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Article: Unilateral syphilitic optic neuritis without meningitis or uveitis.

Yamashita, Shun / Tago, Masaki / Nishi, Tomoyo M / Yamashita, Shu-Ichi

2022 Volume 10, Issue 4, Page(s) e05678

Abstract: A 69-year-old man with left eye pain and visual impairment was diagnosed with syphilitic optic neuritis, who was successfully treated by penicillin. Although it is difficult to decide syphilis as the direct cause of optic neuritis, it is essential to ... ...

Abstract	A 69-year-old man with left eye pain and visual impairment was diagnosed with syphilitic optic neuritis, who was successfully treated by penicillin. Although it is difficult to decide syphilis as the direct cause of optic neuritis, it is essential to diagnose syphilis in every patient with optic neuritis.
Language	English
Publishing date	2022-04-20
Publishing country	England
Document type	Case Reports
ZDB-ID	2740234-4
ISSN	2050-0904
ISSN	2050-0904
DOI	10.1002/ccr3.5678
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Unilateral syphilitic optic neuritis without meningitis or uveitis

Shun Yamashita / Masaki Tago / Tomoyo M. Nishi / Shu‐ichi Yamashita

Clinical Case Reports, Vol 10, Iss 4, Pp n/a-n/a (2022)

2022

Abstract: Abstract A 69‐year‐old man with left eye pain and visual impairment was diagnosed with syphilitic optic neuritis, who was successfully treated by penicillin. Although it is difficult to decide syphilis as the direct cause of optic neuritis, it is ... ...

Abstract	Abstract A 69‐year‐old man with left eye pain and visual impairment was diagnosed with syphilitic optic neuritis, who was successfully treated by penicillin. Although it is difficult to decide syphilis as the direct cause of optic neuritis, it is essential to diagnose syphilis in every patient with optic neuritis.
Keywords	impaired visual acuity ; magnetic resonance imaging ; rapid plasma regain ; syphilitic optic neuritis ; treponema pallidum hemagglutination assay ; Medicine ; R ; Medicine (General) ; R5-920
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	Wiley
Document type	Article ; Online
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Article ; Online: Thrombus between the Posterior Mitral Leaflet and Lateral Wall.

M Nishi, Tomoyo / Yamashita, Shun / Tago, Masaki / Yamashita, Shu-Ichi

Internal medicine (Tokyo, Japan)

2020 Volume 59, Issue 17, Page(s) 2199

Language	English
Publishing date	2020-05-26
Publishing country	Japan
Document type	Journal Article
ZDB-ID	32371-8
ISSN	1349-7235 ; 0021-5120 ; 0918-2918
ISSN (online)	1349-7235
ISSN	0021-5120 ; 0918-2918
DOI	10.2169/internalmedicine.4817-20
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Article ; Online: Heidenhain Variant of Sporadic Creutzfeldt-Jakob Disease with a Variety of Visual Symptoms: A Case Report with Autopsy Study.

Hisata, Yoshio / Yamashita, Shun / Tago, Masaki / Yoshimura, Motoi / Nakashima, Tomotaro / Nishi, Tomoyo M / Oda, Yoshimasa / Honda, Hiroyuki / Yamashita, Shu-Ichi

The American journal of case reports

2023 Volume 24, Page(s) e938654

Abstract: BACKGROUND Sporadic Creutzfeldt-Jakob disease (sCJD) is a fatal disease caused by the change of prion protein (PrP). Affected patients present with rapidly progressive cognitive dysfunction, myoclonus, or akinetic mutism. Diagnosing the Heidenhain ... ...

Abstract	BACKGROUND Sporadic Creutzfeldt-Jakob disease (sCJD) is a fatal disease caused by the change of prion protein (PrP). Affected patients present with rapidly progressive cognitive dysfunction, myoclonus, or akinetic mutism. Diagnosing the Heidenhain variant of sCJD, which initially causes various visual symptoms, can be particularly difficult. CASE REPORT A 72-year-old woman presented with a 2- to 3-month history of photophobia, blurring vision in both eyes. Seven days previously, she showed visual impairment of 20/2000 in both eyes. Left homonymous hemianopia and restricted downward movement of the left eye were observed with an intact pupillary light reflex and normal fundoscopy. On admission, her visual acuity was light perception. Cranial magnetic resonance imaging revealed no abnormality, and electroencephalography showed no periodic synchronous discharges. Cerebrospinal fluid examination on the sixth hospital day revealed tau and 14-3-3 protein with a positive result of real-time quaking-induced conversion. She thereafter developed myoclonus and akinetic mutism and died. Autopsy revealed thinning and spongiform change of the cerebral cortex of the right occipital lobe. Immunostaining showed synaptic-type deposits of abnormal PrP and hypertrophic astrocytes. Consequently, she was diagnosed with the Heidenhain variant of sCJD with both methionine/methionine type 1 and type 2 cortical form based on the western blot of cerebral tissue and PrP gene codon 129 polymorphism. CONCLUSIONS When a patient presents with various progressive visual symptoms, even without typical findings of electroencephalography or cranial magnetic resonance imaging, it is essential to suspect the Heidenhain variant of sCJD and perform appropriate cerebrospinal fluid tests.
MeSH term(s)	Female ; Humans ; Aged ; Creutzfeldt-Jakob Syndrome/diagnosis ; Autopsy ; Myoclonus/pathology ; Akinetic Mutism/pathology ; Brain/pathology
Language	English
Publishing date	2023-03-11
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2517183-5
ISSN	1941-5923 ; 1941-5923
ISSN (online)	1941-5923
ISSN	1941-5923
DOI	10.12659/AJCR.938654
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Article ; Online: Late-Onset Ornithine Transcarbamylase Deficiency Complicated with Extremely High Serum Ammonia Level: Prompt Induction of Hemodialysis as the Key to Successful Treatment.

Yamamoto, Satsuki / Yamashita, Shun / Kakiuchi, Toshihiko / Kurogi, Kazuya / Nishi, Tomoyo M / Tago, Masaki / Yamashita, Shu-Ichi

The American journal of case reports

2022 Volume 23, Page(s) e937658

Abstract: BACKGROUND Ornithine transcarbamylase deficiency (OTCD) is an X-linked semi-dominant disorder, causing possible fatal hyperammonemia. Late-onset OTCD can develop at any time from 2 months after birth to adulthood, accounting for 70% of all OTCDs. CASE ... ...

Abstract	BACKGROUND Ornithine transcarbamylase deficiency (OTCD) is an X-linked semi-dominant disorder, causing possible fatal hyperammonemia. Late-onset OTCD can develop at any time from 2 months after birth to adulthood, accounting for 70% of all OTCDs. CASE REPORT A 35-year-old man with chronic headaches stated that since childhood he felt sick after eating meat. Fourteen days before hospital admission, he began receiving 60 mg/day of intravenous prednisolone for sudden deafness. The prednisolone was stopped 5 days before hospital admission. Four days later, he was transferred to our hospital because of confusion. On admission, he had hyperammonemia of 393 µmol/L. Because he became comatose 7 hours after admission, and his serum ammonia increased to 1071 µmol/L, we promptly started hemodialysis. Because his family history included 2 deceased infant boys, we suspected late-onset OTCD. On day 2 of hospitalization, we began administering ammonia-scavenging medications. Because he gradually regained consciousness, we stopped his hemodialysis on day 6. After his general condition improved, he was transferred to the previous hospital for rehabilitation on day 32. We definitively diagnosed him with late-onset OTCD due to the low plasma citrulline and high urinary orotic acid levels found during his hospitalization. CONCLUSIONS Clinicians should suspect urea cycle disorders, such as OTCD, when adult patients present with marked hyperammonemia without liver cirrhosis. Adult patients with marked hyperammonemia should immediately undergo hemodialysis to remove ammonia, regardless of causative diseases.
MeSH term(s)	Male ; Infant ; Adult ; Humans ; Child ; Ornithine Carbamoyltransferase Deficiency Disease/complications ; Ornithine Carbamoyltransferase Deficiency Disease/diagnosis ; Ornithine Carbamoyltransferase Deficiency Disease/therapy ; Hyperammonemia/etiology ; Hyperammonemia/therapy ; Ammonia/therapeutic use ; Renal Dialysis/adverse effects ; Prednisolone/therapeutic use ; Ornithine Carbamoyltransferase/therapeutic use
Chemical Substances	Ammonia (7664-41-7) ; Prednisolone (9PHQ9Y1OLM) ; Ornithine Carbamoyltransferase (EC 2.1.3.3)
Language	English
Publishing date	2022-11-15
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2517183-5
ISSN	1941-5923 ; 1941-5923
ISSN (online)	1941-5923
ISSN	1941-5923
DOI	10.12659/AJCR.937658
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Article ; Online: Relationships between sites of abdominal pain and the organs involved: a prospective observational study.

Yamashita, Shun / Tago, Masaki / Katsuki, Naoko E / Nishi, Tomoyo M / Yamashita, Shu-Ichi

BMJ open

2020 Volume 10, Issue 6, Page(s) e034446

Abstract: Objectives: Abdominal pain is one of the most frequent chief complaints in primary care settings. The aim of the present study was to determine the positive likelihood ratios (PLRs) and negative likelihood ratios (NLRs) of the relationships between the ... ...

Abstract	Objectives: Abdominal pain is one of the most frequent chief complaints in primary care settings. The aim of the present study was to determine the positive likelihood ratios (PLRs) and negative likelihood ratios (NLRs) of the relationships between the sites of abdominal pain and the organs involved. Design: Prospective observational study. Setting: A single tertiary centre, a university hospital in Japan. Participants: A total of 2591 new outpatients visited the Department of General Medicine at a university hospital from April 2017 to March 2018. Of these, 326 patients aged ≥20 years with abdominal pain were enrolled. Results: Sites of abdominal pain were classified into 11 categories including nine different abdominal sections, 'generalised abdomen' and 'site-indeterminate'. The PLRs between 'right subcostal' and 'liver and biliary tract'; between 'right subcostal' and 'musculoskeletal' between 'epigastric' and 'oesophagus, stomach and duodenum'; between 'right or left flank' and 'urinary tract'; between 'left flank' and 'dermatological'; and between 'mid-lower' and 'intestinal' ranged from 2.17 to 4.14. The PLRs between 'epigastric' and 'urinary tract'; between 'mid-lower' and 'liver and biliary tract'; between 'periumbilical' and 'urinary tract'; and between 'generalised abdomen' and 'oesophagus, stomach and duodenum' were low, ranging from 0.17 to 0.25. The NLR ranged from 0.5 to 1.5, excluding the relationship between 'left flank' and 'dermatological'. Conclusion: The presence of pain at right subcostal, epigastric, right or left flank and mid-lower sites might be useful for identifying the organs involved. Additionally, the presence of pain at mid-lower, epigastric, periumbilical and generalised abdominal sites might be helpful for denying the involvement of some organs. Some sites of abdominal pain can be indicative of the organs involved.
MeSH term(s)	Abdominal Pain/etiology ; Biliary Tract/diagnostic imaging ; Duodenum/diagnostic imaging ; Esophagus/diagnostic imaging ; Female ; Humans ; Liver/diagnostic imaging ; Male ; Middle Aged ; Physical Examination ; Prospective Studies ; Sensitivity and Specificity ; Stomach/diagnostic imaging ; Tomography, X-Ray Computed ; Urinary Tract/diagnostic imaging
Language	English
Publishing date	2020-06-22
Publishing country	England
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2019-034446
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Article ; Online: Relationships between sites of abdominal pain and the organs involved

Masaki Tago / Naoko E Katsuki / Shu-ichi Yamashita / Shun Yamashita / Tomoyo M Nishi

BMJ Open, Vol 10, Iss

a prospective observational study

2020 Volume 6

Abstract: Objectives Abdominal pain is one of the most frequent chief complaints in primary care settings. The aim of the present study was to determine the positive likelihood ratios (PLRs) and negative likelihood ratios (NLRs) of the relationships between the ... ...

Abstract	Objectives Abdominal pain is one of the most frequent chief complaints in primary care settings. The aim of the present study was to determine the positive likelihood ratios (PLRs) and negative likelihood ratios (NLRs) of the relationships between the sites of abdominal pain and the organs involved.Design Prospective observational study.Setting A single tertiary centre, a university hospital in Japan.Participants A total of 2591 new outpatients visited the Department of General Medicine at a university hospital from April 2017 to March 2018. Of these, 326 patients aged ≥20 years with abdominal pain were enrolled.Results Sites of abdominal pain were classified into 11 categories including nine different abdominal sections, ‘generalised abdomen’ and ‘site-indeterminate’. The PLRs between ‘right subcostal’ and ‘liver and biliary tract’; between ‘right subcostal’ and ‘musculoskeletal’ between ‘epigastric’ and ‘oesophagus, stomach and duodenum’; between ‘right or left flank’ and ‘urinary tract’; between ‘left flank’ and ‘dermatological’; and between ‘mid-lower’ and ‘intestinal’ ranged from 2.17 to 4.14. The PLRs between ‘epigastric’ and ‘urinary tract’; between ‘mid-lower’ and ‘liver and biliary tract’; between ‘periumbilical’ and ‘urinary tract’; and between ‘generalised abdomen’ and ‘oesophagus, stomach and duodenum’ were low, ranging from 0.17 to 0.25. The NLR ranged from 0.5 to 1.5, excluding the relationship between ‘left flank’ and ‘dermatological’.Conclusion The presence of pain at right subcostal, epigastric, right or left flank and mid-lower sites might be useful for identifying the organs involved. Additionally, the presence of pain at mid-lower, epigastric, periumbilical and generalised abdominal sites might be helpful for denying the involvement of some organs. Some sites of abdominal pain can be indicative of the organs involved.Trial registration numberUMIN000037686
Keywords	Medicine ; R
Subject code	360
Language	English
Publishing date	2020-06-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
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Article ; Online: A Prospective Observational Study Conducted at a Single Center in Japan to Validate a Previously Developed Predictive Formula of In-Hospital Mortality for Patients Aged ≥65 Years with Endogenous Diseases Transported by Ambulance.

Fujiwara, Motoshi / Tago, Masaki / Hirata, Risa / Yamashita, Shun / Katsuki, Naoko E / Ide, Noriko / Nishi, Tomoyo M / Oda, Yoshimasa / Nishiyama, Masanori / Yamashita, Shu-Ichi

Medical science monitor : international medical journal of experimental and clinical research

2022 Volume 28, Page(s) e938385

Abstract: BACKGROUND In 2019, we developed a predictive formula of in-hospital mortality for inpatients aged ≥65 years transported by ambulance for endogenous diseases. In this study, we aimed to validate this previously developed predictive formula. MATERIAL AND ... ...

Abstract	BACKGROUND In 2019, we developed a predictive formula of in-hospital mortality for inpatients aged ≥65 years transported by ambulance for endogenous diseases. In this study, we aimed to validate this previously developed predictive formula. MATERIAL AND METHODS In this single-center prospective observational study, we enrolled all patients aged ≥65 years who were transported by ambulance and admitted to an acute care hospital in Japan for endogenous diseases. We calculated the score according to our developed formula using age, disturbance of consciousness, the shock index, and amount of oxygen administered, with each item scoring 1 point and then totaling them. We subsequently evaluated the in-hospital mortality rate, stratum-specific likelihood ratio, and area under the receiver operating characteristic curve (AUC) of the formula, using in-hospital mortality as the primary outcome. RESULTS In total, 325 patients were included in this study. Forty-two patients died during hospitalization. Multivariable logistic regression analysis (forced-entry method) revealed that disturbance of consciousness and oxygen administration 5 L/min or more were significantly associated with mortality during hospitalization. In contrast, aged ≥90 years and shock index of 1 or higher were not significant. The mortality and stratum-specific likelihood ratios for scores in the predictive formula of 3 and 4 were 40.9% and 4.66, and 66.7% and 13.48, respectively. The AUC of the predictive formula for in-hospital mortality was 0.670 (95% confidence interval: 0.574-0.767). CONCLUSIONS This study showed that our predictive formula, consisting of factors available immediately after ambulance transport in older patients, is feasible with sufficient discrimination ability and reliability.
MeSH term(s)	Humans ; Aged ; Ambulances ; Hospital Mortality ; Japan ; Reproducibility of Results ; Oxygen
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2022-11-16
Publishing country	United States
Document type	Observational Study ; Journal Article
ZDB-ID	1439041-3
ISSN	1643-3750 ; 1234-1010
ISSN (online)	1643-3750
ISSN	1234-1010
DOI	10.12659/MSM.938385
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Article ; Online: Proliferative Fasciitis/Myositis Involving the Facial Muscles Including the Masseter Muscle: A Rare Cause of Trismus.

Nishi, Tomoyo M / Yamashita, Shun / Hirakawa, Yuka N / Katsuki, Naoko E / Tago, Masaki / Yamashita, Shu-Ichi

The American journal of case reports

2019 Volume 20, Page(s) 1411–1417

Abstract: BACKGROUND Proliferative fasciitis/myositis is a benign disease that can be treated conservatively. However, some patients are mistakenly treated surgically because of a misdiagnosis of the condition as a malignant tumor. CASE REPORT A 50-year-old ... ...

Abstract	BACKGROUND Proliferative fasciitis/myositis is a benign disease that can be treated conservatively. However, some patients are mistakenly treated surgically because of a misdiagnosis of the condition as a malignant tumor. CASE REPORT A 50-year-old Japanese man developed swelling in his left cheek 12 days before admission; he developed a fever and trismus 3 days later. He was admitted to our hospital because of worsening of his condition despite treatment with sitafloxacin for 5 days and needle-aspiration drainage. On admission, he had a fever of 38.1°C, swelling in his left cheek spreading to the lower jaw, and several dental caries. Although ceftriaxone and clindamycin were administered for 7 days because an odontogenic infection was suspected, his condition did not improve. T2-weighted magnetic resonance imaging of the facial muscles on Day 5 of hospitalization showed swelling and high-intensity signals in the left masseter, temporalis, and pterygoid muscles. Macroscopic findings from a biopsy of the left temporalis muscle performed on Day 17 showed white and thickened fascia. Histopathological examination revealed fibrous hyperplasia of the fascia, increased fibrous connective tissue between muscle fibers, and infiltration of inflammatory cells, providing not a definite but a compatible diagnosis of proliferative fasciitis/myositis. Beginning on Day 18, the patient's fever lessened with gradual improvement of his facial swelling and trismus. CONCLUSIONS It is imperative to include proliferative fasciitis/myositis as a possible diagnosis when patients present with facial swelling and trismus of unknown cause.
MeSH term(s)	Facial Muscles/diagnostic imaging ; Fasciitis/diagnosis ; Fever/etiology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Myositis/diagnosis ; Tomography, X-Ray Computed ; Trismus/etiology
Language	English
Publishing date	2019-09-25
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2517183-5
ISSN	1941-5923 ; 1941-5923
ISSN (online)	1941-5923
ISSN	1941-5923
DOI	10.12659/AJCR.917193
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Article ; Online: Pegfilgrastim-associated large-vessel vasculitis developed during adjuvant chemotherapy for breast cancer: A case report and review of the literature.

Nakamura, Jun / Nishi, Tomoyo M / Yamashita, Shun / Nakamura, Hiroaki / Sato, Ken / Oda, Yoshimasa / Iyama, Akihiro

Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners

2020 Volume 26, Issue 7, Page(s) 1785–1790

Abstract: Introduction: Granulocyte colony-stimulating factor (G-CSF) is widely used as a neutrophil supportive therapy in breast cancer chemotherapy. Common adverse events of G-CSF include bone pain, headache, and fatigue; however, reports of G-CSF-associated ... ...

Abstract	Introduction: Granulocyte colony-stimulating factor (G-CSF) is widely used as a neutrophil supportive therapy in breast cancer chemotherapy. Common adverse events of G-CSF include bone pain, headache, and fatigue; however, reports of G-CSF-associated vasculitis are few. Case report: A 66-year-old woman who had undergone surgery for breast cancer received adjuvant chemotherapy with prophylactic use of pegfilgrastim (peg-G). She developed peg-G-associated vasculitis 11 days after initially receiving peg-G. Discussion: G-CSF-associated vasculitis is occasionally accompanied by severe complications such as aortic dissection and aneurysm formation. This case report is important to draw attention towards this rare and difficult-to-diagnosis adverse event of peg-G.
MeSH term(s)	Aged ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Breast Neoplasms/drug therapy ; Chemotherapy, Adjuvant ; Female ; Filgrastim/administration & dosage ; Filgrastim/adverse effects ; Granulocyte Colony-Stimulating Factor/therapeutic use ; Humans ; Polyethylene Glycols/administration & dosage ; Polyethylene Glycols/adverse effects ; Vasculitis/chemically induced
Chemical Substances	Granulocyte Colony-Stimulating Factor (143011-72-7) ; pegfilgrastim (3A58010674) ; Polyethylene Glycols (3WJQ0SDW1A) ; Filgrastim (PVI5M0M1GW)
Language	English
Publishing date	2020-03-18
Publishing country	England
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	1330764-2
ISSN	1477-092X ; 1078-1552
ISSN (online)	1477-092X
ISSN	1078-1552
DOI	10.1177/1078155220910800
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