Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
Volume 34 , Issue 7
Showing 1-24 articles out of 24 articles from the selected issue
  • Toshio MATSUMOTO
    1995 Volume 34 Issue 7 Pages 603-604
    Published: 1995
    Released: March 27, 2006
    JOURNALS FREE ACCESS
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  • Toru HASHIMOTO, Katsuhiro SUZUKI, Ryoichi AMITANI, Fumiyuki KUZE
    1995 Volume 34 Issue 7 Pages 605-610
    Published: 1995
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A polymerase chain reaction (PCR) assay for the rapid detection of Mycobacterium tuberculosis in sputum samples was studied. The target DNA was a 123-base pair (bp) fragment of IS6110, which was repeated in the M.tuberculosis genome and was specific for the M.tuberculosis complex. Glass beads (2mm diameter) and lysozyme were used to lyse the mycobacteria and DNA was extracted by the phenol-extraction method. The amplified PCR product was detected by examination of ethidium-bromide-stained agarose gel and by hybridization with an oligonucleotide alkali-phosphatase-labeled probe. A total of 70 samples were tested. PCR was positive in all 13 smear and culture-positive samples, in 5 of 8 smear-negative and culture-positive samples, and in 1 of 49 smear and culture negative samples. The overall sensitivity and specificity were 85.7% and 98%, respectively. Thus, IS6110 as a PCR target was found to be very useful for the rapid diagnosis of M.tuberculosis infection and start of anti-tuberculous chemotherapy.
    (Internal Medicine 34: 605-610, 1995)
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  • Ryuji OHTANI, Yoshikazu HIASA
    1995 Volume 34 Issue 7 Pages 611-617
    Published: 1995
    Released: March 27, 2006
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    Long-term follow-up of coronary artery stenosis was carried out in 81 patients undergoing successful percutaneous transluminal coronary angioplasty (PTCA). Progression of coronary stenosis was observed in 38 patients with 52 sites, and regression was seen in 23 patients with 23 sites during 2 years or more of follow-up. Progressive change occurred in three sites of 97 PTCA lesions and 49 of 1, 090 non-PTCA lesions (no significant difference). On the other hand, regressive change was observed in 19 sites of PTCA lesions and four of non-PTCA lesions (p<0.05). The percentage of narrowing in PTCA lesions was 28.0±14.4% at 3-6 months after PTCA, and this improved to 22.8±15.8% at late study angiography. Coronary score changes were -0.16±0.54 in PTCA lesions, and 0.08±0.46 in non-PTCA lesions (p<0.01). We concluded that the progression of obstructive coronary artery disease in sites with previous PTCA is less than in those with non-PTCA.
    (Internal Medicine 34: 611-617, 1995)
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  • Makoto SAITOH, Tetsuo YANAGAWA, Teruo KONDOH, Hiroyuki MIYAKODA, Hiros ...
    1995 Volume 34 Issue 7 Pages 618-622
    Published: 1995
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    We examined the responses of plasma catecholamine and plasma renin activity (PRA) during mental (arithmetic) stress and dynamic exercise in 15 normal subjects. Compared to rest values, there was a significant increase in the plasma epinephrine concentration (E), but not in the plasma norepinephrine concentration (NE) or PRA during mental arithmetic. During dynamic exercise, there were significant increases in both NE and E and in PRA. The ratio of E to NE was significantly higher during mental arithmetic than during dynamic exercise. NE was significantly correlated with PRA at rest, during mental arithmetic and dynamic exercise. No significant correlations were observed between E and PRA. Dynamic exercise primarily induces a sympathetic nervous response, and mental (arithmetic) stress mainly induces an adrenal response. The renin-angiotensin-aldosterone system response may in part be regulated by sympathetic nervous activity during both mental (arithmetic) stress and dynamic exercise.
    (Internal Medicine 34: 618-622, 1995)
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  • Toshio ITO, Yoshiaki URABE, Kunihiro SHIRAGA, Kohsaku SAKAGUCHI, Toshi ...
    1995 Volume 34 Issue 7 Pages 623-627
    Published: 1995
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    Multidisciplinary treatments for 534 patients with hepatocellular carcinoma (HCC) over a 12-year period from 1981 to 1992 were retrospectively studied. Cumulative survival curve of all patients showed a fine hyperbolic curve, and 1-year, 3-year-, 5-year survivals were 66, 33, and 18%, respectively. Survival of female patients was better than male patients, and survival of HBsAg-negative patients was better than that of HBsAg-positive patients. Several background factors such as the Child-Pugh classification, liver function tests or factors, number of tumors, and the size of the main tumor were analyzed, and each factor was related to survival. Survival curves of 3 treatments, hepatectomy, percutaneous ethanol injection (PEI), and transcatheter arterial embolization (TAE)+PEI, overlapped to a large degree. Also the survival curve of the more recent 6-year period from 1987 to 1992 was better than that of the earlier 6-year period from 1981 to 1986.
    (Internal Medicine 34: 623-627, 1995)
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  • Masahiko KODA, Shinobu KOMORI, Mayumi NAGAMI, Minae MINOHARA, Yoshikaz ...
    1995 Volume 34 Issue 7 Pages 628-631
    Published: 1995
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    Bathing in hot water induces vasodilatation of the peripheral vessels and alteration of blood distribution. Using a Doppler flowmeter, we evaluated the effect of bathing in hot water on portal hemodynamics. Eight controls and 8 patients with compensated liver cirrhosis remained immersed in hot water at 42°C for 5 minutes. Portal flow significantly decreased from 811±141 (ml/min) at the baseline to 530±98 in the controls and from 855±308 to 642±208 in cirrhotics immediately after bathing. This decrease (25%) in cirrhotics was significantly less than that (35%) in controls because vessel diameter did not decrease as rapidly as it did in controls. Portal flow after 30 minutes returned to the baseline values in controls but remained low in cirrhotics. These findings suggest that cirrhotics have a lower hemodynamic response to bathing in hot water compared with that in controls.
    (Internal Medicine 34: 628-631, 1995)
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  • Shoji HIRASAKI, Norio KOIDE, Kozo UJIKE, Hiroyuki YAMAMOTO, Yasuo FUJI ...
    1995 Volume 34 Issue 7 Pages 632-635
    Published: 1995
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A family with serum cholinesterase (SChE) deficiency is reported. A 64-year-old woman was admitted for the excision of colon adenoma: her laboratory data revealed a markedly decreased level of SChE. SChE genes of the patient and her family members were amplified by the polymerase chain reaction (PCR) and analyzed by direct sequencing. The patient's SChE gene had a homozygous frame shift mutation, in which an extra adenine was inserted in codon 315 (ACC→AACC), resulting in the appearance of a new stop codon in codon 322. The family study disclosed that her brother and sister had the same frame shift mutations in homozygote and heterozygote, respectively.
    (Internal Medicine 34: 632-635, 1995)
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  • Jun KUYAMA, Hironori TAKE, Shigeto MATSUMOTO, Tadahisa NAKAJIMA, Toru ...
    1995 Volume 34 Issue 7 Pages 636-639
    Published: 1995
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    We describe a case of cyclic thrombocytopenia and thrombocytosis, whose cytokine levels, granulocyte-macrophage colony stimulating factor (GM-CSF) and interleukin-6 (IL-6) in plasma, fluctuated in synchrony with platelet count. The levels of the two cytokines correlated significantly with the platelet count for 11 observations over an S-month period (r=0.79, p<0.01 for GM-CSF and r=0.87, p<0.001 for IL-6). No inverse relationship between platelet-associated immunoglobulin G (PAIgG) and platelet count was observed (r=0.39, p>0.20). These findings suggest that the fluctuation of platelet count in this case may result from an aberration of the cytokine network regulating megakaryopoiesis and platelet formation.
    (Internal Medicine 34: 636-639, 1995)
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  • Akira HIRASAWA, Tadatsugu SATO, Tetsuo NISHIKAWA, Kimiharu UOZUMI, Yos ...
    1995 Volume 34 Issue 7 Pages 640-642
    Published: 1995
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 27-year-old male who visited our hospital because of pneumonia was diagnosed as hyper-IgM immunodeficiency syndrome. His serum IgM level was markedly elevated, while the serum level of IgD was normal with a markedly decreased level of serum IgG and IgA. The proportion of T and B cells of peripheral blood lymphocytes was normal. However, B cells bearing surface IgG or IgA were not detectable by immunofluorescence technique. There was a consanguineous marriage in his family, suggesting that his disorder was caused by a genetic abnormality such as X-linked recessive and also autosomal recessive inheritance, although further study is necessary. CD40 ligand cDNA did not appear to contain any abnormal changes within the coding region.
    (Internal Medicine 34: 640-642, 1995)
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  • Yoshitaka KANEITA, Chizuko TAKATA, Ei ITOBAYASHI, Yoshihiro MIYAUCHI, ...
    1995 Volume 34 Issue 7 Pages 643-645
    Published: 1995
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    Two Japanese cases of streptococcal toxic shock syndrome (STSS) are reported. The first patient was a 45-year-old male who developed necrotizing fasciitis and myositis of the left thigh, refractory hypotension, hepatic dysfunction and acute renal failure; the patient died despite treatment. Streptococcus pyogenes was isolated from the inflamed fascia. The second patient was a 69-year-old female who had coagulopathy, polymyositis and hepatic function abnormality. Streptococcus pyogenes was isolated from blood culture. She was immediately placed on high-dose ampicillin as well as other supportive measures, and she survived.
    (Internal Medicine 34: 643-645, 1995)
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  • Akihito YOKOYAMA, Nobuoki KOHNO, Shun FUJINO, Yoshikazu INOUE, Kunio H ...
    1995 Volume 34 Issue 7 Pages 646-648
    Published: 1995
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 43-year-old woman with a 10-year history of bronchial asthma developed marked peripheral blood eosinophilia and symptoms of vasculitis. A diagnosis of Churg-Strauss syndrome (CSS) was made, and her symptoms were successfully treated with low-dose prednisolone. Serum rheumatoid factors (RF) of both IgG and IgM, but not IgA or IgE, subclasses transiently appeared in accordance with the vasculitic phase. Serum interleukin-6 (IL-6) levels also transiently increased in this phase, and the peak level was reached just prior to the maximum of RF elevation, suggesting the role of IL-6 as an inducer of RF. RF and IL-6 seemed to be involved in the pathogenesis of the vasculitis in this patient.
    (Internal Medicine 34: 646-648, 1995)
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  • Ken SUGIMOTO, Satoshi OOSAWA, Takahisa FURUTA, Hajime ARAI, Yoshihiko ...
    1995 Volume 34 Issue 7 Pages 649-653
    Published: 1995
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 38-year-old female was admitted for investigation of the cause of hypergastrinemia, hypercalcemia and an elevated plasma parathyroid hormone (PTH) level. Her siblings, elder brother and sister who had duodenal carcinoid tumor with hypergastrinemia and parathyroid adenomas, were diagnosed as multiple endocrine neoplasia (MEN) type 1. In the present patient, endoscopic examination showed a carcinoid tumor of the duodenum, but examinations by computed tomography (CT) and ultrasonography of the abdomen failed to reveal pancreatic lesions. Serum gastrin levels of this patient and her siblings improved to the normal level after resection of carcinoid tumors. The hypergastrinemia accompanying MEN type 1 in these cases might be due to carcinoid tumor of the duodenum.
    (Internal Medicine 34: 649-653, 1995)
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  • Shigeo FUJIMOTO, Naotsugu KURIHARA, Kazuto HIRATA, Takao KAMIMORI, Shi ...
    1995 Volume 34 Issue 7 Pages 654-656
    Published: 1995
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 20-year-old female was brought to our emergency unit with generalized erythema and discomfort induced by running after having eaten wheat bread. The laboratory examinations, including eosinophils, total IgE, RAST score to wheat, heat challenge test and methacholine inhalation test were within normal limits. No anaphylactoid responses occurred after provocation tests of wheat bread intake or exercise alone. However, on provocation exercise test after eating pancakes, she developed hypotension, generalized itching and urticaria associated with an elevation of plasma histamine levels. These findings suggested wheat-dependent exercise-induced anaphylaxis. This was completely prevented by daily administration of terfenadine 120 mg p.o. without side effects such as fatigue or drowsiness.
    (Internal Medicine 34: 654-656, 1995)
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  • Takahiro YAMADA, Yu FUJIWARA, Eizaburo SASATOMI, Shigeo NAKANO, Osamu ...
    1995 Volume 34 Issue 7 Pages 657-660
    Published: 1995
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    We describe a case of multiple polypoid lesions that occurred in the colon of a 62-year-old man. Eight of the lesions were demonstrated by barium enema, and five were examined histologically. A small nodule in the submucosa of the ascending colon was histologically identical to granular cell tumor, characterized by nested growth of large tumor cells with ample granular cytoplasm and small round nuclei. Immunohistochemically, the cells were positive for S-100, neuron-specific enolase and vimentin, and negative for α-smooth muscle actin and desmin.
    (Internal Medicine 34: 657-660, 1995)
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  • Masahiko MAKI, Yoshiyasu KANEKO, Yasuo OHTA, Takuro NAKAMURA, Rikuo MA ...
    1995 Volume 34 Issue 7 Pages 661-665
    Published: 1995
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 39-year-old man was admitted because of lumbago, vomiting and massive gastrointestinal bleeding. Oliguria developed a few days later, which was followed by hyperkalemia and cardiac arrest. Autopsy disclosed multiple renal cell carcinomas with diffuse metastasis to the liver, adrenal gland, psoas muscle and vertebrae. In addition, a somatostatinoma was found in the pancreas. From these findings and past history of cerebellar hemangioblastoma and spinal hemangioma he was diagnosed to have von Hippel-Lindau disease. Von Hippel-Lindau disease with islet cell tumor is very rare and is reported here with a review of literature.
    (Internal Medicine 34: 661-665, 1995)
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  • Masahiro MIHARA, Keita KAMIKUBO, Keiko HIRAMATSU, Satomi ITAYA, Toru O ...
    1995 Volume 34 Issue 7 Pages 666-669
    Published: 1995
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 50-year-old tetanic woman with hypomagnesemia is described. She had partial resection of the stomach and the jejunum at the age of 20 years. Lack of parathyroid hormone (PTH) function was indicated by hypocalcemia, hyper phosphatemia and high tubular reabsorption of phosphate. However, both plasma concentration of PTH and nephrogenous cAMP were normal. Administration of magnesium sulfate completely normalized serum phosphate and tubular transport of phosphate with only a modest increase in nephrogenous cAMP. The present findings suggest that phosphaturic action of PTH is impaired in magnesium deficiency and that steps distal to cAMP production may be responsible for the renal refractoriness to the hormonal action.
    Internal Medicine 34: 666-669, 1995)
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  • Yoshimune HIRUTA, Keisho CHIN, Kouzou SHITOMI, Toshikatsu ICHIHARA, Ma ...
    1995 Volume 34 Issue 7 Pages 670-673
    Published: 1995
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    In a 24-year-old woman with mitochondrial encephalomyopathy presenting hypertrophic cardiomyopathy, microscopical examination of myocardial biopsy specimen disclosed severe vacuolar degeneration of myocardium and aggregates of enlarged mitochondria with proliferated cristae. Limb muscle biopsy specimen showed "ragged-red fibers" light microscopically and enlarged abnormal mitochondria with markedly increased cristae ultrastructurally. Mitochondrial DNA analysis by polymerase chain reaction (PCR) revealed an A-to-G transition in the mitochondrial transfer RNALeu(UUR) gene at nucleotide position 3, 243 which is reported to be associated with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS). However, the clinical features of this case, presenting mainly cardiac abnormalities, were not consistent with the typical MELAS.
    (Internal Medicine 34: 670-673, 1995)
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  • Hiroyuki OKURA, Iwao GOHMA, Kazuhiro HATTA, Takanobu IMANAKA
    1995 Volume 34 Issue 7 Pages 674-675
    Published: 1995
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 57-year-old woman with Crow-Fukase syndrome presented thiamine deficiency and pulmonary hypertension of unknown etiology. After oral administration of prednisolone and thiamine, echocardiogram showed marked improvement of the pulmonary hypertension. To our knowledge, this is the first case of this syndrome associated with thiamine deficiency and precapillary pulmonary hypertension, which may play a role in the pathogenesis of polyneuropathy and heart failure of this syndrome.
    (Internal Medicine 34: 674-675, 1995)
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  • Hiroshi TANAKA, Yasuhito HONDA, Michio HIRASAWA, Takuya FUJISHIMA, Sho ...
    1995 Volume 34 Issue 7 Pages 676-678
    Published: 1995
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 49-year-old woman complained of cough and a purulent sputum (about 40 ml/day). She kept budgerigars for a period of 30 years, she first noticed a productive cough 10 years previously. Her chest roentgenogram revealed a diffuse reticulonodular pattern. She was diagnosed as having a chronic type of budgerigar breeder's lung associated with chronic bronchitis. Peptostreptococcus anaerobius was cultured from her sputum, bronchoalveolar lavage fluid, as well as from droppings of her budgerigar. This is the second case of hypersensitivity pneumonitis presenting as chronic bronchitis with much sputum in Japan.
    (Internal Medicine 34: 676-678, 1995)
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  • Yuji KAMIYA, Tsutomu HORIKOSHI, Hitoshi TAKAGI, Shuichi OKADA, Kohshi ...
    1995 Volume 34 Issue 7 Pages 679-682
    Published: 1995
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 37-year-old Japanese man was admitted with delirium and hyperammonemia. He was diagnosed as having type II citrullinemia because of an elevated citrulline level on amino acid analysis and very low hepatic argininosuccinate synthetase activity. He also showed a low neutrophil count and a low serum level of granulocyte colony-stimulating factor. Reduced production of this cytokine and/or impairment of its feedback regulation by the neutrophil count may have played a role in the neutropenia of this patient.
    (Internal Medicine 34: 679-682, 1995)
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  • Toshiya WATANABE, Takao NOSHIRO, Taku KUSAKARI, Hiroyoshi AKAMA, Sator ...
    1995 Volume 34 Issue 7 Pages 683-687
    Published: 1995
    Released: March 27, 2006
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    We treated two rare cases of pheochromocytoma which were histopathologically diagnosed as mixed neuroendocrine-neural tumor (MNNT): a 35-year-old male patient associated with ganglioneuroblastoma and cutaneous neurofibromatosis and a 42-year-old male patient with ganglioneuroma. Both patients showed typical clinical manifestations of pheochromocytoma without any familial traits. Although each of the diseases has its own entity and clinical features, these tumors are all derived from the neural crest tissues. The tumorigenesis of MNNT is still unknown. Here, a brief review of the recent literature on this subject is discussed.
    (Internal Medicine 34: 683-687, 1995)
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  • Toshimitsu HATAZOE, Yoshio MURAKAMI, Itsumi UMAKI, Motoi SOHMIYA, Hong ...
    1995 Volume 34 Issue 7 Pages 688-691
    Published: 1995
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 38-year-old man had an acute onset of consciousness loss, pyrexia and hyponatremia. Plasma Adrenocorticotropic Hormone (ACTH) and cortisol levels were low. Plasma ACTH failed to respond to corticotropin-releasing hormone (CRH) and insulin-induced hypoglycemia whereas i.m. injection of ACTH-Z raised plasma cortisol. Plasma insulin-like growth factor-I (IGF-I) and urine growth hormone (GH) concentrations were also low and plasma thyroid-stimulating hormone (TSH) level was rather elevated. Plasma IGF-I and TSH levels were not completely normalized by glucocorticoid (GC) replacement alone although plasma GH responses to pharmacological stimuli were normalized. The GC replacement in combination with daily s.c. injection of recombinant human GH (rhGH) not only normalized plasma IGF-I and IGFBP-3 levels, but also further lowered the plasma TSH level, possibly due to an increased T4/T3 conversion, which resulted in a beneficial change in body composition.
    (Internal Medicine 34: 688-691, 1995)
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  • Muneyasu LEE, Akihiko CHUBACHI, Hidetaka NIITSU, Ikuo MIURA, Masako YA ...
    1995 Volume 34 Issue 7 Pages 692-694
    Published: 1995
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    We describe a 68-year-old Japanese male with hypoplastic acute myelogenous leukemia (AML) who achieved complete hematological reconstitution following granulocyte colony-stimulating factor (G-CSF) administration. The patient had pancytopenia and the bone marrow was hypocellular with 19 to 36% peroxidase-positive blasts without morphological abnormalities suggestive of myelodysplasia. After receiving G-CSF as a supportive therapy for pneumonia, the blood count became normal and the bone marrow was normocellular with less than 5% of blasts. Without subsequent chemotherapy, he relapsed as a form of overt leukemia and died of pneumonia. Chemotherapy may be necessary to maintain remission in hypoplastic AML after hematopoietic reconstitution by G-CSF.
    (Internal Medicine 34: 692-694, 1995)
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  • Tsukasa Nozu, Atsushi TAKAHASHI, Akira UEHARA, Yutaka KOHGO, Tomokatsu ...
    1995 Volume 34 Issue 7 Pages 695-699
    Published: 1995
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 68-year-old man with undifferentiated carcinoma occurring in the Cardioesophageal junction accompanied by hypercalcemia is reported. The serum level of parathyroid hormone-related protein (PTHrP) was remarkably elevated. Serum calcium and PTHrP levels decreased following chemotherapy, but this amelioration was temporary. He died of hypercalcemia. On autopsy, a significant amount of immunoreactive PTHrP was detected in the tumor tissue extract, and the tumor cells were stained strongly positive for PTHrP by immunohistochemistry. This is the first case of undifferentiated carcinoma in the gastrointestinal tract which demonstrated hypercalcemia due to PTHrP produced by the malignant tumor.
    (Internal Medicine 34: 695-699, 1995)
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