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101.
We report two cases of septic pulmonary embolism associated with periodontitis. Chest CT revealed multiple nodular shadows with features characteristic of septic pulmonary embolism in both patients. Both patients had toothache, fever, and chest pain, and showed findings of periodontitis at initial presentation. Antimicrobial agents combined with dental surgery were successful in treatment. While septic pulmonary embolism from the lesions of periodontitis appears to be rare, periodontitis remains important in the differential diagnosis of septic pulmonary embolism. 相似文献
102.
Hashimoto T Abe M Oshima T Shibata H Ozaki S Inoue D Matsumoto T 《British journal of haematology》2004,125(1):38-41
Macrophage inflammatory protein (MIP)-1alpha and MIP-1beta have been identified as candidates for multiple myeloma (MM)-derived bone-resorbing factors. To validate the clinical relevance of these observations, we investigated correlations between the ability of MM cells to secrete these chemokines and the extent of MM bone lesions as well as levels of biochemical bone markers in patients with MM. Patients with multiple bone lesions exhibited higher MIP-1alpha and MIP-1beta secretion from MM cells along with elevated urinary deoxypyridinoline (Dpd), without significant elevation of serum bone-specific alkaline phosphatase (BALP) or osteocalcin compared with those with minimal bone lesions. MIP-1alpha and MIP-1beta levels correlated positively with urinary Dpd and serum BALP but not with serum osteocalcin. These results provide further evidence for a causal role of MIP-1alpha and MIP-1beta in the development of lytic bone lesions, and suggest that MM cells suppress osteoblastic bone formation to cause an imbalance of bone turnover and development of destructive bone lesions. 相似文献
103.
Yushiro Endo Shin-ya Kawashiri Shimpei Morimoto Ayako Nishino Momoko Okamoto Sosuke Tsuji Ayuko Takatani Toshimasa Shimizu Remi Sumiyoshi Takashi Igawa Tomohiro Koga Naoki Iwamoto Kunihiro Ichinose Mami Tamai Hideki Nakamura Tomoki Origuchi Yukitaka Ueki Tamami Yoshitama Nobutaka Eiraku Naoki Matsuoka Akitomo Okada Keita Fujikawa Hideo Otsubo Hirokazu Takaoka Hiroaki Hamada Tomomi Tsuru Shuji Nagano Arinobu Yojiro Toshihiko Hidaka Yoshifumi Tada Atsushi Kawakami 《Medicine》2021,100(1)
We aimed to evaluate the utility of a simplified ultrasonography (US) scoring system, which is desired in daily clinical practice, among patients with rheumatoid arthritis (RA) receiving biological/targeted synthetic disease-modifying antirheumatic drugs (DMARDs).A total of 289 Japanese patients with RA who were started on tumor necrosis factor inhibitors, abatacept, tocilizumab, or Janus kinase inhibitors between June 2013 and April 2019 at one of the 15 participating rheumatology centers were reviewed. We performed US assessment of articular synovia over 22 joints among bilateral wrist and finger joints, and the 22-joint (22j)-GS and 22-joint (22j)-PD scores were evaluated as an indicator of US activity using the sum of the GS and PD scores, respectively.The top 6 most affected joints included the bilateral wrist and second/third metacarpophalangeal joints. Therefore, 6-joint (6j)-GS and -PD scores were defined as the sum of the GS and PD scores from the 6 synovial sites over the aforementioned 6 joints, respectively. Although the 22j- or 6j-US scores were significantly correlated with DAS28-ESR or -CRP scores, the correlations were weak. Conversely, 6j-US scores were significantly and strongly correlated with 22j-US scores not only at baseline but also after therapy initiation.Using a multicenter cohort data, our results indicated that a simplified US scoring system could be adequately tolerated during any disease course among patients with RA receiving biological/targeted synthetic DMARDs. 相似文献
104.
Kazuhito Nomura Sonoko Sakawaki Eiji Sakawaki Ayumu Yamaoka Wakiko Aisaka Hiroyuki Okamoto Yoshihiro Takeyama Shuji Uemura Eichi Narimatsu 《Medicine》2021,100(19)
Introduction:Malignant catatonia (MC) is a movement disorder syndrome characterized by immobility, rigidity, and consciousness disorders that develops in association with mental and physical diseases. It is often fatal due to hyperthermia, rhabdomyolysis, and acute kidney injury. Its clinical symptoms are similar to those of another disorder, neuroleptic malignant syndrome (NMS), and it is often difficult to distinguish between the 2 disorders.Patient concerns:An Asian woman in her 60s with history of schizophrenia. She was admitted to our hospital because of symptoms such as fever, unconsciousness, and muscle rigidity. Blood tests showed kidney injury and high creatinine kinase levels.Diagnoses:At the time of admission, she had been diagnosed with NMS complicated by pulmonary aspergillosis and was undergoing treatment although there was no improvement.Interventions:Subsequently, the administration of propofol, a gamma-aminobutyric acid A agonist, markedly improved the symptoms, and the diagnosis was corrected to MC. At the beginning of her hospitalization, she received dantrolene, bromocriptine, amantadine, and L-3,4-dihydroxyphenylalanine as treatment for NMS, but her symptoms did not improve. With propofol, which is used for sedation, her catatonic symptoms improved markedly. Quetiapine administration further improved the symptoms, and it eventually resolved completely.Outcomes:The patient''s MC was in remission. Prolonged intensive care management resulted in a decline in activities of daily living, and she required rehabilitation at another hospital.Conclusion:This is the first report of MC with suspected involvement of pulmonary aspergillosis. MC differs from NMS, in that it is treated more effectively with gamma-aminobutyric acid A agonists. Although benzodiazepines are the first choice for the diagnosis and treatment of MC, they are ineffective for majority of patients with schizophrenia. However, even in such cases, propofol and quetiapine are effective, and they facilitate diagnosis and treatment. 相似文献
105.
Yasunori Tojo Shuji Bandoh Jiro Fujita Tomoya Ishii Yutaka Ueda Taku Okamoto Cheng-Long Hwang Hiroyasu Yokomise Masashi Ishikawa Shoji Kobayashi Toshihiko Ishida 《Nihon Kokyūki Gakkai zasshi》2003,41(7):474-479
We present a case of a synchronous primary lung cancer adjacent to a hamartoma. In a 48-year-old man, a nodular shadow was found in the right middle lung field in 1990, and had grown slowly for 10 years. Another mass shadow was detected in the right upper lung field in 2000. The patient was admitted to our hospital for further examination of these abnormal shadows. Bronchoscopic examination revealed, in the right upper lobe, a poorly differentiated adenocarcinoma of clinical stage IIIB. Neoadjuvant chemotherapy followed by pneumonectomy was performed. The microscopic findings for the tumor resected from the right S2 showed poorly differentiated adenocarcinoma and those for the other, in the right S3, showed chondromatous hamartoma. Some 50 reports of lung cancer in parents with a chondromatous hamartoma have appeared in the literature. Most of these cases have some common features as follows: 1) men past middle age, 2) adenocarcinoma, and 3) lung cancer and chondromatous hamartoma present in the same lobe. The present case had all of these features, and may assist in the understanding of the process of development of lung cancer adjacent to a hamartoma. 相似文献
106.
Kanaji N Bandoh S Takano K Kadota K Haba R Matsunaga T Kohno K Kushida Y Yamamoto Y Ishida T 《The American journal of the medical sciences》2008,335(4):310-314
Squalene is a type of oil obtained from shark liver. We describe a 76-year-old man diagnosed with chronic exogenous lipoid pneumonia due to squalene. A chest CT scan revealed pulmonary consolidation with ground-glass opacities in the right upper lobe. Positron emission tomography (PET) revealed significant uptake of 2-deoxy-2-F-fluoro-d-glucose (FDG) and 3'-deoxy-3'-F-fluorothymidine (FLT). Bronchoalveolar lavage (BAL) fluid contained many lipid-laden macrophages, and a transbronchial lung biopsy specimen showed clusters of foamy macrophages in alveolar spaces and granulomatous lesions. In addition, the presence of squalene in the BAL fluid was confirmed by gas chromatography-mass spectrometry, leading to a diagnosis of squalene-induced lipoid pneumonia. To the best of our knowledge, this is the first report of squalene-induced lipoid pneumonia in which squalene itself was successfully detected. This case also suggests the possibility that lipoid pneumonia shows significant uptake in FDG-PET and FLT-PET. 相似文献
107.
Koh Okamoto Shuji Hatakeyama Chise Sugita Kenichi Ogura Reiko Ueda Hiroko Kouda Junko Nakata 《Journal of infection and chemotherapy》2018,24(9):759-762
Toxigenic strains of Corynebacterium diphtheriae cause the majority of respiratory diphtheria cases. However, nontoxigenic strains of C. diphtheriae can also cause diseases, and have become increasingly common. Infection that is limited to the anterior nares (nasal diphtheria) is a well-described but rare condition, even for toxigenic C. diphtheriae. We report a case involving chronic carriage of nasal diphtheria caused by nontoxigenic C. diphtheriae, as well as a review of other reported nontoxigenic C. diphtheriae cases in Japan. Mild or asymptomatic nasal diphtheria involving nontoxigenic strains, which can be the source of transmission, may be underrecognized. Our case highlights the importance of awareness regarding nontoxigenic diphtheria among clinicians, especially in the era of improved diphtheria vaccination coverage. 相似文献
108.
曾贵荣 《中国比较医学杂志》2015,25(11):17-20
目的 研究鹌鹑高尿酸血症动物模型及脂代谢。方法 采用高脂饲养鹌鹑30 d后,灌胃给予腺嘌呤(50 mg/只),连续7 d,建立鹌鹑高尿酸血症模型,观察22 d后,取血检测血尿酸、黄嘌呤氧化酶、肌酐(CRE)、尿素氮(BUN)、甘油三脂(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、总胆固醇(CHO)、黄嘌呤氧化酶(XOD)、肝脂酶(HL)、脂蛋白脂酶(LPL)、腺苷脱氢酶(ADA)脂质代谢指标,取关节和肾脏进行组织病理学检查。结果 模型对照组动物血尿酸均明显升高(P<0.01),CRE、BUN、TG、LDL、XOD均有明显升高(P<0.05或P<0.01),血清CHO、LPL、ADA、HDL含量明显降低(P<0.05)。造模后动物足趾关节明显肿大,周围软组织肿胀。X光显示足趾骨密度减低,部分关节面破坏呈溶骨性破坏。病理学检查可见关节滑膜增生,有大量炎症细胞浸润,部分被纤维结缔组织替代,肾脏组织肾小管及间质可见尿酸盐结晶,部分小管轻度扩张,肾间质纤维增生,并伴有大量炎症细胞浸润。结论 该模型具有关节肿大、肾脏尿酸盐沉积等肾脏损伤,且伴有脂代谢紊乱,其病理机制与XOD、ADA相关脂代谢酶活性有关。 相似文献
109.
Tahata Yuki Hikita Hayato Mochida Satoshi Enomoto Nobuyuki Kawada Norifumi Kurosaki Masayuki Ido Akio Miki Daiki Yoshiji Hitoshi Takikawa Yasuhiro Sakamori Ryotaro Hiasa Yoichi Nakao Kazuhiko Kato Naoya Ueno Yoshiyuki Yatsuhashi Hiroshi Itoh Yoshito Tateishi Ryosuke Suda Goki Takami Taro Nakamoto Yasunari Asahina Yasuhiro Matsuura Kentaro Yamashita Taro Kanto Tatsuya Akuta Norio Terai Shuji Shimizu Masahito Sobue Satoshi Miyaki Tomokatsu Moriuchi Akihiro Yamada Ryoko Kodama Takahiro Tatsumi Tomohide Yamada Tomomi Takehara Tetsuo 《Journal of gastroenterology》2022,57(2):120-132
Journal of Gastroenterology - Direct-acting antiviral (DAA) therapy enables a high rate of sustained virologic response (SVR) in patients with hepatitis C virus associated cirrhosis. However, the... 相似文献
110.
Genda Takuya Ichida Takafumi Tanaka Eiji Mochida Satoshi Ueno Yoshiyuki Terai Shuji Inui Ayano Ueda Yoshihide Ohdan Hideki Egawa Hiroto Umeshita Koji Furukawa Hiroyuki Inomata Yukihiro 《Journal of gastroenterology》2022,57(7):495-504
Journal of Gastroenterology - Following liver transplantation (LT), allograft liver failure can be developed by various causes and requires re-LT. Hence, this study aimed to clarify the... 相似文献