Argatroban as an alternative anticoagulant for patients with heparin allergy during coronary bypass surgery.

Although heparin allergy is a rare but well-documented entity, anticoagulation management for cardiac surgery in patients with the heparin allergy has not been established due to its rarity. Here we report a case that shows our anticoagulation strategy during a coronary bypass operation. A 67-year-old man with unstable angina pectoris developed an urticarial rash 10 h after the second exposure to heparin.

[A case of hypothyroidism induced by interferon therapy for renal cell carcinoma].

A 54-year-old man, who had undergone left radical nephrectomy due to a renal cell carcinoma 2 years previously, had received adjuvant interferon (IFN) therapy for 2 years. One month has passed after IFN therapy, when he started to complain of muscle pain. The serum FT3 and FT4 levels were lower than normal range.

[A case of breast cancer with multiple bone metastases improved by high-dose toremifene].

A 63-year-old woman underwent modified radical mastectomy with 3 cycles of adjuvant chemotherapy (cyclophosphamide, epirubicin, 5-fluorouracil) and MPA endocrine therapy for breast cancer. Because of nausea and general fatigue, she refused to continue this therapy and did not visit the hospital. When she came our hospital and 16 months later, she had developed multiple bone metastases.

Decrease in the prevalence of IL-4-producing CD4+ T cells in patients with advanced stage of primary biliary cirrhosis.

Objective: To elucidate the precise immunological features in primary biliary cirrhosis (PBC), we examined the relative prevalence of CD4+ T cells in either symptomatic PBC (sPBC) or asymptomatic PBC patients (aPBC), and furthermore, these results were compared with their histological features.

Methods: Cytokine synthesis of peripheral blood mononuclear cells obtained from 24 PBC patients (9 sPBC and 15 aPBC) were examined by intracellular staining method. The relative prevalence of three distinct CD4+ T cells, gamma-interferon (IFN-gamma)-producing cells (Th1), interleukin-4 (IL-4)-producing cells (Th2), and the cells producing both IL-4 and IFN-gamma (Th0), was analyzed by FACScan and compared with those of closely age-matched healthy and disease controls.

Recurrent annular erythema in a case of seronegative Sjögren's syndrome.

We describe a case of Sjögren's syndrome who repeatedly developed annular erythema on her extremities. Her anti-nuclear antibody, anti-SSA/Ro antibody, and anti-SSB/La antibody were all negative. Characteristics of the annular erythema included a tendency to appear on the extremities especially in summer, spontaneous regression after 1-2 weeks, and residual slight pigmentation.

[MRSA enteritis following severe gastroenteritis of salmonellosis].

A 62-year-old female patient was given cancer chemotherapy for lymph nodes metastases in the left breast cancer. She was admitted to the hospital because of severe watery diarrhea, in hypovolemic shock, and was diagnosed as suffering from not-typhoidal Salmonella by stool culture. After systemic administration of antibiotic agents, she became well in a few days, but on the 16th hospital day, she had severe watery diarrhea, hypovolemic shock and then cardiac arrest.

Lichen planus annularis: an immunohistochemical study.

Lichen planus annularis is a relatively rare skin manifestation of lichen planus. The mechanisms in the formation of annular lesions are not fully understood. We reported here a 57-year-old female with this disease.

[Antiplatelet therapy in cardiac diseases].

1) Myocardial infarction (MI): Aspirin (160-300 mg/day) therapy started immediately after the onset, with or without simultaneous coronary arterial thrombolytic therapy, reduces the mortality rate in vascular diseases, including MI, and prevents reinfarction. Maintenance therapy with the same dosage is also recommended. 2) Angina pectoris: In unstable angina, aspirin in a dose of 300 mg/day for 2 years reduces the mortality and the incidence of MI.

Crohn's disease in the esophagus--report of a case.

A case of esophageal Crohn's disease is described. Crohn's lesion was observed in the lower esophagus, and sarcoid-like granulomas were found in the biopsied specimen. A clinical consideration of this phenomenon is presented.