Japanese Journal of Medicine
Online ISSN : 1881-123X
Print ISSN : 0021-5120
Volume 26, Issue 3
Displaying 1-23 of 23 articles from this issue
  • Fumimaro Takaku
    1987 Volume 26 Issue 3 Pages 313
    Published: 1987
    Released on J-STAGE: March 27, 2006
    JOURNAL FREE ACCESS
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  • Tamotsu FUKUOKA, Shigeru FUJITA
    1987 Volume 26 Issue 3 Pages 314-318
    Published: 1987
    Released on J-STAGE: March 27, 2006
    JOURNAL FREE ACCESS
    Clinical responses of patients with acute leukemia (AL) following the myelodysplastic syndrome (MDS) to the standard therapy are poor. It is considered that the greatly decreased hemopoiesis in these cases is responsible for their clinical picture. We studied leukemia-associated inhibitory activity (LIA), which inhibited human granulocyte-macrophage progenitors, in these patients. Peripheral blood (PB) mononuclear cells (MNC) suppressive to granulocyte-macrophage colony formation were present in 3 of 5 cases of de novo AL and in 3 of 4 cases of AL following MDS. The PB MNC-cultured media from these cases also suppressed colony formation. The elution patterns of LIA of these cases were almost identical in gel chromatography. These results suggest that LIA may be responsible for the suppression of normal granulopoiesis in some patients with AL developed from MDS, and that the profound derangement of normal hemopoietic capability in these cases may be due to multiple complex factors.
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  • Taizo NAKAMURA, Yoshinobu IWASAKI, Yoshitsugu TANAKA, Takashi FUKABORI
    1987 Volume 26 Issue 3 Pages 319-322
    Published: 1987
    Released on J-STAGE: March 27, 2006
    JOURNAL FREE ACCESS
    Radioactive human serum albumin (RHSA) and urea were injected into the pleural cavity of patients with pleural effusions. The dynamics of the pleural liquid was investigated based on the volume of the pleural liquid and on the change in the concentrations of markers. RHSA concentration in the pleural liquid decreased linearly and slowly. Urea disappeared rapidly and exponentially. The analysis shows that water exchanges rapidly at the pleural capillary and that the volume of the pleural liquid is an affecting factor on the turnover of the pleural volume. The dynamics of malignant effusion was the same as that of tuberculous effusion.
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  • Hideo MATSUURA, Subramanian RANGANATHAN, Masaharu YAMAMOTO, Bruce A KA ...
    1987 Volume 26 Issue 3 Pages 323-325
    Published: 1987
    Released on J-STAGE: March 27, 2006
    JOURNAL FREE ACCESS
    Concanavalin A bound to the cell surface decreased the binding and internalization of low density lipoproteins (LDL) to human skin fibroblasts. However, concanavalin A failed to inhibit the degradation of preinternalized LDL. Concanavalin A inhibited the activation of acyl-CoA: cholesterol acyltransferase by LDL. These results strongly suggest that concanavalin A inhibits the metabolism of LDL in human skin fibroblasts by affecting the receptor binding and internalization of LDL.
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  • Nobuyuki HAMAJIMA, Kunio AOKI, Ryuichiro SASAKI, Takuji YAMADA, Akihik ...
    1987 Volume 26 Issue 3 Pages 326-331
    Published: 1987
    Released on J-STAGE: March 27, 2006
    JOURNAL FREE ACCESS
    In order to detect risk factors of gastric ulcer among male workers in Japan, a workplace-based casecontrol study was conducted in a municipal government, using cases registered during 1981 to 1983 with individually matched controls. Statistically significant factors in univariate analysis were smoking, time interval from waking up to leaving home for job, meal time for supper, sleeping hours, anxiety, and gloomy feeling. Logistic analysis showed that among the above factors the significant relative risks were 11.9 (95% confidence interval: 1.6-89.4) for 1-9 cigarettes per day, 9.9 (2.6-37.7) for 10 cigarettes or more per day, and 5.3 (1.6-17.5) for gloomy feeling. These findings obtained among the male Japanese workers were almost consistent with those epidemiologic results in other developed countries that smoking and personality traits are major risk factors of gastric ulcer.
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  • A PAURANIK, M BEHARI, M C MAHESHWARI
    1987 Volume 26 Issue 3 Pages 332-334
    Published: 1987
    Released on J-STAGE: March 27, 2006
    JOURNAL FREE ACCESS
    Case histories of two young Indian female patients are described who, during the course of regular chemotherapy for tuberculous meningitis, developed tuberculoma as suggested by CT-scan. Such lesions were not seen at the start of treatment. Twelve similar cases are collected from literature. Most of the patients developed new symptoms and/or signs having initially shown good response to drugs. The pathogenetic mechanisms for such an evolution of lesions are not known but possibly include immunological modulations. This development should not lead to excessive anxiety for treating physician. Surgery is not needed and a patient follow up is well rewarded. Pyrazinamide has emerged as a useful drug.
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  • Yasuo IWASAKI, Masao KINOSHITA
    1987 Volume 26 Issue 3 Pages 335-338
    Published: 1987
    Released on J-STAGE: March 27, 2006
    JOURNAL FREE ACCESS
    In order to investigate the mode of progression in motor neuron disease (MND), and find if there is any correlation between the muscular pathology and prognosis of the disease, activity index (ACT), atrophy factor of type I muscle fibers (Al), and type II (A2), hypertrophy factor of type I muscle fibers (HI), and type II (H2) and grouping factors were analyzed. Thirty-five patients with MND were evaluated whether there were any factors correlated to the severity of ACT. Among various factors, Al showed the most significant change to the severity of ACT. Therefore, it was suggested that Al was best correlated with the rate of prognosis of the disease process. Probably involvement of the motor neuron innervating type I muscle fibers takes place in the earlier stage than that of the neurons of type II, or there might be some difference of innervation ratio between type I and type II fibers. Further investigation is necessary to evaluate the relationship between the actual prognosis of these patients and their ACT by follow up study.
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  • Susumu SUGAI, Junko TACHIBANA, Makoto SAWADA, Shiro SHIMIZU, Yuko HIRO ...
    1987 Volume 26 Issue 3 Pages 339-347
    Published: 1987
    Released on J-STAGE: March 27, 2006
    JOURNAL FREE ACCESS
    Six patients with malignant lymphomas in autoimmune diseases are described. Four patients who had Sjögren's syndrome (SS) alone or with progressive systemic sclerosis (PSS) or rheumatoid arthritis (RA) developed non-Hodgkin's lymphomas of the B cell type. One patient who had systemic lupus erythematosus (SLE) developed a B cell lymphoma. Another patient with chronic thyroiditis (ChTD) and idiopathic thrombocytopenic purpura (ITP) had a T cell (OKT3/T4) lymphoma. In 5 patients, the autoimmune diseases (2SS, SS/PSS, SS/RA and SLE) preceded B cell lymphomas by one to ll years. In the patient with ChTD/ITP, ChTD and a malignant lymphoma were found simultaneously. A review of Japanese reports on lymphoproliferative disorders associated with these autoimmune diseases is given. This report offers the suggestion that disorders in the immunoregulatory system caused by autoimmune diseases may predispose lymphoproliferative disorders.
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  • Possible Role of T-lymphocytes
    Kunihiko AOYAGI, Norihiko OHHARA, Seiichi OKAMURA, Teruhisa OTSUKA, Ts ...
    1987 Volume 26 Issue 3 Pages 348-352
    Published: 1987
    Released on J-STAGE: March 27, 2006
    JOURNAL FREE ACCESS
    Posthepatitic aplastic anemia (PHAA) is rather uncommon. Most reported cases have developed after non-A, non-B or B type hepatitis. The only case of PHAA occurring after hepatitis A reported so far, was described by Smith et al., who diagnosed it by the long-term elevation of IgG-class antibody in response to hepatitis A virus. Recently, the detection of IgM-class antibody specific against hepatitis A virus (IgM anti-HAV) has been commonly employed for precise diagnosis of hepatitis A. The case reported here is the first case of PHAA occurring after hepatitis A to be diagnosed by radioimmunoassay of IgM anti- HAV. Furthermore, evidence is presented suggesting that the PHAA may have been an immune-related response. Addition of the patient's peripheral T-lymphocytes to cultures of her own bone marrow cells resulted in a reduction in the number of colony-forming units in culture (CFU-C).
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  • Hideo KOBAYASH, Takashi DANBARA, Yasuo SUGAMA, Tatsuya SAITO, Satoshi ...
    1987 Volume 26 Issue 3 Pages 353-359
    Published: 1987
    Released on J-STAGE: March 27, 2006
    JOURNAL FREE ACCESS
    The mediastinum was studied by endoscopie ultrasonography in 121 lung cancer patients. This method facilitates the observation of the lymph nodes, the large vessels and heart in the mediastinum in real time and dynamically. In this paper, the orientation of mediastinal lymph nodes was ultrasonographically studied. This method can detect lymph nodes as small as 3 mm in diameter, and very highly those in bracheobronchial, subaortic, subcarinal, and hilar regions. The mediastinal vascular structures were also easily detected. This method can provide full clinical applicability for analysis of mediastinal involvements in lung cancer patients.
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  • Mitsuko OKADA, Hideki TAKAHASHI, Toshihiro NUKIWA, Rokuro MATSUOKA, Ma ...
    1987 Volume 26 Issue 3 Pages 360-367
    Published: 1987
    Released on J-STAGE: March 27, 2006
    JOURNAL FREE ACCESS
    Despite the relatively high cost and complicated procedures, Gallium-67 (67Ga) scanning and bronchoalveolar lavage (BAL) are increasingly advocated as more sensitive indicators of disease activity in sarcoidosis than chest X-ray and serum angiotensin-converting enzyme activity (SACE). To evaluate the clinical usefulness of 67Ga scanning and BAL, we followed 31 patients with pulmonary sarcoidosis, using these four parameters, at 9- to 24-month intervals over periods of 9 to 48 months. Weobtained 68 complete evaluations. Close correlations were observed among chest X-ray, 67Ga scanning, SACE, and the percentage of lymphocytes in BAL fluid (p < 0.1 to 0.001). Longitudinal changes were also well correlated in these four parameters (p < 0.001) and paralleled the changes in vital capacity (p < 0.01 to 0.001). However, we were unable to predict the patients' outcome from the initial evaluation of these four parameters. These results suggest that, in terms of their usefulness for estimating disease activity, the differences among these four indicators are negligible. We therefore conclude that chest X-ray and SACE sufficiently reflect disease activity and that, at present, routine evaluation by 67Ga scanning and BAL are not necessarily indicated in the long-term management of pulmonary sarcoidosis.
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  • Motoshi KAINUMA, Yasuhiro SHIMADA
    1987 Volume 26 Issue 3 Pages 368-369
    Published: 1987
    Released on J-STAGE: March 27, 2006
    JOURNAL FREE ACCESS
    A case of unexpected detection of bronchial neoplasm in routine general anesthesia is described. On the basis of this case, fiber-optic bronchoscopy in all patients undergoing general anesthesia as a means of early detection of lung cancer is discussed.
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  • Arthur D SCHWABE, Akira NISHIZAWA
    1987 Volume 26 Issue 3 Pages 370-372
    Published: 1987
    Released on J-STAGE: March 27, 2006
    JOURNAL FREE ACCESS
    A 36-year-old male of pure Japanese ancestry presented with a classical 20-year history of Recurrent Polyserositis manifested by self-limited attacks of fever plus pleuritis, peritonitis or arthritis. These attacks were completely suppressed by daily prophylactic colchicine, but recurred when the drug was briefly discontinued. For the past 10 years he has been on 1.2 mg of colchicine daily and has had no further febrile attacks. Although several cases of periodic or cyclic febrile disorders in patients of Japanese ancestry have been cited in the literature, the patient described here appears to satisy the required criteria for a diagnosis of Recurrent Polyserositis in a Japanese.
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  • Shigeki SAKATA, Shigenori NAKAMURA, Kotaro NAGAI, Takashi KOMAKI, Masa ...
    1987 Volume 26 Issue 3 Pages 373-376
    Published: 1987
    Released on J-STAGE: March 27, 2006
    JOURNAL FREE ACCESS
    We have experienced two cases (Case 1: 21-year-old female, Case 2: 26-year-old female) of systemic lupus erythematosus (SLE) associated with hyperthyroidism. Case 1 had been treated with methimazole (MMI) and betamethasone for approximately two years. Although thyroid function improved with the treatment, laboratory data of SLE deteriorated. She was successfully treated with betamethasone alone. Case 2, who had severe side effect (severe hemorrhage due to gastric ulcer) during prednisolone treatment for SLE, was found to have an additional hyperthyroidism. She was treated with intermittent prednisolone administration alone. Physical findings as well as laboratory data of both SLE and hyperthyroidism improved by the therapy.
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  • Jun-ichi WATANABE, Kazuyoshi YAMAGUCHI, Yukihiko SUGIYAMA, Hideki YOTS ...
    1987 Volume 26 Issue 3 Pages 377-380
    Published: 1987
    Released on J-STAGE: March 27, 2006
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    We present here a case of small lymphocytic B cell lymphoma of the lung which developed in a 51-year-old Japanese man who was asymptomatic while his chest X-rays revealed slowly progressive infiltrative shadows. Findings of transbronchial lung biopsy suggested lymphoproliferative disorders and the diagnosis of B-cell lymphoma of the lung was established with lung specimen obtained by an open lung biopsy and through demonstration of monoclonal surface markers on lymphocytes in fresh frozen lung sections. Diagnostic value of surface marker analysis is emphasized.
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  • Tetsuji KOYAMA, Yoshio OURA, Eizo KAKISHITA, Kiyoyasu NAGAI, Takayuki ...
    1987 Volume 26 Issue 3 Pages 381-384
    Published: 1987
    Released on J-STAGE: March 27, 2006
    JOURNAL FREE ACCESS
    A 28-year-old female, who suffered from thrombotic thrombocytopenic purpura (TTP) in the 14th week of her first pregnancy, recovered after a plasma exchange followed by an induced abortion. From six months after the abortion, she no longer required plasma infusions every 3-4 weeks to prevent a relapse of TTP manifested as thrombocytopenia, and complete remission continued until her next pregnancy. In her second pregnancy, she had an immediate relapse of TTP and responded to plasma infusion until the 24th week. However, the TTP gradually became resistant to plasma infusion, and developed into toxemia with edema, hypertension and proteinuria in the 27th week. Although the TTP was alleviated by the infusion of large amounts of plasma, the placenta failed as the result of numerous white infarcts. She delivered a 948 g live baby by cesarean section in the 33rd week. The baby had transient throbmocytopenia but did not suffer from TTP. The mother required plasma infusions every 3-4 weeks for about five months, and she has continued in remission.
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  • Masashi SHIRAHAMA, Takanobu SAKEMI, Shinichiro OSATO, Toru SANAI, Osam ...
    1987 Volume 26 Issue 3 Pages 385-387
    Published: 1987
    Released on J-STAGE: March 27, 2006
    JOURNAL FREE ACCESS
    A 51-year-old man was admitted 3 hours after ingesting approximately 50 ml of mixture of paraquat and organophosphate insecticide. His arterial oxygen pressure fell progressively to 44.6 mmHg.Diagnosed was paraquat-induced interstitial pneumonia. No improvement was observed after treatment with corticosteroid. The pneumonia, however, resolved after irradiation of both lungs and arterial oxygen pressure showed marked improvement. Radiotherapy to the lungs should be considered only in patients who showed progressive deterioration of respiratory function.
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  • Hitoshi TAKAGI, Shoji YAMADA, Takehiko ABE, Kunio ICHIKAWA, Jiro TAKEZ ...
    1987 Volume 26 Issue 3 Pages 388-392
    Published: 1987
    Released on J-STAGE: March 27, 2006
    JOURNAL FREE ACCESS
    A case of hepatocellular carcinoma (HCC) complicated with vascular invasion of the portal vein, hepatic vein, and pulmonary artery, accompanied by inferior vena caval and renal vein thrombosis, is reported. The patient was a 38-year-old female, positive in serum HBsAg and anti-HBe. Because portal trunk thrombosis was pointed out at the first diagnosis, incomplete transcatheter hepatic arterial embolization was carried out three times and one-shot therapy of anti-cancer agent given once. Four months after the first therapy, the patient died of oliguria and hypotension of sudden onset. The autopsy revealed not only intrahepatic vascular invasion but also tumor growth in the bilateral pulmonary arteries and thrombosis from the inferior vena cava to both renal veins unaccompanied by right atrial growth. Because the renal vein was thrombosed and HCC was accompanied by vascular invasion, especially pulmonary arterial invasion, the patient was thought to have become oliguric and hypotensive before severe hepatic failure. The metastatic tumor had grown in the pulmonary trunk without intra-atrial expansion because of the histological tight junction between the tumor and the wall of that vessel.
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  • Shiun Dong HSIEH, Ritsuko YAMAMOTO, Koshi SAITO, Yasuhiko IWAMOTO, Tak ...
    1987 Volume 26 Issue 3 Pages 393-395
    Published: 1987
    Released on J-STAGE: March 27, 2006
    JOURNAL FREE ACCESS
    A 67-year-old male patient presented with rapid progression of whitening and loss of hair in past 2 months was consulted due to the suspicion of hypothyroidism. He had been told to have cardiomegaly for 3 years. Thyroid function was within normal limit. Prostate biopsy was performed because of prostatic hypertrophy and mild elevation of serum acid phosphatase. Amyloid accumulation was observed in the biopsy specimen. Subsequent skin biopsies revealed the same result. The scalp hair and beard grew and turned to black gradually several months after dimethyl sulfoxide (DMSO) treatment. These findings suggest that some of the manifestation of amyloidosis may respond to DMSO treatment.
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  • Hironao OKABE, Hiromi ISHIBASHI, Harumichi KIMURA, Eisuke YOKOTA, Shir ...
    1987 Volume 26 Issue 3 Pages 396-400
    Published: 1987
    Released on J-STAGE: March 27, 2006
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    We treated a Japanese man with Rendu-Osler-Weber disease and a recurrent encephalopathy with hyperammonemia concomitant with recurrent epistaxis, G-I bleeding, congestive heart failure with aortic and mitral regurgitation, and chronic renal failure. At peritoneoscopy, several telangiectasia were noted on the surface of the liver. Angiographical studies revealed widened and tortuous hepatic arteries with early filling of hepatic veins and small pools of contrast medium scattered throughout the parenchyma. The recurrent encephalopathy was attributed to the porto-systemic shunt formed in the liver.
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  • Tohru OGIHARA, Hiroshi KATOH, Hiroko YOSHITAKE, Shigeru IYORI, Ikuo SA ...
    1987 Volume 26 Issue 3 Pages 401-403
    Published: 1987
    Released on J-STAGE: March 27, 2006
    JOURNAL FREE ACCESS
    We describe a case of a 29-year-old man with hyperthyroidism associated with autoimmune hemolytic anemia and periodic paralysis. Euthyroidism, which was achieved by propylthiouracil, brought inhibition of hemolysis and amelioration of anemia in spite of continuously positive direct and indirect Coombs' tests. Neither adrenocortical steroid nor blood transfusion was administered. Since indirect monospecific Coombs' test was negative against anti-human complements serum, the membrane of red blood cells may be less fragile. This is one reason why hemolysis was inhibited by anti-hyperthyroid therapy only. This may indicate that the hyperdynamic circulatory state secondary to hyperthyroidism plays an important role in the destruction of red blood cells which were coated by anti-red blood cell antibody.
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  • Toshiaki NAKASHIMA, Atsushi SANO, Yoshifumi SETO, Toshikazu NAKAJIMA, ...
    1987 Volume 26 Issue 3 Pages 404-408
    Published: 1987
    Released on J-STAGE: March 27, 2006
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    This is a report of a 27-year-old female with hyperbilirubinemia during treatment with chenodeoxycholic acid (CDCA) for the resolution of gallstones. After CDCA administration, serum bilirubin increased markedly without an apparent obstruction of bile ducts. The histological findings of the liver were compatible with toxic liver injury. Bile acids analysis, however, did not reveal the increment of lithocholic acid, toxic metabolite of CDCA in the serum and the hepatic tissue. The bile acids sulfation and the 6α-hydroxylation of CDCA were also normal. Her jaundice disappeared quickly after discontinuation of CDCA. Presumably, in this case, the stagnation of bile acids in the liver caused by choledochal sands facilitated the toxic effect of CDCA on the damaged hepatocytes.
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  • Yoshikazu KAWAKAMI, Shosoku ABE, Masaharu NISHIMURA, Yoshikazu ARAYA, ...
    1987 Volume 26 Issue 3 Pages 409-412
    Published: 1987
    Released on J-STAGE: March 27, 2006
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    A thirty-three-year-old man with diffuse pulmonary ossification associated with chronic bronchitis is described. Chest roentgenograms of the patient showed diffuse reticulo-nodular shadows partially superimposed by calcified reticular opacities. Marked declines in forced vital capacity and air-flow limitation were associated with decreased diffusing capacity of the lung for CO, hypoxemia, and hypercapnia. In the postmortem examination, diffuse dendriform ossification was found mainly in the alveolar space. Neither interstitial fibrosis nor capillary congestion was found histopathologically in the lung.
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