Internal medicine
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A 54-year-old woman presented with an elevated esophageal lesion. Computed tomography (CT) and magnetic resonance imaging revealed a mass in the pancreatic head. Endoscopic ultrasound (EUS) showed a well-defined, round, hypoechoic mass, which was considered lymph node enlargement. ⋯ The pathologically confirmed epithelial cells and multinucleated giant cells were positive for T-SPOT. Clinically, tuberculous lymphadenitis and esophageal tuberculosis were suspected, with successful treatment with anti-tuberculosis therapy resulting in a good response. Our findings suggest that an EUS-FNAB is useful for diagnosing esophageal tuberculosis.
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Case Reports
Successful Treatment of Malignant Lymphoma Following Transcatheter Aortic Valve Replacement: A Case Report.
A 67-year-old woman with severe aortic stenosis (AS) was transferred to our hospital for large B-cell lymphoma treatment. Because of her high risk of anthracycline-induced cardiotoxicity due to severe AS and low performance status, the patient was initially treated with doxorubicin-free chemotherapy. ⋯ Nine days after TAVR, the patient received the first cycle of anthracycline-containing chemotherapy (R-CHOP). Currently, 12 months after completing 4 cycles of R-CHOP, the patient remains in complete remission without having developed cardiotoxicity.
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Objective This study examined whether or not hyperglycemia on admission is associated with poor outcomes in patients with successful reperfusion by mechanical thrombectomy (MT). Methods Consecutive patients with acute anterior circulation stroke and large-vessel occlusion treated with MT were evaluated. Hyperglycemia was defined as a blood glucose level of >140 mg/dL on admission. ⋯ In patients with successful reperfusion, a multivariate regression analysis identified hyperglycemia as a factor associated with poor outcomes (odds ratio, 2.151; confidence interval, 1.166-3.970; p=0.014). Conclusion Among all patients, hyperglycemia on admission was associated with a poor outcome in those treated with MT. Regarding the presence of successful reperfusion by MT, patients with successful reperfusion had such effects.
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Case Reports
Acute Liver Injury and Bilateral Pulmonary Artery Thrombosis due to Hypereosinophilic Syndrome: A Case Report.
A 46-year-old Japanese man was referred to our hospital because of a marked increase in his eosinophil count (22,870/μL) and elevated liver enzyme levels. Computed tomography (CT) showed thrombi measuring approximately 8 cm in both femoral veins. ⋯ Four days after starting treatment, the patient experienced sudden chest pain and cardiopulmonary arrest. CT revealed bilateral pulmonary artery thrombosis, and despite administration of a tissue plasminogen activator, the patient died.
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Objective Radwisp™ is a fluoroscopic video analysis workstation recently developed to evaluate pulmonary circulation, thereby obviating the need for contrast medium or breath-holding. This study validated Radwisp as a diagnostic tool for acute pulmonary embolism (APE) and evaluated its potential utility in patients with symptoms of suspected APE. Methods The study included 10 patients (mean age, 69±16 years old) who were admitted to our hospital for suspected APE based on symptoms and physical examination findings between January 2020 and April 2021. ⋯ Among the residents, the sensitivity and specificity were 88% and 35%, respectively, and the positive and negative predictive values were 76% and 55%, respectively. Conclusion This study showed an initial validation of Radwisp for diagnosing APE, revealing a high sensitivity but not yet achieving a high specificity. Further studies with a larger number of cases are needed to thoroughly evaluate the diagnostic performance.