Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
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Volume 34, Issue 3
Displaying 1-20 of 20 articles from this issue
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  • Hepatic Role in the Storage and Utilization of Fish Oil Fatty Acids in Humans: Studies on Liver Surgery Patients
    Kohsaku SEKINE
    1995 Volume 34 Issue 3 Pages 139-143
    Published: 1995
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.34.139
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    Fish oil fatty acids (FOFA) were analyzed in fresh liver tissue and in subcutaneous and omental adipose tissue obtained from 5 patients who underwent partial hepatectomy. FOFA were also determined in plasma from 5 patients and in 10 healthy subjects. There was a high content of FOFA in the liver phospholipid (PL) fraction (twice that in our previous autopsy study) suggesting that these surgery patients had a hepatic FOFA content of at least 25g. In plasma, FOFA was predominantly found in the PL of high density lipoprotein (HDL) and partly in the PL of other lipoproteins. Since these lipoproteins are produced by the liver, the present findings indicate the role of the liver not only in storage but also in the utilization of FOFA to form the biologically important surface PL component of circulating lipoproteins.
    (Internal Medicine 34: 139-143, 1995)
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  • Event-Related Potential Components Analysis of Cognitive Impairment in Patients with Multiple Lacunar Infarcts
    Hisao TACHIBANA, Kazumi ARAGANE, Minoru SUGITA
    1995 Volume 34 Issue 3 Pages 144-147
    Published: 1995
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.34.144
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    We measured the visual event-related potentials (ERPs) and reaction time (RT) in 21 patients with multiple lacunar infarcts and in 8 age-equivalent normal subjects. The N2 latency of the infarct patients was significantly longer than that of the normal subjects, although the NA and the P3 latencies and RT did not differ between the two groups. The N2 latency was negatively correlated with the scores of Mini-Mental State Examination or the Hasegawa's dementia scale. These results suggest that the impairment of cognitive information processing in these patients arises from an uncertainty in the classification of a perceived event. In addition, the N2 latency may be more sensitive in detecting cognitive impairment in multiple infarct patients.
    (Internal Medicine 34:144-147, 1995)
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  • TRH Stimulation Test in Healthy Elderly: Paradoxical Response of Growth Hormone is Abnormal in Normal Aging
    Sadayoshi OHBU, Narihito YOSHIOKA, Masao HONDA, Yukio ANDOH, Yuji SATO ...
    1995 Volume 34 Issue 3 Pages 148-152
    Published: 1995
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.34.148
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    The purpose of this study was to measure TSH (thyrotropin), PRL (prolactin) and GH (growth hormone) response to a TRH (thyrotropin releasing hormone) stimulation test in 37 healthy elderly male subjects and determine if these responses correlate with the incidence of mental decline; and also, to determine if these responses occur more frequently in the elderly than in the general population. A hyperresponse of TSH was documented in 7 of our 37 elderly male subjects, a delayed response of TSH in 4, a low response of PRL in 29 and a significant paradoxical response of GH in 2. Those subjects with a significant paradoxical response of GH were 82 and 83 years of age and their HDS was 20.0 and 25.5, respectively. We did not find a causal relationship between mental decline and the paradoxical response of GH, but our data suggests that the paradoxical response of GH is not normal in elderly older than 80 years old.
    (Internal Medicine 34:148-152, 1995)
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  • Portal Hypertensive Colopathy: Endoscopic Findings and the Relation to Portal Pressure
    Susumu YAMAKADO, Hidenori KANAZAWA, Masafumi KOBAYASHI
    1995 Volume 34 Issue 3 Pages 153-157
    Published: 1995
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.34.153
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    Portal hypertensive colopathy (PHC) is a new clinical entity in patients with liver cirrhosis. In this study, colonoscopic findings and clinical features including upper gastrointestinal endoscopy and hepatic hemodynamics were prospectively investigated among 35 PH patients with a hepatic venous pressure gradient (HVPG) of greater than 12 mmHg due to chronic liver diseases. Colonoscopy was also performed in 100 patients without liver disease as non-PH controls. The colonoscopy revealed vascular ectasias, vascular irregularity, vascular dilatation, solitary red spots, diffuse red spots, and hemorrhoids in 26, 32, 30, 25, 10 and 25, respectively, of 35 PH patients compared to 3, 7, 3, 11, 0 and 19, respectively, in controls. PHC was endoscopically diagnosed in 27 of 35 PH patients according to our criteria. These patients with PHC were more frequently associated with esophageal varices and portal hypertensive gastropathy, and had higher HVPG than PH patients without PHC. Portal hypertension is an important factor in the etiology of PHC.
    (Internal Medicine 34: 153-157, 1995)
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  • Thrombomodulin in Exercise-Induced Asthma
    Hiroshi KANAZAWA, Naotsugu KURIHARA, Kazuto HIRATA, Takao KAMIMORI, Ta ...
    1995 Volume 34 Issue 3 Pages 158-162
    Published: 1995
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.34.158
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    Thrombomodulin (TM) is a membrane protein present in the vascular endothelium. It has also been found in human plasma, within which, however, its pathological functions have not been clearly described. In this study, the plasma TM concentrations in 19 asthmatic patients were determined by sandwich enzyme immunoassay using two monoclonal antibodies for human TM. The concentration of plasma TM in exercise-induced asthma (EIA) - positive asthmatic patients was significantly increased by exercise challenge. In addition, for these patients a positive correlation was found between the severity of EIA and the degree of change in plasma TM induced by exercise challenge. These findings suggest that the increase in influx of TM into the plasma in EIA-positive asthmatics may be due to generalized pulmonary endothelial damage following exercise challenge.
    (Internal Medicine 34:158-162, 1995)
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  • Parvovirus Infection and Generalized Edema in Adults
    Tetsuya NAKAZAWA, Toshihiko MACHI, Shunsuke KITAGAWA, Hirotoshi MIYAMO ...
    1995 Volume 34 Issue 3 Pages 163-165
    Published: 1995
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.34.163
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    We describe the clinical and laboratory findings of 7 adult patients with serological evidence of recent human parvovirus B19 (HPV) infection who presented with generalized edema. Six of the 7 patients had household contact with children with erythema infectiosum and had flu-like symptoms before visiting hospital. The interval between the flu-like episode and the development of edema ranged from 4 to 13 days (mean 7.0). In all 7 patients, there was serological confirmation of recent HPV infection, and all showed the development of edema following HPV infection without urine abnormalities or anemia. Two patients presented hypocomplementemia, and two patients showed signs of congestive heart failure. HPV may be considered a causative agent of generalized edema not only in the fetus but also in adults and HPV infection should be included in the differential diagnosis of generalized edema formation.
    (Internal Medicine 34:163-165, 1995)
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  • Cytoplasmic Body Myopathy with Hypertrophic Cardiomyopathy
    Yoshiki SEKIJIMA, Shu-ichi IKEDA, Satoshi KATAI, Masayuki MATSUDA, Tak ...
    1995 Volume 34 Issue 3 Pages 166-170
    Published: 1995
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.34.166
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    A patient with cytoplasmic body myopathy presented muscle hypotonia from birth and developed progressive muscular atrophy and weakness, scoliosis, contracture of joints and cardiorespiratory failure. At the age of 17, he died of heart failure. Post mortem examination revealed severe hypertrophy of cardiac walls and generalized muscular atrophy. Microscopic examination showed many cytoplasmic bodies in skeletal muscle fibers and myofiber disarray in myocardium. No cases of cytoplasmic body myopathy with hypertrophic cardiomyopathy have been reported previously. It is suggested that the Z-line component is related to the formation of the cytoplasmic body in skeletal muscle and disarray in the cardiac muscle.
    (Internal Medicine 34:166-170, 1995)
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  • Coronary Thrombosis Induced by Intracoronary Acetylcholine Injection in a Patient with Normal Coronary Myocardial Infarction
    Yasuhiro ENDOH, Nitaro SHIBATA, Kou TAKEICHI, Wakana SHINYA
    1995 Volume 34 Issue 3 Pages 171-175
    Published: 1995
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.34.171
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    A 67-year-old male was admitted with acute myocardial infarction. Coronary thrombolysis was carried out because complete occlusion of the obtuse marginal branch (OM) in the circumflex artery was detected in emergent coronary angiography, and recanalization of the OM was obtained at 3 hours after the onset of chest pain. No significant stenosis of the OM was found in coronary angiography performed at the recovery stage. After intracoronary acetylcholine injection to the left coronary artery, coronary spasm was induced and coronary thrombosis was observed in the left anterior descending artery thereafter. These findings indicate the possibility that the etiology of myocardial infarction is coronary thrombosis induced by coronary spasm.
    (Internal Medicine 34: 171-175, 1995)
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  • Appropriate Intravenous Doses of L-Thyroxine and Magnesium in a Thyroidectomized Patient with Thyroid and Parathyroid Carcinomas Receiving Total Parenteral Nutrition During Acute Necrotizing Pancreatitis
    Kanji SATO, Shozo TORAYA, Keiko SHIRATORI, Yoko KASAGI, Yuko MANDAI, T ...
    1995 Volume 34 Issue 3 Pages 176-182
    Published: 1995
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.34.176
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    A totally thyroidectomized patient with thyroid and parathyroid carcinomas, which had developed after neck irradiation in childhood, became hypercalcemic due to pulmonary metastases. The hypercalcemia was ameliorated by intermittent iv administration of bisphosphonate for 3.5 years, but this gradually became refractory to the bisphosphonate treatment. After right thoracotomy for resection of pulmonary metastases, acute necrotizing pancreatitis developed. The patient was therefore placed on total parenteral nutrition supplemented with T4 and a restricted dose of magnesium. Thyroxine(T4) (30 μg/day, iv) was not sufficient to maintain euthyroidism, but a higher dose (60 μg/day) elicited mild hyperthyroidism to the same extent as that elicited by an oral dose of 100 μg/day. The present case showed that the appropriate iv dose of T4 in this thyroidectomized patient with acute pancreatitis was about 60% of the oral dose. Furthermore, bisphosphonates (pamidronate and alendronate) and magnesium depletion were very effective in controlling the hypercalcemia.
    (Internal Medicine 34:176-182, 1995)
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  • Acromegalic Gigantism with Low Serum Level of Growth Hormone and Elevated Serum Insulin-Like Growth Factor-I
    Reiko MIYAZAKI, Toshihide YOSHIDA, Naoki SAKANE, Tomoko YASUDA, Tuneka ...
    1995 Volume 34 Issue 3 Pages 183-187
    Published: 1995
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.34.183
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    In a case of acromegalic gigantism with hyperprolactinemia is reported, the basal serum growth hormone (GH) levels ranged from 1.2 to 1.9 ng/ml. Serum GH response to either insulin-induced hypoglycemia or GH-releasing hormone was blunted. Frequent blood sampling showed non-pulsatile GH secretion. Serum prolactin and insulin-like growth factor-I (IGF-I) levels were elevated. After unsuccessful surgery, bromocriptine treatment normalized serum prolactin without affecting serum GH and IGF-I levels. Combined administration of octreotide with bromocriptine reduced serum GH and IGF-I levels. In this case, non-pulsatile GH secretion and enhanced tissue sensitivity to GH may induce hypersecretion of IGF-I and cause clinical acromegalic gigantism.
    (Internal Medicine 34:183-187, 1995)
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  • Involvement of the Central Nervous System in Rheumatoid Arthritis: Its Clinical Manifestations and Analysis by Magnetic Resonance Imaging
    Yukio ANDO, Sunako KAI, Eiichiro UYAMA, Kazuhiro IYONAGA, Yoichiro HAS ...
    1995 Volume 34 Issue 3 Pages 188-191
    Published: 1995
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.34.188
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    A rheumatoid arthritis (RA) patient showed high signal intensity in the subcortical region of the frontal and occipital lobes on T2-weighted magnetic resonance imaging (MRI). Histopathological examination in the autopsy specimen revealed severe systemic vasculitis. Additional radiological and laboratory studies revealed that transient cerebral ischemia induced by vasculitis occurred in this patient.
    (Internal Medicine 34: 188-191, 1995)
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  • Primary Malignant Lymphoma of the Liver Associated with Cirrhosis Induced by Hepatitis C Viral Infection
    Kiyoshi MORITA, Hiroshi HOSHINO, Junko IMADA, Norio YOSHIDA, Daisaku N ...
    1995 Volume 34 Issue 3 Pages 192-194
    Published: 1995
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.34.192
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    We present a case of primary malignant lymphoma of the liver of B cell origin with cirrhosis induced by hepatitis C viral infection. A 75-year-old Japanese woman with chronic liver dysfunction was admitted for hepatic tumors. The tumors were hypoechoic on ultrasonography and hypodense on computed tomography. Antibody to hepatitis C virus was positive. Ultrasonically guided biopsy was performed, and we diagnosed hepatic lymphoma with cirrhosis induced by hepatitis C virus clinically and immunohistochemically. This case may be the first report of the association of these two diseases, and may provide additional evidence of a predisposition to malignancy in cirrhosis.
    (Internal Medicine 34: 192-194, 1995)
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  • Collagenous Colitis
    Akio KATANUMA, Toshinori KODAMA, Tomohiro TAMAKI, Shigeo KATABAMI, Ken ...
    1995 Volume 34 Issue 3 Pages 195-198
    Published: 1995
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.34.195
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    Collagenous colitis is characterized clinically by chronic watery diarrhea and pathologically by colonic mucosal subepithelial collagen deposition. We report a 72-year-old woman who had collagenous colitis associated with chronic watery diarrhea. She received a non-steroidal anti-inflammatory agent (sulindac) because of rheumatoid arthritis. Histological examination of biopsy showed a thick subepithelial collagen layer with lymphocytes, plasma cells, and infiltration of a few eosinocytes in the lamina propria. These findings led to the diagnosis of collagenous colitis. After treatment with salazosulfapyridine, her bowel movement became normalized and mucosal subepithelial collagen deposition disappeared.
    (Internal Medicine 34: 195-198, 1995)
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  • Aneurysmal Dilatation of the Pulmonary Trunk with Mild Pulmonic Stenosis
    Takayuki SHINDO, Toshio KURODA, Shintaro WATANABE, Yukihiro HOJO, Hiro ...
    1995 Volume 34 Issue 3 Pages 199-202
    Published: 1995
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.34.199
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    We present the unusual case of a 72-year-old woman whose chest X-ray showed an abnormal left hilar shadow. A pulmonary angiogram revealed an aneurysm in the pulmonary artery with a diameter of 55 mm that extended from the main pulmonary trunk to its bifurcation. Mild pulmonic stenosis with a systolic pressure gradient of 18 mmHg across the pulmonic valve was recognized. Mild dilatation of the ascending aorta was also present. The pressure gradient across the pulmonic valve was lower than is typical for an aneurysmal dilatation, suggesting that this patient represented a case of idiopathic pulmonary artery dilatation. We suspected the presence of a congenital structural alteration common to the pulmonary artery and the ascending aorta.
    (Internal Medicine 34: 199-202, 1995)
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  • Virus-Associated Hemophagocytic Syndrome due to Measles Accompanied by Acute Respiratory Failure
    Atsushi KOMATSUDA, Akihiko CHUBACHI, Akira B MIURA
    1995 Volume 34 Issue 3 Pages 203-206
    Published: 1995
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.34.203
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    An 18-year-old male who was admitted to hospital due to fever, skin rashes, cough, and malaise showed laboratory examination findings of leukopenia, thrombocytopenia, mild liver dysfunction, and hypoxia. Bone marrow aspiration revealed 2% histiocytes with hemophagocytosis. Chest X-ray showed bilateral diffuse interstitial pneumonia. The titer of anti-measles virus antibody was <1:4, and that at convalescence stage was 1:64. He was diagnosed as having hemophagocytic syndrome and acute respiratory failure due to measles, and was treated with methylprednisolone pulse therapy. He promptly recovered from thrombocytopenia and acute respiratory distress. Steroid pulse therapy may be effective in these conditions due to measles.
    (Internal Medicine 34: 203-206, 1995)
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  • Enlargement of Multiple Cavernous Hemangioma of the Liver in Association with Pregnancy
    Tomohiro SAEGUSA, Kazuki ITO, Noriyuki OBA, Masayuki MATSUDA, Koichi K ...
    1995 Volume 34 Issue 3 Pages 207-211
    Published: 1995
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.34.207
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    Four cavernous hemangiomas were found in a 34-year-old woman after the first delivery. All four hemangiomas became enlarged after the second delivery. Due to complaints of symptoms of compression, and to rule out malignancy, surgical intervention was employed. Histologically, the tumors were typical cavernous hemangiomas. Although a relationship between enlargement of hemangiomas and estrogen was suggested, estrogen receptors were not detected in the tumors.
    (Internal Medicine 34: 207-211, 1995)
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  • Pneumatosis Cystoides Intestinalis after Chemotherapy for Hematological Malignancies: Report of 4 Cases
    Shigeo HASHIMOTO, Hiroyuki SAITOH, Ken WADA, Tatsuro KOBAYASHI, Hirosh ...
    1995 Volume 34 Issue 3 Pages 212-215
    Published: 1995
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.34.212
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    Pneumatosis cystoides intestinalis (PCI) is known to be a relatively rare condition which is characterized by gas cysts in the gastrointestinal mucosa. We treated four cases of PCI accompanied by hematological malignancies during chemotherapy treatment. All cases suffered from abdominal discomfort. Abdominal X-ray films revealed gas cysts in the intestine. PCI was observed during leukocytopenic states, and three cases had septicemia. Etoposide was administered to three cases, and prednisolone to all cases. It is considered that PCI sometimes occurs in patients with hematological malignancies during a period of leukocytopenia, and may be caused by intestinal mucosal damage due to myelosuppressive agents and immunosuppression from prednisolone.
    (Internal Medicine 34: 212-215, 1995)
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  • Von Hippel-Lindau Disease with Multiple Spinal Cord Hemangioblastomas, Syringomyelia and Pheochromocytoma
    Hisashi FURUSU, Hidenori MATSUO, Kazuhiko NAKAO, Yasuo UEDA, Wataru AO ...
    1995 Volume 34 Issue 3 Pages 216-219
    Published: 1995
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.34.216
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    A 31-year-old blind man presented with numbness and weakness in the left hand, and elevated blood pressure. Multiple hemangioblastomas in the spinal cord associated with syringomyelia were well demonstrated by gadolinium-enhanced magnetic resonance imaging (MRI). He also had pheochromocytoma in the right adrenal gland, which was disclosed by abdominal computed tomography, MRI and 131I-metaiodobenzylguanidine scintigraphy. MRI screening should be considered for patients with von Hippel-Lindau gene to detect the multiple lesions in this disease.
    (Internal Medicine 34: 216-219, 1995)
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  • Determination of a Common Clonal Origin of Gastric and Pulmonary Mucosa-Associated Lymphoid Tissue Lymphomas Presenting Five Years Apart
    Norihiko KAWAMATA, Tohru MIKI, Tetsuya FUKUDA, Ken SUZUKI, Yuki SUMI, ...
    1995 Volume 34 Issue 3 Pages 220-223
    Published: 1995
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.34.220
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    Mucosa-associated lymphoid tissue (MALT) lymphoma is often mis-diagnosed as a benign tumor. Dissemination to other sites occurs in MALT lymphoma. We report a 60-year-old man with gastric and pulmonary tumors of MALT lymphoma which occurred 5 years apart. Initially, the gastric tumor had been diagnosed as reactive lymphoreticular hyperplasia. To determine whether the two tumors arose from the same malignant clone, we amplified and sequenced the complementarity-determining region 3 of the immunoglobulin heavy chain gene using the polymerase chain reaction (PCR). The sequences were identical except for 11-nucleotide difference, suggesting identical clonality.
    (Internal Medicine 34: 220-223, 1995)
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  • Abrupt-Onset Diabetes Mellitus in the Elderly
    Kazunaga TAKAMATSU, Takahide YORIOKA, Hisayo KUROKAWA, Takashi ITAHARA ...
    1995 Volume 34 Issue 3 Pages 224-227
    Published: 1995
    Released on J-STAGE: March 27, 2006
    DOIhttps://doi.org/10.2169/internalmedicine.34.224
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    We present three elderly Japanese patients with abrupt onset of diabetes mellitus: a 61-year-old male with a complete defect of insulin secretion without insulin resistance, a 60-year-old male with an incomplete defect of insulin secretion associated with insulin resistance, and a 69-year-old female with a complete defect of insulin secretion and insulin resistance. The findings in these cases indicate the heterogeneity in insulin secretion and sensitivity of abrupt onset diabetes mellitus in the elderly. The changes in insulin secretion and sensitivity over time due to glucose toxicity may at least partially explain the heterogeneity.
    (Internal Medicine 34: 224-227, 1995)
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