http://hdl.handle.net/10564/1531 1999-06 Fri, 10 Apr 2026 15:41:17 GMT 2026-04-10T15:41:17Z http://hdl.handle.net/10564/526 タイトル: 糖尿病と下垂体機能障害を合併し,高度の痴呆を呈したKlinefelter症候群の1例 著者: 葛本, 雅之; 鎌田, 勝三郎; 中江, 恵美子; 藤本, 伸一; 藤井, 謙裕; 椎木, 英夫; 藤本, 眞一; 金内, 雅夫; 土肥, 和紘 抄録: We report a case of Klinefelter's syndrome associated with diabetes mellitus, pituitary gland dysfunction, and severe dementia. The patient was a 70-year-old man who had been under medical treatment for diabetes mellitus for twenty years. In March 1998, he developed cerebral infarction and symptoms of dementia. Physical exami- nation revealed projection of both forehead and lower jaw, hypoplasia of the genitals, and blood flow insufficiency beyond the bilateral popliteal arteries. Chromosomal analysis showed a 46, XY/46, XX/47, XXY mosaic pattern. HbA1c rose to 8.4% and ΔIRI/ΔBS was 0.02 ng/ml, indicating decreased insulin secretion. A pituitary gland dysfunction compli- cated the clinical scenario in this patient, the secretion of growth hormone, adrenocor- ticotropic hormone, prolactin, and cortisol was increased, and that of luteinizing hormone, follicle-stimulating hormone, and testosterone was decreased. Magnetic resonance images of the head showed a normal-appearing pituitary gland and cerebral infarction at both the middle and posterior cerebral artery. Therefore, our patient was considered to have vascular dementia. In this report, we discuss the relationship between Klinefelter's syndrome and either diabetes mellitus or pituitary gland dysfunction. Tue, 29 Jun 1999 15:00:00 GMT http://hdl.handle.net/10564/526 1999-06-29T15:00:00Z http://hdl.handle.net/10564/525 タイトル: 横紋筋融解症を頻回に発症した1剖検例 著者: 田宮, 正章; 金内, 雅夫; 栗岡, 英行; 水野, 麗子; 中谷, 秀隆; 松田, 尚史; 椎木, 英夫; 土肥, 和紘; 藤本, 眞一; 中野, 博; 美島, 健二; 市島, 國雄; 村田, 顕也 抄録: A sixty-year-old male was admitted to our hospital because of myalgia. He had been admitted to our hospital four times due to similar myalgia episodes after flu -like symptoms. The diagnosis of rhabdomyolysis was made by laboratory data which showed severe elevation in serum level of creatine kinase and myoglobin. On the fourth hospital day, he died from heart failure following acute renal failure, although hemodialysis had been started. Autopsy was performed and revealed myolysis, but no other evidence to confirm the mechanism of rhabdomyolysis in the present case. Repetitive myolysis episodes could also occur in patients with rhabdomyolysis. Tue, 29 Jun 1999 15:00:00 GMT http://hdl.handle.net/10564/525 1999-06-29T15:00:00Z http://hdl.handle.net/10564/524 タイトル: 急性心筋炎治療中に薬物性急性間質性腎炎・急性問質性肺炎を発症した高齢者の1例 著者: 原田, 幸児; 山野, 繁; 濱野, 一將; 西本, 和央; 中嶋, 民夫; 川本, 篤彦; 坂口, 泰弘; 椎木, 英夫; 土肥, 和紘 抄録: A case of drug-induced acute interstitial nephritis and acute interstitial pneumonitis in the course of acute myocarditis is reported. A 75-year-old woman was admitted to our hospital on December 8, 1997 with a 2-week history of exertional dyspnea. She was in atrial fibrillation with a rapid ventricular rate. The chest X-ray film showed cardiomegaly (cardiothoracic ratio: 61.6%) and severe pulmonary congestion. The electrocardiogram showed poor R progression in leads V 1-4 and negative T waves in leads V 5-6. Echocardiogram showed asynergy of the anterior wall and a large amount of pericardial effusion. Coronary angiogram revealed normal coronary arteries, and myocar- dial biopsy showed the features of acute myocarditis. She remained in rapid atrial fibrilla- tion, so oral amiodarone hydrochloride 400 mg was started on December 14, 1997, reducing to 200 mg daily. She had both knee arthralgia, and was diagnosed as having gonarthrosis. Oral indomethacin farnesil was started at 400 mg daily. One day later, nausea and abdominal pain occurred. The blood urea nitrogen and the serum creatinine were elevated (36 and 3.1 mg/dl), the chest X-ray film showed severe pulmonary congestion, and 67 Ga- citrate scintigram showed increased 67 Ga-citrate uptake in both kidneys. Therefore, acute renal failure due to drug-induced interstitial nephritis was diagnosed and hemodialysis was started. One hundred and forty days after amiodarone hydrochloride was started, severe dyspnea appeared. Chest computed tomography showed the changes of drug-induced acute interstitial pneumonia, so her amiodarone hydrochloride therapy was stopped. Tue, 29 Jun 1999 15:00:00 GMT http://hdl.handle.net/10564/524 1999-06-29T15:00:00Z http://hdl.handle.net/10564/523 タイトル: 冠動脈バイパス術後,急速に透析療法に移行した末期腎不全の1例 著者: 原田, 幸児; 川野, 貴弘; 山野, 繁; 金内, 雅夫; 土肥, 和紘 抄録: The patient was a 68-year-old woman with a 28-year history of hyperten- sion. She complained of frequent episodes of exertional chest pain in about January 1981, and was admitted to a local hospital for investigation of her chest pain. She was diagnosed as having angina pectoris (three-vessel disease) and underwent coronary artery bypass grafting (CABG), with double aorto-coronary bypass (saphenous vein graft to the left anteior descending artery and saphenous vein graft to the posterior descending artery) in May 1981. She subsequently complained of precordial oppression again and was treated with isosorbide dinitrate. Her symptoms was worsened in January 1997. Coronary angiography (CAG) was done in May 1997, and administered contrast medium (Iopamidol 2.72 ml/kg). Before CAG, the serum creatinine was 1.2mg/dl and after CAG it was 3.6 mg/dl. She underwent minimally invasive direct coronary artery bypass grafting (MID- CAB) on June 23, 1997. After MIDCAB, she complained of severe abdominal pain, appearance of severe hypertension, and her renal function worsened (serum creatinine : 7.0 mg/dl) and hemodialysis was started. When renal function worsens after CAG, in associa- tion with the effect of contrast medium and the onset of atheroembolic renal disease, atheroembolism can occur after CABG. In conclusion, a case of renal insufficiency progressing to end-stage renal disease that required dialysis after CAG and MIDCAB is reported. Tue, 29 Jun 1999 15:00:00 GMT http://hdl.handle.net/10564/523 1999-06-29T15:00:00Z