- 著者
- Aygul Dogan Celik Yahya Celik Zerrin Yulugkural Kemal Balci Ufuk Utku
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.47, no.23, pp.2091-2093, 2008 (Released:2008-12-01)
- 参考文献数
- 6
- 被引用文献数
- 3 6
Brucellosis is a zoonosis that is transmissible to humans. It is a disease with multi-systemic involvement caused by the genus Brucella. Neurological complications, including meningitis, meningo-encephalitis, myelitis-radiculoneuritis, brain abscess, epidural abscess and meningo-vascular syndromes, are rarely encountered. We present a patient presenting with acute onset myositis. This kind of presentation has not previously been reported in the English language literature. We conclude that the diagnosis of neuro-brucellosis should be considered in patients presenting with muscle weakness.
- 著者
- Nobue Yagihara Akinori Sato Hiroshi Furushima Masaomi Chinushi Takashi Hirono Yoshifusa Aizawa
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.49, no.18, pp.1979-1982, 2010 (Released:2010-09-15)
- 参考文献数
- 19
- 被引用文献数
- 9 9
A 75-year-old man was admitted to our hospital in January 2010 for evaluation of syncope and abnormal ECG. ECG showed type 1 ST elevation in lead V1 and he was diagnosed as Brugada syndrome. During cardiac catheterization, baseline coronary angiography was normal, but intracoronary ergonovine maleate induced spasms of the right and left coronary arteries concomitant with chest pain and ST elevation on ECG. J waves were accentuated or newly developed. Soon after an intracoronary injection of nitroglycerin, chest pain was relieved and ischemia-induced J wave disappeared and the ST segment returned to the same morphology as baseline. Extrastimuli induced ventricular fibrillation. He received an implantable cardioverter-defibrillator. He was also treated with Ca antagonist and isosorbide dinitrate and has had an uneventful course for 5 months.
- 著者
- Yoshio Yamaoka Mototsugu Kato Masahiro Asaka
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.47, no.12, pp.1077-1083, 2008 (Released:2008-06-16)
- 参考文献数
- 77
- 被引用文献数
- 84 168
Certain populations with high incidences of Helicobacter pylori infection, such as those in East Asian countries, have high incidences of gastric cancer, while other highly infected populations, such as those in Africa and South Asia, do not. The various rates of gastric cancer associated with different geographic areas can be explained, at least in part, by the differences in the genotypes of H. pylori cagA and vacA. Populations expressing a high incidence of gastric cancer are mostly identical with regions where East Asian type CagA is predominant. In contrast, incidence of gastric cancer is low in Africa, South Asia, and Europe, where strains typically possess Western type CagA. Within East Asia, strains from northern parts, where the incidence of gastric cancer is high, predominantly possess the vacA m1 genotype, whereas the m2 genotype is predominant in southern parts where the gastric cancer incidence is low.
- 著者
- Kiminobu Tanizawa Kentaro Fukunaga Noriko Okumura Mitsuko Sugimura Eisaku Tanaka Takashi Hajiro Minoru Sakuramoto Masayoshi Minakuchi Seishu Hashimoto Takehiro Yasuda Yusuke Kaji Kohei Ikezoe Eizaburo Sato Toshifumi Nakajima Yoshio Taguchi
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.49, no.12, pp.1179-1183, 2010 (Released:2010-06-15)
- 参考文献数
- 26
- 被引用文献数
- 3 3
A standard treatment has not yet been established for elderly small-cell lung cancer patients, especially when they have end-stage renal disease. We report the first case of successful chemoradiotherapy in an elderly small-cell lung cancer patient undergoing continuous ambulatory peritoneal dialysis. A 77-year-old Japanese man on continuous ambulatory peritoneal dialysis was diagnosed as having limited disease small-cell lung cancer. He received four monthly cycles of chemotherapy consisting of carboplatin at 240 mg/m2 on day 1 and etoposide at 40 mg/m2 on days 1 and 3. He underwent additional hemodialysis on days 1 and 3, while continuous ambulatory peritoneal dialysis continued as usual on the other days. Following chemotherapy, he underwent hyperfractionated radiotherapy to a total dose of 45 Grey, resulting in complete remission of the disease. A pharmacokinetic study showed an area under the concentration-time curve of carboplatin of 3.41 to 4.88 mg·min/mL, increasing gradually over the first three cycles, while etoposide did not show this gradual increase. The increased area under the concentration-time curve of carboplatin may have reflected a worsened renal function during chemotherapy. Despite dose reductions and favorable areas under the concentration-ime curve of carboplatin, the patient suffered grade 3-4 hematological toxicities, necessitating transfusions and a further dose reduction. The patient died of recurrent small-cell lung cancer 19 months after diagnosis.
- 著者
- Sadatomo Tasaka Hitoshi Tokuda Fumikazu Sakai Takeshi Fujii Kazuhiro Tateda Takeshi Johkoh Norio Ohmagari Hiromitsu Ohta Hideki Araoka Yoshimi Kikuchi Masahide Yasui Kanako Inuzuka Hajime Goto
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.49, no.4, pp.273-281, 2010 (Released:2010-02-15)
- 参考文献数
- 21
- 被引用文献数
- 24 63
Background The clinical features of pneumocystis pneumonia (PCP) differ according to the predisposing factors responsible for immunosuppression. Although PCP in patients with acquired immunodeficiency syndrome (AIDS) has been extensively described, its characteristics in non-AIDS patients, such as those with malignancies, are not thoroughly documented. Study objective To characterize and compare the clinical and imaging features of PCP in patients with malignancies with those in AIDS patients. Design A multi-center retrospective study. Patients and Measurements We evaluated the clinical and radiological features of PCP in 21 patients with malignancies and in 17 with AIDS. Clinical presentation, serum markers, oxygenation, CT findings, and outcome were examined. Results The patients with malignancies showed shorter durations of symptoms before PCP was diagnosed. The levels of serum markers and the oxygenation index did not differ. CT showed diffuse or widespread ground-glass opacity (GGO) in all of the patients evaluated. None of the AIDS patients demonstrated consolidation, whereas half of the patients with malignancy showed consolidation along with GGO. The extent of GGO scored on CT images was significantly greater in the AIDS patients. No correlation was observed between the CT findings and other clinical parameters. All of the AIDS patients recovered from PCP, whereas six patients with malignancies died within a month after the onset of PCP. Conclusion The characteristics of the CT images differed between the patient groups with different underlying disorders, although it remains to be determined whether CT findings are associated with other clinical features or are predictive of the outcome of PCP.
- 著者
- Ito Michiko Hanaoka Masayuki Droma Yunden Hatayama Orie Sato Etsuro Katsuyama Yoshihiko Fujimoto Keisaku Ota Masao
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.47, no.15, pp.1387-1394, 2008
- 被引用文献数
- 1 29
<b>Objective</b> The transforming growth factor beta-1 gene (<i>TGFB1</i>) is one of the most promising candidate genes for chronic obstructive pulmonary disease (COPD). Several case-control studies have been performed and generated inconsistent results. The possible reasons for these discrepancies include the diversity of ethnic populations and the heterogeneity of COPD, including emphysema and airway disease. We designed this study to investigate the association of single nucleotide polymorphisms (SNPs) of <i>TGFB1</i> with the emphysema phenotype in the Japanese population.<br> <b>Methods</b> Eight SNPs in <i>TGFB1</i> (<i>rs2241712</i>, <i>rs1982072</i>, and <i>rs1800469</i> in the promoter region; <i>rs1982073</i> in exon 1; <i>rs2241716</i> and <i>rs4803455</i> in intron 2; <i>rs6957</i> and <i>rs2241718</i> in the 3' region) were genotyped by allelic discrimination assays in 70 COPD patients with emphysema phenotype and 99 healthy smokers. The emphysema phenotype was identified by high-resolution computed tomography imaging using Goddard's method.<br> <b>Results</b> The frequency of one significant haplotype structured by the eight SNPs was significantly higher in the emphysema group (10%) than in the healthy smokers (4%, p=0.02). In the emphysema group, the predicted value of forced expiratory volume in 1 second after bronchodilator administration was significantly associated with the minor alleles of the two SNPs (<i>rs1800469</i> and <i>rs1982073</i>, p=0.007 and 0.032, respectively), however, the low attenuation area and carbon monoxide diffusing capacity were not associated with the SNPs. In addition, the <i>rs1800469T</i> and <i>rs1982073C</i> alleles were significantly more prevalent in patients with severe and very severe airflow limitation than in those with mild and moderate airflow limitation (p=0.007 and 0.041, respectively).<br> <b>Conclusions</b> One significant haplotype of <i>TGFB1</i> is associated with the emphysema phenotype in the Japanese population. Two <i>TGFB1</i> SNPs (<i>rs1800469</i> and <i>rs1982073</i>) are associated with the severity of COPD in patients with emphysema phenotype.<br>
- 著者
- Sahin Mustafa Kebapcilar Levent Taslipinar Abdullah Azal Omer Ozgurtas Taner Corakci Ahmet Akgul Emin Ozgur Yavuz Taslipinar Mine Yazici Mahmut Kutlu Mustafa
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.48, no.1, pp.33-39, 2009
- 被引用文献数
- 21
<b>Objective</b> Obesity is currently a major public health problem and one of the potential underlying causes of obesity in a minority of patients is Cushing's syndrome (CS). Traditionally, the gold standard screening test for CS is 1 mg dexamethasone overnight suppression test. However, it is known that obese subjects have high false positive results with this test.<br> <b>Design</b> We have therefore compared the 1 mg and 2 mg overnight dexamethasone suppression tests in obese subjects. Patients whose serum cortisol after ODST was >50 nM underwent and a low-dose dexamethasone suppression test (LDDST); 24-hour urine cortisol was collected for basal urinary free cortisol (UFC). For positive results after overnight 1-mg dexamethasone suppression test we also performed the overnight 2-mg dexamethasone suppression test.<br> <b>Patients</b> We prospectively evaluated 100 patients (22 men and 78 women, ranging in age from 17 to 73 years with a body mass index (BMI) >30 kg/m<sup>2</sup> who had been referred to our hospital-affiliated endocrine clinic because of simple obesity. Suppression of serum cortisol to <50 nM (1.8 μg/dL) after dexamethasone administration was chosen as the cut-off point for normal suppression.<br> <b>Measurements</b> Thyroid function tests, lipid profiles, homocysteine, antithyroglobulin, anti-thyroid peroxidase antibody levels, vitamin B12, folate levels, insulin resistance [by homeostasis model assessment (HOMA)] and 1.0 mg postdexamethasone (postdex) suppression cortisol levels were measured.<br> <b>Results</b> We found an 8% false-positive rate in 1 mg overnight test and 2% in 2 mg overnight test (p=0.001). There was no correlation between the cortisol levels after ODST and other parameters.<br> <b>Conclusions</b> Our results indicate that the 2 mg overnight dexamethasone suppression test (ODST) is more convenient and accurate than 1-mg ODST as a screening test for excluding CS in subjects with simple obesity.<br>
- 著者
- Masaaki Yano Toshio Kahara Hitoshi Abo Muneyoshi Torita Rika Usuda
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.46, no.3, pp.139-140, 2007 (Released:2007-02-01)
- 参考文献数
- 3
- 被引用文献数
- 4 6