Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
Volume 33 , Issue 3
Showing 1-15 articles out of 15 articles from the selected issue
  • Miyuki NAITOH, Kiyoshi ANDOH, Hiroto SADAKATA, Hiroshi TANAKA, Norio K ...
    1994 Volume 33 Issue 3 Pages 131-135
    Published: 1994
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    In 43 patients with leukemia, we determined the increase of tissue factor (TF) activity production by leukemic cells that was induced by incubation with endotoxin at the time of admission. Definite disseminated intravascular coagulation (DIC) developed in 8 patients on admission (Group III) and in 8 patients just after the initiation of treatment (Group II), but not in the remaining 27 patients (Group I). TF activity before incubation (TF1) was 0.70 U/108 cells or more in 6 patients of Group III, while it was less in all the patients of Group II and 25 of the 27 patients of Group I. On the other hand, TF activity after incubation with endotoxin (TF2) increased to more than 1.11 U/108 cells in all the patients of Groups II and III, while it remained less in all the patients of Group I. These results suggest that the leukemic cells in Group II might not have expressed sufficient TF activity to cause DIC until chemotherapy was begun, and that 1.11 U/108 cells or more of TF2 might strongly indicate the development of DIC during treatment for leukemia.
    (Internal Medicine 33: 131-135, 1994)
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  • Yasutaka TAJIMA, Sanae HOMMA, Kazunori SINPO, Yasunori MARUO, Fumio MO ...
    1994 Volume 33 Issue 3 Pages 136-141
    Published: 1994
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    We examined 21 cases of Neuro-Behçet's syndrome in detail, and present here their clinicoradiological characteristics. Clinically, signs of pyramidal tract and meningeal irritation were frequently observed. In contrast to previous reports, our study demonstrated a near equal frequency in the occurrence of focal cerebral lesions and that of focal brain stem lesions. Notably, our results showed that the atrophy of both the cerebrum and the brain stem was often observed, indicating the presence of continuous disease activity in the central nervous system (CNS). In accordance with the high frequency of meningeal irritation signs, all of our cases exhibited pleocytosis in the cerebrospinal fluid (CSF). These results indicated the possibility that chemical mediators secreted from infiltrating cells in the CSF may somehow inflict damage to the CNS in Neuro-Behçet's syndrome.
    (Internal Medicine 33: 136-141, 1994)
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  • Hiroyuki KATO, Hideyuki WAKASUGI, Masaki YOKOTA, Masayuki FURUKAWA, To ...
    1994 Volume 33 Issue 3 Pages 142-146
    Published: 1994
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    Because it is difficult to diagnose at an early stage, pancreatic carcinoma is usually well advanced by the time it is diagnosed. The combined use of intraoperative radiotherapy, gastrointestinal and/or biliary tract bypass operation, celiac plexus nerve block, and chemotherapy is widely applied in treatment, with favorable results reported in some patients with advanced disease. To evaluate the efficacy of chemotherapy in such combinations, we compared the effect of 5-fluorouracil, its analogues, and mitomycin C on the survival of patients with advanced stage pancreatic cancer. We found no significant difference between the patients treated or not treated with these drugs. Clearly, there is a need for new agents having greater efficacy against pancreatic carcinoma.
    (Internal Medicine 33:142-146, 1994)
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  • Miyuki KATAI, Toru AIZAWA, Noriko OHARA, Kunihide HIRAMATSU, Kiyoshi H ...
    1994 Volume 33 Issue 3 Pages 147-149
    Published: 1994
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 67-year-old man with thrombocytopenia, and amegakaryocytic but otherwise normal bone marrow, was evaluated. Antibody against thrombocytes was negative and the half-life of thrombocytes was normal. In vitro clonal culture of the patient's bone marrow cells yielded no megakaryocyte colony with normal granulocyte-macrophage and erythroid colony formation. Megakaryocyte colony formation of the control bone marrow cells was significantly suppressed by the addition of the patient's serum to the culture, suggesting the existence of humoral inhibitory factor(s) for megakaryocyte colony formation. Therapeutic trials with plasma exchange, cyclosporine, prednisolone, and cyclosporine plus prednisolone were all unsuccessful, but serious bleeding has been absent.
    (Internal Medicine 33:147-149, 1994)
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  • Toru YAMAGUCHI, Hiromi ABE, Toshimitsu MATSUI, Hidesuke KAJI, Masaaki ...
    1994 Volume 33 Issue 3 Pages 150-154
    Published: 1994
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    We describe here a unique case of lymphocytic hypophysitis accompanied by pustulosis palmaris et plantaris and eosinophilia. The patient also suffered from panhypopituitarism with hyperprolactinemia and pituitary diabetes insipidus caused by lymphocytic hypophysitis. Complications of pustulosis palmaris et plantaris and eosinophilia with lymphocytic hypophysitis have not been reported previously. In the present case, the activities of the three diseases correlated well throughout the patient's course, suggesting that a common mechanism might possibly participate in their pathogenesis.
    (Internal Medicine 33:150-154, 1994)
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  • Tatsuyuki MORI, Kazunori NAKASE, Kota TSUJI, Syozaburo NAOAYA, Takeshi ...
    1994 Volume 33 Issue 3 Pages 155-157
    Published: 1994
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    Human T-cell leukemia virus type 1 (HTLV-1) infection is considered to contribute to the risk of malignancies other than adult T-cell leukemia. We report a 64-year-old male HTLV-1 carrier who developed quadruple malignancies such as cancer of the urinary bladder, skin, larynx and liver.
    (Internal Medicine 33:155-157, 1994)
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  • Shinichiro NAGAMITSU, Sayuri OKABAYASHI, Shunichi DAI, Yousuke MORIMIT ...
    1994 Volume 33 Issue 3 Pages 158-162
    Published: 1994
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    This 21-year-old male with hemophilia A developed cytomegalovirus (CMV) retinitis associated with acquired immunodeficiency syndrome (AIDS). He had a history of numerous blood transfusions. Serum antibody titers became positive for human immunodeficiency virus (HIV), when the patient was 18 years of age. Three years later, he developed CMV retinitis due to his immunosuppression. Ganciclovir (DENOSINE®, TAN ABE SEIYAKU CO., LTD., Osaka, Japan) therapy given for 4 weeks produced a marked improvement in the ocular fundal findings, but the neurologic signs and symptoms, including headache, hypoesthesia, disorientation, and dementia became worse. T2-weighted magnetic resonance imaging (MRI) demonstrated a diffuse high intensity area in the periventricular white matter and small focal or patchy lesions in the hippocampus, basal ganglia, midbrain, medulla oblongata and the nucleus dentatus. The patient died of HIV encephalopathy and CMV infection. Characteristic CMV intranuclear inclusion bodies were observed histologically in most sites of the brain including the hippocampus, white matter, basal ganglia, midbrain, medulla oblongata, nucleus dentatus and the retina. Infiltration by monocyte-macrophage and multinucleated giant cells, which are characteristic of HIV encephalopathy, were observed in the periventricular white matter and the hippocampus. In this patient, the neuroimaging findings were compatible with the neuropathologic observations. MR imaging proved useful in detecting the central nervous system (CNS) lesions of AIDS and CMV infection.
    (Internal Medicine 33:158-162, 1994)
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  • Keita KAMIKUBO, Rieko TAKAMI, Tetsuya SUWA, Akihiko SUGIYAMA, Nagatosh ...
    1994 Volume 33 Issue 3 Pages 163-164
    Published: 1994
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    An 80-year-old woman with diabetes mellitus was treated with gliclazide. Prior to the gliclazide administration, her urinary excretion of albumin, serum urea nitrogen and serum creatinine were normal. After the medication, oliguria, edema and azotemia developed. On the twenty-fourth day when the edema was severe and generalized, gliclazide administration was terminated. On the following day urinary volume increased suddenly (5, 740 ml/day). Polyuria persisted for five days. Edema improved and urea nitrogen and creatinine were normalized thereafter. Though the mechanism is not known, the clinical course suggests that gliclazide is the principal causative factor in the water retention and azotemia in this patient.
    (Internal Medicine 33: 163-164, 1994)
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  • Jiro MASUGI, Masahide IWAI, Sachiko KIMURA, Fukashi OCHI, Kotaro SUZUK ...
    1994 Volume 33 Issue 3 Pages 165-166
    Published: 1994
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    Ascorbic acid, reported in 1988 to be effective for idiopathic thrombocytopenic purpura (ITP), is an attractive drug because of its lack of toxicity. Further studies are necessary in order to improve its effectiveness without increasing secondary effects. We present a chronic ITP patient treated with a combination of ascorbic acid and methylprednisolone pulse (MP) therapy who was previously treated with MP therapy alone. The effect of this combination therapy seems to be better than MP therapy alone. This therapy is worth further examination as another therapeutic choice due to its fewer secondary effects than the usual regimen of corticosteroids, splenectomy, and other immunosuppressive drugs.
    (Internal Medicine 33: 165-166, 1994)
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  • Yuji SHIMIZU, Satoshi TSUCHIYA, Satoru WATANABE, Ryusei SAITOH
    1994 Volume 33 Issue 3 Pages 167-171
    Published: 1994
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 53-year-old male with von Recklinghausen's disease, diagnosed to have metastatic large cell carcinoma in the left supraclavicular lymph node, was admitted for radiotherapy. No other primary lesions were found. Emphysematous bullae in both upper lung fields were seen on chest roentgenograph, and the leucocyte count and G-CSF level were extremely elevated. Later, when metastases appeared, systemic chemotherapy was supplemented, but in vain. An autopsy showed large cell carcinoma of the lung derived from the wall of emphysematous bullae in left lung along with multiple metastases. The presence of von Recklinghausen's disease, emphysematous bullae and lung cancer together are noteworthy.
    (Internal Medicine 33:167-171, 1994)
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  • Katsuyoshi TOJO, Makoto OOTA, Hidehiko HONDA, Toshiaki SHIBASAKI, Osam ...
    1994 Volume 33 Issue 3 Pages 172-176
    Published: 1994
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    Endocrinological evaluations of a 48-year-old man with Fabry disease revealed low levels of serum thyroid hormones and high levels of serum thyrotropin (TSH), indicating that the patient had primary hypothyroidism. Also, an exaggerated growth hormone (GH) response to hypoglycemic stimuli was observed. Thin layer chromatography of the lipid extract of the thyroid gland obtained by biopsy demonstrated marked accumulation of ceramide trihexoside (CTH) and ceramide dihexoside (CDH). These findings strongly suggest that thyroid hypofunction and hypothalamic dysfunction could be involved in Fabry disease.
    (Internal Medicine 33: 172-176, 1994)
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  • Takuma BANDO, Masaki FUJIMURA, Yatsugi NODA, Jin-ichiro HIROSE, Goroku ...
    1994 Volume 33 Issue 3 Pages 177-179
    Published: 1994
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 65-year-old man developed respiratory failure with diffuse interstitial shadow, bilateral pleural effusion, and bilateral hilar lymphadenopathy on chest X-ray and CT, after intravenous administration of minocycline. Corticosteroid therapy was effective. The findings from bronchoalveolar lavage (BAL) and transbronchial lung biopsy were compatible with eosinophilic pneumonia. Provocation test supported this diagnosis, but the lymphocyte stimulation test was negative. A review of the literature and the diagnoses of drug-induced pulmonary diseases are discussed.
    (Internal Medicine 33:177-179, 1994)
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  • Yoshiharu MOTOO, Norio SAWABU, Kenzo IKEDA, Yasuhiro TAKEMORI, Hideki ...
    1994 Volume 33 Issue 3 Pages 180-184
    Published: 1994
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    Two cases of mitomycin C nephropathy, which occurred after postoperative chemotherapy for advanced gastric cancer, were followed up for 6 (case 1) and 10 years (case 2). Hemolytic uremic syndrome developed 68 days (case 1) and 160 days (case 2) after the last administration of MMC with a total dose of 60 mg (case 1) and 40 mg (case 2). Serum creatinine levels were normalized in case 1 and they remained at about 2 mg/dl in case 2. Hyporeninemic hypoaldosteronism was transiently seen in case 2. These data suggest that recovery from the acute phase of hemolytic uremic syndrome leads to a good long-term prognosis in MMC nephropathy.
    (Internal Medicine 33:180-184, 1994)
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  • Motoki SANO, Michiaki SUZUKI, Mika SATO, Tetsuya SAKAMOTO, Masanobu UC ...
    1994 Volume 33 Issue 3 Pages 185-187
    Published: 1994
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A patient presenting as severe respiratory failure due to alveolar hypoventilation resulting from respiratory muscle weakness is described. Diagnosis of polymyositis was established by electromyography and muscle biopsy. Steroid therapy was initiated and it ameliorated respiratory failure remarkably. Selective respiratory muscle involvement due to polymyositis has been suggested in this patient. Although fatal respiratory failure is a very rare complication in polymyositis, polymyositis should be considered as one of underlying diseases causing severe respiratory failure.
    (Internal Medicine 33:185-187, 1994)
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  • Yasuyuki ENDO
    1994 Volume 33 Issue 3 Pages 188
    Published: 1994
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    An unusual case of congenital factor XII deficiency with systemic lupus erythematosus (SLE) showing positive lupus anticoagulant (LA) has been treated at the Akita University Hospital since April 1991. The 29 year-old woman displayed a thrombophlebitis on the left leg probably due to LA, as she had been diagnosed as having SLE at age 14 based on positive ANA and anti-DNA, and clinical symptoms including skin changes high fever, and etc. Although LA with SLE is not unusual, the complication of congenital coagulation factor deficiency is rare. Factor XII deficiency was first discovered by Ratnoff & Colopy in 1955 (1), and this disease is thought to have a tendency to cause thrombosis. LA in SLE has been reported since 1972, and is also known to have hemostatic changes. To my knowledge, no patients with both diseases have been reported.
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