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論文

論文
Nagai, Takashi ; Inoue, Chiharu ; Tonouchi, Kazunori ; Tonooka, Naoko ; Imamura, Makoto ; Kaneko, Katumi ; Honma, Manabu
出版情報: The Kitakanto medical journal = 北関東医学.  59  pp.151-155,  2009-05-01.  北関東医学会
概要: application/pdf<br />Journal Article<br />A 49-year-old semi-conscious woman was admitted due to fever and dehydration. Disseminated\nintravascular coagulation (DIC), renal dysfunction and diabetic ketoacidosis were detected. Whole\nbody computed tomography showed multiple nodular lesions in bilateral lungs and kidneys indicating\nseptic emboli, and intrauterine lesions. We diagnosed multiple organ failure followed by intrauterine\ninfection due to untreated diabetes mellitus. Vaginal discharge and blood culture revealed Klebsiella\npneumoniae. We used multi-antibiotics for sepsis,respirator at low tidal volume ventilation,200mg of\nsivelestat sodium hydrate and 300mg of hydrocortisone for respiratory failure, gabexate mesilate and\nanti-thrombin III for DIC, transfusion for bleeding from uterus and regular insulin aiming for a blood\nglucose range of from 80 to 140mg/dl. When we extracted the myoma uteri,the patient’s fever subsided\nand the C-reactive protein became negative. Treating diabetes mellitus is important for the prevention\nof severe infection. 続きを見る
2.

論文

論文
Nagai, Takashi ; Imamura, Makoto ; Shimizu, Eri ; Mori, Masatomo
出版情報: The Kitakanto medical journal = 北関東医学.  56  pp.339-342,  2006-11-01.  北関東医学会
概要: application/pdf<br />Journal Article<br />A 62-year-old man was administered pegylated interferon α-2a and ribavirin for chronic hepatitis\nC. He had come to our hospital for treatment of chronic hepatitis C and diabetic triopathy. After diet\nand insulin therapy blood glucose levels (HbA1c; 6.0-6.8%, glycosylated Alb ; 18.5-20%) were adequately\nmaintained for a year. However, AST and ALT levels ranged from 50 to 60 mU/ml by\nursodeoxycholic acid and Stronger Neo-Minophagen C. Although liver function improved after interferon\nand ribavirin combination therapy, visual acuity decreased due to diabetic retinopathy deterioration.\nAfter the end of interferon and laser photocoagulation therapy, visual acuity improved. 続きを見る
3.

論文

論文
Nagai, Takashi ; Imamura, Makoto ; Negishi, Tetuo ; Mori, Masatomo
出版情報: The Kitakanto medical journal = 北関東医学.  55  pp.145-149,  2005-05-01.  北関東医学会
概要: application/pdf<br />Journal Article<br />A 49-year-old woman was admitted because of hyperglycemia. On a delivery at age 29 iron deficiency anemia was indicated. She was injected with 40mg of saccharated ferric oxide every two weeks until age 40. At age 35 menopause occurred. Serum ferritin increased (4,300ng/ml). An abdominal computed tomogram (CT) showed increased hepatic CT density. Iron deposition in the parenchymal cells of the liver was shown in a biopsy specimen. Secondary hemochromatosis was diagnosed. Her gonadotropin release decreased. After 30 months serum ferritin had decreased gradually to the normal range after daily 1,000mg injection of deferoxamine mesilate. Although the hepatic CT density decreased, gonadotropin release and insulin release were not improved. 続きを見る
4.

論文

論文
Nagai, Takashi ; Negishi, Tetuo ; Imamura, Makoto ; Mori, Masatomo
出版情報: The Kitakanto medical journal = 北関東医学.  55  pp.37-39,  2005-02-01.  北関東医学会
概要: application/pdf<br />Journal Article<br />A 43-year-old diabetic woman was admitted in the 15th week of her first pregnancy. When HbAlc levels were 8.2%, we began diet therapy and continuous subcutaneous insulin infusion (CSII) therapy. The HbAlc levels subsequently ranged from 6.2 to 6.7%. She was delivered without complications of a healthy male infant (3120g) in the 38th week. Metformin was then administered. Six months later she was diagnosed as being in the 21st week of pregnancy. We changed from metformin to CSII therapy immediately. The HbAlc levels had ranged from 6.0 to 6.4% before the CSII therapy and from 5.8 to 6.3% after the CSII therapy during the entire second pregnancy. A macrosomia delivery (4070g) occurred in the 37th week. Although glycemic control was better during the 2nd pregnancy than the 1st pregnancy, metformin use until the 21st week may have induced macrosomia. 続きを見る