Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
Volume 31 , Issue 7
Showing 1-24 articles out of 24 articles from the selected issue
  • Eijiro SATOYOSHI
    1992 Volume 31 Issue 7 Pages 841-846
    Published: 1992
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    The special medical care in the National Sanatorium prolonged the life span of the patients with progressive muscular dystrophy from 15.8 years to 20.4 years over the last 20 years. Various new drug trials for muscular dystrophy have been implemented in the last 12 years in Japan. Bestatin and Loxistatin, protease inhibitors, showed definite improvement on dystrophic mice or hamsters, animal models of muscular dystrophy. However clinical application of these drugs failed to prove the effects on patients with Duchenne muscular dystrophy. The difficulty of clinical evaluation and judgement of effects in progressive neurological diseases is discussed.
    (Internal Medicine 31 : 841-846, 1992)
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  • Shigenobu UMEKI, Rinzo SOEJIMA
    1992 Volume 31 Issue 7 Pages 847-856
    Published: 1992
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    The clinical courses of 11 cases of eosinophilic pneumonia which were clinico-pathohistologically diagnosed and found to be unassociated with organic disorders producing peripheral blood eosinophilia were extensively investigated and compared with various types of eosinophilic pneumonia previously reported. Five cases of acute eosinophilic pneumonia fulfilled the following criteria : 1) less than a one-month history of symptoms prior to diagnosis, 2) a short clinical course and 3) no recurrence. Six cases of chronic eosinophilic pneumonia fulfilled the following criteria : 1) more than a two-month history of symptoms prior to diagnosis, 2) a prolonged
    clinical course and 3) recurrence. The results suggested that various types of previously reported eosinophilic pneumonia classified by sex, the presence or absence of peripheral blood eosinophilia, the degree of clinical symptoms or peripheral blood eosinophilia, and the degree of abnormalities on chest X-ray films should be extensively reevaluated.
    (Internal Medicine 31 : 847-856, 1992)
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  • Hiroshi Kanazawa, Naotsugu KURIHARA, Kazuto HIRATA, Shigeo FUJIMOTO, T ...
    1992 Volume 31 Issue 7 Pages 857-860
    Published: 1992
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    Extracellular proteolysis is hypothesized to be the major cause of pulmonary emphysema and oxygen-derived free radicals and neutrophil elastase are thought to play an important role in its pathogenesis. In this study, peripheral polymorphonuclear leukocytes (PMNs) obtained from 16 patients with emphysema generated a significantly larger amount of superoxide and elastase activity than those obtained from normal controls. A significant correlation was observed between elastase activity and superoxide release. In addition, the superoxide release
    showed a negative correlation with the disease duration. The superoxide release appeared to correlated with a decline of FEV1.0 over the course of several years in 8 patients. It seems likely that activated PMN splay an important role in the development of pulmonary emphysema.
    (Internal Medicine 31 : 857-860, 1992)
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  • Akemi KUBO SHIMASAKI, Kyoji HIRATA, Tetsuji KAWAMURA, Nobuya KUNIBE, K ...
    1992 Volume 31 Issue 7 Pages 861-865
    Published: 1992
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    The level of serum granulocyte colony-stimulating factor (G-CSF) obtained from patients with leukocytosis (>10, 000/μl) between May 1989 and April 1991 was measured by enzyme immunoassay. Studied were 18 patients with malignant neoplasms (median age, 64 years) and 14 patients with hematologic disease (median age, 59 years). Increased serum G-CSF values ranging from 70 to 374pg/ml were noted in 7 of 15 lung cancer cases, a case of malignant thymoma and a blastic crisis of chronic myelogenous leukemia. The rest of the cases showed a normal value (<60 pg/ml). There was no correlation between the neutrophil count and G-CSF level. In lung cancer cases with high G-CSF values, neither a characteristic histologic type nor common elevation of tumor markers could be seen. The neutrophil alkaline phosphatase score was significantly increased and hypercalcemia was presented in high G-CSF cases. G-CSF may contribute at least in part to unknown leukocytosis observed in malignant neoplasms, especially in lung cancer.
    (Internal Medicine 31 : 861-865, 1992)
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  • Tadakuni YAMASAKI
    1992 Volume 31 Issue 7 Pages 866-870
    Published: 1992
    Released: March 27, 2006
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    The functional aspects of the peripheral blood lymphocytes from 6 patients with primary selective IgM deficiency (sIgMD) were analyzed to elucidate its pathogenesis. The surface IgM positive B cells were present at almost the same percentage as in controls, but the percentage of cluster of differentiation (CD)4+ T cells was higher and that of CD8+ T cells was low. The patient B cells showeda significantly lower proliferative response to Staphylococcus aureus Cowan strain I (SAC) than control B cells and did not produce a significant amount of IgM when co-cultured with control T cells. Interestingly, mitomycin C (MMC)-treated patient T cells induced a greater amount of IgM production by control B cells. In addition, patient B cells treated with SAC and B cell differentiation factors (BCDF) failed to secrete IgM. These results suggest that the pathogenesis of sIgMD may be mainly due to an intrinsic defect in B cell maturation.
    (Internal Medicine 31 : 866-870, 1992)
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  • Satoshi KIMURA, Shinichi OKA, Takuo TOYOSHIMA, Yoshihiro HIRABAYASHI, ...
    1992 Volume 31 Issue 7 Pages 871-876
    Published: 1992
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    Adverse reactions to the standard dose (1, 200 mg/day-1, 500mg/day) of azidothymidine (AZT) are serious. An in vitro pharmacokinetic study of intracellular AZT-5'-triphosphate suggested the feasibility of a clinical trial with reduced doses of AZT. A randomized trial with reduced doses of AZT (group A ; 400mg/day, n=15, group B ; 800mg/day, n=13), was conducted enrolling 28 patients with human immunodeficiency virus infection. The effective rate of AZT on CD4+ lymphocyte counts was similar for both groups, but the duration of the effect of AZT was significantly longer in group A (p<0.05). In group B, adverse reactions were more frequently observed (p<0.01), and AZT was withdrawn or the dose was reduced more frequently (p<0.05). These results suggest that AZT at a dose of 400 mg/day is less toxic, and is more beneficial for long-term treatment.
    (Internal Medicine 31 : 871-876, 1992)
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  • Takashi YAMADA, Toru AIZAWA, Yoshitaka NAGASAWA, Masaki ISHIHARA, Mits ...
    1992 Volume 31 Issue 7 Pages 877-884
    Published: 1992
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    Ninety-four overweight subjects with normal glucose tolerance (NGT) or impaired glucose tolerance (IGT) were followed for 10 years. No one from the NGT group developed diabetes, however 32% of the IGT subjects did develop diabetes. Initial data of the IGT subjects who developed diabetes were significantly different from those who did not develop diabetes. Fasting, peak and/or ∑plasma glucose (PG), IRI and CPR at 180 minutes and CPR/IRI at 0 and 180 minutes were increased, and the peak time of PG was delayed ; also the prevalence of a positive family history was higher, and the body weight heavier. Seventy-nine percent of IGT subjects with the initial ∑PG of ≥40 Mm or a positive family history developed diabetes whereas only 3% of those with ∑PG of <40mM and a negative family history developed diabetes. Therefore, it might be considered that among the overweight adults with IGT, those with ∑PG of ≥40 mM or a positive family history are diabetes prone and those with ∑PG of <40 mM and a negative family history are diabetes resistant.
    (Internal Medicine 31 : 877-884, 1992)
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  • Fumihiro YAMASAWA, Yasumasa OKADA, Kouichiro ASANO, Masaaki MORI, Hiro ...
    1992 Volume 31 Issue 7 Pages 885-892
    Published: 1992
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    The effect of intravenous recombinant human tissue-type plasminogen activator (tPA) on arterial blood gases was compared with the effect of heparin treatment in acute pulmonary thromboembolism. Fifteen patients received heparin alone (group A), 5 cases were treated with 7.7×106I.U. of tPA (group B) and 10 cases with 15×106I.U. of tPA (group C) combined with heparin treatment. Arterial oxygen tension before treatment was not significantly different among the three groups. PaO2 was dramatically improved on the 1st day in group C. By the 7th day, PaO2 of group B had improved to the level of group C. However, the PaO2 of group A on the 7th day was not significantly different compared to the pre-treatment value. In group C, post-treatment perfusion lung scintigrams were improved compared to the pre-treatment images, but this was not the case in group B. Treatment with tPA is more effective for acute pulmonary thromboembolism than heparin alone and a high dose of tPA (15×106I.U.) leads to rapid improvement in arterial blood gases and lung perfusion images.
    (Internal Medicine 31: 885-888, 1992)
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  • Tetsuro EMORI, Yoshihiro KURIYAMA, Satoshi IMAKITA, Tohru SAWADA
    1992 Volume 31 Issue 7 Pages 889-892
    Published: 1992
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 60-year-old man developed left hemiparesis and homolateral ataxia with normal sensation and normal somatosensory evoked potentials. A lacunar infarct with gadolinium enhancement in the right dorsolateral part of the thalamus was demonstrated on magnetic resonance imaging. Thalamic lesion is a relatively rare cause of ataxic hemiparesis ; most of the reported cases of ataxic hemiparesis caused by thalamic lesion were accompanied by sensory disturbances. This is an interesting case which suggested that the thalamic lesion could be responsible for the ataxic hemiparesis without a sensory disturbance.
    (Internal Medicine 31 : 889-892, 1992)
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  • Mayumi TAKAHASHI, Tsukasa EBE, Tomoo KOHARA, Masayoshi INAGAKI, Hirosh ...
    1992 Volume 31 Issue 7 Pages 893-898
    Published: 1992
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 55-year-old male presented with a recurrent fever of over 38°C, occurring at irregular intervals 1-6 times a month with chest, back or abdominal pain. After admission to our hospital, we found the following characteristics : 1) the febrile attacks were accompanied by obvious inflammatory findings and pleuritis or peritonitis ; 2) the patient's elder sister had a similar periodic fever ; and 3) there were no apparent causative factors responsible for his symptoms. Therefore, we diagnosed this as a case compatible with familial Mediterranean fever. The febrile attacks have been completely suppressed by daily colchicine. This is the seventh case of familial Mediterranean fever reported in Japan.
    (Internal Medicine 31 : 893-898, 1992)
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  • Takenori SAKAI, Toshikazu KATOH, Kouzou ASADA, Kan YAGI, Ryouichi YOSH ...
    1992 Volume 31 Issue 7 Pages 899-903
    Published: 1992
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A rare case of portal hepatic venous shunt (PHVS) via an intrahepatic portal vein aneurysm (PVA) is presented. A 66-year-old man was admitted for examination of a mass in the liver. Ultrasonography demonstrated a cystic lesion (15 mm in diameter) at the posterior superior segment of the right hepatic lobe which communicated with the right portal vein (RPV) and right hepatic vein (RHV). Superior mesenteric portography showed a biloculate aneurysm in RPV and PHVS. Color doppler ultrasonography indicated that flow in the tracts entered the aneurysmal cavity from RPV and drained into RHV.
    (Internal Medicine 31 : 899-903, 1992)
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  • Yoshifumi HIROOKA, Kazuya YUASA, Keiko HIBI, Atsuko ISHIKAWA, Gen SOBU ...
    1992 Volume 31 Issue 7 Pages 904-907
    Published: 1992
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 70-year-old woman with hyperparathyroidism associated with parkinsonism is reported. Her primary initial symptom was parkinsonism, but it was levodopa-resistant. Chemical and hormonal findings revealed that she had hyperparathyroidism. The symptoms were relieved after the surgical removal of a parathyroid adenoma. Although this type of case has been reported only rarely, it suggests that hypercalcemia might be an aggravating factor in levodopa-resistant parkinsonism.
    (Internal Medicine 31 : 904-907, 1992)
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  • Katsuya TANAKA, Akira SATO, Takeshi NAITO, Kimihiro KURAMOCHI, Hideo I ...
    1992 Volume 31 Issue 7 Pages 908-911
    Published: 1992
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    Noonan syndrome has been diagnosed by the characteristic physical stigmata for more than two decades. Recent studies of growth hormone secretory pattern provide a new category of growth hormone neurosecretory dysfunction to characterize short stature. We describe herein a case of growth hormone neurosecretory dysfunction in a 16-year-old boy with Noonan syndrome. Growth hormone neurosecretory dysfunction was diagnosed primarily based on the low amplitude and small numbers of the spontaneous bursts of growth hormone secretion during 12-hour nocturnal growth hormone sampling. Treatment with synthetic human growth hormone has markedly accelerated the growth velocity for one year and a half. This case notes the wide spectrum of short stature in Noonan syndrome and the effectiveness of treatment with human growth hormone.
    (Internal Medicine 31 : 908-911, 1992)
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  • Yutaka USUI, Hitoshi AIDA, Yuji KIMULA, Hirotaro MIURA, Shigemitsu TAK ...
    1992 Volume 31 Issue 7 Pages 912-916
    Published: 1992
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A case of hypersensitivity pneumonitis (HP) induced by hexamethylene diisocyanate (HDI) is described. Serial determinations of the lymphocyte surface phenotypes by two-color assay revealed the following : 1) increased activated cytotoxic T lymphocytes in the bronchoalveolar lavage fluid (BALF), and 2) increased percentage and absolute number of non-major histocompatibility complex (MHC)-restricted natural killer (NK) cells in the peripheral blood (PB) during the recovery phase of the disease. These findings were considered to be related to the activity of the disease.
    (Internal Medicine 31 : 912-916, 1992)
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  • Kazuo ISOBE, Toyoo NIWA, Mitsuru OHKUBO, Midori OHBA, Masahiko SHIKANO ...
    1992 Volume 31 Issue 7 Pages 917-921
    Published: 1992
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    The first case of Klinefelter's syndrome accompanied by diabetes insipidus and diabetes mellitus is reported. A 41-year-old man admitted for hyperosmolar diabetic coma with a past history of diabetes insipidus was diagnosed as having Klinefelter's syndrome by endocrinological examination and sex chromosome analysis. In this case, glucose tolerance test was normalized half a year later and blood glucose was well controlled with diet therapy alone.
    (Internal Medicine 31 : 917-921, 1992)
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  • Katsumi DEGUCHI, Tetsuya TSUKADA, Eiichi IWASAKI, Hideo WADA, Seiko MU ...
    1992 Volume 31 Issue 7 Pages 922-925
    Published: 1992
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    We report a 31-year-old female who had repeated thrombosis and was diagnosed as having congenital homozygous protein C deficiency based on decreased protein C antigen and activity, and the findings of family history. This patient had shown no symptom of thrombosis until the age of 27 years, when she had cerebral infarction as the first symptom. Low molecular weight heparin was useful for disseminated intravascular coagulation (DIC) that complicated protein C deficiency in this patient.
    (Internal Medicine 31 : 922-925, 1992)
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  • Yoko KONAGAYA, Masaaki KONAGAYA, Yukio MANO
    1992 Volume 31 Issue 7 Pages 926-929
    Published: 1992
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A young woman with slowly progressive muscular weakness and atrophy localized in both thighs is reported. Laboratory, electromyographic and histological findings suggested that the patient suffered from chronic myositis with a background of autoimmune disorder. Quadriceps myositis is a rare condition. The previously reported cases of this disease in the literature are reviewed.
    (Internal Medicine 31 : 926-929, 1992)
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  • Yuko YOSHITOMI, Shigeru KOHNO, Hironobu KOGA, Shigefumi MAESAKI, Yasuh ...
    1992 Volume 31 Issue 7 Pages 930-932
    Published: 1992
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 76-year-old man who was admitted to the hospital because of chronic renal insufficiency and chronic hepatitis died of Corynebacterium group JK pneumonia, after showing a slight improvement by treatment of Staphylococcus aureus with sulbactam/cefoperazone and minocycline. Transtracheal aspiration (TTA) just before his death revealed numerous gram-positive bacilli phagocytized by many neutrophils and more than 108 colony forming units (CFU)/ml of Corynebacterium group JK. A drug susceptibility test showed Corynebacterium group JK was resistant to many antibiotics, with the exception of vancomycin and amikacin.
    (Internal Medicine 31 : 930-932, 1992)
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  • Masataka TOMITA, Mitsugu HASEGAWA, Yasushi AKUTSU, Tsutomu OKUDAIRA
    1992 Volume 31 Issue 7 Pages 933-935
    Published: 1992
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 69-year-old woman was admitted because of dyspnea. Thereafter, she fell into a state of shock. Resuscitation was attempted but she did not respond to it and died on the second hospital day. According to the autopsy findings, a wide range of area from the larynx to the trachea was covered with pseudomembrane. In the culture of bacteria, alpha Streptococcus and Corynebacterium genus (non-diphtherial) were all that was detected. These findings suggest that pseudomembranous lesion, an endogenous foreign matter of the air passage should be suspected when a patient presents with sudden dyspnea.
    (Internal Medicine 31 : 933-935, 1992)
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  • Toshitaka KOBAYASHI, Yuji SATO, Yuichi HASEGAWA, Toshiro NAGASAWA, Yas ...
    1992 Volume 31 Issue 7 Pages 936-940
    Published: 1992
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 59-year-old female was admitted to Tsukuba University Hospital and diagnosed as IgA-λ multiple myeloma (stage IIIA). No cardiovascular disorder with the exception of minor ischemic changes in ECG was revealed before treatment. Recombinant human α-interferon (IFN) at a dose of 3 million units combined with melphalan and prednisolone was administrated. Sixteen hours after the first administration of IFN, IFN was suspended by the symptoms of congestive heart failure (CHF). Treatment with diuretics and catecholamine products showed almost complete recovery from CHF in 3 weeks. An adverse reaction to IFN was strongly suspected as the cause of CHF.
    (Internal Medicine 31 : 936-940, 1992)
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  • Toshio INADA, Tomofumi YANO, Satsuki SHIMA, Yasuhiro ISHIKAWA, Shoichi ...
    1992 Volume 31 Issue 7 Pages 941-945
    Published: 1992
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    The case of a 39-year-old man with inflammatory pseudotumor of the spleen is presented. This is an extremely rare benign lesion with histologic features of non-specific inflammatory and reparative changes. The literature is reviewed and this case is compared clinically and radiologically with the previously reported cases.
    (Internal Medicine 31 : 941-945, 1992)
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  • Akio KOYAMA, Katsuhisa SASOU, Haruhisa NAKAO, Asamitsu HIRANO, Hitoshi ...
    1992 Volume 31 Issue 7 Pages 946-950
    Published: 1992
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 47-year-old woman presented with hemoptysis and her chest X-ray films showed an opacity suggesting a mass in the left lower lung field. Based on radiographic investigations, the mass was diagnosed as an aneurysm develop in an anomalous vessel and was considered to be a Pryce type I pulmonary intralobar sequestration. Resection of the left lower lobes was performed and the aneurysm was found to be filled with thrombus. It is rare for an aneurysm to form in an aberrant vessel. This complication may have been the result of regional sclerosis affecting the anomalous artery as well as systemic atherosclerosis.
    (Internal Medicine 31 : 946-950, 1992)
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  • Yuji Morita, Seiya KATOH, Hideaki WATANABE, Hisao HARADA, Eiji UNO, Ma ...
    1992 Volume 31 Issue 7 Pages 951-954
    Published: 1992
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    We report a case of rheumatoid nodules of the lung seen in a patient with palindromic rheumatism. A 54-year-old man with palindromic rheumatism was admitted for evaluation of three nodules in the right upper lobe on chest roentgenogram. Wedge resection was performed for the purpose of confirmative diagnosis and treatment. Histology of these lung lesions revealed palisaded histiocytic cells surrounding a layer of central necrosis, which were considered to be characteristic findings of rheumatoid nodule. Such a case is extremely rare. To our knowledge, only one other case has been reported before in the literature.
    (Internal Medicine 31 : 951-954, 1992)
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  • Takashi HAYASAKA, Haruki SASAKI, Takashi SUGAWARA, Shin-ichi YASUURA, ...
    1992 Volume 31 Issue 7 Pages 955-959
    Published: 1992
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A patient with allergic granulomatous angiitis accompanied by increases in serum interleukin-2 receptor (IL-2R) and interferon-a (IFN-α) levels is reported. Laboratory findings revealed leukocytosis with eosinophilia and increased serum IgE and IgG. The serum IL-2R and IFN-α were increased. The serum immune complex, interferon-β, -γ and complements remained at normal levels. The serum IgE, IgG, IL-2R and IFN-α correlated with disease activity. Immunofluorescent studies using frozen sections obtained from the dermal lesion showed no immunoglobulin or complement deposits on vascular walls. Measurements of serum IL-2R and IFN-α might be considered reliable serologic indicators of disease activity.
    (Internal Medicine 31 : 955-959, 1992)
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