Internal Medicine

Allergy and Angitis: Two aspects of Churg-Strauss Syndrome

Munehiko MORISHITA

2001 Volume 40 Issue 2 Pages 77
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.77

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Hepatitis C Virus and Cardiomyopathy

Akira MATSUMORI

2001 Volume 40 Issue 2 Pages 78-79
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.78

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Retroviruses and Autoimmunity

Iwao SEKIGAWA, Hitoshi OGASAWARA, Hiroshi KANEKO, Takashi HISHIKAWA, H ...

2001 Volume 40 Issue 2 Pages 80-86
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.80

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The investigation of human retroviruses has shown dramatic progress since the discovery of human immunodeficiency virus (HIV). These studies have also contributed to the exploration of the role of retroviruses, including endogenous retroviruses, in the induction of autoimmune diseases such as systemic lupus erythematosus (SLE). This review describes the potential role of retroviruses in autoimmunity, based on recent findings including our own results.
(Internal Medicine 40: 80-86, 2001)

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Current Status and Future of Lung Transplantation

Hiroshi DATE

2001 Volume 40 Issue 2 Pages 87-95
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.87

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Lung transplantation has been performed successfully outside Japan since 1983 in patients with end-stage lung disease. More than 9, 000 lung transplants have been reported in The Registry of the International Society for Heart and Lung Transplantation. In contrast, a transplant law became effective in Japan only recently, and four universities were designated as official lung transplant centers (Okayama, Osaka, Kyoto and Tohoku Universities). In October 1998, the first successful living-donor lobar lung transplantation was performed at Okayama University. Since then, seven lung transplants (four from living donors and three from cadaveric donors) have been successfully performed in Japan. Although lung transplantation offers acceptable prospects for 5-year survival, chronic rejection and donor shortage remain to be major problems. In an effort to address the donor shortage issue, living-donor lobar lung transplantations have been performed with satisfactory intermediate survival and functional results.
(Internal Medicine 40: 87-95, 2001)

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Epstein-Barr Virus-Associated Gastric Cancer in a Patient with Dermatomyositis

Kentaro YAMASHITA, Masayo HOSOKAWA, Sae HIROHASHI, Yoshiaki ARIMURA, T ...

2001 Volume 40 Issue 2 Pages 96-99
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.96

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A 59-year-old man was admitted presenting systemic rash and muscle weakness. He was diagnosed to have dermatomyositis and a check was made for internal malignancy. Gastrointestinal endoscopy revealed a Borrmann type II tumor on the middle body of the stomach. Biopsy specimens showed a well differentiated adenocarcinoma, and total gastrectomy was performed. The final diagnosis was moderately differentiated adenocarcinoma invading into the proper muscular layer, with metastases to regional lymph nodes. Most of the neoplastic cells were shown to be positive for Epstein-Barr virus by means of EBV-encoded RNA in situ hybridization. The symptoms of dermatomyosi tis disappeared completely after surgery.
(Internal Medicine 40: 96-99, 2001)

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Estrogen Therapy in a Male Patient with Chronic Hepatitis C and Irradiation-induced Testicular Dysfunction

Ichiro SHIMIZU, Toshihiro OMOYA, Yuki KONDO, Yoshihiro KUSAKA, Akemi T ...

2001 Volume 40 Issue 2 Pages 100-104
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.100

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We report an 18-year-old male patient who developed chronic hepatitis C after blood transfusion and had testicular dysfunction after irradiation for a testicular relapse of childhood acute lymphocytic leukemia after cessation of maintenance therapy, and the initiation of testosterone replacement therapy at puberty. Concomitant administration of estradiol resulted in a reduction in serum alanine aminotransferase and ferritin levels and hepatic iron concentration and staining after 2 years of estrogen therapy, although interferon therapy was withdrawn because of adverse effects. This observation suggests that endogenous estradiol may play a beneficial role in male patients with chronic hepatitis C.
(Internal Medicine 40:100-104, 2001)

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Giant Negative T Waves during Interferon Therapy in a Patient with Chronic Hepatitis C

Takayuki FUJIWARA, Katsuyuki KIURA, Koji OCHI, Hiromi MATSUBARA, Hiros ...

2001 Volume 40 Issue 2 Pages 105-109
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.105

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Interferon-a (IFN-α) has been widely used for treatment of chronic hepatitis C in Japan. In general, cardiovascular adverse reactions are rare in association with IFN-α therapy. Here, a 64-year-old man with chronic active hepatitis C complained of fatigue, palpitation and depression, and developed atrial fibrillation with prominent negative T waves during IFN-α therapy. Echocardiogram showed septal and apical hypertrophy. Three days after discontinuation of IFN-α, subjective symptoms and atrial fibrillation subsided. It is unclear whether or not IFN-α induced the giant negative T waves with apical hypertrophy. We might observe the developing course of hepatitis C virus (HCV) - related myocardial hypertrophy by chance. Cardiovascular toxicity should be carefully monitored during IFN-α therapy even in patients with minor cardiac disease, such as premature ventricular contracture (PVC) and mild hypertension.
(Internal Medicine 40: 105-109, 2001)

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Familial Idiopathic Hypoparathyroidism, Sensorineural Deafness and Renal Dysplasia

Shimon ISHIDA, Haruhiko ISOTANI, Keiichi KAMEOKA, Toshiyuki KISHI

2001 Volume 40 Issue 2 Pages 110-113
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.110

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We describe a 27-year-old woman with familial idiopathic hypoparathyroidism, bilateral sensorineural deafness and right renal aplasia. There was a family history of deafness in her father and two other family members with sensorineural deafness, one of whom had hypoparathyroidism. To our knowledge, there have been four previous reports of idiopathic hypoparathyroidism associated with sensorineural deafness and renal dysplasia. The clinical features were not identical to any of the four previous reports. Although no chromosome abnormalities were present in the patient using standard trypsin G-banding analysis, we speculate that some common genetic mutation caused hypoparathyroidism, sensorineural deafness and renal dysplasia.
(Internal Medicine 40: 110-113, 2001)

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Successful Steroid Therapy for Cefdinir-induced Acute Tlibulointerstitial Nephritis with Progressive Renal Failure

Yasukazu KIMURA, Minoru KAWAMURA, Masahiko OWADA, Takuya FUJIWARA, Chi ...

2001 Volume 40 Issue 2 Pages 114-117
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.114

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A 58-year-old woman was admitted to our hospital because of renal dysfunction that continued to progress even after withdrawal of cefdinir, the presumed cause of acute renal failure. Renal histologic findings included interstitial fibrosis accompanied by moderate lymphocytic infiltration, and tubular atrophy with reduced numbers of epithelial cells. Mesangial cells and glomerular basement membranes were nearly normal. Scintigraphy with ⁶⁷gallium disclosed diffuse abnormal accumulation in both kidneys. A lymphocyte stimulation test with cefdinir was positive. The patient was diagnosed with acute tubulointerstitial nephritis caused by cefdinir. Serum creatinine concentrations continued to rise after withdrawal of the drug, but steroid therapy was effective in normalizing renal function.
(Internal Medicine 40: 114-117, 2001)

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Fulminant Pneumonia Due to Aeromonas hydrophila in a Man with Chronic Renal Failure and Liver Cirrhosis

Hiroshi MURATA, Hiroshi YOSHIMOTO, Masatoshi MASUO, Hitoshi TOKUDA, Sh ...

2001 Volume 40 Issue 2 Pages 118-123
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.118

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A 40-year-old man on hemodialysis was admitted due to dyspnea and chest pain and was diagnosed with pneumonia and pericarditis. Ampicillin was administered, but thereafter severe septic shock developed. The fulminant type of pneumonia progressed rapidly, and he died only 48 hours after the onset of symptoms. The autopsy and sputa culture revealed pneumonia due to Aeromonas hydrophila. The source of this infection remained unkown. Interestingly, there were two types of A. hydrophila found during such a short period. The physician should suspect this disease by questioning the patient's history. Early treatment with adequate antibiotics is the only means of saving such a patient's life.
(Internal Medicine 40: 118-123, 2001)

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Analgesic-induced Asthma Caused by 2.0% Ketoprofen Adhesive Agents, But Not by 0.3% Agents

Kosuke KASHIWABARA, Hiroyuki NAKAMURA

2001 Volume 40 Issue 2 Pages 124-126
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.124

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A 74-year-old woman was admitted with an asthma attack. She had a 40-year history of sinusitis, nasal polyp and analgesic-induced asthma; however, asthma had never occurred when she used a 0.3% ketoprofen adhesive patch (Mohrus^®) for stiff shoulder or lumbago. In the hospital, a life-threatening asthma attack suddenly occurred two and a half hours after application of a 2.0% ketoprofen adhesive tape (Mohrus tape^®) to her shoulder. She was treated with bronchodilator and glucocorticoid and extubated after 20 hours. A drug lymphocyte stimulating test (DLST) was strongly positive for ketoprofen. We suspected that drug-induced hypersensitivity coexisted in the present case, but it was not clear whether or not the hypersensitivity was related to the pathogenesis of analgesic-induced asthma.
(Internal Medicine 40: 124-126, 2001)

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Sarcoid Reaction in Primary Tumor of Bronchogenic Large Cell Carcinoma Accompanied with Massive Necrosis

Kosuke KASHIWABARA, Masakazu TOYONAGA, Yuji YAMAGUCHI, Hiroyuki NAKAMU ...

2001 Volume 40 Issue 2 Pages 127-130
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.127

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A 49-year-old woman consulted our hospital for evaluation of a tumor with cavitation in the S⁶ segment of the right lung. She was given a diagnosis of pulmonary tuberculoma because percutaneous needle aspiration cytology revealed epithelioid cells with a background of necrosis. However, a diagnosis of large cell carcinoma with central necrosis (p-T2NOMO) was established by thoracoscopic lung biopsy six months later. Pathological findings of surgical resection specimens showed that epithelioid cell granulomas adjacent to the neoplasm had a sarcoid reaction and the necrosis was related to the rapidly growing tumor because there was no clinical evidence of systemic sarcoidosis and pulmonary mycobacterial or fungal infection. This is the first report in which sarcoid reactions were recognized in a primary large cell carcinoma.
(Internal Medicine 40: 127-130, 2001)

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Rhabdomyolysis Triggered by an Asthmatic Attack in a Patient with McArdle Disease

Kenji TSUSHIMA, Shigeru KOYAMA, Mayumi UENO, Keisaku FUJIMOTO, Takeo I ...

2001 Volume 40 Issue 2 Pages 131-134
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.131

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We describe a patient with McArdle disease who developed rhabdomyolysis triggered by a bronchial asthmatic attack. A 64-year-old man had chronic pulmonary emphysema with asthma, and an asthmatic attack led to severe rhabdomyolysis that required continuous hemodiafiltration. After 2 years, a physical examination revealed atrophy of the extremities compared with previous examinations, especially of the intercostal muscles. During that time, he suffered two severe bronchial asthmatic attacks. His serum level of creatinine kinase remained between 4, 000 and 7, 000 IU/l when he did not suffer from asthmatic attacks and rhabdomyolysis had abated. Therefore, we suspected that his recent muscle atrophy was caused by asthmatic attacks, and discussed the possibility of his respiratory muscle weakness due to McArdle disease in relation to his severe bronchial asthmatic attacks as well as chronic obstructive pulmonary disease.
(Internal Medicine 40: 131-134, 2001)

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Susac's Syndrome: Beneficial Effects of Corticosteroid Therapy in a Japanese Case

Kazuhiro TASHIMA, Eiichiro UYAMA, Yoichiro HASHIMOTO, Toshiro YONEHARA ...

2001 Volume 40 Issue 2 Pages 135-139
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.135

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Susac's syndrome is a rare disorder characterized by the triad of microangiopathy of the brain and retina with hearing loss. More than 50 affected individuals have been reported worldwide, all Caucasians. We herein identify the first Japanese patient with Susac's syndrome. A 36-year-old man developed recurrent subacute encephalopathy, bilateral sensorineural hearing loss, and retinal arteriolar occlusions, caused by microangiopathy from a year previously. T2-weighted MRI showed multiple high-signal lesions predominantly in the periventricular white matter. During the exacerbated phase both high-dose intravenous methylprednisolone and oral prednisone therapy produced beneficial effects. He showed definite remission within 2 years from the disease onset.
(Internal Medicine 40: 135-139, 2001)

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A Patient with Severe Palindromic Rheumatism and Frequent Episodes of Pain

Shingo TAKATA, Seishi HARADA, Fumihiro MITSUNOBU, Takashi MIFUNE, Yasu ...

2001 Volume 40 Issue 2 Pages 140-143
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.140

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A 44-year-old man began to experience episodes of joint pain with erythema in his knees, elbows, shoulders, and hands in April 1996. He was diagnosed as having palindromic rheumatism. Due to the increasing frequency and severity of these episodes, he was admitted to our hospital in May 1999. Heat therapy to the affected area produced a rapid improvement in symptoms. In addition, the continued use of physical therapy during symptom-free periods tended to reduce the frequency and severity of pain attacks. We present this case and discuss treatment options in patients with palindromic rheumatism.
(Internal Medicine 40: 140-143, 2001)

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1. Hypertension and Genes

Jitsuo HIGAKI, Tomohiro KATSUYA, Ryuichi MORISHITA, Toshio OGIHARA

2001 Volume 40 Issue 2 Pages 144-147
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.144

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Under classical strategy, scientists have tried first to find a physiological phenomenon specific for essential hypertension, then to identify the protein underlying the physiological abnormality, and finally to clarify the causative gene which encoded the protein. On the other hand, under the reverse genetic approach, the correlation between hypertension and genetic abnormality is identified first, and then the pathogenesis is clarified-in reverse order. Therefore, it is not extraordinary for unexpected results to be obtained in the correlation between a gene and a disease, suggesting that this approach has a possibility to be a breakthrough in the chaos of hypertension research.

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2. Genetic Engineering in Hypertension Research

Hiroki KURIHARA

2001 Volume 40 Issue 2 Pages 147-151
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.147

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3. The Sympathetic Nervous System in Essential Hypertension: Pathophysiological Significance

Shuichi TAKISHITA

2001 Volume 40 Issue 2 Pages 151-153
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.151

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4. Pathogenesis of Hypertension -Kidney as a Pathogenetic Organ of Hypertension-

Koichi HAYASHI

2001 Volume 40 Issue 2 Pages 153-156
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.153

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5. Renin-Angiotesin System and Hypertension

Toshiro FUJITA

2001 Volume 40 Issue 2 Pages 156-158
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.156

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1. Diffuse Infiltrative Lung Disease -New Clinical Biomaker in Diffuse Interstitial Pneumonia

Shosaku ABE, Hiroki TAKAHASHI

2001 Volume 40 Issue 2 Pages 159-162
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.159

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2. Obstructive Lung Disease

Ken OHTA

2001 Volume 40 Issue 2 Pages 162-164
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.162

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3. Immunological Lung Disease -Recent Advances in the Pathogenesis of Hypersensitivity Pneumonitis

Yasuyuki YOSHIZAWA, Tadashi FURUIE, Yoshio OTANI, Yuki SUMI, Megumi SA ...

2001 Volume 40 Issue 2 Pages 164-167
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.164

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4. Molecular Pathogenesis of Lung Cancer and Its Molecular Targeted Therapy

Saburo SONE, Tsutomu SHINOHARA, Yasuhiko NISHIOKA, Seiji YANO

2001 Volume 40 Issue 2 Pages 167-170
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.167

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5. Respiratory Tract Infection

Atsushi SAITO, Kazuyoshi KAWAKAMI, Futoshi HIGA

2001 Volume 40 Issue 2 Pages 171-172
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.171

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1. Hepatitis Viruses Update

Kazuhiko KOIKE

2001 Volume 40 Issue 2 Pages 173-175
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.173

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2. Recent Advances in Acute and Fulminant Hepatitis in Japan

Satoshi MOCHIDA, Kenji FUJIWARA

2001 Volume 40 Issue 2 Pages 175-177
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.175

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3. Update of Liver Disease Related to Chronic Hepatitis B Virus Infection

Tetsuya ISHIKAWA, Shinichi KAKUMU

2001 Volume 40 Issue 2 Pages 178-179
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.178

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4. Topics of Type C Chronic Liver Disease

Norio HAYASHI

2001 Volume 40 Issue 2 Pages 180-181
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.180

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5. Clinical Practice of Hepatitis: Myocardial Diseases, Nephritis, and Vasculitis Associated with Hepatitis Virus

Akira MATSUMORI

2001 Volume 40 Issue 2 Pages 182-184
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.182

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6. Hepatitis Virus and Extrahepatic Manifestations -Skin, Mucosa, Muscle, and Hematopoietic Organs-

Michio SATA, Yumiko NAGAO

2001 Volume 40 Issue 2 Pages 185-189
Published: 2001
Released on J-STAGE: March 27, 2006

DOIhttps://doi.org/10.2169/internalmedicine.40.185

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