1997-04 http://hdl.handle.net/10564/1517 2026-04-10T15:42:23Z 2026-04-10T15:42:23Z 野村, 久美子 布谷, 隆治 藤田, 泰三 平井, 純 中室, 卓也 山野, 繁 http://hdl.handle.net/10564/364 2017-05-29T06:07:10Z 1997-04-29T15:00:00Z

タイトル: 脳波異常を呈した若年発症のACTH単独欠損症の1例 著者: 野村, 久美子; 布谷, 隆治; 藤田, 泰三; 平井, 純; 中室, 卓也; 山野, 繁 抄録: A case of isolated adrenocorticotropic hormone (ACTH) deficiency is reported. A 25-year-old unconscious female was referred to Hirai Hospital. On admission, her blood glucose level was 25 mg/dl, and her systolic blood pressure was 110 mmHg. She became alert just after intravenous administration of glucose. Plasma ACTH, plasma cortisol, urinary 17-hydroxycorticosteroid (17-OHCS) and urinary 17-ketosteroid (17-KS) levels were low. The circadian periodicity of ACTH and cortisol was disordered. The ACTH-Z test indicated a delayed response in the urinary 17-OHCS and 17-KS levels. Following the rapid ACTH test and lysine vasopressin (LVP) test, plasma ACTH and cortisol were disordered. The levels of other pituitary hormones were within normal limits, and the various stimulation tests also showed normal responses. Hence, a diagnosis of isolated ACTH deficiency was made. On the 3rd hospital day, a diffuse slow-wave pattern was observed on the electroencephalogram (EEG). The clinical symptoms improved notably after oral administration of hydrocortisone 20 mg/day. On the 50th hospital day, the EEG did not show a diffuse slow-wave pattern. We therefore sugest that hydrocor- tisone is effective -for treatment of diffuse slow-wave pattern on the EEG. In this case, it is believed that the hypoglycemic symptoms and the diffuse slow-wave pattern were induced by isolated ACTH deficiency.

1997-04-29T15:00:00Z 前田, 光一 http://hdl.handle.net/10564/363 2017-05-29T06:07:18Z 1997-04-29T15:00:00Z

タイトル: 緑膿菌性慢性下気道感染症の病態と治療に関する臨床的・基礎的研究 著者: 前田, 光一 抄録: The present study was addressed to analyze the clinical features of chronic lower respiratory tract infections (CLRTI) due to Pseudomonas aeruginosa in relation to bacteriological findings as determined by transtracheal aspiration (TTA), and also to evaluate clinically and basically a long-term chemotherapy of erythromycin (EM) or clarithromycin (CAM) against CLRTI. The following results were obtained ; 1. The isolation rate of P. aeruginosa among the total isolates from CLRTI patients by TTA increased year by year. As predisposing factors to exacerbate in CLRTI caused by P. aeruginosa alone, the early colonization by P. aeruginosa in the airway or immunological status of patients was very important. Mucoid P. aeruginosa was more important as a persistent infection in CLRTI than nonmucoid P. aeruginosa. 2. A Long-term treatment of EM benefited patients with CLRTI due to P. aerzaginosa from improvement of purulent sputum, dyspnea on effort, and decreased PaO₂. CAM was able to substitute for EM when EM was not effective for CLRTI deu to P. aeruginosa. 3. EM inhibited biofilm formation in culture of human epithelial cells and P. aeruginosa. In patients with CLRTI, the administration of EM or CAM enhanced the IL-2 producing ability of peripheral blood mononuclear cells (PBMC) and also elevated serum IL-4 levels in the early phase of treatment. Thereafter, the IL-2 producing ability of PBMC gradually decreased and returned to the levels of healthy controls. The above are new findings on the clinical features of incurable CLRTI due to P. aeruginosa, and beneficial aspects of treatment with macrolides.

1997-04-29T15:00:00Z Mizuno, Reiko Fujimoto, Shinichi Nonaka, Hideo Dohi, Kazuhiro http://hdl.handle.net/10564/362 2017-06-11T23:20:26Z 1997-04-29T15:00:00Z

タイトル: AN ELDERLY CASE OF ISCHEMIC CARDIOMYOPATHY WITH SUCCESSFUL IMPROVEMENT IN LEFT VENTRICULAR FUNCTION AFTER PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY 著者: Mizuno, Reiko; Fujimoto, Shinichi; Nonaka, Hideo; Dohi, Kazuhiro 抄録: A 76-year-old woman was admitted to our hospital because of dyspnea and palpitation. A 12-lead EGG showed ventricular premature beats, but no evidence of old or new myocardial infarction. Chest X-ray showed pulmonary congestion and an increased cardio-thoracic ratio. Echocardiogram showed severe left ventricular chamber dilatation and diffuse hypokinesis of the left ventricular wall. The results of these noninvasive diagnostic procedures suggested dilated cardiomyopathy. On the twelfth hospital day, the patient developed chest pain with increased serum creatinine phosphokinase. Emergency cardiac catheterization was performed, and severe three-vessel disease was revealed. Staged PTCA was performed for all three vessels. One month after complete revascularization of the three vessels, the left ventriculography showed that left ventricular ejection fraction had improved to 49 % from 26 % at admission. In elderly patients with severe generalized poor left ventricular wall motion, in whom ischemic cardiomyQpathy rather than dilated cardiomyopathy can be ruled out, PTCA should be considered as a treatment modality.

1997-04-29T15:00:00Z 中嶋, 民夫 濱野, 一將 上村, 史朗 坂口, 泰弘 藤本, 眞一 橋本, 俊雄 土肥, 和紘 http://hdl.handle.net/10564/361 2017-05-29T06:07:10Z 1997-04-29T15:00:00Z

タイトル: アルコール摂取後に高度の高脂血症を呈したChurg-Strauss症候群による心筋炎の1例 著者: 中嶋, 民夫; 濱野, 一將; 上村, 史朗; 坂口, 泰弘; 藤本, 眞一; 橋本, 俊雄; 土肥, 和紘 抄録: We report a 46-year-old man with myocarditis due to Churg-Strauss syndrome, who was admitted to our hospital because of marked hyperlipidemia and liver dysfunction. He had been an outpatient because of the impaired cardiac function after myocarditis due to Churg-Strauss syndrome. He had drunk alcohol 200mg/day for 3 months before admission. His serum at the outpatient clinic was markedly hemolytic and chylous. The serum bilirubin level was 2.2 mg/dl, of which direct bilirubin was 1.1 mg/dl. The serum cholesterol level was 801 mg/dl, and the triglyceride level was 3,564 mg/dl. Macrocytic hyperchromic anemia was revealed. These abnormalities improved rapidly after admission. The cause of his severe hyperlipidemia was attributed to the complication of Zieve's syndrome, because the triad of the syndrome, jaundice, hyperlipidemia and hemolytic anemia, were present after the alcohol abuse. Furthermore, the hyperlipidemia was thought to be enhanced by the adrenocorticosteroid, which had been prescribed for myocarditis due to Churg-Strauss syndrome.

1997-04-29T15:00:00Z