المؤلفون: Kosuke Obama, Tomohisa Tabuchi, Hirosaka Inoue

المصدر: Internal Medicine. 61:87-90

مصطلحات موضوعية: musculoskeletal diseases, medicine.medical_specialty, medicine.medical_treatment, Gastroenterology, Arthritis, Rheumatoid, chemistry.chemical_compound, immune system diseases, Lactate dehydrogenase, Internal medicine, Internal Medicine, medicine, Humans, skin and connective tissue diseases, Intravascular large B-cell lymphoma, Chemotherapy, medicine.diagnostic_test, business.industry, General Medicine, Middle Aged, medicine.disease, Lymphoproliferative Disorders, Lymphoma, Discontinuation, Methotrexate, chemistry, Rheumatoid arthritis, Abdominal ultrasonography, Female, Lymphoma, Large B-Cell, Diffuse, business, medicine.drug

الوصف: A 56-year-old woman with rheumatoid arthritis who had been taking methotrexate (MTX) for six years visited our hospital with dyspnea and dizziness. Abdominal ultrasonography revealed mild splenomegaly. Laboratory examinations showed a marked elevation in soluble interleukin-2 receptor and lactate dehydrogenase levels. These abnormalities revealed a spontaneous regression after MTX discontinuation, however, they worsened again four months later. Skin biopsies revealed a diagnosis of intravascular large B-cell lymphoma (IVLBCL), and we diagnosed MTX-associated IVLBCL (MTX-IVLBCL) based on its characteristic course. Despite the recurrence of IVLBCL, it showed a good response to chemotherapy. MTX-IVLBCL should therefore be treated with consideration since it has different characteristics from that of de novo IVLBCL.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d7e5555c21e0bc1c64fb43ac0182b2ccTest
https://doi.org/10.2169/internalmedicine.7531-21Test

المؤلفون: Masahiro Shinoda, Yuto Yoshida, Masaharu Shinkai, Miwa Morikawa, Shinichiro Ota, Osamu Sasaki, Takatomo Hirouchi, Kenichi Kamachi, Kanako Shinada, Takashi Sato

المصدر: Internal Medicine

مصطلحات موضوعية: Male, Neutrophils, Lymphocyte, 030204 cardiovascular system & hematology, Fibrinogen, Leukocyte Count, chemistry.chemical_compound, 0302 clinical medicine, Japan, Risk Factors, Tachycardia, Platelet, Oximetry, Age Factors, General Medicine, Middle Aged, C-Reactive Protein, medicine.anatomical_structure, COVID-19 Nucleic Acid Testing, Cohort, Original Article, Female, 030211 gastroenterology & hepatology, CRP, medicine.drug, Adult, medicine.medical_specialty, Fever, 03 medical and health sciences, White blood cell, Internal medicine, Lactate dehydrogenase, Internal Medicine, medicine, pneumonia, Humans, Lymphocyte Count, Retrospective Studies, L-Lactate Dehydrogenase, Platelet Count, SARS-CoV-2, business.industry, screening, COVID-19, medicine.disease, Comorbidity, clinical feature, Pneumonia, chemistry, business

الوصف: Objective We aimed to clarify clinical and laboratory characteristics of coronavirus disease 2019 (COVID-19) patients, and further explore the features to detect COVID-19 pneumonia at the first visit to community-based hospitals. Methods Diagnoses of COVID-19 were based on positive results from real-time reverse-transcription polymerase chain reaction testing of nasopharyngeal-swab specimens. We retrospectively reviewed the medical records of patients showing positive results. The clinical characteristics and results of blood tests were compared between the patients with and without pneumonia. The risk factors associated with pneumonia were then evaluated by a multivariable analysis. Results The study cohort comprised 154 patients, including 117 patients (76.0%) with pneumonia at first visit. Significant differences were seen in age, the frequency of fever, tachycardia, desaturation (peripheral oxygen saturation ≤95%), any comorbidity, neutrocyte count and fraction, lymphocyte count and fraction, platelet count, lactate dehydrogenase (LDH), C-reactive protein (CRP), and fibrinogen between the patients with and without pneumonia. Using a multivariable analysis, CRP ≥0.3 mg/dL and fibrinogen >400 mg/dL were found to be associated with the presence of pneumonia. Conclusion Community-based settings for screening COVID-19 patients should perform chest X-ray and blood tests for white blood cell fractions, fibrinogen, LDH, and CRP. Of these, elevations in the CRP and fibrinogen levels could be critically associated with the presence of COVID-19 pneumonia.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::52fbbf7b81f79e2f8dfe8bad18cf6a54Test
https://doi.org/10.2169/internalmedicine.5528-20Test

المؤلفون: Suguru Sato, Hikaru Tomita, Natsumi Watanabe, Kenichiro Hirai, Mami Rikimaru, Takaya Kawamata, Hiroyuki Minemura, Atsuro Fukuhara, Yoko Shibata, Naoko Fukuhara, Yuki Sato, Kenya Kanazawa, Yoshinori Tanino, Takashi Umeda, Manabu Uematsu, Mikako Saito, Julia Morimoto, Tatsuhiko Koizumi, Junpei Saito, Takefumi Nikaido, Yasuhito Suzuki, Ryuichi Togawa

المصدر: Internal Medicine

مصطلحات موضوعية: Male, Pathology, medicine.medical_specialty, Lung Neoplasms, brain, Case Report, 030204 cardiovascular system & hematology, lung, Metastasis, 03 medical and health sciences, Enteropathy-Associated T-Cell Lymphoma, 0302 clinical medicine, Intestinal Neoplasms, Internal Medicine, medicine, Humans, metastasis, Pathological, Aged, Lung, Brain Neoplasms, business.industry, Cancer, lactate dehydrogenase, General Medicine, monomorphic epitheliotropic intestinal T-cell lymphoma, medicine.disease, Small intestine, Lymphoma, medicine.anatomical_structure, 030211 gastroenterology & hepatology, Differential diagnosis, business, CD8

الوصف: Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is a primary intestinal T-cell lymphoma and other organ involvement is very rare. A rare case of MEITL involving the lung and brain is herein reported. The patient developed panperitonitis with a small intestinal perforation, and emergency surgery was performed. The pathological findings from the surgical specimens demonstrated atypical lymphoid cells which were positive for CD3, CD8, and CD56. Moreover, the pathological findings of lung specimens taken by bronchoscopy were consistent with those of the small intestine. It is therefore important to include the possibility of MEITL in the differential diagnosis of cancer patients.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7f03fabedcae00ee3f45fe2501bf6317Test
https://doi.org/10.2169/internalmedicine.4710-20Test

المؤلفون: Mitsuru Sada, Haruyuki Ishii, Yukari Ogawa, Masaki Tamura, Hajime Goto, Daisuke Kurai, Manami Inoue, Kojiro Honda, Takuma Yokoyama, Takayasu Watanabe, Miku Oda, Hajime Takizawa, Kosuke Ohkuma, Hirokazu Kimura, Hiroki Nunokawa, Takeshi Saraya

المصدر: Internal Medicine. 57:2479-2487

مصطلحات موضوعية: medicine.medical_specialty, biology, business.industry, Hazard ratio, Area under the curve, General Medicine, biology.organism_classification, medicine.disease, Legionella pneumophila, Gastroenterology, Confidence interval, 03 medical and health sciences, Pneumonia, chemistry.chemical_compound, 0302 clinical medicine, Respiratory failure, chemistry, Internal medicine, Lactate dehydrogenase, Internal Medicine, Medicine, 030212 general & internal medicine, business, Hyponatremia, 030217 neurology & neurosurgery

الوصف: Objective We investigated a novel diagnostic scoring system to differentiate Legionella pneumophila pneumonia from Streptococcus pneumoniae pneumonia. Methods We retrospectively reviewed the clinical data of 62 patients with L. pneumophila pneumonia (L-group) and 70 patients with S. pneumoniae pneumonia (S-group). Results The serum sodium (Na) levels tended to be lower according to the severity [age, dehydration, respiratory failure, orientation disturbance, low blood pressure (A-DROP)] score in the L-group. On a multivariate analysis, we found that four factors were independent predictive markers for inclusion in the L-group: relative bradycardia [hazard ratio (HR) 5.177, 95% confidence interval (CI): 1.072-24.993, p=0.041], lactate dehydrogenase (LDH) levels ≥292 IU/L (HR 6.804, 95% CI: 1.629-28.416, p=0.009), C-reactive protein (CRP) levels ≥21 mg/dL (HR 28.073, 95% CI: 5.654-139.462, p

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::94480240ad507e273a56faf103f2870eTest
https://doi.org/10.2169/internalmedicine.0491-17Test

المؤلفون: Tohru Iseki, Shingo Suzuki, Yota Katsuyama, Yusuke Hirota, Masatomi Ikusaka

المصدر: Internal Medicine

مصطلحات موضوعية: Male, medicine.medical_specialty, Myeloma protein, Pregabalin, Case Report, Body weight, Gastroenterology, 030218 nuclear medicine & medical imaging, Diagnosis, Differential, 03 medical and health sciences, chemistry.chemical_compound, red flags, 0302 clinical medicine, Internal medicine, Lactate dehydrogenase, Internal Medicine, medicine, Back pain, Humans, Multiple myeloma, Lumbar Vertebrae, business.industry, truly non-secretory multiple myeloma, M-protein, General Medicine, Middle Aged, medicine.disease, chemistry, 030220 oncology & carcinogenesis, FLAG (chemotherapy), Lumbar disc herniation, medicine.symptom, Multiple Myeloma, business, Low Back Pain, Intervertebral Disc Displacement, medicine.drug

الوصف: A 60-year-old man was referred to us with high levels of aspartate aminotransferase and lactate dehydrogenase (LDH). He did not complain of any symptoms; however, he had been diagnosed with lumbar disc herniation, even though his back pain improved only to half of its previous level with pregabalin. Thus, we asked about the red flag of back pain and confirmed that he had involuntary body weight loss, which led us to diagnose truly non-secretory multiple myeloma, a variant of multiple myeloma that is associated with M-protein negativity and a normal serum free light chain level.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5dbf5ccc241106e0d13067fd65e23ea2Test
https://doi.org/10.2169/internalmedicine.56.8158Test

المؤلفون: Kazuei Ogawa, Hideyoshi Noji, Hiroshi Takahashi, Saho Wakamatsu, Kazuhiro Tasaki, Kazuhiko Ikeda, Hiroshi Ohkawara, Hiroyuki Suzuki, Akiko Shichishima-Nakamura, Yasuchika Takeishi, Masumi Sukegawa, Kayo Harada-Shirado, Miki Furukawa

المصدر: Internal Medicine. 53:1549-1552

مصطلحات موضوعية: Solitary fibrous tumor, Pathology, medicine.medical_specialty, Prednisolone, Tumor resection, Administration, Oral, Oral prednisolone, Diagnosis, Differential, Internal Medicine, Humans, Medicine, Glucocorticoids, Aged, Dose-Response Relationship, Drug, business.industry, General Medicine, Thoracic Surgical Procedures, medicine.disease, Solitary Fibrous Tumor, Pleural, Pleural Solitary Fibrous Tumor, Female, Radiography, Thoracic, Anemia, Hemolytic, Autoimmune, Bilirubin levels, Autoimmune hemolytic anemia, Tomography, X-Ray Computed, business, Serum lactate dehydrogenase

الوصف: We herein report a 74-year-old woman who presented with autoimmune hemolytic anemia (AIHA) associated with pleural solitary fibrous tumor (SFT). Her AIHA was initially treated with 1 mg/kg daily of oral prednisolone (PSL) for 2 months, which had a limited effect. However, after surgical tumor resection, the patient showed remarkable improvement of AIHA with normalizations of serum lactate dehydrogenase and bilirubin levels, and we were able to rapidly reduce the PSL dosage. This is the first description of a case of AIHA caused by SFT.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5161c171e0947f898f0ad9834d15ad10Test
https://doi.org/10.2169/internalmedicine.53.2121Test

المؤلفون: Shingo Takanashi, Ken Okumura, Mika Kumagai, Akihito Hayashi, Takeshi Morimoto, Yukihiro Hasegawa, Koichi Okudera

المصدر: Internal Medicine. 44:26-34

مصطلحات موضوعية: Male, Vascular Endothelial Growth Factor A, medicine.medical_specialty, Pathology, Lung Neoplasms, Enolase, Sensitivity and Specificity, Gastroenterology, chemistry.chemical_compound, Japan, Internal medicine, Lactate dehydrogenase, Internal Medicine, Carcinoma, Humans, Medicine, Clinical significance, Platelet, Carcinoma, Small Cell, Survival analysis, Aged, L-Lactate Dehydrogenase, Platelet Count, business.industry, General Medicine, Middle Aged, Prognosis, medicine.disease, Immunohistochemistry, Survival Analysis, respiratory tract diseases, Vascular endothelial growth factor, chemistry, Multivariate Analysis, Disease Progression, Female, business

الوصف: Objective To clarify the clinical significance of vascular endothelial growth factor (VEGF) in Japanese patients with small cell lung cancer (SCLC).Materials and Methods We measured serum VEGF levels using an enzyme-linked immunosorbent assay in 45 patients with SCLC before treatment and in 38 patients with benign pulmonary disease and in 32 healthy subjects (71 non-malignant subjects). VEGF immunostaining was performed in tissue biopsies obtained from 23 SCLC patients during bronchoscopic examination.Results Median serum VEGF level was 332 pg/ml in patients with SCLC and 160 pg/ml in non-malignant subjects, respectively. The 95% cut-off level to exclude non-malignant subjects was 500 pg/ml. An elevated VEGF level (>500 pg/ml) was found more frequently in patients with extensive disease of SCLC than in those with the limited disease (p

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8fd4aa9d7e150e7b98561a613b94dd8fTest
https://doi.org/10.2169/internalmedicine.44.26Test

المؤلفون: Bo Huang, Guowei Lin, Bobin Chen, Zhiguang Lin, Jing Song, Xiaoping Xu, Jing Zhang

المصدر: Internal Medicine. 51:2529-2536

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Lymphoma, Pancytopenia, Comorbidity, Fever of Unknown Origin, Gastroenterology, Drug Therapy, Internal medicine, Weight Loss, Biopsy, Internal Medicine, Humans, Medicine, Hypoalbuminemia, Fever of unknown origin, Retrospective Studies, L-Lactate Dehydrogenase, medicine.diagnostic_test, business.industry, Beta-2 microglobulin, General Medicine, Middle Aged, Prognosis, medicine.disease, Surgery, Elevated alkaline phosphatase, Treatment Outcome, Disease Progression, Etiology, Female, medicine.symptom, beta 2-Microglobulin, business

الوصف: OBJECTIVE To investigate the clinical characteristics, diagnostic approaches, short-term efficacy of treatment and prognosis of lymphoma patients presenting with a fever of unknown origin (FUO). METHODS We reviewed the records of 132 patients finally diagnosed with lymphoma in Huashan Hospital, half of whom initially presented with a FUO. The other 66 lymphoma patients without a history of FUO were diagnosed within a month when several patients in the FUO group were also diagnosed. RESULTS The patients presenting with a FUO were predominantly young men (71.21%, p=0.35) characterized by a temperature ≥ 39°C (55/66, 83.33%). Compared with the non-FUO group, patients in the FUO group more often had pancytopenia and hypohepatia, 61.54% with hypoalbuminemia (p

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3a19ea75a184a6baf41e7ffaf92aa0bcTest
https://doi.org/10.2169/internalmedicine.51.7817Test

المؤلفون: Hideos Harigae, Ryu Watanabe, Tsuyoshi Shirai, Naruhiko Takasawa, Yumi Tajima, Hiroshi Fujii, Hiroshi Sato, Tomonori Ishii

المصدر: Internal Medicine. 50:53-57

مصطلحات موضوعية: Male, Hemolytic anemia, medicine.medical_specialty, Thrombotic microangiopathy, Prednisolone, Kidney, urologic and male genital diseases, Gastroenterology, Plasma, Intravenous cyclophosphamide, Recurrence, hemic and lymphatic diseases, Elevated lactate dehydrogenase, Internal medicine, Azathioprine, Ascites, Internal Medicine, Humans, Medicine, Blood Transfusion, Cyclophosphamide, Purpura, Thrombotic Thrombocytopenic, medicine.diagnostic_test, Thrombotic Microangiopathies, business.industry, General Medicine, Middle Aged, medicine.disease, Schistocyte, Surgery, Renal biopsy, medicine.symptom, business, Immunosuppressive Agents, medicine.drug

الوصف: A 46-year-old man presented with fever, thrombocytopenia, and a considerable accumulation of ascites. Although prednisolone and intravenous cyclophosphamide pulse (IVCY) were effective, he experienced recurrence. Renal insufficiency and hemolytic anemia developed subsequently. Schistocytes, negative Coombs' test, and elevated lactate dehydrogenase levels indicated thrombotic microangiopathy (TMA). He recovered well after receiving plasma infusion, IVCY, and prednisolone. Renal biopsy revealed subendothelial widening, thereby confirming TMA. This is a very rare case of TMA that presented with a considerable volume of ascites.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b823293065a3d315257006c3605d5d20Test
https://doi.org/10.2169/internalmedicine.50.4330Test

المؤلفون: Yosuke Kobayashi, Makiko Akahane, Yukinori Okada, Takahiko Arai, Izuki Amano, Tomoko Takezawa, Yasuo To, Nobuyuki Horita, Masako To

المصدر: Internal Medicine. 50:189-195

مصطلحات موضوعية: Male, medicine.medical_specialty, Combination therapy, Exacerbation, medicine.drug_class, chemical and pharmacologic phenomena, Kaplan-Meier Estimate, Methylprednisolone, Gastroenterology, Tacrolimus, Idiopathic pulmonary fibrosis, Fraction of inspired oxygen, Internal medicine, Internal Medicine, medicine, Humans, Intensive care medicine, Glucocorticoids, Survival rate, Aged, Retrospective Studies, Aged, 80 and over, L-Lactate Dehydrogenase, business.industry, General Medicine, Middle Aged, Prognosis, medicine.disease, Idiopathic Pulmonary Fibrosis, Oxygen, Treatment Outcome, surgical procedures, operative, Corticosteroid, Drug Therapy, Combination, Female, business, Immunosuppressive Agents, medicine.drug

الوصف: Objective Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) occurs during the chronic progressive course of idiopathic pulmonary fibrosis. Mortality is estimated to be >70%, because no effective treatment has been established. We evaluated the effectiveness of combination therapy of tacrolimus and methylprednisolone for AE-IPF. Methods Patients of AE-IPF treated with methylprednisolone pulse therapy with or without tacrolimus (targeting 20 ng/mL) during the period between January 2001 and April 2010 were retrospectively reviewed. The primary endpoints were survival rate and duration. We also observed lactate dehydrogenase levels, partial pressure of arterial oxygen/fraction of inspired oxygen ratio (P/F ratio), KL-6, occurrence of re-exacerbation, and computed tomography score. Results Fifteen Japanese patients [tacrolimus group aged 74.2±6.0 years old (n=5), non-tacrolimus group aged 75.1±12.8 years old (n=10)] were identified. Pre-treatment clinical parameters were not significantly different between the two groups. Four of 5 tacrolimus group patients and 1 of 10 non-tacrolimus group patients survived (p 92 days (tacrolimus group) and 38 days (non-tacrolimus group) (p

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::bc9a7fd528cbd9dd37c851b1e3a74f8eTest
https://doi.org/10.2169/internalmedicine.50.4327Test