Internal medicine
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A case of rhabdomyolysis associated with bacteremic pneumonia due to Staphylococcus aureus is reported. A 58-year-old man was admitted because of severe left lobar pneumonia, and presented myoglobinuria on admission. ⋯ Rhabdomyolysis has rarely been reported in cases of bacterial infection, especially those due to Staphylococcus aureus. This case might be an extremely rare case of rhabdomyolysis complicating Staphylococcus aureus bacteremia following severe left upper lobar pneumonia.
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A benign Becker muscular dystrophy (BMD) patient with a marked decrease in dystrophin exhibited remarkable expression of dystrophin-related protein (DRP) on most of the muscle cell membrane. A phenotypic Duchenne muscular dystrophy patient with a truncated form of dystrophin exhibited no DRP expression on the muscle cell membrane except for the neuromuscular junction. Increased DRP expression might compensate for a lack of dystrophin in some BMD patients.
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A 55-year-old man developed multiple erythematous skin lesions after surgery for acoustic neurinoma. Necrosis and detachment of the epidermis developed and a diagnosis of toxic epidermal necrolysis (TEN) was made. Progressive dyspnea was evident two days after the onset of the skin lesions. ⋯ On bronchoscopic examination, erosion, vesicle formation, necrosis and desquamation of the epidermis were seen in the tracheobronchial mucosa. Therapy, including prednisolone, improved the skin lesions as well as the chest X-ray and bronchoscopic findings. Tracheobronchial and pulmonary lesions were followed before, during and after treatment of TEN.
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Case Reports
Long-term survival in a patient with malignant carcinoid treated with high-dose octreotide.
Octreotide acetate, a long-acting somatostatin analogue, is effective in controlling and markedly reducing the symptoms of carcinoid crisis. We report a patient with carcinoid syndrome with prolonged survival for 4.5 years with high dose octreotide therapy and survived for 7.5 years after the first flushing, in spite of episodes of severe carcinoid crisis. ⋯ Although administration of such a high dosage of octreotide has never been reported before, we found that octreotide could be used at this dosage safely without inducing serious side effects, and probably prolonged the patient's survival. Our experience with this case indicates that octreotide acetate is an effective drug in controlling carcinoid crisis and prolonging survival without serious side effects.
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Comparative Study
Simultaneous ultrasonic monitoring of gallbladder emptying and gastric emptying after liquid test meal.
Gastric emptying and gallbladder emptying were measured simultaneously using simplified ultrasound (US) techniques after a liquid test meal in seven volunteers on two separate days. Sequential changes in cross-sectional areas of the gastric body and antrum and in gallbladder volume were represented as a monoexponential process after the test meal. ⋯ Sequential measurement of cross-sectional areas at the gastric body using ultrasound is simple and reliable for the assessment of gastric emptying after a liquid meal. US technique is promising for the evaluation of the relationship of gallbladder emptying to gastric emptying as a routine practice.