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Minoru KANAZAWA
1996 Volume 35 Issue 11 Pages
835-836
Published: 1996
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Masatoshi KUDO
1996 Volume 35 Issue 11 Pages
837-838
Published: 1996
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Fumiyuki KUZE
1996 Volume 35 Issue 11 Pages
839-840
Published: 1996
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Takashi DAMBARA
1996 Volume 35 Issue 11 Pages
841
Published: 1996
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Takeyoshi KUNIEDA
1996 Volume 35 Issue 11 Pages
842-843
Published: 1996
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Tadakatsu YAMADA, Mitsunori OKAMOTO, Takashi SUEDA, Masaki HASHIMOTO, ...
1996 Volume 35 Issue 11 Pages
844-848
Published: 1996
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To elucidate the response of conductance and resistance vessels of the coronary artery after intracoronary isosorbide dinitrate (ISDN), we evaluated 11 patients with variant angina and 13 controls with a Doppler guidewire. Epicardial arterial diameter increased significantly after ISDN in patients with variant angina while it did not change significantly in the controls. Coronary diastolic flow velocity increased significantly in controls (p<0.05), but was unchanged in patients with vasospastic angina. Coronary flow volume increased from 23.8±18.6 to 46.5±28.4 ml/min in patients with vasospastic angina as well as in the controls from 32.2±24.2 to 54.7±44.4 ml/min. Coronary resistance did not differ between the two groups before or after the injection of ISDN. Conductance vessels were dilated to a greater extent in the patients with variant angina. However, the response of resistance vessels did not differ significantly between the two groups.
(Internal Medicine 35: 844-848, 1996)
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Hirotaka TOSHIMORI, Masashi OKAMOTO, Kuninobu NAKATSURU, Hiroyuki HIDA ...
1996 Volume 35 Issue 11 Pages
849-854
Published: 1996
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A 49-year-old female with multiple endocrine neoplasia (MEN) type 1 associated with malignant lymphoma, lipoma, functioning adenomatous goiter, non-functioning adrenal tumor, polyneuropathy, postoperative primary hyperparathyroidism, and hepatitis B virus was a human T lymphotropic virus type 1 (HTLV-1) carrier. She underwent parathyroidectomy for primary hyperparathyroidism at age 44. At age 49, examinations of the enlarged para-aortic lymph nodes revealed diffuse small non-cleaved B cell lymphoma in stage II, and other various complications were also found. Multiple tumorigenetic factors were considered to be involved in the present case.
(Internal Medicine 35: 849-854, 1996)
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Nobuya IKUTA, Hiroyuki TANIGUCHI, Yasuhiro KONDOH, Kenzo TAKAGI, Tetsu ...
1996 Volume 35 Issue 11 Pages
855-860
Published: 1996
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Neutrophils are reported to be a major factor in the pathogenesis of the adult respiratory distress syndrome (ARDS). We measured serial levels of circulatory interleukin (IL)-8 and neutrophil elastase in 16 patients with ARDS at the onset, on day 3 and on day 7 and studied the relationship of these levels to the clinical course. Circulatory IL-8 levels of all the patients at the onset were significantly elevated compared with controls, mean±SE, 30.0±6.7 pg/ml and 3.39E0.3 pg/ml, respectively. There was a significant correlation between IL-8 and neutrophil elastase levels at the onset (r = 0.65, p<0.01). In nonsurvivors circulatory IL-8 levels were significantly higher than those of survivors throughout the study. There were significant differences in oxygenation, as reflected by PaO
2/F
IO
2 ratios, between survivors and nonsurvivors at day 7, mean±SE, 208.5±21.9 and 113.5±9.6, respectively. In conclusion, we have shown that the level of circulatory IL-8 is elevated in patients with ARDS, and sustained high levels of circulatory IL-8 might be correlated with a poor outcome.
(Internal Medicine 35: 855-860, 1996)
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Fumihito YOSHII, Yukito SHINOHARA, Tsuneyuki TAKEOKA, Yasuhisa KITAGAW ...
1996 Volume 35 Issue 11 Pages
861-865
Published: 1996
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Nipradilol is a new type of β-blocker which possesses nitroglycerin-like vasodilating action in addition to β-blocking action. We investigated the efficacy and safety of nipradilol for treating tremor in 20 patients with essential tremor (ET group) and 20 patients with Parkinson's disease (PD group). AH patients received nipradilol (6 mg per day) for more than 8 weeks. Improvement of tremor appeared within 2 or 4 weeks after the start of nipradilol therapy, and the efficacy rate, denned as "moderately effective" or over, was 42.5% in all 40 patients, while that defined as "slightly effective" or over was 87.5%. The efficacy rate tended to be higher in the ET group compared with the PD group. Mean blood pressure was significantly decreased from the 4th week after the start of treatment and heart rate was significantly reduced from the 2nd week of treatment. Laboratory examination showed no significant changes.
(Internal Medicine 35: 861-865, 1996)
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Akio KANDA, Masahiro ARAKAWA, Yasuhiko SASAKI
1996 Volume 35 Issue 11 Pages
866-870
Published: 1996
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We present a 58-year-old man with hyperglycemic subcoma. His blood glucose level was 1, 163 mg/100 ml on admission and the data of the coagulate system revealed abnormalities in the prothrombin time, fibrinogen and serum fibrin degradation products. Continuous intravenous insulin infusion therapy (CIII) was performed, and a satisfactory recovery of consciousness level and blood glucose level were obtained. Further examination revealed the patient had Crohn's disease (CD) associated with IgG and IgM anticardiolipin antibodies (aCLs). The patient was treated with corticosteroid hormones and salazosulfapyridine, and the abnormalities in the coagulate system returned to the normal range and aCLs eventually disappeared. It was speculated that in such a case, anticardiolipin antibody may play a role in the pathogenesis of CD.
(Internal Medicine 35: 866-870, 1996)
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Tatsuya Usui, Kiyoshi KITANO, Takashi MIDORIKAWA, Kaname YOSHIZAWA, Hi ...
1996 Volume 35 Issue 11 Pages
871-875
Published: 1996
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We report a 24-year-old Japanese female hospitalized with jaundice and ascites. She exhibited hepatosplenomegaly, severe liver dysfunction, and slight polycythemia with an increase in serum levels of β-thromboglobin and platelet factor 4. Bone marrow was hypercellular with an increase in progenitor cells. The aggregation response of platelets to ADP and to collagen was markedly increased. Venography revealed narrowed hepatic veins with 'spider web' sign. Liver biopsy revealed hepatic congestion. Budd-Chiari syndrome was diagnosed, and was thought to be due to thrombosis related to myeloproliferative disorder. Liver transplant was successful in relieving symptoms.
(Internal Medicine 35: 871-875, 1996)
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Hiroyuki ITOH, Michiya YAMAMOTO, Noriyasu TANIMOTO, Tomoaki OKABAYASHI ...
1996 Volume 35 Issue 11 Pages
876-879
Published: 1996
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A 32-year-old obese female was hospitalized with dyspnea. Echocardiogram revealed left ventricular dilatation. Chest X-ray film showed enlarged heart size and prominent pulmonary congestion. Simple obesity with congestive heart failure (CHF) due to cardiomyopathy of obesity was diagnosed according to the absence of obvious disease that caused obesity or CHF. After diet therapy and medication, subjective symptoms disappeared and body weight was reduced from 137 kg to 85 kg. Although few reports of cardiomyopathy of obesity have been reported in Japan, we propose the possibility that similar cases will be on the increase because Japanese dietary habits are now becoming more similar to those of Caucasians.
(Internal Medicine 35: 876-879, 1996)
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Akinari TABARU, Masaaki ENDOU, Yoshifumi MIURA, Makoto OTSUKI
1996 Volume 35 Issue 11 Pages
880-882
Published: 1996
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We report a case of generalized peritonitis caused by spontaneous intraperitoneal rupture of the urinary bladder. A 74-year-old female was admitted with abdominal pain and biochemical findings of acute renal failure (ARF). She had recently complained of macrohematuria. She had a past history of radiotherapy for uterine cervical cancer and Parkinson's disease treated with levodopa and amantadine. We diagnosed this case as intraperitoneal rupture of the bladder by cystogram. Biochemical findings of ARF might have resulted from urine reabsorption. Intraperitoneal rupture of the bladder should be considered in all cases of peritonitis, especially in patients with urological symptoms and features of ARF.
(Internal Medicine 35: 880-882, 1996)
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Yusuke OKUYAMA, Yusuke NAKAOKA, Kunihiko KIMOTO, Kotaro OZASA
1996 Volume 35 Issue 11 Pages
883-885
Published: 1996
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We report a case of tuberculous spondylitis (Pott's disease) with bilateral pleural effusion in a 25-year-old male patient, Left-pleural effusion was observed on admission. The initial diagnosis was tuberculous pleuritis. However, during anti-tuberculosis chemotherapy, back pain and right-pleural effusion appeared, by further examination, we diagnosed an active tuberculous spondylitis of the 11th and 12th thoracic vertebrae possibly by the dissemination of
Mycobacterium tuberculosis through blood circulation or lymphatic circulation. In cases in which anti-tuberculosis chemotherapy is not so effective, the possibility of the rarely-appearing extra-pulmonary manifestation of tuberculous spondylitis must be considered.
(Internal Medicine 35: 883-885, 1996)
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Yoshihisa TAKANO, Kazukiyo OIDA, Yoshiaki KOHRI, Yoshio TAGUCHI, Keisu ...
1996 Volume 35 Issue 11 Pages
886-889
Published: 1996
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We encountered a 73-year-old man with acute pulmonary embolism (PE) and Baker's cyst. Venography revealed that the right popliteal vein was compressed by Baker's cyst and deep venous thrombosis (DVT) had developed. DVT associated with Baker's cyst is rather common and these two conditions are thought to be causally related. Baker's cyst is the most frequent mass lesion in the popliteal region. We suggest that Baker's cyst is a risk factor for PE as well as surgery and trauma.
(Internal Medicine 35: 886-889, 1996)
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Takashi ISHIDA, Masafumi KAMACHI, Taro HANADA, Koichi YAMAZAKI, Shigea ...
1996 Volume 35 Issue 11 Pages
890-893
Published: 1996
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We report a case of mucous gland adenoma of the trachea in a 73-year-old male revealed by bronchoscopy. The tumor was resected with a contact neodymium: yttrium aluminum garnet (Nd-YAG) laser after five years of observation. The tumor was histologically peculiar because it presented numerous cystically dilated, or irregularly shaped mucus-filled glands lined with cuboidal or tall columnar cells. In some parts, the lining cells of the tumor showed papillary proliferation. We diagnosed this tumor as a mucous gland adenoma of the trachea. We review the clinical features of this rare tumor and discuss the usefulness of the laser in the diagnosis and the therapy.
(Internal Medicine 35: 890-893, 1996)
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Atsushi NAKANO, Kazuhiro HATTA, Yoichiro KOBASHI, Masashi GOTO, Takano ...
1996 Volume 35 Issue 11 Pages
894-897
Published: 1996
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A 20-year-old man with ulcerative colitis was admitted because of fever, eruption and lymphadenopathy. He had started taking salazosulfapyridine one month previously. Lymph node biopsy revealed angioimmunoblastic lymphadenopathy. Autoantibody titers were all negative, and viral antibody titers were not increased retrospectively. Rearrangement of T-cell receptor β and chromosomal aberration were not seen on the lymph node. This case is considered not to be a peripheral T-cell lymphoma but rather salazosulfapyridine-induced angioimmunoblastic lymphadenopathy (AIL), which is the second case in English language literature.
(Internal Medicine 35: 894-897, 1996)
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Takashi IHARA, Tomoyuki TSUJIKAWA, Keiko HODOHARA, Hisayuki INOUE, Yos ...
1996 Volume 35 Issue 11 Pages
898-901
Published: 1996
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A 64-year-old man was referred to our hospital for evaluation of progressive anemia. On admission, he had a severe normocytic normochromic anemia [hemoglobin 7.5 g/dl] requiring a blood transfusion. Endocrinological studies demonstrated an isolated ACTH deficiency. After receiving glucocorticoid replacement therapy, his anemia was rapidly corrected, his hematocrit and hemoglobin remained elevated for approximately 4 months. We present evidence that glucocorticoid plays an important role in the physiological regulation of human erythropoiesis.
(Internal Medicine 35: 898-901, 1996)
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Takakazu HIGUCHI, Atsuko IMAGAWA, Makoto MURAHASHI, Hajime HARA, Yoshi ...
1996 Volume 35 Issue 11 Pages
902-904
Published: 1996
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A case of spinal epidural abscess following epidural anesthesia is described. Gadolinium-enhanced magnetic resonance images were essential in diagnosis of the abscess without frank pus formation, in defining the extension of the infection, and in assessing the therapeutic effect. The patient was successfully treated non-operatively before neurological symptoms developed and full recovery was achieved.
(Internal Medicine 35: 902-904, 1996)
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Ryoichi HAYASHI, Norinao HANYU, Nobuo YANAGISAWA
1996 Volume 35 Issue 11 Pages
905-908
Published: 1996
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A patient with a brainstem hemorrhage and alpha-pattern coma is reported. Brainstem auditory and somatosensory evoked responses were severely abnormal, suggesting bilateral lesions of the pons, which was confirmed by magnetic resonance imaging. Regional cerebral blood flow, studied using IMP-SPECT, showed no remarkable regional radioactive accumulation or deficit in either the cerebral cortex or the subcortical regions. Based on these findings, we speculate that the alpha-pattern coma may be observed when the functions of brain structures rostral to the pontomesencephalic junction are preserved.
(Internal Medicine 35: 905-908, 1996)
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Fumihito YOSHII, Katsunori AKIYAMA, Yukito SHINOHARA
1996 Volume 35 Issue 11 Pages
909-911
Published: 1996
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We report a patient with herpes simplex virus type 1 encephalitis (HSE) who showed abnormal magnetic resonance imaging (MRI) signals in the basal ganglia. The lesions were asymmetric and became apparent with relapse of the neurological symptoms, but they completely disappeared, concomitantly with improvement of the illness.
(Internal Medicine 35: 909-911, 1996)
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Yoshihiro MIYASHITA, Hiroaki KOIKE, Akihiko MISAWA, Hideaki SHIMIZU, K ...
1996 Volume 35 Issue 11 Pages
912-915
Published: 1996
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A 48-year-old woman with antiphospholipid syndrome (APS) developed pulmonary hypertension without any thromboembolic episode. Multiple pulmonary perfusion defects suggestive of pulmonary thrombosis or in situ thrombosis were observed. Deep venous thrombosis (DVT) of the right femoral vein without symptoms was also detected by contrast venography. Asymptomatic pulmonary hypertension complicated with a hypercoagulable state such as in this case suggests that not only recurrent asymptomatic pulmonary thrombosis, but also in situ thrombosis in pulmonary vessels are possible and important factors in the pathogenesis of pulmonary hypertension.
(Internal Medicine 35: 912-915, 1996)
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