An autopsy revealed diffuse alveolar
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Cytokine Release Syndrome with Relative Adrenal Insufficiency Induced by Ipilimumab and Nivolumab Combination Therapy for Clear Cell Renal Cell Carcinoma Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Kohei Yamamoto, Shinsuke Shiotsu, Misaki Sasakura, Shunya Tanaka, Shiho Goda, Taisuke Tsuji, Tatsuya Yuba, Chieko Takumi, Noriya Hiraoka
Combination therapy with ipilimumab and nivolumab is indicated for many types of cancers; however, several patients experience immune-related adverse events (irAEs). We herein report a case of cytokine release syndrome (CRS) in a 63-year-old woman with stage IV left clear cell renal cell carcinoma. Our patient developed CRS while taking prednisolone, 43 days after the start of ipilimumab and nivolumab
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Severe acute interstitial nephritis induced by α-glucosidase inhibitor miglitol in an elderly patient with type 2 diabetic nephropathy Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Kazutoshi Ono, Takahiro Masuda, Yuko Ono, Erika Hishida, Hiromichi Yoshizawa, Toshimi Imai, Hiroshi Satonaka, Tetsu Akimoto, Daisuke Nagata
A 79-year-old male patient with type 2 diabetic nephropathy and hypertension was admitted to our hospital because of acute kidney injury with significantly elevated serum creatinine (8.12 mg/dL) and urinary β2-microglobulin (β2MG, 31,748 μg/L) levels. α-Glucosidase inhibitor (α-GI) miglitol, started two weeks prior to presentation, was discontinued because drug-induced acute interstitial nephritis
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Primary Ciliary Dyskinesia Caused by Homozygous DNAAF1 Mutations Resulting from a Consanguineous Marriage: A Case Report from Japan Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Masashi Ito, Kozo Morimoto, Mikio Saotome, Akiko Miyabayashi, Keiko Wakabayashi, Hiroyuki Yamada, Minako Hijikata, Naoto Keicho, Ken Ohta
We present the case of a 58-year-old female patient with primary ciliary dyskinesia (PCD). She was born to parents with a consanguineous marriage. Chest computed tomography conducted at age 41 years indicated no situs inversus, and findings of bronchiectasis were limited to the middle and lingular lobes. Despite long-term macrolide therapy, bronchiectasis exacerbations frequently occurred. PCD was
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A Case of Refractory Gastroesophageal Reflux Disease Successfully Treated with Endoscopic Anti-gastroesophageal Reflux Mucosal Resection by the ESD-G Method (with video) Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Shun Sasaki, Kazuhiro Ota, Taro Iwatsubo, Noriaki Sugawara, Akitoshi Hakoda, Hironori Tanaka, Yosuke Mori, Toshihisa Takeuchi, Kazuhide Higuchi, Hiroki Nishikawa
A 70-year-old man who had undergone treatment for gastroesophageal reflux disease (GERD) by a family doctor presented to our hospital with severe heartburn and dysphagia despite taking vonoprazan (20 mg) for 3 months. A diagnosis of vonoprazan-refractory nonerosive reflux disease was made based on esophagogastroduodenoscopy and esophageal function examinations. The patient elected to undergo endoscopic
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Repeated Syncope Following COVID-19 Infection Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Yoh Arita, Kota Takaki, Yuto Suetani, Kana Shichijo, Nobuyuki Ogasawara
A 74-year-old woman presented to our hospital with syncope after a coronavirus disease 2019 (COVID-19) infection. Upon admission, she passed out, and an 8-second sinus arrest was detected during telemetry monitoring. During the next syncope episode, telemetry monitoring showed that her heart rate decreased from 80 to 36 bpm, accompanied by a 2.4-second pause. A permanent pacemaker was implanted; however
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Diagnostic Value of sLR11 and sIL-2R in the Cerebrospinal Fluid for Malignant Central Nervous System Lymphoma Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Naomi Shimizu, Sanshiro Nakao, Hidekazu Hasunuma, Chiaki Nakaseko, Tomo Shimizu, Hiroyuki Ebinuma, Hideaki Bujo
Objective We previously reported that patients with acute leukemia and malignant lymphoma (ML) demonstrated significantly increased serum soluble LR11 (sLR11) levels compared to normal controls. Accurately diagnosing ML of the central nervous system (CNS ML) using cytology is frequently difficult. Therefore, we evaluated the use of cerebrospinal fluid (CSF) sLR11 and soluble interleukin-2 receptor
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Trends in the Incidence of Renal Replacement Therapy due to Rapidly Progressive Glomerulonephritis in Japan, 2006-2021 Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Minako Wakasugi, Ichiei Narita
Objective Patients with rapidly progressive glomerulonephritis (RPGN) are at a high risk of progression to end-stage kidney disease (ESKD), requiring renal replacement therapy (RRT). The present study examined recent trends in the incidence of RRT due to RPGN in Japan. Methods The number of patients with incident RRT due to RPGN by sex from 2006 to 2021 was extracted from the Japanese Society of Dialysis
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A Case of Successful Immunosuppressive Therapy for Interstitial Lung Disease Associated with Sjögren's Syndrome With Double-positive Anti-SS-A and Anti-centromere Antibodies Intern. Med. (IF 1.2) Pub Date : 2024-03-04 Koji Suzuki, Mitsuhiro Akiyama, Yasushi Kondo, Shuntaro Saito, Jun Kikuchi, Hironari Hanaoka, Yuko Kaneko
Sjögren's syndrome (SS) can present with extraglandular organs, such as interstitial lung disease (ILD). Anti-SS-A antibody is frequently found in SS cases, whereas anti-centromere antibody (ACA) is detected in some SS cases. Notably, the anti-SS-A and ACA double-positive cases exhibited distinct features with a higher prevalence of ILD. However, there have so far been no reports on the treatment of
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Autopsy of Drug-induced Lung Injury with Atypical Diffuse Alveolar Disorder due to Amiodarone: A Case Report Intern. Med. (IF 1.2) Pub Date : 2024-02-26 Hikaru Mamizu, Hiroki Kohda, Yuusuke Tomita, Takuma Hatakeyama, Maiko Mamizu, Daisuke Ishikawa, Hidenori Kawakami, Toshiki Furukawa, Takashi Ishida, Tsuyoshi Sakai
Amiodarone, a prominent antiarrhythmic drug, may cause lung injury. We herein report the case of an 87-year-old man who had been taking amiodarone for 5 years and was subsequently referred due to respiratory failure. Chest computed tomography revealed multiple consolidations with air bronchograms in both lungs. Despite administering steroid pulse therapy, his respiratory failure worsened, and he died
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Right-sided Herpes Zoster Ophthalmicus Complicated by Bilateral Third, Fourth, and Sixth Cranial Nerve Palsies and Syndrome of Inappropriate Antidiuretic Hormone Secretion: A Case Report Intern. Med. (IF 1.2) Pub Date : 2024-02-26 Tomoaki Shima, Kairi Yamashita, Kanako Furuta, Kohei Tsujino, Saeko Nagai, Daiji Torimura, Hiroaki Ohtsuka, Yuki Tomita, Takuro Hirayama, Shunsuke Yoshimura, Teiichiro Miyazaki, Yohei Tateishi, Akira Tsujino
Cases of herpes zoster ophthalmicus (HZO) complicated by bilateral ophthalmoplegia are rare, and no cases of bilateral third, fourth, or sixth cranial nerve palsies have been reported. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a rare complication of HZO. We herein report an 80-year-old Japanese woman with right-sided HZO complicated by meningoencephalitis and discuss the pathogenesis
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Rare Co-occurrence of Spinal Cord Hemorrhage from Radiation-induced Cavernous Hemangioma and Classical Hodgkin Lymphoma Post-transplant Lymphoproliferative Disorder Intern. Med. (IF 1.2) Pub Date : 2024-02-26 Takahiro Shimizu, Yu Nagashima, Takashi Matsukawa, Akihiko Mitsutake, Mizuho Kawai, Yurino Horiuchi, Keishi Yokoyama, Kensuke Takaoka, Yuya Kurihara, Kazuhiro Toyama, Kaori Sakuishi, Mineo Kurokawa, Tatsushi Toda
Post-transplant lymphoproliferative disorders (PTLDs) are lymphoproliferative diseases that occur after solid organ transplantation or hematopoietic stem cell transplantation (HSCT). The development of PTLD is often associated with reactivation of Epstein-Barr virus (EBV). A 26-year-old woman with a history of HSCT and total-body irradiation developed spinal cord hemorrhage from a radiation-induced
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An In-depth Single-center Retrospective Assessment of In-Hospital Outcomes in Acute Myocardial Infarction Patients with and without Diabetes Intern. Med. (IF 1.2) Pub Date : 2024-02-26 Sho Hitomi, Yorihiko Koeda, Kengo Tosaka, Nozomu Kanehama, Masanobu Niiyama, Masaru Ishida, Tomonori Itoh, Yoshihiro Morino
Objective This study examined variations in in-hospital mortality causes and identified independent mortality predictors among patients with acute myocardial infarction (AMI) with and without diabetes mellitus (DM). Methods We examined factors influencing in-hospital mortality in a single-center retrospective observational study. Separate multivariate analyses were conducted for both groups to identify
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Kluyvera georgiana Bacteremia Due to Acute Cholangitis: A Report of the First Known Case and a Literature Review Intern. Med. (IF 1.2) Pub Date : 2024-02-26 Go Endo, Sachiko Kanai, Hiroto Nishio, Hideki Hashimoto, Yoshimi Higurashi, Yusuke Nomura, Yousuke Nakai, Mitsuhiro Fujishiro
We herein present the first known case of bacteremia caused by Kluyvera georgiana in a 67-year-old female undergoing chemotherapy for recurrent pancreatic cancer. The patient underwent choledochojejunotomy and thereafter developed ascending cholangitis. The diagnosis of K. georgiana was confirmed using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. A literature review
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The New potential for Using Franseen Needles in Interventional EUS Intern. Med. (IF 1.2) Pub Date : 2024-02-26 Nozomi Okuno, Kazuo Hara, Shin Haba, Takamichi Kuwahara, Toshitaka Fukui, Minako Urata, Yoshitaro Yamamoto, Takashi Kondo
Objective Adverse events such as bile leakage and bleeding are among the issues that need to be resolved in EUS-guided choledochoduodenostomy (EUS-CDS). To overcome this problem, we developed a new EUS-CDS technique using a 19-G Franseen needle without tract dilation. This study aimed to evaluate the safety and efficacy of the new EUS-CDS technique. Methods This single-center retrospective study included
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Is Podocytopathy Associated with Gross Hematuria after COVID-19 Vaccination in Patients with Immunoglobulin A Nephropathy? Intern. Med. (IF 1.2) Pub Date : 2024-02-26 Atsuhiko Suenaga, Naoki Sawa, Yuki Oba, Daisuke Ikuma, Akinari Sekine, Masayuki Yamanouchi, Eiko Hasegawa, Hiroki Mizuno, Tatsuya Suwabe, Kei Kono, Keiichi Kinowaki, Kenichi Ohashi, Motoaki Miyazono, Yutaka Yamaguchi, Noriko Uesugi, Yoshifumi Ubara
We experienced three cases of a fever and subsequent severe, prolonged gross hematuria after COVID-19 vaccination. A kidney biopsy revealed immunoglobulin A (IgA) nephropathy, and electron microscopy showed two types of podocytopathy (podocyte damage): loss of foot processes from the glomerular basement membrane and foot process effacement. Mesangial interposition was also present in cases 1 and 3
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Calcium Polystyrene Sulfonate Crystal-related Airway Obstruction Intern. Med. (IF 1.2) Pub Date : 2024-02-26 Hideshige Seki, Kensuke Narukawa, Yurika Mitsui, Yukari Shirasugi, Shigeki Morita, Tsuyoshi Takahashi
An 83-year-old man diagnosed with multiple myeloma presented with renal failure and hyperkalemia. The patient was treated with calcium polystyrene sulfonate (CPS; kalimate) for hyperkalemia. On the 10th day after starting CPS, airway obstruction due to the presence of a mass was observed, and the patient died on that same day. Autopsy revealed that the mass was located between the trachea and epiglottis
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A Prompt Diagnosis and Treatment of a Case of Nuclear Protein of the Testis Carcinoma Characterized by a Bronchial Lesion and High Serum Alpha-fetoprotein Level Following Genomic Testing Intern. Med. (IF 1.2) Pub Date : 2024-02-26 Hiroaki Matsuura, Go Makimoto, Naohiro Oda, Kiichiro Ninomiya, Hisao Higo, Masanori Fujii, Kammei Rai, Eiki Ichihara, Kadoaki Ohashi, Katsuyuki Hotta, Masahiro Tabata, Yoshinobu Maeda
Nuclear protein of the testis carcinoma (NUTC) is a rare and aggressive malignancy. We herein report a case of NUTC in the lung characterized by a bronchial lesion and elevated alpha-fetoprotein levels. A 35-year-old Japanese man presented to our institution with suspected advanced lung cancer based on a histological examination. Subsequently, next-generation sequencing (NGS) yielded a positive BRD4-NUTM1
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Severe Left Main Coronary Artery Stenosis and Aortic Regurgitation in a Patient Presenting with Takayasu Arteritis Intern. Med. (IF 1.2) Pub Date : 2024-02-26 Akiko Tanihata, Atsushi Shibata, Kazutoshi Teragaki, Toshitake Yoshida, Ryoko Kitada, Akimasa Morisaki, Asahiro Ito, Yasuhiro Izumiya, Daiju Fukuda
We herein report the case of a 46-year-old woman with Takayasu arteritis (TA), severe stenosis in the left main coronary artery (LMCA), and severe aortic regurgitation. Prednisolone and tacrolimus were initiated as TA treatments. Two months after initiating medical therapy, the aortic regurgitation severity improved to a moderate grade, although there was no obvious improvement in LMCA stenosis. Thus
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The Diversity of Neurological Complications Associated with Herpes Zoster: A Retrospective Case Series of 26 Patients Intern. Med. (IF 1.2) Pub Date : 2024-02-26 Joe Nemoto, Jun-ichi Ogasawara, Michiaki Koga
Objects This study clarified a variety of neurological phenotypes associated with varicella-zoster virus (VZV) reactivation. Methods This retrospective single-center study included consecutive patients with herpes zoster accompanied by neurological disturbances from April 2016 to September 2022. A comparative analysis was performed to examine whether or not the neurological phenotype and severity were
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An Extremely Delayed Onset of Frey Syndrome: A Case Report and Literature Review Intern. Med. (IF 1.2) Pub Date : 2024-02-26 Yuya Kobayashi, Kazuki Kasuga, Yusaku Shimizu, Yoshiki Sekijima
We report the case of an 80-year-old man with Frey syndrome that developed 30 years postoperatively, which is an exceptionally long period before its occurrence. Sweating and flushing occurred on only the side of his face where the surgery was performed, and he had no other causative abnormalities. Following treatment with botulinum toxin, the patient's symptoms resolved. Extremely early- and late-onset
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Bilateral or Unilateral Aldosterone Hypersecretion and Responsiveness to Therapy are Associated with Differences in Calcium/Phosphate Homeostasis in Patients with Primary Aldosteronism Intern. Med. (IF 1.2) Pub Date : 2024-02-26 Miki Yarita-Kawana, Satoshi Kidoguchi, Yohei Suehiro, Naoki Sugano, Takashi Yokoo
Introduction Primary aldosteronism is characterized by the autonomous excretion of aldosterone, which may induce bone mineral disorders. Patients and methods A total of 96 patients with primary aldosteronism were analyzed to identify differences in the regulation of serum calcium/phosphate balance between patients with unilateral and bilateral aldosterone hypersecretion and to determine whether or
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A Case of Atypical Hemolytic Uremic Syndrome Triggered by Acute Pancreatitis in a Patient with a Membrane Cofactor Protein (CD46) Genetic Variant Intern. Med. (IF 1.2) Pub Date : 2024-02-26 Kosuke Mochizuki, Naohiro Toda, Masaaki Fujita, Satoshi Kurahashi, Hisako Hirashima, Kazuki Yoshioka, Tomoya Kitagawa, Akira Ishii, Toshiyuki Komiya
Atypical hemolytic uremic syndrome (aHUS) is a type of HUS. We herein report a case of aHUS triggered by pancreatitis in a patient with a heterozygous variant of membrane cofactor protein (MCP; P165S), a complement-related gene. Plasma exchange therapy and hemodialysis improved thrombocytopenia and anemia without leading to end-stage kidney disease. This MCP heterozygous variant was insufficient to
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Cardiac Sarcoidosis which Occurred four Years after Successful Treatment of Cutaneous Sarcoidosis with Minocycline Intern. Med. (IF 1.2) Pub Date : 2024-02-26 Hiroaki Kawano, Tetsufumi Motokawa, Yoshinobu Eishi, Akito Setoguchi, Yuki Ueno, Motoi Takenaka, Shinji Okano, Reiko Ideguchi, Kenichi Ohashi, Koji Maemura
A 67-year-old woman was admitted to our hospital because of a complete right bundle branch block. She had been treated with minocycline for skin sarcoidosis and her symptoms had ameliorated four years previously. Gallium scintigraphy revealed an abnormal uptake in the heart but not in the skin or lungs. She was diagnosed with cardiac sarcoidosis, although an endomyocardial biopsy could not detect any
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Pancreatic Pseudocyst after Fully Covered Self-expandable Metallic Stent Placement: A Case Report Intern. Med. (IF 1.2) Pub Date : 2024-02-26 Mitsuhito Koizumi, Sho Ishikawa, Kaori Marui, Masahito Kokubu, Yusuke Okujima, Yuki Numata, Yoshiki Imamura, Teru Kumagi, Yoichi Hiasa
A 70-year-old woman presented with stage III pancreatic head cancer. After endoscopic sphincterotomy, a fully covered self-expandable metallic stent (FCSEMS) was placed in the common bile duct to manage jaundice. The patient developed a fever and abdominal pain 40 days after stent placement, with a suspected diagnosis of infected pancreatic pseudocyst. Purulent discharge from the papilla was observed
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Coronary Aneurysm after Excimer Laser Catheter Ablation and Plain Balloon Angioplasty for Chronic Total Occlusion in a Patient with Kawasaki Disease Intern. Med. (IF 1.2) Pub Date : 2024-02-26 Makoto Hoyano, Kazuyuki Ozaki, Naoki Kubota, Shintaro Yoneyama, Takeshi Okubo, Ryutaro Ikegami, Takayuki Inomata
A 37-year-old man with a history of Kawasaki disease presented with total occlusion of the right coronary artery. The patient underwent percutaneous coronary intervention (PCI) with excimer laser coronary angioplasty (ELCA) and plain balloon angioplasty (POBA). Three months after PCI, a coronary aneurysm with restenosis was detected at the PCI site, and PCI was performed again using a small balloon
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A Case of an Splenic Artery Aneurysm and Focal Nodular Hyperplasia Associated with an Abdominal Vascular Abnormality of Hereditary Hemorrhagic Telangiectasia Intern. Med. (IF 1.2) Pub Date : 2024-02-26 Satoru Hagiwara, Koichi Nakagawa, Yoriaki Komeda, Naoshi Nishida, Akihiro Yoshida, Tomoki Yamamoto, Takuya Matsubara, Masatoshi Kudo
In October 2021, a 51-year-old woman developed a skin rash. Abdominal computed tomography revealed a large splenic artery aneurysm and an intrahepatic portovenous shunt. As her splenic artery aneurysm was at risk of rupture, she was referred to the Kindai University Hospital and underwent coiling surgery. In October 2023, approximately two years after she had been initially referred, contrast-enhanced
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Clinical Features of Tachycardia-induced Cardiomyopathy in Patients with Atrial Fibrillation Intern. Med. (IF 1.2) Pub Date : 2024-02-19 Yukimi Uotani, Nobuo Sasaki, Mika Nakashima, Rie Akiyama, Naoto Oguri, Shogo Miyamoto, Shunsuke Miyauchi, Sho Okamura, Yousaku Okubo, Takehito Tokuyama, Haruya Ohno, Yukiko Nakano
Objective Atrial fibrillation (AF) is the most common cause of tachycardia-induced cardiomyopathy (TIC). However, which patients with AF are prone to developing TIC remains unclear. In this study, we investigated the clinical features of AF patients with TIC. Methods This single-center study included 722 patients with AF (average age, 63.1±10.2 years old; 191 women) who underwent radiofrequency catheter