Noriaki Ohkiba

Kashiwa Municipal Hospital

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Isao Minami

Tokyo Medical and Dental University

Nozomi Murooka

Kashiwa Municipal Hospital

Hideyuki Okuma

Nerima General Hospital

Koshi Hashimoto

Dokkyo Medical University Saitama Medical Center

Yoshihiro Ogawa

Kyushu University

Takeshi Inazawa

Kashiwa Municipal Hospital

Kenichi Kawahori

Tokyo Medical and Dental University

Yuji Tanaka

National Defense Medical College

Xin Wang

First Affiliated Hospital of Bengbu Medical College

Ryotaro Bouchi

Committee on Publication Ethics

Cooperative Institutions

Tokyo Medical and Dental University

Kashiwa Municipal Hospital

Hiratsuka Kyosai Hospital

University of Yamanashi

Yokohama Municipal Minato Red Cross Hospital

National Defense Medical College

Tokyo University of Science

Gifu University

Keio University

The University of Tokyo

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Monomicrobial Fournier's Gangrene Caused by Panton-Valentine Leukocidin-negative Methicillin-susceptible <i>Staphylococcus aureus</i> ST8 in Japan

Internal Medicine (2020)

Hirofumi Yamagishi Kenichi Kawahori Noriaki Ohkiba Nozomi Murooka Takeshi Inazawa

Methicillin-resistant Staphylococcus aureus USA300, belonging to sequence type (ST) 8, is a rare cause of necrotizing fasciitis in the USA. We herein report a case of monomicrobial Fournier's gangrene caused by an ST8, methicillin-susceptible Staphylococcus aureus (designated ksw1). Whole-genome sequencing and analyses for virulence determinants revealed that, unlike USA300, ksw1 lacked virulence genes, such as Panton-Valentine leukocidin and SCCmec, while harboring the toxic shock syndrome toxin-1 gene. These genomic features correlate with ST8 CA-MRSA/J, which is the major genotype of ST8 in Japan.

Panton–Valentine leukocidin

Leukocidin

SCCmec

Gangrene

Toxic shock syndrome

Multilocus sequence typing

10.2169/internalmedicine.4334-19

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A Case of Refractory Hypothyroidism due to Poor Compliance Treated with the Weekly Intravenous and Oral Levothyroxine Administration

Case Reports in Endocrinology (2019)

Yujiro Nakano Koshi Hashimoto Noriaki Ohkiba Hideyuki Okuma Isao Minami

Refractory hypothyroidism is caused by decreased gut absorption, increased metabolism, and poor compliance. Previous studies suggested that the weekly oral, suppository, or intramuscular administration of levothyroxine (LT4) is an effective treatment for refractory hypothyroidism. However, limited information is currently available on treatment involving the weekly intravenous administration of LT4. We managed a case of refractory hypothyroidism due to poor compliance, for which, by weekly intravenous LT4 administration, LT4 was intravenously administered weekly at a dose of 300 μ g without any adverse effects such as acute ischemic heart diseases or liver dysfunction and effectively maintained the euthyroid status for 14 months. The weekly oral administration of LT4 (700 μ g) was also safely performed and was as effective as its intravenous administration. We herein present precise clinical course of the present case including pharmacokinetic data during the weekly intravenous and oral administration of LT4 and discuss the safety and efficacy of the treatments.

Levothyroxine

Refractory (planetary science)

10.1155/2019/5986014

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A case of type B insulin resistance syndrome with postprandial hyperglycemia successfully treated with liraglutide

Tōnyōbyō/Tounyoubyou (2017)

Satoru Uchida Mina Yamaguchi Hiromi Hasegawa Noriaki Ohkiba Ryotaro Bouchi

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Systemic Sarcoidosis with Thyroid Involvement

Internal Medicine (2017)

Hideyuki Okuma Koshi Hashimoto Xin Wang Noriaki Ohkiba Nozomi Murooka

A 66-year-old woman, who was diagnosed with iritis, visited our hospital due to general malaise. A blood analysis revealed hypercalcemia. Computed tomography revealed mediastinal and hilar lymph node hyperplasia. Moreover, 67Gallium scintigraphy demonstrated strong accumulation in the lesions, suggesting sarcoidosis. A core needle biopsy (CNB) of the hypoechoic areas of the thyroid was performed because the patient refused to undergo a bronchoscopic examination. The scattering of slightly acidophilic epithelioid cell granulomas was observed in the pathological examination of the biopsy specimen. Based on this finding, the patient was diagnosed with sarcoidosis. Although sarcoidosis rarely involves the thyroid gland, in the present case, thyroid CNB was an alternative diagnostic method that allowed a pathological diagnosis to be obtained.

10.2169/internalmedicine.8324-16

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Citations (15)