Internal Medicine
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Print ISSN : 0918-2918
ISSN-L : 0918-2918
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Volume 32, Issue 6
Displaying 1-20 of 20 articles from this issue
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  • The Prognosis of Idiopathic Portal Hypertension in Japan
    Shouji ICHIMURA, Ryuichiro SASAKI, Yousuke TAKEMURA, Hirotoshi IWATA, ...
    1993 Volume 32 Issue 6 Pages 441-444
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.441
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    To clarify the factors relating to the prognosis of patients with idiopathic portal hypertension (IPH), we followed 171 patients with IPH until the end of 1990, who were registered in the database among those with abnormal portal circulation as of 1985 in hospitals of Japan. During the followup period, twenty patients died; 6 from gastro-intestinal tract bleeding, 5 from hepatic insufficiency and 9 from other causes. Cox's proportional hazard model suggested that male patients (hazard ratio 4.85, 95% confidence interval 1.82-12.94), with a disease onset at less than 40 years of age (H.R. 3.94, 95% C.I. 1.31-11.57), and/or with varices (H.R. 2.86, 95 % C.I. 1.05-7.77) generally had poorer prognoses.
    (Internal Medicine 32: 441-444, 1993)
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  • Distribution of Mesenteric and Splenic Blood Flow in Cirrhosis of the Liver as Estimated by Radionuclide Angiography
    Noriyuki HAMATO, Fuminori MORIYASU, Hitoshi SOMEDA, Motoshige NABESHIM ...
    1993 Volume 32 Issue 6 Pages 445-448
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.445
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    ±We used radionuclide angiography following an injection of 185 MBq Tc-99m tin colloid as a non-invasive method for measuring the mesenteric and portal components of the total hepatic circulation, according to the method of Fleming et al (J Nucl Med 24; 1983). Fifty-seven patients with cirrhosis and 33 controls were examined. The relative mesenteric flow (MF) and the relative portal flow (PF) were 68.6 ± 8.5% and 78.6 ± 5.9%, respectively, in the control group. These values were 42.0 ± 16.4% and 70.9 ± 8.9%, respectively in the cirrhosis group, and were significantly lower than in the controls. In the cirrhosis group, the reduction in PF was small, while that in MF was large. Consequently, we found that portal blood flow was relatively well maintained in the cirrhosis patients, while the contribution of splanchnic blood flow to the portal flow was relatively reduced.
    (Internal Medicine 32: 445-448, 1993)
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  • A HTLV-I Carrier Who Showed Various Symptoms and Antibodies of Autoimmune Diseases
    Masao MIZUKI, Shinichi TAGAWA, Masaru SHIBANO, Yuji OKAMOTO, Junzo NOJ ...
    1993 Volume 32 Issue 6 Pages 449-454
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.449
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    We report a 37-year-old female HTLV-I carrier with complicating primary biliary cirrhosis (PBC) and mixed connective tissue disease (MCTD). Serum anti-HTLV-I antibody titer was ×256. Flower cells (4.5%) were found in the peripheral blood. Southern blot analysis showed no clonal integration in peripheral blood lymphocyte (PBL) DNA. Polymerase chain reaction showed the HTLV-I genome in PBLDNA. As cholestatic liver dysfunction and serum titer of anti-mitochondrial antibody were found, a clinical diagnosis of PBC was made. This patient later developed MCTD. These diseases responded well to prednisone. The pathogenetic relationship of HTLV-I infection with various autoimmune diseases is discussed.
    (Internal Medicine 32: 449-454, 1993)
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  • Circulating Abnormal Cells Detected in a Patient with Immunoblastic Lymphadenopathy
    Taijiro ISHIYAMA, Kazuyuki WATANABE, Yoshihisa AKIMOTO, Hideyuki UENO, ...
    1993 Volume 32 Issue 6 Pages 455-458
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.455
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    An unusual case of immunoblastic lymphadenopathy (IBL) with circulating CD3-CD4+ cells is reported. A lymph node biopsy specimen showed the characteristic features of IBL. Two-color analyses demonstrated that the circulating abnormal cells were CD3-, CD4+, HLA-DR+, and CD25-. Chromosomal analysis revealed unrelated clones in the lymph node. Though 48% of the peripheral blood lymphocytes were abnormal, no clonal rearrangement of the TcR β chain gene was detected in the peripheral blood. This case might point out the possibility that some cases of IBL truly had no TcR gene rearrangement and were dysplasias.
    (Internal Medicine 32: 455-458, 1993)
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  • Deterioration of Congestive Heart Failure after Converting to VOO Mode from DDD Mode in a Dilated Cardiomyopathy Patient; Importance of Atrial Contribution
    Kanji IGA, Kenjiro HORI, Tadashi MATSUMURA, Hiromitsu GEN
    1993 Volume 32 Issue 6 Pages 459-461
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.459
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    We describe a 62-year-old dilated cardiomyopathy patient in whom congestive heart failure progressed shortly after DDD mode was changed to VOO mode because of battery exhaustion. Emergency battery exchange with restoration of DDD mode improved his functional status to the previous level; pulmonary capillary wedge pressure decreased from 28 to 24 mmHg and cardiac output increased from 1.5 to 2.0 L/min associated with widening of the aortic pulse pressure. Maintenance of atrial contraction is therefore important even if left ventricular systolic function is markedly impaired and left ventricular end-diastolic pressure is increased.
    (Internal Medicine 32: 459-461, 1993)
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  • Pevalence of Gastroesophageal Varices Supplied by Intrahepatic Portal Branch
    Tadashi IWAO, Atsushi TOYONAGA, Motoaki KIM, Michihiro SUMINO, Motoki ...
    1993 Volume 32 Issue 6 Pages 462-464
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.462
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    The contribution of the intrahepatic portal branch to the gastroesophageal varices is rare. This anomalous pathway (a large left intrahepatic portal branch) was proved by portographic study and by imaging techniques in a 54-year-old man with cirrhosis. The overall prevalence of this type of collateral in the literature is only 1.9 %in 908 patients with portal hypertension. In addition, all are via the left portal venous branch. It may be speculated that the mechanism of this variation is due to dilatation of the rest of the intrahepatic portal system via a small anastomosis due to portal hypertension.
    (Internal Medicine 32: 462-464, 1993)
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  • Chromosomal Translocation t(13;16) in a Patient with Idiopathic Hypogonadotropic Hypogonadism
    Ikuo KIKUCHI, Motohisa NAGAMINE, Akira UEDA, Kenroh MIHARA, Masashi SE ...
    1993 Volume 32 Issue 6 Pages 465-467
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.465
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    A patient with idiopathic hypogonadotropic hypogonadism (IHH) had an apparently balanced reciprocal translocation involving chromosomes 13 and 16 [t(13;16)(ql4.11;q24)]. The patient's father has the same chromosomal translocation with no apparent physical abnormalities. The role of the chromosomal translocation in this patient is discussed.
    (Internal Medicine 32:465-467, 1993)
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  • Direct Identification of Lung Cancer Cells Producing Granulocyte Colony Stimulating Factor with Monoclonal Anti-G-CSF Antibodies
    Akira NAGATOMO, Hitomi OOIKE, Akiko HARADA, Takayuki SASAKI, Tetsuya H ...
    1993 Volume 32 Issue 6 Pages 468-471
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.468
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    This is a case report of an 82-year-old man with squamous cell lung cancer which produced GCSF. The leukocyte cell count was elevated to 94, 400/mm3. The serum G-CSF concentration was also elevated to 351 pg/ml. This is the first report to demonstrate, by application of immunohistochemical staining techniques directly to tumor tissue obtained at autopsy, squamous carcinoma cells which produce G-CSF. The tumor cells were stained with monoclonal anti-G-CSF antibodies.
    (Internal Medicine 32: 468-471, 1993)
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  • Splenic Lymphoma with Villous Lymphocytes with CD5+, CDllc+ B-Cell Phenotype
    Shuichi MIYAWAKI, Takashi MACHII, Hisami HIRABAYASHI, Toru SAKURA, Hir ...
    1993 Volume 32 Issue 6 Pages 472-475
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.472
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    A 64-year-old male suffered from splenomegaly without lymphadenopathy. His WBC count on admission was 6.1×l09/l with 55% abnormal lymphocytes. No monoclonal gammopathy was detected. Abnormal cells shown in films usually had relatively abundant cytoplasm with serrated edges. Under phase-contrast microscopy, the cells displayed short, needle-like processes. The immunophenotype of peripheral blood mononuclear cells were CD19+, CD20+, CDllc+, FMC7+, CD5+, CD10-, CD25- and SIg+. The spleen histology showed a distinctive pattern of white pulp infiltration by abnormal lymphocytes with features of plasma cell differentiation. These findings were compatible with the features of splenic lymphoma with villous lymphocytes.
    (Internal Medicine 32: 472-475, 1993)
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  • Diffuse Cerebrospinal Gliomatosis Mimicking Amyotrophic Lateral Sclerosis
    Kazushi MATSUSHIMA, Hiroki KOCHA, Ryo WATANABE, Masao HONDA, Nobuo NAK ...
    1993 Volume 32 Issue 6 Pages 476-479
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.476
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    We present a case in which the clinical manifestations mimicked amyotrophic lateral sclerosis (ALS) and the pathological findings showed diffuse cerebrospinal gliomatosis. Diffuse cerebrospinal gliomatosis may be disguised as ALS when it predominantly involves the spinal cord and brain stem, and may not be easily differentiated from ALS. Therefore, diffuse cerebrospinal gliomatosis should be taken into consideration in the differential diagnosis of ALS.
    (Internal Medicine 32: 476-479, 1993)
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  • Primary Pulmonary B-Cell Lymphoma Diagnosed by κ-λ, Imaging of Broncho-Alveolar Lavage Fluid Lymphocytes
    Yoshio NEHASHI, Masaru NAKANO, Kenta UTSUMI, Yuichi ICHINOSE, Keisuke ...
    1993 Volume 32 Issue 6 Pages 480-483
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.480
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    A 69-year-old woman was examined due to abnormal pulmonary shadows on her chest roentgenogram. Although small lymphocyte proliferation was revealed in specimens by transbronchial lung biopsy (TBLB), immunoglobulin light chain restriction could not be seen. We attempted to verify the B-cell clonality by broncho-alveolar lavage (BAL) and a new sensitive method called κ-λ imaging (KLI), which was available for the detection of monoclonal B cells. Therefore, B-cell monoclonality was found. Thus, the patient was diagnosed as having primary pulmonary lymphoma (PPL). PPL may be differentiated from benign lymphoproliferative disorders such as pseudolymphoma and lymphocytic interstitial pneumonia by KLI of BAL-derived lymphocytes.
    (Internal Medicine 32: 480-483, 1993)
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  • Increased RAHA Titer and Interleukin-6 Levels in the Synovial Fluid in a Patient with Polymyalgia Rheumatica
    Akiko ZEN-NYOJI, Hiroyuki SHIMIZU, Ken-ichi OHTANI, Kouichi OSHIMOTO, ...
    1993 Volume 32 Issue 6 Pages 484-486
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.484
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    We report a patient with polymyalgia rheumatica (PMR) accompanied by an increased Rheumatoid Arthritis Hemagglutinin Test (RAHA) titer and interleukin-6 level in the synovial fluid. A 60-year-old female was admitted because of polymyalgia, a body temperature of 39.2°C, and an erythrocyte sedimentation rate increased to 94 mm/h. Since a muscle biopsy failed to show a specific finding, she was diagnosed as PMR.The titer of RAHA and the interleukin-6 level were increased only in the synovial fluid; prednisolone treatment decreased both. The present case raised the possibility that a similar mechanism in rheumatoid arthritis may involve the development of synovitis in PMR.
    (Internal Medicine 32: 484-486, 1993)
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  • Polymyositis-Dermatomyositis and Non-Hodgkin's Lymphoma
    Takao ENDO, Naomi KAWAGUCHI, Masaaki YASHIMA, Hiromu TEI, Hirokazu HAY ...
    1993 Volume 32 Issue 6 Pages 487-489
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.487
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    An association between polymyositis-dermatomyositis (PM/DM) and malignancy has been reported. However, controversy exists regarding a direct causal relationship between the two diseases. We describe a patient who had had PM and subsequently developed non-Hodgkin's lymphoma, and discuss the possibility of their causal relation.
    (Internal Medicine 32: 487-489, 1993)
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  • Alcoholic Hypertriglyceridemia with Decreased Activity of Lipoprotein Lipase and Hepatic Triglyceride Lipase
    Yoichi HIASA, Kimio NAKANSHI, Kouji TADA, Yuji MIZUKAMI, Kouichi AKAMA ...
    1993 Volume 32 Issue 6 Pages 490-493
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.490
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    A 35-year-old male with alcoholic hypertriglyceridemia due to decreased lipoprotein lipase (LPL) and hepatic triglyceride lipase (HTGL) activities is reported. The patient had been drinking about 180 ml of whiskey (equivalent to 80 g of 100% ethanol) every day for the last 17 years, and the highest levels of serum triglyceride (TG) and cholesterol were 5, 120 mg/dl and 506 mg/dl, respectively. Serum TG level returned to normal levels after complete alcohol abstinence. Further intake of ethanol resulted in an increase in serum TG to 326 mg/dl with a concomitant decrease in the serum levels of LPLand HTGL activities.
    (Internal Medicine 32: 490-493, 1993)
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  • Squamous Cell Carcinoma Showing Lobar Consolidation without Collapse
    Yoshinori OHTSUKA, Makoto YAMAMOTO, Aya YOSHIOKA, Shosaku ABE, Yoshika ...
    1993 Volume 32 Issue 6 Pages 494-497
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.494
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    Most squamous cell carcinoma of the lung arises in the large bronchi and causes bronchial obstruction. We report a 74-year-old man with a squamous cell carcinoma of the lung whose roentgenogram revealed a lobar consolidation without collapse. A postmortem examination showed that the tumor cells filled the alveolar spaces completely without destroying the original architecture of the lung. The finding that tumor cells replacing alveolar epithelium, as in bronchioloalveolar cell carcinoma, was not seen throughout the lung. Airway obstruction by the tumor was not observed at any bronchus. These pathological findings seemed to explain the radiological findings.
    (Internal Medicine 32: 494-497, 1993)
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  • Hepatic Cirrhosis Showing False-Positive Serum C-Reactive Protein Reaction
    Megumi SATO, Motonobu SUGIMOTO, Shunji NANBA, Noriko KASATORI, Tsutomu ...
    1993 Volume 32 Issue 6 Pages 498-501
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.498
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    A 58-year-old male who had been diagnosed as hepatic cirrhosis four years previously was admitted to our hospital because his serum C-reactive protein (CRP) level had gradually risen, reaching 139 mg/dl. No inflammation findings were observed subjectively or objectively. Close examination revealed his CRP reaction to be false positive. His serum CRP showed positive only in a latex agglutination method using goat anti-CRP IgG. This false-positive reaction was thought to be owing to the abnormally glycosylated IgM, which has an affinity for the goat serum IgG.
    (Internal Medicine 32: 498-501, 1993)
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  • Non-Hodgkin's Malignant Lymphoma of the Bone with Intracavitary Cardiac Involvement
    Hiroshi SATO, Motoi TAKAHASHI
    1993 Volume 32 Issue 6 Pages 502-507
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.502
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    An 84-year-old man with non-Hodgkin's malignant lymphoma presented with a pathological fracture of the femur and also an intra-atrial mass on echocardiography. The patient was given palliative low-dose chemotherapy, but died of tumor dissemination, hypercalcemia, and dehydration. Autopsy revealed diffuse large B-cell lymphoma involving multiple bones and lymph nodes (the latter were not detected during staging), and a solitary mass on the posterior wall of the right atrium. This rare lesion appeared to be due to hematogenouss pread, since the myocardium and pericardium were free of tumor infiltration. A literature review indicated that the frequency of cardiac involvement differed between contemporary and earlier reports, mainly due to the availability of increasingly sophisticated diagnostic methods and improvements in chemotherapy.
    (Internal Medicine 32: 502-507, 1993)
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  • Rheumatoid Arthritis in a Patient with Pseudoxanthoma Elasticum
    Minoru SATOH, Masashi AKIZUKI, Nobuaki HAMA, Hideto AKAMA, Yasutsugu M ...
    1993 Volume 32 Issue 6 Pages 508-509
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.508
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    Pseudoxanthoma elasticum (PXE) is a rare, inherited disorder of the connective tissue. Possible association of autoimmune thyroiditis and PXE has been suggested, but reports of other autoimmune diseases complicating PXE are rare. We report a case of rheumatoid arthritis (RA) in a patient with PXE. Since the frequency of PXE is likely to be underdiagnosed, further studies to elucidate the true incidence and significance of the association of RA and PXE will be needed.
    (Internal Medicine 32: 508-509, 1993)
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  • Hypertrophic Cranial Pachymeningitis Associated with Mixed Connective Tissue Disease; A Comparison with diopathic and Infectious Pachymeningitis
    Mika FUJIMOTO, Jun-ichi KIRA, Hiroyuki MURAI, Takeo YOSHIMURA, Katsumi ...
    1993 Volume 32 Issue 6 Pages 510-512
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.510
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    This is the first report describing hypertrophic cranial pachymeningitis which developed in association with mixed connective tissue disease (MCTD).A 56-year-old man with a two-year history of MCTDgradually developed symptoms of headache and blurred vision. Bilateral papilledema and increased opening pressure and mild pleocytosis of the cerebrospinal fluid were noted. Magnetic resonance imaging of the brain revealed a diffuse thickening and a gadoliniumenhancement of the cranial dura mater. While five previous patients, diagnosed as idiopathic or infectious hypertrophic cranial pachymeningitis in our department, had either otitis media or sinusitis and showed multiple cranial nerve involvement, the present patient had neither otitis media nor sinusitis and did not show any cranial nerve involvement other than papilledema.
    (Internal Medicine 32: 510-512, 1993)
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  • Disseminated Intravascular Coagulation in a Patient with Systemic Lupus Erythematosus with Lupus Anticoagulant
    Mitsuhiko TANAKA, Shigeto KOBAYASHI, Naoto TAMURA, Hiroshi HASHIMOTO, ...
    1993 Volume 32 Issue 6 Pages 513-517
    Published: 1993
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.32.513
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    A 19-year-old female patient with systemic lupus erythematosus (SLE) who had lupus anticoagulant (LA) and concurrently developed disseminated intravascular coagulation (DIC) during an exacerbation of "central nervous system (CNS) lupus". Since no other indications or causes for DIC could be demonstrated, she was treated with prednisolone and anticoagulants, which rapidly alleviated her DIC condition as well as "CNS lupus". Although abnormalities of coagulation are frequently reported in SLE patients, DIC rarely occurs in patients with SLE without associated complications. A review of the pathogenesis of DIC in patients with SLE is discussed.
    (Internal Medicine 32: 513-517, 1993)
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