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World Journal of Gastroenterology 2024年第18期30卷 2402-2417页

作者： Daisuke Usuda Yuki Kaneoka Rikuo Ono Masashi Kato Yuto Sugawara Runa Shimizu Tomotari Inami Eri Nakajima Shiho Tsuge Riki Sakurai Kenji Kawai Shun Matsubara Risa Tanaka Makoto Suzuki Shintaro Shimozawa Yuta Hotchi Ippei Osugi Risa Katou Sakurako Ito Kentaro Mishima Akihiko Kondo Keiko Mizuno hiroki takami Takayuki Komatsu Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima 177-8521TokyoJapan Department of Sports Medicine Faculty of MedicineJuntendo UniversityBunkyo 113-8421TokyoJapan

Viral hepatitis represents a major danger to public health,and is a globally leading cause of *** five liver-specific viruses:Hepatitis A virus,hepatitis B virus,hepatitis C virus,hepatitis D virus,and hepatitis E virus,each have their own unique epidemiology,structural biology,transmission,endemic patterns,risk of liver complications,and response to antiviral *** remain few options for treatment,in spite of the increasing prevalence of viral-hepatitiscaused liver ***,chronic viral hepatitis is a leading worldwide cause of both liver-related morbidity and mortality,even though effective treatments are available that could reduce or prevent most patients’*** 2016,the World Health Organization released its plan to eliminate viral hepatitis as a public health threat by the year 2030,along with a discussion of current gaps and prospects for both regional and global eradication of viral ***,treatment is sufficiently able to prevent the disease from reaching advanced ***,future therapies must be extremely safe,and should ideally limit the period of treatment necessary.A better understanding of pathogenesis will prove beneficial in the development of potential treatment strategies targeting infections by viral *** review aims to summarize the current state of knowledge on each type of viral hepatitis,together with major innovations.

关键词： Hepatitis A virus Hepatitis B virus Hepatitis C virus Hepatitis D virus Hepatitis E virus Current perspectives

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Obligate aerobic, gram-positive, weak acid-fast, nonmotile bacilli, Tsukamurella tyrosinosolvens: Minireview of a rare opportunistic pathogen

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World Journal of Clinical Cases 2022年第24期10卷 8443-8449页

作者： Daisuke Usuda Risa Tanaka Makoto Suzuki Shintaro Shimozawa Hayabusa Takano Yuta Hotchi Shungo Tokunaga Ippei Osugi Risa Katou Sakurako Ito Kentaro Mishima Akihiko Kondo Keiko Mizuno hiroki takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima-ku 177-8521TokyoJapan Department of Medicine Juntendo UniversityBunkyo-ku 113-8421TokyoJapan

Tsukamurella species are obligate aerobic,gram-positive,weak acid-fast,nonmotile *** are found in various environments,such as soil,water,sludge,and petroleum reservoir wastewater,and belong to the order *** 2016,there was a reclassification of species within the genus Tsukamurella,merging the species Tsukamurella tyrosinosolvens(***)and Tsukamurella *** species are clinically considered to be a rare opportunistic pathogen,because most reported cases have been related to bacteremia and intravascular prosthetic devices and *** date,it has been isolated only from human specimens,and has always been associated with clinical disease;human infections are very *** infections have included pneumonia,brain abscesses,catheter-related bloodstream infections,ocular infections,bacteremia,and sepsis presenting with septic pulmonary emboli in patients who are *** date,there is no commercially available test for *** the other hand,sequence-based identification,including matrix-assisted laser desorption ionization time-of-flight mass spectrometry,is an alternative method for identifying clinical isolates that are either slow growers or difficult to identify through biochemical *** golden standards for diagnosis and optimal management still remain to be ***,newer molecular biological techniques can provide accurate identification,and contribute to the appropriate selection of definitive therapy for infections caused by this *** of several antimicrobial agents have been proposed for treatment,though the length of treatment for infections has yet to be determined,and should be individualized according to clinical *** patients often experience severe cases due to infection,and life-threatening *** events associated with dissemination and/or failure of source control have ***

关键词： Tsukamurella tyrosinosolvens Gram-positive bacilli Opportunistic infection Sequence-based identification Matrix-assisted laser desorption ionization time-of-flight mass spectrometry Combination antibiotic therapy

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Hemorrhagic shock due to submucosal esophageal hematoma along with mallory-weiss syndrome:A case report

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World Journal of Clinical Cases 2022年第27期10卷 9911-9920页

作者： Jiro Oba Daisuke Usuda Shiho Tsuge Riki Sakurai Kenji Kawai Shun Matsubara Risa Tanaka Makoto Suzuki Hayabusa Takano Shintaro Shimozawa Yuta Hotchi Kenki Usami Shungo Tokunaga Ippei Osugi Risa Katou Sakurako Ito Kentaro Mishima Akihiko Kondo Keiko Mizuno hiroki takami Takayuki Komatsu Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima-ku 177-8521TokyoJapan Faculty of Medicine Juntendo UniversityBunkyo-ku 113-8421TokyoJapan

BACKGROUND Esophageal submucosal hematoma is a rare *** the exact etiology remains uncertain,vessel fragility with external factors is believed to have led to submucosal bleeding and hematoma formation;the vessel was ruptured by a sudden increase in pressure due to nausea,and the hematoma was enlarged by antiplatelet or anticoagulant *** conditions are rare,with a better *** present the first known case of submucosal esophageal hematoma-subsequent hemorrhagic shock due to Mallory-Weiss *** SUMMARY A 73-year-old female underwent endovascular treatment for an unruptured cerebral *** patient received aspirin and clopidogrel before surgery and heparin during surgery,and was well during the *** hours after returning to the ICU,she complained of chest discomfort,vomited 500 m L of fresh blood,and entered hemorrhagic *** submucosal hematoma with Mallory-Weiss syndrome was diagnosed through an endoscopic examination and computed *** addition to a massive fluid and erythrocyte transfusion,we performed a temporary compression for hemostasis with a Sengstaken-Blakemore(S-B)***,she became hemodynamically *** postoperative day 1,we performed an upper gastrointestinal endoscopy and confirmed no expansion of the hematoma nor any recurring bleeding;therefore,we removed the S-B tube and clipped the gastric mucosal laceration at the esophagogastric *** started oral intake on postoperative day *** patient made steady progress,and was discharged on postoperative day *** We present the first known case of submucosal esophageal hematoma subsequent hemorrhagic shock due to Mallory-Weiss syndrome.

关键词： Esophageal submucosal hematoma Hemorrhagic shock Mallory-Weiss syndrome Antithrombotic therapy Anticoagulant therapy Case report

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Amebic liver abscess by Entamoeba histolytica

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World Journal of Clinical Cases 2022年第36期10卷 13157-13166页

作者： Daisuke Usuda Shiho Tsuge Riki Sakurai Kenji Kawai Shun Matsubara Risa Tanaka Makoto Suzuki Hayabusa Takano Shintaro Shimozawa Yuta Hotchi Shungo Tokunaga Ippei Osugi Risa Katou Sakurako Ito Kentaro Mishima Akihiko Kondo Keiko Mizuno hiroki takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima 177-8521TokyoJapan Department of Sports Medicine Faculty of MedicineJuntendo UniversityBunkyo 113-8421TokyoJapan

Amebic liver abscesses(ALAs)are the most commonly encountered extraintestinal manifestation of human invasive amebiasis,which results from Entamoeba histolytica(***)spreading *** can be complicated by liver abscess in 9%of cases,and ALAs led to almost 50000 fatalities worldwide in *** there have been fewer and fewer cases in the past several years,ALAs remain an important public health problem in endemic *** causes both amebic colitis and liver abscess by breaching the host’s innate defenses and invading the intestinal *** often enter the circulatory system,where they are filtered in the liver and produce abscesses,and develop into severe invasive diseases such as *** clinical presentation can appear to be colitis,including upper-right abdominal pain accompanied by a fever in ALA *** diagnosis requires nonspecific liver imaging as well as detecting *** antibodies;however,these antibodies cannot be used to distinguish between a previous infection and an acute ***,diagnostics primarily aim to use PCR or enzyme-linked immunosorbent assay to detect *** can be treated medically,and percutaneous catheter drainage is only necessary in approximately 15%of *** indicated treatment is to administer an amebicidal drug(such as tinidazole or metronidazole)and paromomycin or other luminal cysticidal agent for clinical *** is good with almost universal *** which diagnostic methods are most efficacious will necessitate further analysis of similar clinical cases.

关键词： Amebic liver abscess Entamoeba histolytica Polymerase chain reaction Enzyme-linked immunosorbent assay Percutaneous catheter drainage Amebicidal drug

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High doses of dextromethorphan induced shock and convulsions in a 19-year-old female:A case report

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World Journal of Clinical Cases 2023年第16期11卷 3870-3876页

作者： Shintaro Shimozawa Daisuke Usuda Toru Sasaki Shiho Tsuge Riki Sakurai Kenji Kawai Shun Matsubara Risa Tanaka Makoto Suzuki Yuta Hotchi Shungo Tokunaga Ippei Osugi Risa Katou Sakurako Ito Suguru Asako Kentaro Mishima Akihiko Kondo Keiko Mizuno hiroki takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima-city 177-8521TokyoJapan Clinical Training Center Juntendo University Nerima HospitalNerima-city 177-8521TokyoJapan Department of Sports Medicine Faculty of MedicineJuntendo UniversityBunkyo-city 113-8421TokyoJapan

BACKGROUND Dextromethorphan is a prevalent antitussive agent that can be easily obtained as an over-the-counter *** has been a growing number of reported cases of toxicity in recent ***,there are numerous instances of mild symptoms,with only a limited number of reports of severe cases necessitating intensive *** presented the case of a female who ingested 111 tablets of dextromethorphan,leading to shock and convulsions and requiring intensive care that ultimately saved her *** SUMMARY A 19-year-old female was admitted to our hospital via ambulance,having overdosed on 111 tablets of dextromethorphan(15 mg)obtained through an online importer in a suicide *** patient had a history of drug abuse and multiple self-inflicted *** the time of admission,she exhibited symptoms of shock and altered ***,upon arrival at the hospital,the patient experienced recurrent generalized clonic convulsions and status epilepticus,necessitating tracheal *** convulsions were determined to have been caused by decreased cerebral perfusion pressure secondary to shock,and noradrenaline was administered as a *** lavage and activated charcoal were also administered after *** systemic management in the intensive care unit,the patient’s condition stabilized,and the need for vasopressors *** patient regained consciousness and was *** patient was subsequently transferred to a psychiatric facility,as suicidal ideation *** We report the first case of shock caused by an overdose of dextromethorphan.

关键词： Dextromethorphan Drug overdose Shock Symptom Treatment Case report

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Penile and scrotal strangulation by stainless steel rings in an human immunodeficiency virus positive man: A case report

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世界临床病例杂志 2023年第24期11卷 5811-5816页

作者： Daisuke Usuda Nobuyoshi Kaminishi Masashi Kato Yuto Sugawara Runa Shimizu Tomotari Inami Shiho Tsuge Riki Sakurai Kenji Kawai Shun Matsubara Risa Tanaka Makoto Suzuki Shintaro Shimozawa Yuta Hotchi Ippei Osugi Risa Katou Sakurako Ito Kentaro Mishima Akihiko Kondo Keiko Mizuno hiroki takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima 177-8521TokyoJapan Clinical Training Center Juntendo University Nerima HospitalNerima 177-8521TokyoJapan Sports Medicine Juntendo UniversityBunkyo 113-8421TokyoJapan

BACKGROUND Penoscrotal constriction devices are either used as autoerotic stimuli or to increase sexual pleasure or performance by maintaining an erection for a longer period,and a variety of metallic and non-metallic objects are *** the other hand,penile strangulation is a rare urologic emergency that requires prompt evaluation and intervention to prevent long-term *** goal of treating penile incarceration is to remove the foreign object as soon as *** the other hand,removal can be very challenging,and often requires resourcefulness and a multidisciplinary *** SUMMARY A 47-year-old man who has sex with men was transferred to our hospital for persistent phallodynia and scrotal pain,accompanying swelling due to strangulation by stainless steel *** medical history included acquired immunodeficiency *** day prior,he had put three stainless steel rings on his penis and scrotum before sexual *** sexual intercourse,he was unable to remove them,due to swelling of his penis and *** swelling persisted,and he felt pain in the affected area the next day,then he was transferred to our hospital by *** emergency department found that his penis and scrotum were markedly engorged and *** established a diagnosis of penile and scrotal strangulation by stainless steel *** unsuccessfully attempted to cut the rings using a cutter,then requested a rescue team via emergency medical *** cut through each ring in two places,using an electric-powered angle grinder,and successfully removed all of the ***,he was discharged and went *** We report the first case of penile and scrotal strangulation by stainless steel rings in an human immunodeficiency virus positive person.

关键词： Penile strangulation Stainless steel ring Human immunodeficiency virus Urologic emergency Management Case report

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Secondary pulmonary infection by Fusarium solani and Aspergillus niger during systemic steroid treatment for COVID-19:A case report

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世界临床病例杂志 2023年第26期11卷 6280-6288页

作者： Daisuke Usuda Masashi Kato Yuto Sugawara Runa Shimizu Tomotari Inami Shiho Tsuge Riki Sakurai Kenji Kawai Shun Matsubara Risa Tanaka Makoto Suzuki Shintaro Shimozawa Yuta Hotchi Ippei Osugi Risa Katou Sakurako Ito Kentaro Mishima Akihiko Kondo Keiko Mizuno hiroki takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima 177-8521TokyoJapan Department of Sports Medicine Juntendo UniversityBunkyo 113-8421TokyoJapan

BACKGROUND Coronavirus disease 2019(COVID-19)-associated invasive pulmonary aspergillosis presents a diagnostic challenge due to its non-specific clinical/imaging features,as well as the fact that the proposed clinically diagnostic algorithms do not necessarily apply to COVID-19 *** addition,Fusarium *** a rare cause of opportunistic life-threatening fungal *** Fusarium infection in an immunocompromised host is intractable,with a high likelihood of resulting *** our knowledge,this is the first case of secondary pulmonary infection by Fusarium solani(***)and Aspergillus niger(***)during systemic steroid treatment for *** SUMMARY A 62-year-old male was transported to our hospital by ambulance with a complaint of fever and *** established a diagnosis of pneumococcal pneumonia,complicated with COVID-19 and septic shock,together with acute renal *** was admitted to the intensive care unit,to be treated with piperacillin/tazobactam,vancomycin,and 6.6 mg per day of dexamethasone sodium phosphate,along with noradrenaline as a vasopressor,ventilator management,and continuous *** condition improved,and we finished the vasopressor on the fifth hospital *** administered dexamethasone for ten days,and finished the course of *** the eleventh day,patient respiratory deterioration was observed,and a computed tomography scan showed an exacerbation of bilateral ground-glass-opacity-like consolidation,together with newly appeared cavitary lesions in the *** changed antibiotics to meropenem plus *** addition,a fungal infection was considered as a possibility based on microscopic findings of sputum,and we began coadministration of ***,the pneumonia worsened,and the patient died on the seventeenth day of ***,*** and *** were identified from sputum collected on the twelfth *** was believed that he developed a cell-mediated immune defic

关键词： Fusarium solani Aspergillus niger Pulmonary infection Cell-mediated immune deficiency Coronavirus disease 2019 Case report

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Bicuspidization Using the Open-Sleeve Technique for Congenital Aortic Stenosis during Infancy

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Congenital Heart Disease 2024年第2期19卷 177-183页

作者： Toshi Maeda hiroki Ito Keiichi Hirose Kisaburo Sakamoto Departments of Cardiovascular Surgery Mt.Fuji Shizuoka Children’s HospitalShizuoka420-8660Japan

Congenital aortic stenosis(cAS)frequently requires intervention during the neonatal or infantile ***,surgical repair is challenging because of the narrow surgical *** performed bicuspidization using the open-sleeve technique for cAS with a unicuspid aortic valve in two ***,the patients were doing well without reintervention for the aortic valve for 8 and 6 years,*** aortic annular diameter increased along with somatic *** for neonates or infancy can be performed safely using the open-sleeve technique as its midterm results have been satisfactory.

关键词： Aortic valve repair infant bicuspidization open-sleeve technique

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Do changes in intracoronary pressure aid coronary spasm diagnosis using the spasm provocation test?

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World Journal of Cardiology 2024年第1期16卷 16-26页

作者： hiroki Teragawa Chikage Oshita Yuko Uchimura Department of Cardiovascular Medicine JR Hiroshima HospitalHiroshima 732-0057Japan

BACKGROUND Although the spasm provocation test(SPT)can diagnose coronary spasms,it would be helpful if it could also predict their *** To investigate whether coronary spasms can be predicted using changes in intracoronary artery pressure measured using a pressure wire during the *** Seventy patients underwent SPTs with pressure-wire measurement of intracoronary artery *** each SPT,the pressure wire was advanced into the distal portion of the right coronary artery(RCA)and left anterior descending coronary artery,and the ratio of intracoronary pressure to aortic pressure(Pd/Pa)was *** spasm was defined as an arterial narrowing of>90%in response to the administration of acetylcholine(ACh),with chest symptoms and/or ischemic electrocardiographic *** was administered to the RCA at low,moderate,or high doses of 20,50,or 80μg,respectively,and to the left coronary artery(LCA)at low,moderate,or high doses of 50,100,or 200μg,*** arteries with coronary spasms at low doses of ACh were defined as group L,and those with coronary spasms at moderate or high doses were defined as group *** who did not occur coronary spasms at any ACh dose were designated as group *** Among the 132 coronary arteries assessed using a pressure wire,there were 49 in group N,25 in group L,and 58 in group *** Pd/Pa was the lowest in group L(P=0.001).The decrease in the Pd/Pa between baseline to low doses of ACh was lower in group MH than in group N(P<0.001).A receiver-operating characteristics analysis showed that the cutoff baseline Pd/Pa value for predicting group L was 0.95,with a sensitivity of 0.600(15/25)and a specificity of 0.713(76/107)and that the cutoff value of Pd/Pa from baseline to low doses of ACh for predicting group MH was−0.04,with a sensitivity of 0.741(43/58)and a specificity of 0.694(34/49).CONCLUSION These findings suggest that indices of intracoronary pressure during SPT may be useful means for

关键词： Acetylcholine Coronary spasm Intracoronary pressure Pressure wire Spasm provocation test Vasospastic angina

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Endoscopic hemostasis using self-expandable metal stent combinedwith PuraStat® for patient with high risk of post-endoscopicsphincterotomy bleeding (with video)

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 94-96页

作者： Takeshi Ogura Yuki Uba Masahiro Yamamura Nobu Nishioka hiroki Nishikawa 2nd Department of Internal Medicine Osaka Medical and Pharmaceutical UniversityOsakaJapan

To the Editor:Endoscopic sphincterotomy(EST)is an established technique for removal of bile duct stones and self-expandable metal stent(SEMS)***,bleeding can be considered an adverse event after EST,particularly for patients with high risk of bleeding such as those on *** the various techniques reported for obtaining endoscopic hemostasis[1-3].

关键词： bleeding stasis endoscopic

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