Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
Volume 37 , Issue 8
Showing 1-17 articles out of 17 articles from the selected issue
  • Hidekazu SHIGEMATSU
    1998 Volume 37 Issue 8 Pages 651
    Published: 1998
    Released: March 27, 2006
    JOURNALS FREE ACCESS
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  • Hironobu SASANO
    1998 Volume 37 Issue 8 Pages 652
    Published: 1998
    Released: March 27, 2006
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  • Hiroshi NONOGI, Shunichi MIYAZAKI, Yoichi GOTO, Yoshio ISHIDA, Toshiis ...
    1998 Volume 37 Issue 8 Pages 653-661
    Published: 1998
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    Objective: The present study was designed to determine the ability of positron emission tomography (PET) to assess myocardial viability and ischemia in acute myocardial infarction (MI) after reperfusion therapy (thrombolysis and/or coronary angioplasty). Methods: PET with fluorine-18-labeled fluorodeoxyglucose (FDG) under fasting conditions and thallium-201 singlephoton emission computed tomography (TL) were analyzed in 21 patients one week following MI. Myocardial viability was also assessed by regional wall motion using serial analysis of 2-D echocardiography or left ventriculography. Results: Marked uptake of FDG together with a residual perfusion defect were observed in the infarct region in all patients one week post MI. However, in 9 of the 21 patients, the infarct-related coronary artery had no significant stenosis after reperfusion therapy and remained patent in one month post MI suggesting no myocardial ischemia. In contrast, in 4 of the 21 patients the regional wall motion was akinetic and there was a complete defect observed with TL imaging at one month post MI, indicating no viability in the infarct region. Conclusions: PET using fasting FDG at one week post MI had a limitation to predict myocardial viability or ischemia.
    (Internal Medicine 37: 653-661, 1998)
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  • Hironaka IGARASHI, Yasuo KATAYAMA, Toshikazu TSUGANEZAWA, Manabu YAMAM ...
    1998 Volume 37 Issue 8 Pages 662-668
    Published: 1998
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    Three-dimensional anisotropy contrast (3DAC) magnetic resonance imaging is a new algorithm for the treatment of apparent diffusion tensor using the three primary colors. To determine if 3D AC has a clinical application for human brain, six normal volunteers and twenty patients with supratentorial cerebrovascular accidents were examined using clinical magnetic resonance imaging (MRI), and the changes in the 3DAC images associated with Wallerian degeneration of the pyramidal tract were evaluated. The 3DAC images exhibited impressive anatomical resolution. In all chronic stage patients with hemiparesis, the colors in the pyramidal tract were faded. Patients examined during the acute stage who later recovered from hemiparesis had no visible changes of the 3DAC image, whereas patients who recovered poorly showed distinct color fading in the pyramidal tract within 14 days following stroke. In conclusion, very fine anatomical structures are visible on 3DAC images, and it can be used as a diagnostic tool for the human brain.
    (Internal Medicine 37: 662-668, 1998)
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  • Toshinori TAKADA, Eiichi SUZUKI, Masaaki NAKANO, Hiroshi KAGAMU, Hirok ...
    1998 Volume 37 Issue 8 Pages 669-673
    Published: 1998
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    Polymyositis and dermatomyositis (PM/DM) without creatine kinase (CK) elevation shows a poor prognosis. PM/DM is complicated with interstitial lung disease (ILD), some of which progress rapidly. To clarify the clinical features of PM/DM from the viewpoint of ILD progression, the clinical data of 25 PM/DM patients with ILD were reviewed. They were classified as responders or non-responders. The patients whose ILD responded to steroid therapy and elicited good clinical courses were termed as responders. On the other hand, the patients who had rapidly progressive ILD resistent to steroid therapy were considered as non-responders. The patients diagnosed to have DM were likely to be steroid-resistant. The non-responder group revealed significantly high aspartate aminotransferase (AST), low CK, low white blood cell (WBC), and low absolute lymphocyte counts in their peripheral blood. High CK/AST may be a favorable predictor of the disease. The percentages of lymphocytes in bronchoalveolar lavage fluid were increased in both groups. However, the percentages of two responders with low CK/AST were lower than those of three non-responders. A steroid-resistant ILD group with PM/DM may be clinically different from a steroid-responsive ILD group.
    (Internal Medicine 37: 669-673, 1998)
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  • Tomoyuki KOGA, Tomoko ABE, Hideki NORIYUKI, Noritaka IWATANI, Takako O ...
    1998 Volume 37 Issue 8 Pages 674-677
    Published: 1998
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 59-year-old female with 20-year history of slowly progressing muscle atrophy and sensory disturbance of upper extremities showed short stature, scoliosis, hunger type of sensory dissociation of the upper extremities and pyramidal tract sign of the lower extremities. Magnetic resonance imaging (MRI) clarified hypoplasia of the anterior pituitary lobe, Arnold-Chiari malformation and cervical syringomyelia. Insulin and arginine stimulating tests revealed partial type of isolated growth hormone (GH) deficiency but GH gene analysis detected no defects of GH genes. It was considered to be a rare case of non-hereditary hypopituitarism with Chiari malformation and syringomyelia not associated with perinatal injury, namely a midline anomaly syndrome.
    (Internal Medicine 37: 674-677, 1998)
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  • Mina KOMUTA, Masaru HARADA, Takato UENO, Yasuyo UCHIMURA, Chizuko INAD ...
    1998 Volume 37 Issue 8 Pages 678-682
    Published: 1998
    Released: March 27, 2006
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    Anorexia nervosa is an eating disorder characterized by a fear of weight gain and a preoccupation with body image. Although hepatic involvement has been reported in patients with anorexia nervosa, the mechanism is not fully understood. We describe a patient with anorexia nervosa with liver function abnormalities. Light and electron microscopic observations revealed a remarkable accumulation of glycogen in hepatocytes. These results suggest that adaptive responses to starvation may alter carbohydrate metabolism in patients with anorexia nervosa.
    (Internal Medicine 37: 678-682, 1998)
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  • Akiko KAWAKAMI, Yasuyuki OKAMOTO, Tsunehiko YAMAMOTO, Youichi TATSUMI, ...
    1998 Volume 37 Issue 8 Pages 683-686
    Published: 1998
    Released: March 27, 2006
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    We report an 18-year-old male with a history of polyuria, polydipsia, and thirst since childhood. In a hypertonic saline infusion test, the patient's plasma vasopressin rose only to 0.28 pg/ml. In a water deprivation test, his urinary osmolality rose only to 189 mosmol/kg and then rose to 538 mosmol/kg by vasopressin administration. A Tl-weighted magnetic resonance imaging (MRI) scan revealed a loss of the posterior pituitary bright spot. Sequencing of the vasopressin gene showed a heterozygous point mutation that replaced Ala at the carboxyterminus of the signal peptide with Thr. His father also had similar history, and we therefore diagnosed his illness as familial central diabetes insipidus.
    (Internal Medicine 37: 683-686, 1998)
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  • Takumi YOSHIDA, Akiho OBARA, Kohei YAMAUCHI, Toshihide NAKADATE, Akiko ...
    1998 Volume 37 Issue 8 Pages 687-690
    Published: 1998
    Released: March 27, 2006
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    In three cases of primary pulmonary amyloidosis the chief complaint was hemosputum. The diagnosis of amyloidosis was made using histochemical analysis of bronchial wall biopsy in all cases; multiple nodular lesions were observed in trachea and bronchi on flexible fiberoptic bronchoscopy. The surface of the tracheobronchial inucosa was smooth but bled easily. In one patient, chest X-ray film showed a solitary nodular shadow in the left lower lung field. These three cases were tracheobronchial amyloidosis, and one case was combined with nodular parenchymal type amyloidosis.
    (Internal Medicine 37: 687-690, 1998)
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  • Yojiro SADAMOTO, Yasunobu ABE, Kazumi HIGUCHI, Kenichi KATO, Shinji MA ...
    1998 Volume 37 Issue 8 Pages 691-693
    Published: 1998
    Released: March 27, 2006
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    Castleman's disease (CD) usually manifests as a solitary mediastinal tumor and only rarely as an isolated retroperitoneal mass. In the latter instances it is difficult to distinguish radiographically from other retroperitoneal masses. We report a 22-year-old female patient with retroperitoneal CD of the hyaline vascular type presenting with arborizing calcification. This characteristic calcification pattern is considered unique to CD, and is useful in diagnosis when present.
    (Internal Medicine 37: 691-693, 1998)
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  • Yoh-ichi ISHIDA, Manabu UTIKOSHI, Masao KUROSAKI, Katuroh OHTA, Tatsuy ...
    1998 Volume 37 Issue 8 Pages 694-699
    Published: 1998
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 50-year-old woman was treated with prednisolone for polymyositis. During the therapy, thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS) occurred. Neither plasma infusion nor plasma exchange could relieve the clinical manifestations of TTP/HUS. Moreover, massive ascites appeared and worsened her condition. She died approximately one year after the diagnosis of polymyositis. The autopsy revealed centri-lobular hepatic necrosis and nonthrombotic obliteration of hepatic small veins. The diagnosis of hepatic veno-occlusive disease (VOD) was made. It was suspected that common factors other than cytoreductive therapy had damaged the endothelium and caused TTP/HUS and VOD in a case of polymyositis.
    (Internal Medicine 37: 694-699, 1998)
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  • Haruo ICHIKAWA, Tetsuki AMANO, Kenji KAWABATA, Masahiko KUSHIRO, Jun W ...
    1998 Volume 37 Issue 8 Pages 700-703
    Published: 1998
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    We treated a 31-year-old woman with systemic lupus erythematosus, renal failure with nephrotic syndrome, and a long-standing seizure disorder, who developed severe hyperammonemia with a fatal outcome. Blood chemistry examination did not indicate liver disease, and amino acid concentrations did not suggest a defect in the urea cycle. Discontinuation of anticonvulsant treatment with valproic acid (VPA) failed to bring about improvement. We speculated that hyperanimonemia in this case was induced by VPA, and the existence of other underlying factors, including the administration of aspirin and cimetidine, hypoalbuminemia, and renal failure might elevate the concentration of the serum free fraction of VPA.
    (Internal Medicine 37: 700-703, 1998)
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  • Masafumi IHARA, Haruo TANAKA, Yo NISHIMURA
    1998 Volume 37 Issue 8 Pages 704-707
    Published: 1998
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 35-year-old woman was admitted to our hospital with complaints of a two-year history of recurrent, daily episodes of transient ischemic attacks; the symptoms consisted of scotoma of her left eye, vertical diplopia, and paresthesia of her right arm. The presence of lupus anticoagulants and anticardiolipin antibodies led to the diagnosis of antiphospholipid syndrome (APS). After thrombotest values had decreased to 30% (international normalized ratio: 1.5) with warfarin, her symptoms did not recur. This suggests that anticoagulant therapy is effective for the prevention of recurrence of ischemic events complicated by primary APS, even when they occur repeatedly.
    (Internal Medicine 37: 704-707, 1998)
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  • Atsuo TANAKA, Akira SUGAWARA, Kazutomo SAWAI, Takashi KUWAHARA
    1998 Volume 37 Issue 8 Pages 708-710
    Published: 1998
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 39-year-old female visited our hospital because of morning stiffness, arthralgia, skin rash of the extremities and general fatigue. On examination, she also had a malar rash and an oral ulcer. Laboratory findings revealed that antinuclear antibodies were positive and complement component levels (C3, C4, CH50) were all low. Serology for human parvovirus B19 (HPV-B19) was positive for both immunoglobulin (Ig)M and IgG. Gradually, her symptoms improved and laboratory data returned to normal range without medications. This case suggests that HPV-B19 infection may be attributed to the pathogenesis of systemic lupus erythematosus.
    (Internal Medicine 37: 708-710, 1998)
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  • Jun TOJO, Tomoe NISHIMAKI, Hironobu OHYANAGI, Ayako SAITO, Hiromasa OH ...
    1998 Volume 37 Issue 8 Pages 711-714
    Published: 1998
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 61-year-old woman presented with high fever, headache and left facial palsy with diplopia. Histopathological examination of the biosied specimens taken from nasal mucosa and kidney revealed a granulomatous angiitis with giant cell infiltration. Ga-DTPA-enhanced magnetic resonance imaging (MRI) revealed a thickening of dura mater in the middle cranial fossa and tentorium cerebelli. The observed left facial and occulomotor palsy was considered to be caused by pachv meningitis associated with Wegener's granulomatosis (WG). Cyclophosphamide combined with prednisolone effectively improved the symptoms. However, the patient died of acute interstitial pneumonitis, presumably caused by cyclophosphamide. The pathohistology obtained in the autopsy revealed a fibrous thickening of the dura mater in the left meningen with a segmental scarring of the arteries and a necrotizing arteritis in the kidney.
    (Internal Medicine 37: 711-715, 1998)
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  • Mitsunori WATANABE, Toshio FUKUSATO
    1998 Volume 37 Issue 8 Pages 716a
    Published: 1998
    Released: March 27, 2006
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  • Yasuhiro NISHIMOTO, Hiroshi HOSHINO
    1998 Volume 37 Issue 8 Pages 716b-717
    Published: 1998
    Released: March 27, 2006
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