Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
Volume 35 , Issue 10
Showing 1-18 articles out of 18 articles from the selected issue
  • Masahiro KIKUCHI
    1996 Volume 35 Issue 10 Pages 753
    Published: 1996
    Released: March 27, 2006
    JOURNALS FREE ACCESS
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  • Teiji YAMAMOTO
    1996 Volume 35 Issue 10 Pages 754-755
    Published: 1996
    Released: March 27, 2006
    JOURNALS FREE ACCESS
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  • Keisaku FUJIMOTO, Keishi KUBO, Takashige MIYAHARA, Yukinori MATSUZAWA, ...
    1996 Volume 35 Issue 10 Pages 756-763
    Published: 1996
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    It has been suggested that respiratory muscle dysfunction plays a major role in the development of acute ventilatory failure in patients with chronic obstructive pulmonary disease (COPD). In this study, we devised a respiratory muscle relaxation maneuver using wedge-shaped wooden plates, with which pressure was exerted on the intercostal and accessory respiratory muscles by hand, or by tapping with a wooden hammer, for 15-20 minutes twice a day. The muscle relaxation maneuver was performed in 5 moderate to severe pulmonary emphysema patients for 4 weeks and in 7 emphysema patients for 6 weeks, and the effects on pulmonary function were examined. After the therapy, inspiratory capacity (IC) and vital capacity (VC) in both the 4 weeks- and 6 weekstreated groups, and the forced expiratory volume in 1 second (FEV1.0) in the 6 weeks-treated group were significantly increased, and CO2 retention had also improved. Daily peak expiratory flow (PEF) showed significant increases from 2 weeks after the initiation of the therapy. These results suggest that the respiratory muscle relaxation maneuver is effective for improving the pulmonary function of pulmonary emphysema patients.
    (Internal Medicine 35: 756-763, 1996)
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  • Yoshinobu MAEDA, Yoshihiko SEGAWA, Nagio TAKIGAWA, Ichiro TAKATA, Nobu ...
    1996 Volume 35 Issue 10 Pages 764-771
    Published: 1996
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    Serum soluble cytokeratin 19 fragment (CYFRA) levels were measured in 251 patients with lung cancer and 139 patients with benign lung diseases to determine the clinical usefulness of CYFRA level determination in the diagnosis and monitoring of lung cancer. Serum levels of CYFRA were measured by a 2-step sandwich ELISA method. When the cut-off value was defined as 3.5 ng/ml, which was associated with a specificity of 95% for benign lung diseases, CYFRA had a high sensitivity (53%) in all patients with lung cancer. Both the serum level of CYFRA and its sensitivity increased significantly with the increase in clinical stage. A comparison of areas under receiver operating characteristic curves showed that CYFRA had the most power of discrimination in the diagnosis of lung cancer among markers including carcinoembryonic antigen, squamous cell carcinoma antigen, carbohydrate antigen 19-9, and neuron-specific enolase. A good correlation was found between serial changes in serum CYFRA levels during therapy and clinical responses for 18 patients who underwent chemotherapy and/or radiotherapy. Our findings suggest that CYFRA may be a marker of choice for screening and monitoring of lung cancer, particularly squamous cell carcinoma.
    (Internal Medicine 35: 764-771, 1996)
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  • Shinji TERAMOTO, Takeshi MATSUSE, Eiichi SUDO, Eijiro OHGA, Hirofumi K ...
    1996 Volume 35 Issue 10 Pages 772-778
    Published: 1996
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    To investigate the long-term effects of the inhaled anticholinergic bronchodilator, oxitropium bromide (OTB), on lung function, exercise capacity, and dyspnea in patients with chronic obstructive pulmonary disease (COPD), spirometry and symptom-limited exercise testing before and 1, 6, and 12 months after the regular use of OTB (600 μg/day) were performed in 12 patients with the use of OTB (mean age 69.9±3.1 years; FEV1/FVC 53.3±1.6%) as well as in 12 control patients who were not treated with OTB (Mean age 68.8±2.8 years; FEV1/FVC 52.6±1.9%). The dyspnea was evaluated by the slope of the regression line between Borg scale and oxygen uptake (Vo2) during exercise (Borg scale slope: BSS). At 1, 6, and 12 months after the start of OTB, the forced expiratory volume in one second (FEV1) and the exercise capacity (maximal Vo2) were greater than the pretreatment values and the dyspnea index (BSS) was significantly improved compared with the pretreatment value, while these parameters slightly worsened in the control patients over one year. In conclusion, the chronic use of an inhaled anticholinergic bronchodilator may provide beneficial improvements in expiratory flow rate, exercise performance, and dyspnea in mild to moderate COPD patients over one year.
    (Internal Medicine 35: 772-778, 1996)
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  • Takamichi MIYAMOTO, Takehiko SHIBATA, Syu MATSUURA, Mineyuki KAGESAWA, ...
    1996 Volume 35 Issue 10 Pages 779-782
    Published: 1996
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    We report a case of eosinophilic gastroenteritis, which has features of the predominant subserosal type presented as an ileus and ascites. A 48-year-old Japanese woman was admitted to our hospital because of epigastralgia, lower abdominal pain and vomiting. She had a past history of allergic disorders. The computed tomographic scan revealed ascites, and marked wall thickening and dilatation of the intestine. This patient showed eosinophilic ascites without marked peripheral eosinophilia. Histologic examination demonstrated eosinophilic infiltrates did not predominate in the gastrointestinal tract. Conservative treatment of intravenous infusion of antibiotics and Ringer's solution was effective in this case.
    (Internal Medicine 35: 779-782, 1996)
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  • Jun-ichi OKANO, Goushi SHIOTA, Yutaka HORIE, Akeri MITSUDA, Takeaki SU ...
    1996 Volume 35 Issue 10 Pages 783-784
    Published: 1996
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 20-year-old man with hepatocellular carcinoma (HCC) died of intraperitoneal bleeding from ruptured HCC, which was diagnostic from hemorrhagic ascites. At autopsy, a small nodule covered with hematogenous deposits was noted in the pelvic cavity near the left iliac artery. Microscopic findings showed that this was a ruptured metastatic nodule from HCC. Rupture of a metastatic nodule from HCC, especially one located on the peritoneal surface, has rarely been reported in the literature.
    (Internal Medicine 35: 783-784, 1996)
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  • Naoyuki FUJITA, Keiko MATSUMOTO, Nobuyuki SHIGA, Akiko NONAKA, Yuji KO ...
    1996 Volume 35 Issue 10 Pages 785-790
    Published: 1996
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 58-year-old man visited our hospital because of back pain. Blood examinations revealed the presence of acute inflammation and an increase of pancreatic enzymes. Abdominal computed tomography indicated pseudocysts in the pancreas. The patient was diagnosed as having acute pancreatitis with pseudocysts formation. During the course of the disease, a newly formed pseudocyst in the pancreatic head compressed the common bile duct, leading to the obstructive jaundice. In addition, the rupture of a pseudocyst in the pancreatic tail caused intraperitoneal hemorrhage. This is an interesting case of acute pancreatitis with pseudocysts in which two rare complications developed.
    (Internal Medicine 35: 785-790, 1996)
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  • Tadakatsu YAMADA, Mitsunori OKAMOTO, Takashi SUEDA, Masaki HASHIMOTO, ...
    1996 Volume 35 Issue 10 Pages 791-794
    Published: 1996
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    Successful catheter ablation for a patient with both Wolff-Parkinson-White syndrome and sustained atrial tachycardia has not been reported. We describe a patient with Wolff-Parkinson-White syndrome associated with sustained atrial tachycardia, in whom an atrioventricular accessory pathway and an intra-atrial reentrant circuit were successfully ablated in a single session. Radiofrequency catheter ablation for the left-sided atrioventricular accessory pathway was performed via the trans-septal approach. Catheter ablation for the atrial tachycardia was achieved in the right atrium where the earliest and fractionated atrial activation was obtained. Catheter ablation for multiple lesions during a single session is feasible.
    (Internal Medicine 35: 791-794, 1996)
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  • Akira OHTAHARA, Kimihiko HATTORI, Masaharu FUKUKI, Sigemasa HIRATA, Gi ...
    1996 Volume 35 Issue 10 Pages 795-798
    Published: 1996
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    Angiosarcoma is one of the most common cardiac tumors, but early detection of this tumor is often difficult, as exemplified by our patient, a 55-year-old woman whose cardiac tumor was first detected by echocardiography. Surgical removal of the tumor was impossible due to its extensive pericardial invasion. Pathological diagnosis was not complete before autopsy because of the wide occupied necrotized area of the tumor. There is no diagnostic imaging technique available to detect such a necrotized area. An imaging technique more powerful than echocardiography and able to diagnose angiosarcoma earlier is needed.
    (Internal Medicine 35: 795-798, 1996)
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  • Noriko KAWASHIMA, Machiko MISHIMA, Ryokichi SHINDO, Mari HIRANO, Shini ...
    1996 Volume 35 Issue 10 Pages 799-802
    Published: 1996
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    We report here findings in a 51-year-old Japanese man with non-insulin-dependent diabetes mellitus who complained of exercise-induced cramps. Muscle biopsy showed scattered regenerating fibers, small angular fibers and increased PAS positive particles. Electron microscopic examination revealed an abnormal accumulation of glycogen particles in subsarcolenmmal areas and between myofibrils while chemical studies showed an increased glycogen concentration and decreased phosphoglycerate mutase (PGAM), 46.9% of the normal mean value. Thus, partial PGAM deficiency, insulin resistance and mild diabetic sensory-motor polyneuropathy can induce severe cramps.
    (Internal Medicine 35: 799-802, 1996)
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  • Masahiro HARA, Kazuo ICHIKAWA, Kesami MINEMURA, Hiroaki KOBAYASHI, Nao ...
    1996 Volume 35 Issue 10 Pages 803-807
    Published: 1996
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    We report a 19-year-old female case of acromegaly associated with Chiari-I malformation and polycystic ovary syndrome. She also had syringomyelia and thoracic scoliosis. Although the association of acromegaly and Chiari-I malformation was by chance, exaggerated secretion of growth hormone may have aggravated the scoliosis. The incidence of polycystic ovary in acromegalic patients remains to be elucidated. However, elevation of plasma insulin and insulin-like growth factor, that is usually observed in patients with acromegaly, could stimulate androgen production in the ovaries. The patient was successfully treated with transsphenoidal adenomectomy for pituitary tumor and correction surgery for thoracic scoliosis.
    (Internal Medicine 35: 803-807, 1996)
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  • Akihiko IWASE, Kouichi SHIMIZU, Yoshiaki NAKAYA, Kyouichi SAKAMOTO, Sh ...
    1996 Volume 35 Issue 10 Pages 808-810
    Published: 1996
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    We report a case of localized fibrous mesothelioma (LFM) of the pleura with bronchogenic carcinoma. LFM arose in the visceral pleura of the upper lobe in the left lung, and lung adenocarcinoma was located in the ipsilateral lower lobe. LFM is a rare mesenchymal tumor of the pleura. Concomitant occurrence with bronchogenic carcinoma has not been previously reported in the English literature.
    (Internal Medicine 35: 808-810, 1996)
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  • Toru TAKAHASHI, Mikiya SATOH, Hidetoshi SATOH
    1996 Volume 35 Issue 10 Pages 811-814
    Published: 1996
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 70-year-old female had an abnormal chest roentgenogram. Inflltrative shadows were recognized in the right lung, and an open lung biopsy (OLE) specimen revealed usual interstitial pneumonia (UIP). Xerostomia, keratoconjunctivitis sicca, and lymphocyte infiltration in salivary glands were consistent with Sjögren's syndrome; she was diagnosed as having pulmonary fibrosis in association with Sjögren's syndrome (SjS-IP). Acute exacerbation occurred and she was successfully treated with corticosteroids. Unilateral exacerbation and UIP in SjS-IP are rare. OLE is useful for diagnosis and to select a pertinent therapy if lung involvement is unilateral in Sjögren's syndrome.
    (Internal Medicine 35: 811-814, 1996)
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  • Tetsuya NAKADA, Hiromitsu SATO, Fuyuhiko INOUE, Fumi MIZOROGI, Kazuo N ...
    1996 Volume 35 Issue 10 Pages 815-820
    Published: 1996
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    Cancers producing colony-stimulating factors and associated with marked leukocytosis are relatively rare. We report here a case of a thyroid cancer producing both granulocyte colonystimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF). A 72-year-old woman had a thyroid carcinoma with significant neutrophilia and eosinophilia without any evidence of infection. The serum concentrations of both G-CSF and GM-CSF were elevated significantly in this patient, which might have induced the leukocytosis. Furthermore, the G-CSF concentrations in thyroid tumor tissue and metastatic lesions in the lung and skin examined at autopsy also were extremely high.
    (Internal Medicine 35: 815-820, 1996)
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  • Ken-ichi ATARASHI, Nobuyuki YOSHIMURA, Hiroshi NODERA, Koichi TSUKIMOT ...
    1996 Volume 35 Issue 10 Pages 821-825
    Published: 1996
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    We describe a case of recurrent histiocytic necrotizing lymphadenitis (HNL) with aseptic meningitis. The patient was a 46-year-old male and a carrier of human T lymphotropic virus type I (HTLV-I). The patient had a past medical history of at least three relapses of HNL. In addition, his sister, who was also an HTLV-I carrier, had recurrent clinical episodes consistent with those of HNL, suggesting familial HNL occurrence. This observation suggests the possibility that HTLV-I infection is relevant to the pathogenesis of HNL.
    (Internal Medicine 35: 821-825, 1996)
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  • Takayuki TANAKA, Toru SATO, Youichi AKIFUJI, Masahiko SAKAMOTO, Hirosh ...
    1996 Volume 35 Issue 10 Pages 826-830
    Published: 1996
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 69-year-old women with malignant lymphoma (diffuse large:Working Formulation) had associated with intracavital involvement of the right ventricle. The patient was referred to us for further examination with a diagnosis of heart failure. A tumor mass was detected by magnetic resonance imaging in the right ventricular outflow tract. While in the hospital the patient experienced cardiogenic shock due to neoplastic pulmonary embolism. The tumor was surgically resected and the patient was then treated with systemic chemotherapy. She went into complete remission and has continued in this state for six months. This case demonstrates that early diagnosis and intensive chemotherapy contribute to a good prognosis of patients with malignant lymphoma associated with massive involvement of a cardiac chamber. A review of the Japanese literature is presented.
    (Internal Medicine 35: 826-830, 1996)
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  • Shigeaki SUZUKI, Makoto ICHIJO, Hirofumi FUJII, Yasuo MATSUOKA, Yoshih ...
    1996 Volume 35 Issue 10 Pages 831-834
    Published: 1996
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    This is the first report of acute Wernicke's encephalopathy in which characteristic magnetic resonance (MR) findings have been verified by postmortem histopathological examination. The high-signal areas surrounding the third and the fourth ventricles and the aqueduct on the T2-weighted images reflected the spongy disintegration of the neuropil, which is the typical pathological finding in Wernicke's encephalopathy. We confirmed that MR imaging is essential to the early diagnosis of Wernicke's encephalopathy.
    (Internal Medicine 35: 831-834, 1996)
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