Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
Volume 42 , Issue 2
Showing 1-21 articles out of 21 articles from the selected issue
  • Shunichi KUMAKURA, Shotai KOBAYASHI
    2003 Volume 42 Issue 2 Pages 133-134
    Published: 2003
    Released: March 27, 2006
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  • Nobuhiro YAMADA
    2003 Volume 42 Issue 2 Pages 135-136
    Published: 2003
    Released: March 27, 2006
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  • Kazuo Otake, Junko Takagi
    2003 Volume 42 Issue 2 Pages 137-138
    Published: 2003
    Released: March 27, 2006
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  • Hiroshi Shoji, Masahide Kaji
    2003 Volume 42 Issue 2 Pages 139
    Published: 2003
    Released: March 27, 2006
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  • Shigemasa Sawada, Masami Takei
    2003 Volume 42 Issue 2 Pages 140-141
    Published: 2003
    Released: March 27, 2006
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  • RYUZO SASAKI
    2003 Volume 42 Issue 2 Pages 142-149
    Published: 2003
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    Erythropoietin (EPO) produced by the fetal liver and adult kidney is an essential stimulator of erythropoiesis. EPO production is regulated through hypoxic activation of gene transcription and possibly hypoxia-induced stabilization of its mRNA. In the liver of early embryos in which EPO production poorly responds to hypoxia, retinoic acid may be an important stimulator. In this decade, new sites of EPO production have been found: central nervous system and reproductive organs. These tissues have a paracrine and/or autocrine system of EPO, which is independent of the endocrine system (kidney/bone marrow) in adult erythropoiesis. In the central nervous system, astrocytes are the main producers of EPO, while EPO receptor is expressed in neurons. EPO protects neurons from a various types of damage. The uterine EPO is likely involved in the estrogen-dependent angiogenesis of the endometrial layer. The possible functions of EPO in other tissues and tissue-characteristic regulation of EPO production are also discussed in this review.
    (Internal Medicine 42: 142-149, 2003)
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  • Nobuya OBANA, Sho TAKAGI, Yoshitaka KINOUCHI, Yoshihisa TOKITA, Akihir ...
    2003 Volume 42 Issue 2 Pages 150-153
    Published: 2003
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    Objective Telomere shortening is correlated with cell turnover and aging, but it has been recently suggested to occur not only by aging but by several biochemical factors of metabolic disorders predisposing to atherosclerosis.
    Patients and Methods We compared telomere length of peripheral blood mononuclear cells of patients with the metabolic disorders, hypercholesterolemia (HC) and diabetes mellitus (DM), according to the presence or absence of coronary diseases.
    Results The results demonstrated that HC and/or DM patients with coronary diseases have significantly shorter telomere length than healthy controls (p=0.0014).
    Conclusion Telomere shortening may be involved in the mechanisms that promote coronary diseases under some circumstances of metabolic disorders.
    (Internal Medicine 42: 150-153, 2003)
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  • Tetsuya ISHIDA, Katsuro HIMENO, Yasuko TORIGOE, Megumi INOUE, Osamu WA ...
    2003 Volume 42 Issue 2 Pages 154-157
    Published: 2003
    Released: March 27, 2006
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    We report a case of selenium deficiency in a patient with Crohn's disease on long-term total parenteral nutrition (TPN). She manifested lassitude of the legs, discoloration of the nail beds, and macrocytosis. Since her plasma selenium level was found to be below the measurable level, we diagnosed this case as selenium deficiency. After intravenous administration of sodium selenite, her symptoms were reversed. Careful attention should be paid to selenium deficiency when a patient receives long term TPN; supplementary administration of selenium via TPN maybe required because selenium is often not routinely added to TPN formulations.
    (Internal Medicine 42: 154-157, 2003)
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  • Keiko KAWAI, Kojiro MICHITAKA, Shozo MIYAUCHI, Masahiro SANO, Masanori ...
    2003 Volume 42 Issue 2 Pages 158-162
    Published: 2003
    Released: March 27, 2006
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    A 50-year-old woman was diagnosed with acute-onset autoimmune hepatitis. She did not respond to steroid therapy including pulse therapy, and was subsequently treated with living donor-liver transplantation 36 days after the beginning of steroid therapy. Except for a period of transient mild acute rejection, her liver function tests remained within a normal range for 2.5 years after the operation. The courses of autoimmune hepatitis patients treated with living-donor liver transplantation have not been previously documented to our knowledge. Living donor-liver transplantation is thought to be one of the therapy options for severe autoimmune hepatitis.
    (Internal Medicine 42: 158-162, 2003)
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  • Satoshi KURISU, Ichiro INOUE, Takuji KAWAGOE, Masaharu ISHIHARA, Yuji ...
    2003 Volume 42 Issue 2 Pages 163-167
    Published: 2003
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 67-year-old man, who was previously diagnosed with vasospastic angina and treated with standard therapy, was admitted to our hospital because of recurrent chest pain refractory to sublingual nitroglycerin. Admission electrocardiography revealed ST segment elevation in II, III and aVF, and his symptoms were relieved by intravenous bolus administration of nicorandil. He was diagnosed to have active variant angina, and remained symptomatic even after treatment with calcium antagonists and nitrates at optimal doses. Intravenous bolus administration of nicorandil was consistently effective to relieve his symptoms. Anginal attack was finally prevented by massive oral nicorandil in addition to conventional treatment.
    (Internal Medicine 42: 163-167, 2003)
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  • Keiko YAMAGAMI, Katsunobu YOSHIOKA, Haruna SAKAI, Mariko FUKUMOTO, Tet ...
    2003 Volume 42 Issue 2 Pages 168-173
    Published: 2003
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 26-year-old woman 3 months post-partum was admitted to our hospital suffering from gross visual disturbance. Magnetic resonance imaging (MRI) revealed a pituitary mass, extending into the suprasellar cistern, with intense gadolinium enhancement. Lymphocytic hypophysitis (LHy) was suspected, and the patient received high dose methylprednisolone pulse therapy (HDMPT). Her visual disturbance was dramatically ameliorated on the first day following initiation of HDMPT, and MRI revealed marked mass reduction. Her pituitary function recovered 6 months after therapy. This case report suggests that HDMPT proved effective for mass reduction of severe LHy and could obviate the need for a useless surgery.
    (Internal Medicine 42: 168-173, 2003)
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  • Masayasu YONEDA, Kiyoshi ODA
    2003 Volume 42 Issue 2 Pages 174-177
    Published: 2003
    Released: March 27, 2006
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    A 40-year-old man was hospitalized due to fever, muscular swelling and pain. He had poorly controlled diabetes with many dental caries and repeated periodontitis. CT revealed multiple intramuscular abscesses; administration of antibiotics and pus drainage were performed. Intraoral infection was suspected as the route of infection of pyomyositis, and a total of six teeth was extracted. In the clinical treatment of diabetic patients, it is important to instruct patients to routinely check for the presence of traumatic injuries of the lower extremities, and to have routine check-ups and dental care to check for dental caries or periodontitis.
    (Internal Medicine 42: 174-177, 2003)
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  • Emi MACHIDA, Masayuki HANIUDA, Takashi EGUCHI, Makoto KURAI, Takeshi Y ...
    2003 Volume 42 Issue 2 Pages 178-181
    Published: 2003
    Released: March 27, 2006
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    Mediastinal granular cell tumor is an exceptionally rare tumor; there are only a few previously reported cases. Wereport a 21-year-old man with a granular cell tumor in the right posterior mediastinum. Chest computed tomography scans and magnetic resonance imaging revealed a 15×20 mm well circumscribed, homogeneous mass, which was closely associated with the vertebral column. The T1-weighted magnetic resonance image showed low intensities, and moderate intensities were found on the T2-weighted magnetic resonance image. Gd-DTPA enhancement was remarkable on the tumor surface. The present case differed from ordinary neurogenic tumors in magnetic resonance imaging findings. Thoracoscopic resection of the tumor was performed. The tumor was associated with the sympathetic nerve. Histologic analysis revealed a benign granular cell tumor.
    (Internal Medicine 42: 178-181, 2003)
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  • Kazuhiro IYONAGA, Kazuya ICHIKADO, Hiroyuki MURANAKA, Kazuhiko FUJII, ...
    2003 Volume 42 Issue 2 Pages 182-186
    Published: 2003
    Released: March 27, 2006
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    Multicentric Castleman's disease (MCD) is an uncommonand often incurable lymphoproliferative disorder. There has been some recent evidence that rare cases of MCD manifest diffuse lung involvement, but the features in these cases are not well characterized. We report just such a biopsy-proven case of MCD with typical laboratory abnormalities including serum interleukin-6 elevation and characteristic high-resolution CT findings. Immunopathologically, the features of the lung tissue resembled those of lymphocytic interstitial pneumonia with predominant infiltration of B cells and plasma cells. In addition, the abnormal appearance of B cells in bronchoalveolar lavage fluid was of diagnostic value. Although MCD is often refractory to treatment including corticosteroid, chemo-and immuno-therapy, we show successful treatment with corticosteroid and cyclophosphamide and 4 years of complete remission.
    (Internal Medicine 42: 182-186, 2003)
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  • Tetsuro OHNISHI, Gen YAMADA, Noriharu SHIJUBO, Yoko TAKAGI-TAKAHASHI, ...
    2003 Volume 42 Issue 2 Pages 187-190
    Published: 2003
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 47-year-old man, who had been diagnosed as myelodysplastic syndrome (MDS), complained of a severe cough and a high-grade fever. Chest CT disclosed scattered small nodules and ground-glass opacities with interlobular septal thickening in both lung fields and a mass lesion in the right lower lobe. Pathological findings of the ground-glass opacities and the mass lesion obtained by video-assisted thoracoscopic surgery revealed the accumulation of eosinophilic amorphous material in the alveoli and confirmed the diagnosis of pulmonary alveolar proteinosis (PAP). Autoantibodies against granulocyte-macrophage colony-stimulating factor (GM-CSF) in sera were below sensitivity, while the GM-CSF level was elevated in bronchoalveolar lavage fluid. He was diagnosed as secondary PAP associated with MDS.
    (Internal Medicine 42: 187-190, 2003)
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  • Naoko NAKAMURA, Kazuya NOKURA, Takaaki ZETTSU, Hiroshi KOGA, Masayuki ...
    2003 Volume 42 Issue 2 Pages 191-194
    Published: 2003
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    We describe two adult cases of neurologic complications occurring after influenza vaccination. The first case was a 62-year-old man who experienced convulsions 5 days after vaccination, and the second case was a 70-year-old man who exhibited paraplegia 7 days after vaccination. Diagnoses of acute disseminated encephalomyelitis and transverse myelitis with acute motor axonal neuropathy were made, respectively, and steroid pulse therapy and intravenous gamma globulin therapy alleviated the patients' symptoms. Although the efficacy and cost benefit of influenza vaccination have been widely accepted, such neurologic complications might occur in the elderly or even in adults.
    (Internal Medicine 42: 191-194, 2003)
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  • Munehisa SHIMAMURA, Eiichiro UYAMA, Teruyuki HIRANO, Tatsuhumi MURAKAM ...
    2003 Volume 42 Issue 2 Pages 195-198
    Published: 2003
    Released: March 27, 2006
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    We report a Japanese case of sporadic Creutzfeldt-Jakob disease (CJD) presenting as progressive supranuclear palsy. For 2 years after onset, neurological deficits had slowly progressed but neither myoclonusnor periodic synchronous discharge was observed. Diffusion-weighted image (DWI) showed unique high signal lesions in the bilateral frontal cortex, left parietooccipital and occipital cortices, but there was nearly no change eight months later. Needle biopsy revealed deposition of prion protein of a patchy/perivacuolar type with spongiform degeneration. Thus, the phenotype of sporadic CJD seems variable and DWI should be performed, even in atypical cases lacking the characteristics of CJD.
    (Internal Medicine 42: 195-198, 2003)
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  • Takashi NlSHIDA, Aya M. TOKUMARU, Katsumi DOH-URA, Akira HlRATA, Kazuo ...
    2003 Volume 42 Issue 2 Pages 199-202
    Published: 2003
    Released: March 27, 2006
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    We describe a 67-year-old Japanese man with probable sporadic Creutzfeldt-Jakob disease (CJD) who had valine homozygosity at codon 129, a rarity in the Japanese. T2-weighted magnetic resonance imaging (MRI) detected high-intensity lesions in the bilateral middle cerebellar peduncles and basal ganglia as well as cerebellar and cortical atrophy. He developed cerebellar ataxia and subsequent mental deterioration, myoclonus, and periodic synchronous discharge as shown in an electroencephalogram. Cerebrospinal fluid examination showed a high level of neuron-specific enolase and a positive immunoassay for the 14-3-3 protein. He died of pneumonia 10 months after the initial symptomsappeared. Whether or not the genetic polymorphism increased his susceptibility to sporadic CJD is not clear because valine homozygosity at codon 129 is less than 1% in the normal Japanese population. Although there is no convincing evidence in the present case, the MRI findings of cerebellar peduncle changes, which are rare in CJD, suggest a kind of degeneration, demyelination, or both.
    (Internal Medicine 42: 199-202, 2003)
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  • Yuya KUNISAKI, Hiroshi GOTO, Kikuo KITAGAWA, Masanori NAGANO
    2003 Volume 42 Issue 2 Pages 203-207
    Published: 2003
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    A 22-year-old woman with ulcerative colitis developed skin eruptions, liver dysfunction, and atypical lymphocytes in the peripheral blood two weeks after she started taking salazosulfapyridine (SASP). Skin eruptions and liver damage were severe. Drug-induced lymphocyte stimulation test (DLST) for SASP was positive. She was diagnosed as having SASP-induced hypersensitivity syndrome (HS). Corticosteroid therapy was needed to suppress these reactions. The transient elevation of HHV-6 IgG titer paralleled the symptoms, which indicated that these reactions were associated with the reactivation of HHV-6. Wesuggest that HHV-6 IgG titer is one of the modalities for the diagnosis and the prediction of the clinical course of HS.
    (Internal Medicine 42: 203-207, 2003)
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  • Yoshihiro MATSUKAWA, Noboru KITAMURA, Motohide KANEKO, Daijirou YOSHIO ...
    2003 Volume 42 Issue 2 Pages 208-210
    Published: 2003
    Released: March 27, 2006
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    An alcohol abuser with hepatitis C developed multibacterial sepsis. His mean 100% alcohol intake reached 400 ml/day. In January 2001, he suddenly experienced fever (39°C) with no other symptoms. One week later, he was admitted to our hospital and was subsequently diagnosed with sepsis associated with four species of bacteria (Streptococcus constellatus, Fusobacterium mortiferum, Bacteroides thetaiotaomicron, and non-spore-forming anaerobic gram-positive bacillus). A drip infusion of imipenem/cilastatin was administrated, resulting in a successful therapeutic outcome. No underlying disorder was found except for gastric ulcers and hepatic cirrhosis. Damagedgastric mucosa was assumed to be the possible cause and route for the bacterial invasion.
    (Internal Medicine 42: 208-210, 200
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  • Takayuki KAWAGUCHI, Naoya IGAKI, Sinichi KINOSHITA, Tomokazu MATSUDA, ...
    2003 Volume 42 Issue 2 Pages 211-218
    Published: 2003
    Released: March 27, 2006
    JOURNALS FREE ACCESS
    We searched for innovative treatments specifically targeted to the cytokines of three critically ill patients with streptococcal toxic shock syndrome (STSS). Direct hemoperfusion with polymyxin B-immobilized fiber improved the hemodynamicsin all three patients whohad developed shock at presentation. Continuous hemodiafiltration coupled with plasma exchange for simultaneous removal of several mediators of the inflammatory cascade improved outcome in case 2 and lessened the aggressive clinical course and prolonged survival in case 3. The application of these technologies appears to open new and interesting therapeutic options and may lead to improved survival in STSS.
    (Internal Medicine 42: 211-218, 2003)
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