Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
Volume 52 , Issue 6
Showing 1-11 articles out of 11 articles from the selected issue
ORIGINAL ARTICLE
  • Daokun Yang, Hai Jun Liang, Duan Li, Xin Wei, Li Ma, Zhansheng Jia
    2013 Volume 52 Issue 6 Pages 653-660
    Published: 2013
    Released: March 15, 2013
    JOURNALS OPEN ACCESS
    Objective Previous studies have reported that telaprevir is effective for treating chronic hepatitis C virus (HCV) genotype 1 infection; however, the efficacy and safety of telaprevir-based regimens remain uncertain.
    Methods To assess the efficacy and safety of telaprevir in patients with chronic HCV genotype 1 infection, we conducted a meta-analysis of all available randomized controlled trials (RCT) comparing the efficacy and safety of the addition of telaprevir to a standard regimen (combination of telaprevir with peginterferon and ribavirin, TPR group) with the standard regimen alone (peginterferon and ribavirin, PR group).
    Results Ultimately, six RCTs involving a total of 2,759 patients with chronic HCV genotype 1 infection were included in this meta-analysis. The outcomes showed that the sustained virologic response (SVR) rate was significantly higher in the TPR group (1,284/1,932, 66.5%) than in the PR group (296/827, 35.8%) with a pooled odds ratio (OR) [3.81, 95% confidence interval (CI) 2.43-5.96, p<0.001]. The results also showed that the relapse rate was significantly lower in the TPR group (190/1,484, 12.8%) than in the PR group (140/425, 32.9%) with a pooled risk ratio (RR) (0.40; 95% CI 0.24-0.66, p<0.001). However, there was an increased risk of serious adverse events in the TPR group (RR=1.45, 95% CI 1.12-1.87, p=0.005).
    Conclusion Telaprevir-based regimens can significantly increase the SVR rate and reduce the relapse rate in patients with chronic HCV genotype 1 infection. However, the safety of telaprevir-based regimens still requires further study.
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CASE REPORTS
  • Jian-Ming Li, Ting Li, Dong-Sheng Xu, Rong-Fang Shi
    2013 Volume 52 Issue 6 Pages 661-665
    Published: 2013
    Released: March 15, 2013
    JOURNALS OPEN ACCESS
    Left ventricular noncompaction (LVNC) is a rare congenital disease. We herein present less common single photon emission computed tomography (SPECT) images of myocardial perfusion in an adult patient with LVNC. The images revealed segmental and seriously decreased myocardial perfusion with moderate enlargement of the left ventricle. Quantitative electrocardiogram-gated SPECT showed a moderately decreased left ventricular ejection fraction with impaired contractions. The SPECT findings were very similar to those of ischemic cardiomyopathy (ICM). Cardiac magnetic resonance (CMR) and echocardiography confirmed the diagnosis of LVNC. Physicians should be aware of this uncommon cardiomyopathy and conduct comprehensive analyses in order to make a better differential diagnosis.
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  • Shunsuke Yamada, Hideki Yotsueda, Tadashi Nagara, Ken Goto, Yutaka Nak ...
    2013 Volume 52 Issue 6 Pages 667-671
    Published: 2013
    Released: March 15, 2013
    JOURNALS OPEN ACCESS
    A 64-year-old man undergoing chronic hemodialysis was admitted under a shock state with macrohematuria and fatigue lasting for two hours. A blood analysis revealed severe anemia. Computed tomography disclosed a large right-sided perirenal hematoma. The patient was successfully treated with radical nephrectomy, leading to a histological diagnosis of spontaneous rupture of renal cell carcinoma (RCC). One year after rupture of the right RCC, he again developed macrohematuria and computed tomography revealed a left-sided perirenal hematoma. Radical nephrectomy followed by a histological examination revealed spontaneous rupture of the left-sided RCC. This case emphasizes the importance of conducting periodic imaging evaluations of chronic hemodialysis patients with renal cystic masses.
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  • Erhan Tatar, Banu Sarsik, Ozkan Gungor, Banu Yaman, Nazan Ozsan, Secki ...
    2013 Volume 52 Issue 6 Pages 673-677
    Published: 2013
    Released: March 15, 2013
    JOURNALS OPEN ACCESS
    The risk of de novo malignancy is significantly higher in patients who have undergone organ transplantation than in the general population. Long-term immunosuppressive treatment, in addition to age, genetic predisposition and infectious agents, plays a major role in the development of malignancy. Although skin and hemopoietic system cancers are common, atypical presentations of malignancies may occasionally be seen during long-term follow-up in patients with functioning allografts. In this report, four cases, each with more than one different primary malignancy (one patient with three malignancies and three patients with two malignancies), are presented.
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  • Yee Hyung Kim, Young Kyung Lee, Jee-Hong Yoo
    2013 Volume 52 Issue 6 Pages 679-683
    Published: 2013
    Released: March 15, 2013
    JOURNALS OPEN ACCESS
    Asthma is a chronic airway disease characterized by reversible airflow limitation with airway wall thickening. Although some studies have reported changes in airway dimensions estimated on chest CT in patients with chronic asthma, little is known about dynamic changes in airway dimensions between acute exacerbations of asthma and recovery. Our case documents significant changes in the bronchial wall, as estimated on serial chest CT scans, over a short-term interval during an exacerbation of asthma.
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  • Satoshi Ano, Yuko Morishima, Yukio Ishii, Mio Kawaguchi, Yosuke Matsun ...
    2013 Volume 52 Issue 6 Pages 685-687
    Published: 2013
    Released: March 15, 2013
    JOURNALS OPEN ACCESS
    We herein report the case of a 39-year-old man with recurrent asthma exacerbations preceded by abdominal cramps with the urge to defecate. The patient had a history of near-fatal asthma associated with these gastrointestinal symptoms starting five years before his admission. He stated that, even when his daily asthma symptoms were under control, he suffered from attacks, especially when he had a strong urge to defecate. Although the contribution of increased parasympathetic tone to the onset of bronchospasms was likely, anticholinergics were not effective. Instead, the patient's symptoms successfully improved following the prophylactic use of laxatives, which might therefore be an appropriate therapeutic option for this type of asthma.
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  • Zhiyong Yu, Liangding Hu, Min Jiang, Hongmei Ning, Chen Xu, Botao Li, ...
    2013 Volume 52 Issue 6 Pages 689-693
    Published: 2013
    Released: March 15, 2013
    JOURNALS OPEN ACCESS
    Infection with Scedosporium apiospermum (S. apiospermum) is rare, although it is associated with a high fatality rate, especially in immunosuppressed patients. A 23-year-old man with acute myelogenous leukemia (AML) (M2) who was pretreated with chemotherapy for autologous bone marrow transplantation developed a skin ulcer on the left groin. After a culture study demonstrated the presence of S. apiospermum, voriconazole was administered and the lesion rapidly improved. Since a diagnosis of S. apiospermum continues to depend on the results of a fungal culture and most isolates of S. apiospermum are resistant to amphotericin B, voriconazole should be considered as the first choice when "mold" is thought to be the causative organism.
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