Internal Medicine
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Volume 32, Issue 4
Displaying 1-21 of 21 articles from this issue
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  • Gene Therapy
    Fumimaro TAKAKU
    1993 Volume 32 Issue 4 Pages 273
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.273
    JOURNAL FREE ACCESS
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  • Postoperative Pneumonia in Elderly Patients: Incidence and Mortality in Comparison with Younger Patients
    Kimikazu IWAMOTO, Satoshi ICHIYAMA, Kaoru SHIMOKATA, Nobuo NAKASHIMA
    1993 Volume 32 Issue 4 Pages 274-277
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.274
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    To determine whether elderly patients have an increased incidence of postoperative pneumonia and/or an increased mortality, we conducted a retrospective study of 4, 380 patients who underwent thoracic, abdominal or neurosurgery under general anesthesia. Thirty of these patients developed postoperative pneumonia (incidence, 0.68%). The elderly patients aged 65 years or older who underwent thoracic surgery had the highest incidence of pneumonia. Nine of the 30 patients with pneumonia died (mortality, 30%). Elderly patients did not show a higher mortality than the younger patients. The extent of pulmonary infiltrates on chest roentgenogram and the serum bilirubin level, both of which were determined at the onset of pneumonia, independently had a significant association with mortality. Our study suggests that advanced age is a risk factor for postoperative pneumoniain patients who undergo thoracic surgery.
    (Internal Medicine 32: 274-277, 1993)
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  • Lung Abscess: Analysis of 66 Cases from 1979 to 1991
    Takeshi MORI, Tsukasa EBE, Mayumi TAKAHASHI, Hiroshi ISONUMA, Hideo IK ...
    1993 Volume 32 Issue 4 Pages 278-284
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.278
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    Sixty-six patients with bacterial lung abscess were treated between 1979 and 1991 in our hospital. Among these patients, death occurred in one of the 42 cases of community-acquired infection (mortality rate: 2.4%) and in 16 of the 24 cases of nosocomial infection (mortality rate: 66.7%). Of all 66 cases, 55 were culture-positive, and the etiologic agents isolated from 24 of the culture-positive cases were found to be anaerobic bacteria. The most common aerobes isolated from the foci were identified as Staphylococcus aureus, Klebsiella spp. and Pseudomonas aeruginosa, while the most common anaerobes were Bacteroides spp., Peptostreptococcus, Fusobacterium spp., micro-aerophilic Streptococcus and Veillonella. The mortality was higher in the cases with P. aeruginosa, Klebsiella spp. and Candida spp. than in those with other bacteria. The prognosis of lung abscess patients proved to depend on the presence of underlying diseases and on superinfection with aerobes.
    (Internal Medicine 32: 278-284, 1993)
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  • Percutaneous Transluminal Coronary Angioplasty for Acute Myocardial Infarction
    Hidemasa KITAZUME, Toru IWAMA, Yoshio AGEISHI, Ichiro KUBO
    1993 Volume 32 Issue 4 Pages 285-290
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.285
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    Between 1986 and 1991, direct coronary angioplasty was attempted in 79 patients. The procedure was successful in 76 patients (96%), unsuccessful without complications in 2 patients, and major complications occurred in 1 patient (ventricular fibrillation and cardiogenic shock). Reperfusion was obtained from 1 to 7.5 hours (mean: 3.3 ± 1.3 hours) after the onset of chest pain. Amongthe 76 successfully dilated patients, there was one cardiac death and 68 had predischarge angiography (64 patent, 2 stenosed, and 2 occluded). Although only 33 of the 58 patients (57%) angiographically followed after discharge showed persistence of primary patency, 52 of the 57 (91%) followed further obtained final patency when angioplasty was repeated up to 4 times. These results indicate that direct angioplasty in the community hospital setting can achieve a high primary success rate and a low reocclusion rate.
    (Internal Medicine 32: 285-290, 1993)
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  • Shunt Nephritis: Efficacy of an Antibiotic Trial for Clinical Diagnosis
    Eisei NOIRI, Shoji KUWATA, Kazuo NOSAKA, Akihide NAKAO, Shigeo TANIGUC ...
    1993 Volume 32 Issue 4 Pages 291-294
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.291
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    Coagulase negative staphylococcus, a normal skin flora, is especially nosopoietic under shunt management, because coagulase negative staphylococcus sometimes forms a biofilm around itself at catheter tips in vivo, which shields the organism from the effects of antibiotics. But it is difficult to distinguish this pathogen from a possible confounding contamination of a blood culture. In this article, we report a case, and discuss how a patient with suspected shunt nephritis should be examined and treated. In addition, to further histological and prognostic interpretation, we review the previously reported cases of shunt nephritis in Japanese adults.
    (Internal Medicine 32: 291-294, 1993)
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  • Primary Embryonal Carcinoma of the Retroperitoneum
    Nobuyuki OHKUBO, Tohru OGIHARA, Toshihiro MIURA, Kenzo SOEJIMA, Shiger ...
    1993 Volume 32 Issue 4 Pages 295-297
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.295
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    A 32-year-old man with primary embryonal carcinoma of the retro peritoneum, a very rare condition, is reported. The disease took an acute course with rapid enlargement of cervical and inguinal lymph nodes, and high serum alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG) values were observed. His testes were, however, intact. Remarkable tumor regression was achieved by systemic combination chemotherapy with cisplatin, vin lastine, and bleomycin (PVB therapy). This chemotherapy is beneficial even in advanced cases. In the two years since therapy, no recurrence has been observed.
    (Internal Medicine 32: 295-297, 1993)
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  • Ulcerative Colitis in Female Siblings with an Identical Human Leukocyte Antigen Haplotype (A24, Bw52, DR52 and DQw1)
    Kazuo AMANO, Akira SEKO, Hiroshi SUGIYAMA, Toshiaki TAKAHASHI, Tadashi ...
    1993 Volume 32 Issue 4 Pages 298-301
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.298
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    Two female siblings with ulcerative colitis are reported. Both the 30-year-old elder sister and the 28-year-old younger sister developed bloody stools and diarrhea; ulcerative colitis was diagnosed by endoscopic and histologic examination of the colon. Their maternal aunt also suffered from the disease. Human leukocyte antigen analysis revealed an identical haplotype for the sisters (A24, Bw52, DR2 and DQw1), while the aunt had A24, Bw52 and DR2. The haplotypes of Japanese patients with familial ulcerative colitis are reviewed, and the role of human leukocyte antigens in this disease is discussed.
    (Internal Medicine 32: 298-301, 1993)
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  • Selective IgM Deficiency in a Patient with Hashimoto's Disease
    Shigeru KIMURA, Mari TANIGAWA, Yasumitsu NAKAHASHI, Mamoru INOUE, Yosh ...
    1993 Volume 32 Issue 4 Pages 302-307
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.302
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    A 70-year-old man with Hashimoto's disease had selective IgM deficiency, while other immunoglobulin levels were normal. In vitro mixing experiments were carried out in which B cells and T cells from the patient and from a healthy control donor were co-cultured in the presence of pokeweed mitogen, in order to investigate the etiology of IgM hypoproduction. The results indicated that the patient had B-cell dysfunction, involving the impairment of B-cell differentiation. In addition, both IgG of the healthy control donor and thyroid hormone may play important roles in the pathogenesis of this case.
    (Internal Medicine 32: 302-307, 1993)
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  • Fatal Angioedema Associated with Enalapril
    Yuichi OIKE, Yasuhiro OGATA, Daisuke HIGASHI, Toshiyuki MATSUMURA, Yui ...
    1993 Volume 32 Issue 4 Pages 308-310
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.308
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    A 37-year-old female with a history of hypertension for 5 years was brought to the emergency room with swelling of the tongue and neck after the second dose of enalapril. After administration of hydrocortisone by her physician, she went to the emergency room. Her dyspnea and dysarthria were relieved. However, she experienced recurrence of the symptoms followed by respiratory arrest. She suffered severe anoxic brain damage and died three days later. Although angioedema is a rare occurrence with the use of enalapril, it is potentially life threatening.
    (Internal Medicine 32: 308-310, 1993)
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  • Sclerosing Peritonitis Associated with Keratoconjunctivitis Sicca, Pleurisy, and Secretory Otitis Media
    Nobuaki ISHII, Mitsuro CHIBA, Masahiro IIZUKA, Osamu MASAMUNE, Masashi ...
    1993 Volume 32 Issue 4 Pages 311-315
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.311
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    A male case of sclerosing peritonitis of unknown cause, associated with keratoconjunctivitis sicca, pleurisy, and secretory otitis media, is presented. These unusual complications are very similar to the adverse reactions to the beta-adrenergic blocking agent, practolol, which is known to cause sclerosing peritonitis. This similarity suggests an etiological association between the sclerosing peritonitis of this case and that caused by practolol. The sclerosing peritonitis of this case may be considered to occur as part of some systemic disorder, and thus casts doubt on the hitherto accepted hypothesis that sclerosing peritonitis results from infectious peritonitis.
    (Internal Medicine 32: 311-315, 1993)
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  • Lactic Dehydrogenase Anomaly in a Patient with Chronic Renal Failure
    Toshiaki SHIBASAKI, Yoshihiko KAGUCHI, Iwao OHNO, Fumio ISHIMOTO, Osam ...
    1993 Volume 32 Issue 4 Pages 316-318
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.316
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    A 67-year-old man with chronic renal failure (CRF) was defined to have lactic dehydrogenase (LDH)-immunoglobulin A (IgA) complex, the so-called "LDH anomaly", in his serum and pleural effusion. He was found to have a pleural effusion on the right side during maintenance dialysis at a satellite hospital. A LDH-IgA complex was detected in the serum and pleural effusion by the method of current electrophoresis. The immunoglobulin class was found to be IgA (K) by counter immunoelectrophoresis. LDH anomaly is extremely rare in patients with CRF; the clinical significance of this substance in serum and pleural effusion remains unclarified.
    (Internal Medicine 32: 316−318, 1993)
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  • Progressive External Ophthalmoplegia and Myositis
    Hiroshi SUOH, Ko SAHASHI, Tohru IBI, Michinari TASHIRO, Fumiaki TANAKA ...
    1993 Volume 32 Issue 4 Pages 319-322
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.319
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    We reported a senile male patient with progressive external ophthalmoplegia (PEO) and myositis. The ophthalmoplegia was severe, but other neuromuscular features were nearly normal. Muscle enzymes in serum were moderately elevated. Autoimmune, endocrinological or malignant diseases were not observed during the previous 4 years. Pathology of non-weak limb muscles biopsied twice was consistent with active inflammatory myopathy. The ragged-red or cytochrome c oxidase-negative fibers, which are a hallmark of mitochondrial myopathy with PEO, were not increased in comparison with age-matched control muscles. Analysis of mitochondrial DNA in muscle by the Southern blot method did not reveal any deletions. It was concluded that the inflammatory myopathy, myositis clinically localized at the ocular muscles, is an important and distinct disorder in PEO.
    (Internal Medicine 32: 319-322, 1993)
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  • Silent Lupus Nephritis with Fingerprint Deposits
    Akihiro TOJO, Kenjiro KIMURA, Yasunobu HIRATA, Hiroaki MATSUOKA, Tsune ...
    1993 Volume 32 Issue 4 Pages 323-326
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.323
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    A 26-year old woman with diffuse active lupus nephritis showed no proteinuria. Electron microscopy revealed a typical fingerprint pattern in glomerular subendothelial electron dense deposits. Out of 21 renal biopsy cases of lupus nephritis, we found fingerprint deposits in 4 cases (19%) including the present case. All of the cases showed diffuse proliferative glomerulonephritis with overt proteinuria, except the present case. To our knowledge, the present case is the first reported case of active lupus nephritis, where fingerprint deposits were found, with normal urinalysis.
    (Internal Medicine 32: 323-326, 1993)
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  • Exacerbation of Ulcerative Colitis during Alpha-Interferon Therapy for Chronic Hepatitis C
    Akira MITORO, Masahide YOSHIKAWA, Kouji YAMAMOTO, Mayumi MIMURA, Yoshi ...
    1993 Volume 32 Issue 4 Pages 327-331
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.327
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    We report a 34-year-old man with chronic hepatitis C who showed exacerbation of ulcerative colitis during alpha-interferon (IFNα) therapy. Discontinuance of the IFNα therapy improved his symptoms, suggesting that IFNα administration might worsen ulcerative colitis. The administration of sulfasalazine allowed the patient to receive IFNα again without flare-up of ulcerative colitis. This case suggests the possible efficacy of sulfasalazine therapy in patients with ulcerative colitis complicated by some other diseases requiring IFNα administration.
    (Internal Medicine 32: 327-331, 1993)
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  • A Patient with Congenital Plasminogen Deficiency Manifesting Primary Pulmonary Hypertension
    Takashi OKAMURA, Yasuo TSUDA, Masahiro MURAKAWA, Kazuhiro MAKIZUMI, Ka ...
    1993 Volume 32 Issue 4 Pages 332-335
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.332
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    A 25-year-old Japanese man was diagnosed as having primary pulmonary hypertension, on the basis of the findings of cardiac catheterization and ventilation-perfusion scintiscans. The plasma level of plasminogen in this patient was found to be reduced to 43% by a functional assay and 61 mg/l by an antigenic assay. Based on the family study, the patient was considered to have a heterozygous congenital plasminogen deficiency. Accordingly, it is suggested that the defective fibrinolysis in this patient may have played an important role in the development of primary pulmonary hypertension through microthrombosis.
    (Internal Medicine 32: 332-335, 1993)
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  • Sleep Apnea and Palatal Myoclonus in a Patient with Neuro-Behçet Syndrome
    Nobuo SAKURAI, Yasuo KOIKE, Yoshiki KANEOKE, Takeshi YASUDA, Akira TAK ...
    1993 Volume 32 Issue 4 Pages 336-339
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.336
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    A 50-year-old man with neuro-Behçet syndrome showed truncal imbalance, dementia, palatal myoclonus, snoring and rhythmic inspiration synchronized with palatal myoclonus. Magnetic resonance imaging showed hypertrophy of the bilateral inferior olivary nuclei with slight pontine atrophy. A polysomnographic recording disclosed sleep apnea during non-REM sleep: 6% central type, 46% mixed type, and 48% obstructive type. We speculate that lesions of the respiratory center or related structures in the brainstem resulted in sleep apnea and that laryngeal myoclonus also affected the apnea.
    (Internal Medicine 32: 336-339, 1993)
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  • Aseptic Localized Peritonitis in a Patient with Chemical Meningitis Associated with Craniopharyngioma Cysts
    Tetsuo MAEDA, Tsutomu KAZUMI, Kazuhiko HOTTA, Yoshihiko ISHIDA, Muneyo ...
    1993 Volume 32 Issue 4 Pages 340-342
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.340
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    We report a rare case of a young woman with cystic craniopharyngioma who developed not only aseptic chemical meningitis as an initial sign but also aseptic localized peritonitis which was confirmed by the presence of ascites.
    (Internal Medicine 32: 340-342, 1993)
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  • Increased Serum Level of Interleukin-5 in a Patient with Episodic Angioedema and Eosinophilia Syndrome
    Tsuzuku MURAKAMI, Junji KATO, Katsuhisa KOGAWA, Naoki WATANABE, Sumio ...
    1993 Volume 32 Issue 4 Pages 343-345
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.343
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    A case of episodic angioedema and eosinophilia syndrome is reported. An 18-year-old male suffered from monthly episodes of angioedema, pruritic papules, weight gain, and fever for twelve years. During the episodes, peripheral eosinophils and serum levels of interleukin (IL)-5, an eosinophil proliferating cytokine were elevated. Extensive evaluations disclosed neither visceral involvement nor evidence of parasitic infections, collagen diseases, or neoplastic disorders. Corticosteroid treatment brought about a dramatic clinical improvement concomitant with decrement of eosinophils and serum IL-5 was observed. These observations suggest that IL-5 may be a causative factor for this pathological state.
    (Internal Medicine 32: 343-345, 1993)
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  • Right Ventricular Inflow Obstruction due to Giant Hematoma Formed by Chronic Constrictive Pericarditis
    Mitsuaki ISOBE, Kazuhide YAMAOKI, Takao SUGIYAMA, Yoshinori SEKO, Masa ...
    1993 Volume 32 Issue 4 Pages 346-349
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.346
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    A 26-year-old man having chronic constrictive pericarditis with rare complications is described. Right ventricular inflow obstruction was caused by an intracavity giant mass which was surrounded by thick calcified pericardium. The mass consisted of old bloody fluid with some calcified tissue. The findings of auscultation closely mimicked those of tricuspid valvular stenosis.
    (Internal Medicine 32: 346-349, 1993)
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  • Treatment of Ulcerative Colitis with Camostat Mesilate, A Serine Protease Inhibitor
    Shigeru SENDA, Yoshihide FUJIYAMA, Tadao BAMBA, Shiro HOSODA
    1993 Volume 32 Issue 4 Pages 350-354
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.350
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    We were able to induce and maintain remission with camostat mesilate, a serine protease inhibitor, in two patients with ulcerative colitis, to whom salicylazosulfapyridine could not be administered due to previous side effects. The enzymatic activity of proteases from granulocyte, pancreatic juice and bacteria is possibly harmful to the inflammed colonic mucosa. Camostat mesilate can be expected to have an anti-inflammatory effect on the damaged mucosa of inflammatory bowel disease.
    (Internal Medicine 32: 350-354, 1993)
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  • Imported Plasmodium malariae Malaria
    Toshimasa NISHIYAMA, Tsuneji ARAKI, Hiroyuki AMANO, Hiroyuki OKAYAMA, ...
    1993 Volume 32 Issue 4 Pages 355
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.355
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