Internal medicine
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A 57-year-old man was admitted with fever and epigastralgia, and presented with splenomegaly and pancytopenia. A CT scan revealed splenic infarctions. There were no lymphadenopathies, skin lesions, or neurological abnormalities. ⋯ The patient died of the disease 11 months after onset. To our knowledge, this is the first report of AIVL that presented with splenic infarction. This distinct lymphoma should be included in the differential diagnosis of splenic infarction.
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A 19-year-old woman presented with acute onset of cough and dyspnea. She started smoking two weeks before the appearance of symptoms. On admission, arterial blood gas analysis on room air breathing revealed PaO2 55 Torr. ⋯ Eosinophil infiltration was also observed in transbronchial lung biopsy specimens. The final diagnosis was acute eosinophilic pneumonia (AEP). Although few reports have demonstrated diffuse fine nodular shadows in AEP, localized fine nodular shadows on chest roentgenogram and CT may sometimes be the sign of AEP especially in the early phase of the clinical course.
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To evaluate the clinical features, etiology, and prognosis of patients who required long-term mechanical ventilation (LMV) of over three months for respiratory failure following underlying disease, and observation of their clinical course until death. ⋯ This study has demonstrated that appropriate treatment for respiratory tract infections such as VAP and the prevention of nasocomial infection due to MRSA is of paramount importance for patients requiring long-term mechanical ventilation of over three months.
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Comparative Study
Open-label compassionate use one year-treatment with pirfenidone to patients with chronic pulmonary fibrosis.
We attempted to evaluate the feasibility (therapeutic efficacy, tolerance, and clinical courses after treatment) of pirfenidone, an anti-fibrotic drug for patients with chronic pulmonary fibroses such as idiopathic pulmonary fibrosis (IPF). ⋯ The feasibility of Pirfenidone as a therapeutic drug was confirmed for patients with advanced pulmonary fibrosis.
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Editorial Comment
Headache and spontaneous vertebral artery dissection.