JaLCDOI 10.18926/AMO/52658
フルテキストURL 68_3_171.pdf
著者 Hagiya, Hideharu| Matsumoto, Mitsuaki| Yamasawa, Takahiko| Haruki, Yuto| Otsuka, Fumio|
抄録 A 79-year-old man who had undergone a right femoropopliteal (FP) bypass operation 6 weeks previously was diagnosed with vascular graft infection caused by Staphylococcus lugdunensis. Another FP bypass operation was performed, with long-term administration of antibiotics, and the patient eventually recovered well without any recurrences for over 2 years. Although S. lugdunens is classified as coagulase-negative Staphylococcus, its pathogenicity has been reported to be equal to that of S. aureus. Based on the literature review, the organism characteristically colonizes the inguinal area of human skin;thus, operations such as FP bypass grafting may place patients at a relatively high risk for infection by S. lugdunensis, a potentially high-pathogenicity organism.
キーワード coagulase-negative Staphylococcus (CNS) femoropopliteal (FP) bypass Staphylococcus lugdunensis vacuum-assisted closure (VAC) therapy vascular graft infection (VGI)
Amo Type Case Report
発行日 2014-06
出版物タイトル Acta Medica Okayama
68巻
3号
出版者 Okayama University Medical School
開始ページ 171
終了ページ 175
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2014 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 24942796
Web of Sience KeyUT 000337655600007
JaLCDOI 10.18926/AMO/53341
フルテキストURL 69_2_119.pdf
著者 Terasaka, Tomohiro| Hagiya, Hideharu| Kimura, Kosuke| Nada, Takahiro| Nakamura, Eri| Hanayama, Yoshihisa| Sugiyama, Hitoshi| Kobayashi, Yasuyuki| Yanai, Hiroyuki| Otsuka, Fumio|
抄録 We report the case of a 46-year-old hypertensive Japanese female with renal insufficiency related to unilateral renal hypoplasia. The patient was found to have developed paraganglioma in the retroperitoneal space over a 5-year period. Catecholamine-producing tumors are not usually recognized as conditions associated with renal hypoplasia. Our long-term observation of the patient eventually led us to the diagnosis of paraganglioma. In hypertensive patients with chronic kidney disease, not only the renin-angiotensin-aldosterone system but also catecholamine activity may be involved, particularly in the patients whose cases are complicated with unilateral renal hypoplasia.
キーワード catecholamine paraganglioma renal hypoplasia renovascular hypertension secondary hypertension
Amo Type Case Report
発行日 2015-04
出版物タイトル Acta Medica Okayama
69巻
2号
出版者 Okayama University Medical School
開始ページ 119
終了ページ 122
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2015 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 25899634
Web of Sience KeyUT 000353181700007
JaLCDOI 10.18926/AMO/53342
フルテキストURL 69_2_123.pdf
著者 Waseda, Koichi| Hagiya, Hideharu| Hanayama, Yoshihisa| Terasaka, Tomohiro| Kimura, Kosuke| Tsuzuki, Takao| Hasegawa, Kou| Nada, Takahiro| Nakamura, Eri| Murakami, Kazutoshi| Kondo, Eisei| Otsuka, Fumio|
抄録 An 81-year-old Japanese male with primary Sjögren syndrome (pSS) developed a low-grade fever and productive cough which were refractory to antibiotic therapy. Based on the high level of eosinophils observed in his bronchial alveolar lavage, he was diagnosed with chronic eosinophilic pneumonia (CEP) and successfully treated by oral prednisolone. Interstitial lung diseases associated with pSS (pSS-ILDs) usually present as nonspecific interstitial pneumonia or usual interstitial pneumonia; therefore, the present case is extremely unique in that the patientʼs condition was complicated with CEP. A diagnosis of advanced gallbladder cancer was made in the patientʼs clinical course, suggesting the advisability of a whole-body workup in cases of pSS, especially in elderly patients.
キーワード bronchial alveolar lavage eosinophilic pneumonia eosinophilia interstitial lung diseases Sjögren syndrome
Amo Type Case Report
発行日 2015-04
出版物タイトル Acta Medica Okayama
69巻
2号
出版者 Okayama University Medical School
開始ページ 123
終了ページ 127
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2015 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 25899635
Web of Sience KeyUT 000353181700008
JaLCDOI 10.18926/AMO/53679
フルテキストURL 69_5_319.pdf
著者 Hagiya, Hideharu| Iwamuro, Masaya| Tanaka, Takehiro| Hanayama, Yoshihisa| Otsuka, Fumio|
抄録 A 60-year-old woman with rheumatoid arthritis treated with methotrexate for a decade complained of slight epigastric discomfort. A positive cytomegalovirus (CMV) antigenemia test indicated the probability of CMV-related gastrointestinal infection, for which esophagogastroduodenoscopy was performed. Endoscopic findings showed a non-specific duodenal mucosal lesion;however, pathological investigation revealed evidence of CMV duodenitis. There is scarce information on the clinical and pathological features of CMV-related duodenitis, likely due to its low prevalence. CMV infection in the upper gastrointestinal tract should be considered as a differential diagnosis in high-risk individuals, particularly those with symptoms relating to the digestive system. Biopsy examinations are preferable for the definitive diagnosis of CMV gastrointestinal infection, even without specific endoscopic features.
キーワード antigenemia cytomegalovirus (CMV) gastrointestinal infection methotrexate opportunistic infection
Amo Type Case Report
発行日 2015-10
出版物タイトル Acta Medica Okayama
69巻
5号
出版者 Okayama University Medical School
開始ページ 319
終了ページ 323
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2015 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 26490030
Web of Sience KeyUT 000365519600009
JaLCDOI 10.18926/AMO/52402
フルテキストURL 68_2_57.pdf
著者 Hagiya, Hideharu| Naito, Hiromichi| Hagioka, Shingo| Okahara, Shuji| Morimoto, Naoki| Kusano, Nobuchika| Otsuka, Fumio|
抄録 The effect of antibiotics during the perioperative period of percutaneous dilatational tracheostomy (PDT) is still controversial. A total of 297 patients who underwent the PDT procedure were divided into 2 groups:those administered antibiotics perioperatively and those not administered antibiotics. Wound infections were noted in 7 cases (incidence rate, 2.36%) and no death was recorded. Of the 69 patients without antibiotics, 5 developed wound infections (incidence rate, 7.25%), while only 2 of the 228 patients with antibiotics developed wound infections (incidence rate, 0.88%) (p=0.002;risk ratio, 8.82;95% confidence interval, 1.67-46.6). Of the 7 cases of wound infection, 5 cases occurred during the early period after PDT (within 7 days). Collectively, the present results suggest that prophylactic administration of antibiotics may prevent the incidence of PDT-induced wound infection, especially in the early phase after the PDT procedures. The need for antibiotics in PDT should be reconsidered.
キーワード airway management critically ill patient percutaneous dilatational tracheostomy surgical site infection
Amo Type Original Article
発行日 2014-04
出版物タイトル Acta Medica Okayama
68巻
2号
出版者 Okayama University Medical School
開始ページ 57
終了ページ 62
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2014 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 24743781
Web of Sience KeyUT 000334652700001
JaLCDOI 10.18926/AMO/54977
フルテキストURL 71_2_97.pdf
著者 Iwamuro, Masaya| Kondo, Eisei| Tanaka, Takehiro| Hagiya, Hideharu| Kawano, Seiji| Kawahara, Yoshiro| Otsuka, Fumio| Okada, Hiroyuki|
抄録 We retrospectively analyzed the cases of 14 patients (9 women, 5 men, mean age: 51.6 years) with cytomegalovirus (CMV) involvement in the esophagus, stomach, and/or duodenum diagnosed at a single center, to determine their endoscopic features and clinical backgrounds. Thirteen patients (92.9%) had hematologic disease; the other had rheumatoid arthritis. Of the former, 12 patients underwent allogeneic hematopoietic stem cell transplantation, and 9 of these patients had graft-versus-host disease (GVHD) before undergoing esophagogastroduodenoscopy (EGD). All 14 patients had been taking one or more immunosuppressive agents including cyclosporine (n=10), corticosteroids (n=9), mycophenolic acid (n=6), tacrolimus (n=3), and methotrexate (n=1). Tests for CMV antigenemia were positive in 11 patients (78.6%). EGD examinations revealed esophageal (n=3), gastric (n=9), and duodenal involvement (n=6). Macroscopically, esophageal lesions by CMV infection presented as redness (n=1), erosions (n=1), and ulcers (n=1). Gastric lesions manifested as redness (n=7), erosions (n=3), exfoliated mucosa (n=2), and verrucous erosions (n=1). Mucosal appearances in the duodenum varied: redness (n=2), ulcers (n=2), multiple erosions (n=2), single erosion (n=1), edema (n=1). CMV was detected even in the intact duodenal mucosa (n=1). In conclusion, physicians must recall the relevance of CMV infection when any mucosal alterations exist in the upper gastrointestinal tract of immunosuppressed patients.
キーワード cytomegalovirus duodenum esophagogastroduodenoscopy esophagus stomach
Amo Type Original Article
発行日 2017-04
出版物タイトル Acta Medica Okayama
71巻
2号
出版者 Okayama University Medical School
開始ページ 97
終了ページ 104
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 28420890
JaLCDOI 10.18926/AMO/55861
フルテキストURL 72_2_189.pdf
著者 Nakao, Shinichiro| Hagiya, Hideharu| Kimura, Keigo| Mitsui, Tomomi| Oyama, Akane| Hongyo, Kazuhiro| Takahashi, Yusuke| Nakagami, Futoshi| Tomono, Kazunori| Rakugi, Hiromi|
抄録 A 65-year-old Japanese man with bilateral carotid atherosclerosis presented with right neck pain and fever. Contrast-enhanced computed tomography suggested carotid arteritis, and carotid ultrasonography showed an unstable plaque. The patient developed a cerebral embolism, causing a transient ischemic attack. Helicobacter cinaedi was detected in blood culture, and H. cinaedi-associated carotid arteritis was diagnosed. Empirical antibiotic therapy was administered for 6 weeks. After readmission for recurrent fever, he was treated another 8 weeks. Although the relationship between H. cinaedi infection and atherosclerosis development remains unclear, the atherosclerotic changes in our patient’s carotid artery might have been attributable to H. cinaedi infection.
キーワード atherosclerosis bacteremia bacterial translocation Helicobacter cinaedi vascular infection
Amo Type Case Report
発行日 2018-04
出版物タイトル Acta Medica Okayama
72巻
2号
出版者 Okayama University Medical School
開始ページ 189
終了ページ 192
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2018 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 29674769
JaLCDOI 10.18926/AMO/54597
フルテキストURL 70_5_383.pdf
著者 Nishiwaki, Masatake| Hagiya, Hideharu| Kamiya, Toru|
抄録 Kikuchi-Fujimoto disease (KFD) is a benign cause of self-limiting subacute necrotizing lymphadenitis. KFD is rarely complicated with reactive hemophagocytic lymphohistiocytosis (HLH), and the clinical features of the simultaneous occurrence of these conditions are uncertain. A 30-year-old Japanese man with a persistent fever and sore throat presented to our hospital for treatment. Laboratory analysis showed bicytopenia, and radiological studies showed systemic lymphadenopathy accompanied by splenomegaly. A bone marrow examination showed hemophagocytic macrophages, suggesting HLH. Malignant lymphoma was suspected as a possible underlying disease, but the histology of the lymph nodes led to a final diagnosis of KFD and treatment with prednisolone (1 mg/kg/day), resulting in clinical improvement. This case highlighted the importance and difficulty of differentiating KFD from malignant lymphoma as an underlying condition of HLH. The literature review showed that patients with HLH-associated KFD may have higher serum ferritin and lactate dehydrogenase levels compared to typical KFD cases. Definite diagnosis based on pathological examination is essential for a better understanding of this rare disease. The presence of systemic lymphadenopathy does not exclude the possibility of KFD. This case serves to remind physicians that KFD is a potential etiology of HLH.
キーワード hemophagocytic lymphohistiocytosis hemophagocytic syndrome histiocytic necrotizing lymphadenitis Kikuchi disease Kikuchi-Fujimoto disease
Amo Type Case Reports
発行日 2016-10
出版物タイトル Acta Medica Okayama
70巻
5号
出版者 Okayama University Medical School
開始ページ 383
終了ページ 388
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2016 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 27777431
Web of Sience KeyUT 000388098700008