Internal medicine
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We retrospectively investigated spinal magnetic resonance imaging (MRI) manifestations at neurological onset in Japanese patients with spinal cord sarcoidosis. ⋯ Spinal cord sarcoidosis exhibits a predilection for young men and middle-aged women among Japanese individuals and is characterized by intramedullary T2-elongated lesions spreading more than three vertebral segments peaking at the C5 level, two types of abnormal intramedullary enhancement reflecting disease progression, frequent nerve root involvement and lymphadenopathy.
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To evaluate the effects of six-month liraglutide treatment on body weight, visceral and subcutaneous fat and related markers in Japanese type 2 diabetic patients. ⋯ In addition to its glucose-lowering effects, liraglutide exhibits weight loss promotion actions, reducing subcutaneous fat areas in particular. The weight and total fat area reduction properties of liraglutide are likely to be beneficial when this medication is used in combination with other oral antidiabetic drugs and insulin.
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Case Reports
Drug-induced thrombotic thrombocytopenic purpura successfully treated with recombinant human soluble thrombomodulin.
A 61-year-old woman with recurrent non-small cell lung cancer presented with thrombocytopenia, microangiopathic hemolytic anemia, neurological abnormalities, renal failure and a fever that appeared during chemotherapy with gemcitabine and bevacizumab. She was diagnosed with drug-induced thrombotic thrombocytopenic purpura (TTP). ⋯ However, after three months, the hypertension was controllable without anti-hypertensive drugs. Twelve months later, the ninth course of vinorelbine was administered safely, preventing the patient's lung cancer from progressing.
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Case Reports
Dolichoectatic vertebrobasilar dissecting aneurysm originating from atherosclerosis: an autopsy case.
We herein report an unusual case of profound brain infarction of the posterior circulation due to a dolichoectatic vertebrobasilar dissecting aneurysm (DVDA) originating from atherosclerosis. On autopsy, diffuse atherosclerosis was observed with a multi-fusiform aneurysm measuring 1 to 2 cm in diameter ranging from the left vertebral artery to the basilar artery. ⋯ The DVDA observed in this case was considered to be slowly progressive and associated with the development of atherosclerosis. The etiology of structural destabilization in patients with DVDA involves rupture of the internal elastic lamina, which is dislodged by massive hematomas that form atheromatous lesions.
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Patients who meet the Rome III criteria for functional dyspepsia (FD) are generally classified into the following two subgroups, those with postprandial distress syndrome (PDS) and those with epigastric pain syndrome (EPS), in order to treat the dyspeptic symptoms caused by the respective pathophysiological conditions. However, whether simple classification of FD can accurately distinguish the pathophysiological differences between PDS and EPS remains to be clarified because the pathophysiology of FD is characterized and complicated by various factors. ⋯ The simple classification of FD patients into two subgroups according to the Rome III criteria following diagnosis does not indicate any differences in the pathophysiology related to the respective dyspeptic symptoms of FD patients.