Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
Volume 46, Issue 19
Displaying 1-11 of 11 articles from this issue
  • Tomoyuki Iwasaki, Masato Yoneda, Atsushi Nakajima, Yasuo Terauchi
    2007 Volume 46 Issue 19 Pages 1633-1639
    Published: 2007
    Released on J-STAGE: October 01, 2007
    Objective We investigated the association between the serum butyrylcholinesterase (BChE) activity and parameters of adiposity, insulin resistance and the serum lipid profile, including the serum levels of triglyceride (TG), HDL-cholesterol (HDL-C) and LDL-cholesterol (LDL-C) in Japanese patients with type 2 diabetes and non-diabetic subjects.
    Patients and Methods A total of 259 Japanese subjects [171 patients with type 2 diabetes (age 60.4±11.9 years, BMI 25.0±4.4) and 88 non-diabetic subjects (age 54.2±15.0 years, BMI 25.8±4.7)] were enrolled in the study. To assess the hepatic fat content, the ratio of the CT attenuation value of the liver to that of the spleen (L/S ratio) was calculated.
    Results Serum BChE activity was significantly correlated with various indices of adiposity, including the waist circumference, L/S ratio, visceral fat area (VFA), subcutaneous fat area (SFA) and BMI, and also with the TG, HDL-C, LDL-C and HOMA-R, in the entire subject population. Even after adjustment for five variables, namely, age, gender, HbA1c, CRP and serum ferritin (the serum levels of ferritin and CRP have been reported to be associated with adiposity and insulin resistance), the serum BChE activity was still correlated with the waist circumference, L/S ratio, VFA, SFA, BMI, TG, HDL-C, LDL-C and HOMA-R. Furthermore, changes in the serum BChE activity were associated with changes in the L/S ratio, VFA and SFA at 1 year after the baseline.
    Conclusions These results indicate that the serum BChE activity is associated with parameters of adiposity, the serum lipid profile and the degree of insulin resistance.
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  • Moritsugu Kimura, Masao Toyoda, Keiko Kobayashi, Makiko Abe, Takako Ko ...
    2007 Volume 46 Issue 19 Pages 1641-1645
    Published: 2007
    Released on J-STAGE: October 01, 2007
    Objective Membranous nephropathy (MN) is the most common cause of adult-onset nephrotic syndrome and its management is still controversial. The aim of this study was to determine the effectiveness of corticosteroid-alone therapy for controlling proteinuria in MN.
    Methods Twenty-three patients, which had moderate proteinuria (admission 24-hour urinary protein excretion 1.0 to 3.5 g/day) with primary MN were studied retrospectively.
    Results Thirteen patients received corticosteroid-alone therapy combined with rest and dietary therapy (steroid group), while the other 10 patients were treated with rest and diet alone (non-steroid group). These two groups did not differ with respect to their laboratory features at the time of admission. After discharge, 5 of 13 patients of the steroid group dropped out . Therefore, only 8 patients could be followed up. As the result, 5 of 8 patients (62.5%) achieved complete remission (CR) and 3 of 8 patients (37.5%) had incomplete remission (ICR), so none of the patients failed to improve. On the other hand, 3 of 10 patients of the non-steroid group dropped out. Then, 7 patients were followed up. None of the 7 patients showed improvement during follow-up and 5 of these 7 patients were started on corticosteroids. Finally, as this result, 4 of 5 patients (80%) could achieve CR by 2 years after hospital discharge. Moreover, in the remaining 2 patients from the non-steroid group, no remission could be achieved even 2 years after discharge.
    Conclusion These results suggest that long-term corticosteroid-alone therapy is beneficial for controlling proteinuria in patients with MN.
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  • Yong Bum Park, Dae Young Cheung, Jin Il Kim, Soo-Heon Park, Se-Hyun Ch ...
    2007 Volume 46 Issue 19 Pages 1647-1649
    Published: 2007
    Released on J-STAGE: October 01, 2007
    Inflammatory fibroid polyp (IFP) is a rare, localized, nonneoplastic lesion originating from the submucosa of the gastrointestinal tract. Microscopically, these lesions are made up of a complex network of variable-size blood vessels and diffuse inflammatory cells contained in the edematous stroma. They are most often found in the stomach, followed by the small intestine, and rarely in the esophagus or the large intestine. We report a case of sigmoid colonic IFP presenting bloody stool treated with endoscopic resection.
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  • Nobuhiro Kanaji, Shuji Bandoh, Norihiro Nagamura, Yoshio Kushida, Reij ...
    2007 Volume 46 Issue 19 Pages 1651-1655
    Published: 2007
    Released on J-STAGE: October 01, 2007
    We report a case of epidermal growth factor receptor (EGFR) inhibitor-sensitive lung adenocarcinoma with carcinomatous meningitis who showed a good response to gefitinib, an oral tyrosine kinase inhibitor of EGFR. This good response to gefitinib treatment was attributed to evidence of an EGFR mutation, L858R in exon 21, which was detected in a small amount of cerebrospinal fluid (CSF) before the positive CSF cytology. Patients with carcinomatous meningitis often have a poor performance status, and therefore diagnostic approaches and therapeutic methods are also often limited. Detection of EGFR mutations may be a useful method for non-small cell lung cancer diagnosis, and also facilitate determination of appropriate therapeutic protocols.
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  • Seiko Nakayama, Hiroshi Mukae, Tomohito Morisaki, Noriho Sakamoto, Kaz ...
    2007 Volume 46 Issue 19 Pages 1657-1661
    Published: 2007
    Released on J-STAGE: October 01, 2007
    A 52-year-old woman was admitted to our hospital for further examination of blurred vision, abnormal lung shadows and an elevated level of angiotensin-converting enzyme. Sarcoidosis was suspected, however, careful history taking revealed the existence of photosensitivity and polyarthralgia. Laboratory tests showed lymphocytopenia, liver dysfunction, hypergammaglobulinemia, and positive anti-nuclear, anti-double stranded DNA and anti-smooth muscle antibodies. Liver biopsy examination showed chronic active hepatitis. She was diagnosed with the triplex of sarcoidosis, systemic lupus erythematosus and autoimmune hepatitis. Marked improvement was noted after corticosteroid therapy.
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  • Keiichi Onji, Wataru Matsuura
    2007 Volume 46 Issue 19 Pages 1663-1667
    Published: 2007
    Released on J-STAGE: October 01, 2007
    A 49-year-old man without heart murmur was admitted with fever because of bacteremia following a tooth extraction. Antibiotics rapidly alleviated the fever; however, a small nodule in the pulmonary artery was identified on computed tomography (CT). When the patient experienced chest discomfort with fever, CT demonstrated the absence of the nodule and the appearance of an abnormal lung opacity, and echocardiography showed turbulent retrograde flow in the pulmonary artery. We had the rare opportunity to follow a case of pulmonary bacterial endarteritis and subsequent pulmonary embolism with clinically silent patent ductus arteriosus (PDA) that was confirmed by 3-dimensional CT.
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