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Nihon Naika Gakkai Zasshi 02/2009; 98(1):184, 211-2.
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ABSTRACT: A 64-year-old man was admitted due to hypokalemia-related myopathy. He was heavy drinker. He felt the stress of alcohol withdrawal during his hospitalization. The patient suffered a cardiopulmonary arrest lasting approximately 5 minutes on the fifth hospital day. One day later, ST-segment elevation was observed in leads I, aV(L), and V(2-6). Emergent cardiac catheterization was performed for suspicion of acute myocardial infarction. Normal coronary arteries with anterior akinesis of the left ventricle were revealed during the procedure. The present case may be an atypical form of "Takotsubo cardiomyopathy" in which the left ventricular contraction is due to focal anterior wall motion abnormalities.
Internal Medicine 05/2004; 43(4):300-5. · 0.94 Impact Factor
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ABSTRACT: A 47-case-year old male was admitted to our hospital because of high fever and general fatigue. He had no immune deficiency, and had no other disease in his past history. On admission, the white blood cell count and C-reacted protein were severely elevated (18,700/microliter, 27.7 mg/dl, respectively) and abdominal CT revealed multiple low density, From these results, he was diagnosed as liver abscess. Intravenous MINO and SBT/CPZ injection were started. On the fifth hospital day, he suffered from headache and nuchal rigidity. The clinical data revealed the cerebro-spinal fluid (CSF) counting 8,336 cells/mm3 (mononuclear 8,000,) protein at 119 mg/dl, and sugar 42 mg/dl. CSF cultures were negative, but Klebsiella was recognized in the blood culture and drainage fluid in liver abscess. This condition was diagnosed as bacterial meningitis and antibiotics were changed to intravenous CTRX and MEPM. Furthermore we administered oral PSL and intravenous steroid-pulse therapy. After these combination therapies his condition improved gradually. After 40 hospital day, however, he suddenly had double vision, Axial FLAIR (SE6,000/120) image revealed with high signal intensity at 4th ventricle. Intravenous MEPM was administered again. On the 60th hospital day, double vision was gradually improved and abnormal intensity at 4th ventricle was almost disappeared. This case may provide us a considerable suggestion on the treatment of bacterial meningitis.
Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 12/2003; 77(11):977-81.
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ABSTRACT: We treated four patients with amyotrophic lateral sclerosis (ALS) and nine patients with spinocerebellar degeneration (SCD) using transcranial magnetic stimulation (TMS) with an SMN-1200 transcranial magnetic stimulator. The stimulus strength was below 1.5 T and the interpulse interval was greater than 5 s. The stimulus coil was placed on P3, P4 and the bilateral cervical and lumbar root in the ALS patients, and tangentially over Iz, 4 cm lateral to the right from Iz and 4 cm lateral to the left from Iz in the SCD patients. Ten consecutive pulses were delivered to each region in the ALS patients and 15 in the SCD patients. Transcranial magnetic stimulation (TMS) was applied for a total of 20 days for in-patients and once or twice a week as ongoing therapy for outpatients. Patients with ALS were assessed according to the Barthel index, and a respiratory function test was performed before and after TMS. Patients with SCD were neurologically assessed according to the International Cooperative Ataxia Rating Scale (ICARS). In addition, the patients were evaluated for regional cerebral blood flow (rCBF) by 99 m Tc-ECD SPECT using a modified Patlak-plot method before and after the TMS trial.No change in the Barthel index or rCBF was observed in patients with ALS. The respiratory function test results improved in one patient in the ALS group. The ICARS rating of seven patients with SCD improved after TMS. The rCBF of patients with SCD in the bilateral cerebellar hemispheres was significantly faster compared to their flow rate before TMS. These data suggest the potential usefulness of TMS as a therapeutic tool for ALS and SCD.
International Congress Series 1235:525-532.
