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Reiji KASUKAWA
1996 Volume 35 Issue 1 Pages
1-2
Published: 1996
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Jacob GEORGE, Yair LEVY, Yehuda SHOENFELD
1996 Volume 35 Issue 1 Pages
3-9
Published: 1996
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The concept of autoimmunity is regarded as the inability of the immune system to distinguish between self and non-self. This oversimplification of the concept is far from explaining the complex and perplexing mechanisms that are postulated to lead to its development. The transition from autoimmune state, in which no corresponding clinical manifestation exist, to an autoimmune disease, is further complicated by the evidence of multiple factors that participate in the evolution of the disease state. This article is written in a stepwise manner, initially reviewing the basic elements of the immune system, which are essential to understanding the fundamental processes underlying the occurrence of autoimmunity. Subsequently, a description of the factors involved in the etiopathogenesis and the presumed triggering events leading to the emergence of autoimmune diseases are described, with special emphasis on the important role of the idiotypic network, either in the maintenance of the normal immune response, or in the breakdown of self-tolerance eventuating in the autoimmune disease.
Internal Medicine 35: 3-9, 1996)
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Nobuhiro TSUKADA, Ken WADA, Sadao AOKI, Shigeo HASHIMOTO, Kenji KISHI, ...
1996 Volume 35 Issue 1 Pages
10-14
Published: 1996
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Ten patients with acute promyelocytic leukemia (APL) were treated with all-trans retinoic acid (ATRA). Eight of 10 patients achieved complete remission (CR), and among the 8 newly diagnosed cases, 7 achieved CR. Five of 8 CR cases remained in CR after 8 to 30 months. Except for hypotension and a large gastric ulcer resulting from hyperhistaminemia, the adverse effects of ATRA were generally mild. Severe thrombotic tendency occurred in a patient treated with ATRA combined with tranexamic acid. Intensive chemotherapy consisting of daunorubicin (DNR) and other agents was scheduled for the patients who achieved CR with ATRA.
(Internal Medicine 35:10-14, 1996)
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Kazuhito KUGA, Satoshi HASUMURA, Seishi NAGAMORI, Gotaro TODA, Kenji K ...
1996 Volume 35 Issue 1 Pages
15-18
Published: 1996
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A 43-year-old man with chronic active hepatitis C was treated with interferon-β (IFN-β) at a dosage of 6×10
6 IU/day for a planned 6-week period. Ocular hyperemia, ophthalmalgia, and increased intraocular pressure in the right eye developed 20 days after the start of treatment. Intraocular pressure remained high, even after discontinuation of IFN therapy, laser therapy, and iridectomy. Two days later, the right eye was removed because perforation had occurred. The ocular symptoms that developed in this case were thought to have been caused and exacerbated by IFN administration.
(Internal Medicine 35:15-18, 1996)
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Hiroki TERAGAWA, Tatsuya HONDO, Koichi TAKAHASHI, Hiroshi WATANABE, Hi ...
1996 Volume 35 Issue 1 Pages
19-23
Published: 1996
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Sarcoidosis is characterized by multisystemic granulomatous lesions of unknown etiology. A 62-year-old woman developed sarcoidosis after treatment with α-2a interferon (IFN) for 24 weeks (total dose: 522 million units) for chronic hepatitis C. She developed complete atrioventricular block and multiple noncaseating granulomatous lesions in the lung. IFN therapy, which may disturb cellular immune activation in some patients, may have contributed to the onset and progression of sarcoidosis.
(Internal Medicine 35: 19-23, 1996)
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Naotsuka OKAYAMA, Makoto ITOH, Yoshifumi YOKOYAMA, Kenji TSUCHIDA, Tos ...
1996 Volume 35 Issue 1 Pages
24-29
Published: 1996
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Although inflammatory polyposis of the colon is a recognized local complication of ulcerative colitis, giant inflammatory polyposis that totally obliterates the colonic lumen is uncommon, and most of the patients have been from Western countries. We report a Japanese man who had localized giant inflammatory polyposis that obstructed the retrograde flow of barium in a double-contrast barium enema study at the splenic flexure in ulcerative colitis. After resection by total proctocolectomy and ileostomy, pathological examination of the specimen confirmed localized giant inflammatory polyposis in the descending colon and spelnic flexure without malignancy.
(Internal Medicine 35: 24-29, 1996)
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Akira KAWASHIMA, Toshimichi KANEKI, Takuji HARADA, Shiro SHINOZAKI, Sh ...
1996 Volume 35 Issue 1 Pages
30-32
Published: 1996
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We report a case with left pleural effusion caused by a pancreaticopleural fistula, which was formed between a small pseudocyst in the pancreatic body and the posterior mediastinal side of left costophrenic recess. The patient, a 66-year-old male with an alcohol drinking habit, had cough and chest pain but no symptoms or signs suggestive of abdominal pathology. In this case, computed tomographic scan performed immediately after endoscopic retrograde pancreatography was very useful not only in demonstrating the presence of the pancreatic internal fistula but in clarifying its anatomical relation to the surrounding organs.
(Internal Medicine 35: 30-32, 1996)
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Akio NAKATA, Satoshi HIROTA, Hiroshi TSUJI, Eisuke TAKAZAKURA
1996 Volume 35 Issue 1 Pages
33-35
Published: 1996
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We observed an unusual case of interventricular septal wall dissection in a patient with a prior myocardial infarction. Echocardiography, magnetic resonance imaging, and left ventriculography revealed separation of the right-side and left-side walls of the interventricular septum with an accessory chamber between the two walls. Morphologic findings were consistent with interventricular septal dissection.
(Internal Medicine 35: 33-35, 1996)
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Hisashi FUNADA, Hiroki SHIRASAKI, Tamotsu MATSUDA, Miwa AKASOFU
1996 Volume 35 Issue 1 Pages
36-38
Published: 1996
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Rhabdomyolysis with myogiobinuria is an uncommon complication of sepsis, whether monomicrobial or polymicrobial, even in its severe form. We describe a middle-aged woman with acute leukemia who developed rhabdomyolysis and myogiobinuria during the fatal course of chemotherapy-induced sepsis due to
Bacteroides thetaiotaomicron and
Enterococcus faecalis, followed by multiple organ dysfunction syndrome. In addition, autopsy revealed disseminated infections with
Aspergillus and
Candida. None of these organisms has been reported to be involved in the pathogenesis of rhabdomyolysis. Therefore, the etiology of the rhabdomyolysis in this case was probably multifactorial, with polymicrobial septic processes being possibly important contributing factors.
(Internal Medicine 35: 36-38, 1996)
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Shigeru KOYAMA, Takeo ICHIYOSHI, Masaaki CHINO, Takayuki KANBAYASHI
1996 Volume 35 Issue 1 Pages
39-42
Published: 1996
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A 50-year-old Japanese female with a long history of Raynaud's phenomenon presented with progressive dyspnea due to pulmonary hypertension. The diagnosis of systemic lupus erythematosus was confirmed by proteinuria, lymphocytopenia, bilateral pleurisy, and a seizure of convulsion which was consistent with neurological manifestations of systemic lupus erythematosus, whereas the antinuclear antibody showed a low titer. Despite improvement in the activity of systemic lupus erythematosus, steroid treatment did not alter the progression of pulmonary hypertension, which increased in severity, eventually resulting in her death. We believe pulmonary hypertension to be an unusual but critical complication of systemic lupus erythematosus.
(Internal Medicine 35: 39-42, 1996)
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Tetsuo FURUKAWA
1996 Volume 35 Issue 1 Pages
43-44
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Zenji SHIOZAWA
1996 Volume 35 Issue 1 Pages
45-47
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Yasuo KOIKE, Akira TAKAHASHI
1996 Volume 35 Issue 1 Pages
48-50
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Mikihiro KIHARA, Mitsuo TAKAHASHI
1996 Volume 35 Issue 1 Pages
50-52
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Takamichi HATTORI
1996 Volume 35 Issue 1 Pages
52-53
Published: 1996
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Tadao BAMBA, Shigeki KOYAMA, Yasuharu SAITO
1996 Volume 35 Issue 1 Pages
53-55
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Yoshio YAZAKI
1996 Volume 35 Issue 1 Pages
56-58
Published: 1996
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Masahiko KINOSHITA, Takayoshi TSUTAMOTO
1996 Volume 35 Issue 1 Pages
58-59
Published: 1996
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Shigetake SASAYAMA, Akira MATSUMORI
1996 Volume 35 Issue 1 Pages
60-63
Published: 1996
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Hidetsugu ASANOI, Hiroshi INOUE
1996 Volume 35 Issue 1 Pages
63-64
Published: 1996
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Hirohide MATSUO
1996 Volume 35 Issue 1 Pages
65-67
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Chuwa TEI, Nobuyuki TANAKA
1996 Volume 35 Issue 1 Pages
67-69
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Masaharu KASAI
1996 Volume 35 Issue 1 Pages
70-73
Published: 1996
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Masahiro IMAMURA
1996 Volume 35 Issue 1 Pages
73-75
Published: 1996
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Mine HARADA
1996 Volume 35 Issue 1 Pages
75-77
Published: 1996
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Yoshihisa KODERA, Yasuo MORISHIMA, Noriyuki HIRABAYASHI, Mitsune TANIM ...
1996 Volume 35 Issue 1 Pages
78-83
Published: 1996
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