Internal medicine
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Case Reports
Diffuse liver metastasis of small cell lung cancer causing marked hepatomegaly and fulminant hepatic failure.
A 62-year-old female was admitted for examination of an abnormal liver function. Plain CT and MRI of the abdomen showed marked hepatomegaly but no visible nodular lesion in the liver. ⋯ There was almost complete parenchymal replacement with metastatic tumor in the liver. Neoplastic involvement of the liver should be considered in the differential diagnosis of fulminant hepatic failure of unknown etiology.
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Comparative Study
Noninvasive ventilation improves the outcome of pulmonary complications after liver resection.
Pulmonary complications are associated with increased mortality after liver resection. Although noninvasive ventilation (NIV) has proved to be an effective treatment for respiratory failure after abdominal surgery, including organ transplantation, its efficacy for pulmonary complications following liver resection per se has not been reported. The aim of this retrospective study was to investigate the effects of NIV in patients with postoperative pulmonary complications after liver resection. ⋯ NIV is effective in patients with respiratory failure and/or massive atelectasis after liver resection.
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Case Reports
Pulmonary capillary hemangiomatosis-like foci detected by high resolution computed tomography.
We report a case of pulmonary capillary hemangiomatosis-like foci (PCH-like foci), presenting as multiple ground-glass opacities (GGOs) on high resolution computed tomography (HRCT). The patient underwent a left lingual segmentectomy to make a definite diagnosis of these GGOs on chest CT. Histological findings were similar to PCH; however, there were no clinical symptoms or findings of pulmonary hypertension. Accordingly, PCH-like foci was diagnosed.
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Case Reports
Massive eosinophilic pleural effusion preceding vasculitic symptoms in Churg-Strauss syndrome.
We report a case of Churg-Strauss syndrome (CSS) presenting as a massive pleural effusion. A 52-year-old asthmatic Japanese woman presented with progressive dyspnea caused by an eosinophilic pleural effusion (EPE). She also had chronic sinusitis, skin lesions and blood eosinophilia, but no antineutrophil cytoplasmic antibodies. ⋯ The pleural effusion resolved soon after corticosteroid treatment was started. CSS is rare as a cause of EPE, but should be included in the differential diagnosis of EPE in asthmatic patients. This is the first report showing that EPE can precede other vasculitic symptoms in CSS.
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Case Reports
A case of afebrile miliary tuberculosis that progressed from tuberculous spondylitis with iliopsoas abscess.
We present a case of a 78-year-old woman who visited our hospital for chronic atrial fibrillation. She consulted an orthopedic surgeon for lumbar pain in August 2009 and has been followed up for osteoporosis. ⋯ Diffuse miliary shadow, which was undetected earlier, was noted on chest roentgenogram; she was diagnosed with miliary tuberculosis. Lumbar pain is common in elderly individuals and should be regarded as one of the tuberculosis symptoms, considering its atypical course in elderly patients.