http://hdl.handle.net/10564/1547 2002-02 Thu, 09 Apr 2026 00:09:39 GMT 2026-04-09T00:09:39Z http://hdl.handle.net/10564/66 タイトル: SPECTにて一過性全般性脳血流低下を示した非ヘルペス性ウイルス性脳症の1症例 著者: 山内, 孝之; 森川, 将行; 洪, 基朝; 井上, 雄一朗; 大澤, 弘吉; 岸本, 年史; 飯田, 順三 抄録: Elderly persons have a tendency to present with mental disorders such as delirium. Environmental changes are known to induce mental disorders such as delirium in elderly persons. At the time of acute mental sorder or impalrment, we need to take encephalitis or encephalopathy into consideration. In particular, evere encephalitis may cause sequelae such as dementia, personality change or disturbance of cerebral blood flow; these patients need to receive treatment at an early stage. We report a case of non-herpes viral encephalopathy with a transient diffuse decrease in cerebral blood flow on brain SPECT during antiviral therapy. After the 72-year-old female had a tooth extracted, she gradually demonstrated psychiatric symptoms, which consisted of insomnia, delusion of persecution, delusion of observation and disorientation. Finally, she was complicated with disturbance of consciousness and admitted to our psychiatric ward. She was suspected of having encephalopathy, and treated mainly with acyclovir. She temporarily improved, but after a while her consciousness deteriorated again. Brain MRI showed normal findings, whereas brain SPECT (99mTc-ECD) showed a diffuse decrease in cerebral blood flow. Therefore, she was treated with oxygen inhalation and therapeutic agents which improved cerebral blood flow. As result, she completely recovered and has had not any sequela such as dementia or personality change. It was suggested that brain SPECT is useful to evaluate the pathology and decide the treatment for patients who demonstrate acute eterioration of consciousness during antiviral therapy. Wed, 27 Feb 2002 15:00:00 GMT http://hdl.handle.net/10564/66 2002-02-27T15:00:00Z http://hdl.handle.net/10564/65 タイトル: 肺高血圧を伴う心房中欠損症に急性心筋梗塞を合併した高齢者の1例 著者: 吉村, 充代; 中嶋, 美鐘; 渡邉, 眞言; 福島, 猛; 藤井, 厚史; 西田, 育功; 花谷, 正和; 野中, 秀郎; 長阪, 重雄; 関, 寿夫 抄録: We describe a patient with pulmonary hypertension associated with an atrial septal defect (ASD) who suffered an acute myocardial infarction. The patient, 70-year-old man, was admitted to our hospital after developing chest pain. He had een diagnosed as having an ASD at the age of 69. From the electrocardiogram obtainedon admission, acute myocardial infarction was suspected. Coronary anglography revealed total obstruction of the left anterior descending coronary artery, which was successfully treated by percutaneous transluminal coronary angioplasty(PTCA). Because of repeated heart failure, ASD closure and coronary artery bypass grafting (CABG) were performed in a one-stage operation. After surgery, cardiac function improved. Direct PTCA in the acute phase and ASD closure and CABG in the chronic phase were effective for heart failure in this patient. Wed, 27 Feb 2002 15:00:00 GMT http://hdl.handle.net/10564/65 2002-02-27T15:00:00Z http://hdl.handle.net/10564/62 タイトル: An Autopsy Case of Overwhelming Sepsis with Hypoglycemia in a Patient with Alcoholic Liver Cirrhosis 著者: Matsumura, Norihiko; Saitoh, Naotoshi; Yamaguchi, So-ichi; Kikawa, Tadatoshi; Hanatani, Masakazu; Nonaka, Hideo 抄録: A 46-year-old man, unconscious, was admitted to our hospitalas an emergency case. He was known to have liver disease due to excessive alcohol intake. He had fallen while riding a motorcycle one week before admission. On arrival, he was comatose and in a state of shock. Petechiae and subcutaneous bleeding were observed on his trunk and extremities. His left upper and lower extremities were remarkably swollen, and a discolored, elevated, hard mass was found on the outer side of the left ankle joint. He was diagnosed as having disseminated intravascular coagulation complicated by renal and liver failure. Hypoglycemia(plasma glucose level 29 mg/dl), hyperammonemia and severe metabolic acidosis were found. He was treated with controlled ventilation, plasma expanders, blood transfusion, antibiotics, dopamine, noradrenaline, nafamostate gabexate and hypertonic glucose. Despite this intensive treatment, he died of irreversible shock 20 hours after admission. Postmortem examination revealed small vegetation in the aortic Valve and microabscesses in the kidney, heart, thyroid gland, and retroperitoneal adipose tissues. These findings suggest that he had developed sepsis stemming from cellulitis further to alcoholic liver cirrhosis. It is considered imperative that physicians consider the possibility of hypoglycemia in all patients with multiorgan failure. Wed, 27 Feb 2002 15:00:00 GMT http://hdl.handle.net/10564/62 2002-02-27T15:00:00Z http://hdl.handle.net/10564/61 タイトル: 原発性アルドステロン症に甲状腺乳頭癌を合併した1例 著者: 辻本, 達寛; 飯岡, 弘伊; 浪崎, 正; 豊川, 泰勲; 上野, 貴久美; 鶴薗, 卓也; 松村, 吉庸; 永吉, 純一; 黒岡, 公雄; 岩井, 哲郎; 小橋, 和雄; 岡本, 新悟; 福井, 博 抄録: A44-year-old man with primary aldosteronism associated with papillary carcinoma of the thyroid is presented. He was admitted to our hospital for further evaluation of periodic paralysis, hypokalemia and hypertension. Laboratory data revealed low plasma renin activity, and elevated plasma aldosterone concentration. These dataindicated that the patient had prlmary aldosteronism. Ultrasonography, dynamic-CT and magnetic resonanceimaging demonstrated the existence of a hypovascular tumor in the right adrenal gland. During further examination, a Calcified tumor was found in his neck and diagnosed as thyroid carcinoma. The adrenal tumor was removed and its histologlCal diagnosis was aldosterone producing adenoma. Wed, 27 Feb 2002 15:00:00 GMT http://hdl.handle.net/10564/61 2002-02-27T15:00:00Z