巻号一覧
88 巻 (2014)
- 6 号 p. 827-
- 5 号 p. 669-
- 4 号 p. 417-
- 3 号 p. 269-
- 2 号 p. 141-
- 1 号 p. 1-
前身誌
88 巻, 2 号
選択された号の論文の6件中1～6を表示しています
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原著
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森岡 悠, 岸田 修二, 今村 顕史, 関谷 紀貴, 柳澤 如樹, 菅沼 明彦, 味澤 篤2014 年 88 巻 2 号 p. 141-148
発行日: 2014/03/20
公開日: 2017/07/28
ジャーナル フリー背景：抗HIV 療法の進歩によってHIV 感染者の長期生存が可能になってきた現在，HIV 関連神経認知障害（HAND）が問題となりつつある．本邦においてHAND の報告は少なく，臨床像や有病率は明らかではない． 対象・方法：都立駒込病院において，平成18 年度のエイズ研究事業で作成された8 つの神経心理検査からなるHIV 感染者高次機能評価バッテリーが30 人のHIV 感染者に施行された．中枢神経合併症のため5 人が除外され，HAND の合併が疑われた25 人の患者背景，頭部MRI 所見，髄液所見，神経心理検査結果を重症度別に比較した．また，バッテリー内の一部の検査を組み合わせて，簡易バッテリーとして用いた場合の検討を行った． 結果：25 人中19 人（76％）がHAND と診断され，その内訳は7 人がHIV 認知症，8 人が軽度神経認知障害，4 人が無症候性神経認知障害であった．重症度別では，患者背景，頭部MRI 所見，髄液所見はいずれも一定の傾向が見られなかった．簡易バッテリーの検討では，International HIV Dementia Scale もしくは符号の検査のいずれかがカットオフ値以下であった場合，94.7％のHAND 症例は検出可能であった． 結論：臨床的にHAND の合併が疑われた大部分のHIV 感染者に対してHAND の診断がなされた．HIV 感染者高次機能評価バッテリー内の一部の神経心理検査は有用であったが，現行のHAND の診断基準に合致したものに改訂する必要がある．抄録全体を表示PDF形式でダウンロード (292K) -
菊池 隆秀, 坂巻 文雄, 谷山 大輔, 土橋 酉紀, 山岸 拓也, 北原 光夫2014 年 88 巻 2 号 p. 149-154
発行日: 2014/03/20
公開日: 2017/07/28
ジャーナル フリー2009 年3 月東京都A 区の，ある高齢者介護施設X で肺炎球菌肺炎が集団発生した．培養結果に基づいた症例定義により15 例が検出された．同定された肺炎球菌はペニシリンG に対して感性であり，全例が莢膜血清型11A であることが確認された．15 例中2 例が死亡した．当時の施設利用者の中で1 名を除いて23 価肺炎球菌ポリサッカライドワクチン（以下PPV と略す）の接種歴が無かった．PPV 未接種で，かつ未罹患の入所者を対象にPPV 接種を実施し施設利用者全員に対して抗菌薬の予防投与を行った．同時に施設内での飛沫感染予防策を徹底し，利用者間の接触を制限した．これらの感染拡大予防策の導入の後，アウトブレイクは発生後11 日で終息できた．抄録全体を表示PDF形式でダウンロード (436K)
症例
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杤谷 健太郎, 清水 恒広, 篠原 浩, 土戸 康弘, モイ メンリン, 高崎 智彦2014 年 88 巻 2 号 p. 155-159
発行日: 2014/03/20
公開日: 2017/07/28
ジャーナル フリーA 31-year-old Japanese female had stayed in Australia from January to May 2013. She presented with a sudden onset of left ankle and right knee arthralgia in March but neither fever nor rash was present. As her arthralgia persisted, she visited our hospital upon her return to Japan in May. When she came to our hospital, she complained of left ankle and right knee pain, but no arthritis findings. Laboratory findings were also within normal ranges. Ross River virus (RRV) antibody levels were examined as she was suspected of having contracted the disease in Australia. RRV IgG antibody and IgM antibody were positive, and the patient was confirmed as a case of acute RRV disease. RRV disease is endemic in Australia, but there are no prior reports of the disease in Japan. This is the first case of RRV disease confirmed in Japan. Typical symptoms of RRV disease include arthralgia, fever, and rash. Our patient had only arthralgia. With the increase in the number of travelers and length of stay in RRV endemic regions, health care providers need to consider the disease in their differential diagnosis, among returning travelers with arthralgia, fever, rash and a travel history to RRV-endemic regions.抄録全体を表示PDF形式でダウンロード (1755K) -
山田 有美, 土井 正男, 上綱 雅一, 桑原 正雄, 大下 久美, 清水 里美, 渡部 八重子, 藤上 良寛2014 年 88 巻 2 号 p. 160-165
発行日: 2014/03/20
公開日: 2017/07/28
ジャーナル フリーMycoplasma pneumoniae is one of the common pathogens of the community-acquired pneumonia in adults and children. Macrolide antibiotics are considered to be the first-choicedrugforM. pneumoniae infections. However, macrolide-resistant M. pneumoniae was first detected from Japanese pediatric patients in 2000, and it has been increasing over the past decade. On the other hand, the Immunocard Mycoplasma IgM test is widely used as a rapid and easy diagnostic method for M. pneumoniae pneumonia, but false-positive or false-negative cases have been reported in adults. Therefore new methods have been developed recently. Using the LAMP assay, the results are available rapidly and accurately. We report herein on two cases of M. pneumoniae bronchopneumonia in which the LAMP assay was useful in the diagnosis and treatment.抄録全体を表示PDF形式でダウンロード (549K) -
加藤 博史, 柳澤 如樹, 関谷 紀貴, 菅沼 明彦, 今村 顕史, 味澤 篤2014 年 88 巻 2 号 p. 166-170
発行日: 2014/03/20
公開日: 2017/07/28
ジャーナル フリーWe report herein on a 20-year-old Japanese man who was referred to our hospital for fever and diarrhea after returning from Indonesia. On admission, his blood test was essentially normal, besides a slight elevation in inflammatory markers. After excluding malaria and dengue fever, empiric use of ceftriaxone was initiated for suspected enteric fever, which was unsuccessful. However, drastic clinical improvement was observed after initiation of minocycline. The polymerase chain reaction test for Rickettsia typhi was positive from serum samples on admission, confirming the diagnosis of murine typhus. Although rarely seen in Japan, clinicians should be aware of this disease when examining patients with fever coming back from murine typhus endemic areas.抄録全体を表示PDF形式でダウンロード (305K) -
谷山 大輔, 平尾 磨樹, 小鮒 美香, 油田 さや子, 北原 光夫2014 年 88 巻 2 号 p. 171-175
発行日: 2014/03/20
公開日: 2017/07/28
ジャーナル フリーWe report herein on a case of the primary intestinal tuberculosis in which small intestine perforation developed. A 60-year-old man with congestive heart failure developed fever and sudden onset of abdominal pain while he was in the hospital. Computed tomography of the abdomen showed a large amount of free-air and the thickening of a part of the ileum. Perforation of the gastrointestinal tract was diagnosed. The patient underwent emergency exploratory laparotomy and a partial resection of the ileum was performed. The presence of nodules in the ileum suggested possible tuberculosis of the intestine. Pathologically caseating epithelioid granulomas were noted and the diagnosis of tuberculosis of the ileum was made although microbiologically tuberculous bacilli were not documented. The patient was successfully treated with antituberculosis chemotherapy. Although intestinal tuberculosis is a rare cause of intestinal perforation, it is important to include intestinal tuberculosis as one of the cases.抄録全体を表示PDF形式でダウンロード (674K)
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