Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society最新文献

[A case of acute respiratory distress syndrome associated with pandemic influenza A (H1N1) pneumonia which was aggravated by the cessation of corticosteroid therapy]. [1例与大流行性甲型H1N1流感肺炎相关的急性呼吸窘迫综合征，因停止皮质类固醇治疗而加重]。

Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society Pub Date : 2011-12-01

Makoto Hibino, Kenichiro Akazawa, Koji Hikino, Motoki Oe

{"title":"[A case of acute respiratory distress syndrome associated with pandemic influenza A (H1N1) pneumonia which was aggravated by the cessation of corticosteroid therapy].","authors":"Makoto Hibino, Kenichiro Akazawa, Koji Hikino, Motoki Oe","doi":"","DOIUrl":"","url":null,"abstract":"A 72-year-old man was admitted to the intensive care unit of our hospital with acute respiratory distress syndrome (ARDS). A chest CT scan showed diffuse consolidations and ground-glass opacities in both lungs. We diagnosed ARDS secondary to community-acquired pneumonia. We then started mechanical ventilation with airway pressure release ventilation and treated him with antibiotics, peramivir, and corticosteroids, despite negative results for a rapid antigen test for influenza. Bronchial lavage on day 10 showed blood-tinged fluid and hemosiderin-laden macrophages, but no bacteria or fungi. Real-time reverse-transcriptase polymerase chain reaction testing yielded a positive result for pandemic influenza A (H1N1). The mechanical ventilator was removed on day 15, corticosteroid administration was discontinued on day 22 and antibiotics were discontinued on day 23. However, he had a fever on day 28, pleural pain and dyspnea on day 29, and exacerbation of the infiltration as demonstrated on chest CT on day 30. On day 31, repeat bronchoalveolar lavage showed an increase in the number of total cells which were lymphocyte-predominant, but there were no pathogens. We believed that this clinical exacerbation might have occurred due to the re-exacerbation of pandemic influenza A (H1N1) pneumonia due to the cessation of corticosteroids. The re-administration of corticosteroids was effective, and were eventually tapered. Currently, the use of corticosteroid therapy for severe pandemic influenza A (H1N1) pneumonia is controversial, but even the late administration of corticosteroid therapy may be effective. However, this case also suggests that the early administration of corticosteroid therapy as immunomodulation might be effective in selected cases, and that cessation of such therapy during the early phase of ARDS may cause exacerbation of clinical symptoms.","PeriodicalId":19218,"journal":{"name":"Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society","volume":"49 12","pages":"955-63"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30474697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Nontuberculous pulmonary mycobacteriosis complicated by pleuritis]. [非结核性肺分枝杆菌病合并胸膜炎]。

Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society Pub Date : 2011-12-01

Hiraku Ichiki, Seiya Ueda, Akira Watanabe, Chika Sato, Masahiro Abe

{"title":"[Nontuberculous pulmonary mycobacteriosis complicated by pleuritis].","authors":"Hiraku Ichiki, Seiya Ueda, Akira Watanabe, Chika Sato, Masahiro Abe","doi":"","DOIUrl":"","url":null,"abstract":"Pleuritis is a rare complication associated with nontuberculous mycobacteriosis of the lung and its etiology remains to be clarified. We investigated pleuritis associated with nontuberculous mycobacteriosis of the lung in 304 patients who visited our hospital. Of these, 9 patients (3%) had pleural effusion not attributable to any factor other than pleuritis; these cases were diagnosed as pleuritis. Massive pleural effusion requiring drainage was rare (1 patient, 0.3%) and pleuritis accompanied by pneumothorax was also rare (2 patients, 0.7%). The lung lesions in the patients with pleuritis were often extensive or contained a cavity. All these patients showed infection with Mycobacterium avium complex (MAC). Although it is difficult to diagnose MAC-induced pleuritis, patients with this condition often present with at least 1 of the following signs: the presence of nontuberculous mycobacterium in pleural effusion, a predominance of lymphocytes among the cells detected in pleural effusion, a high adenosine deaminase level, and the disappearance of pleural effusion following treatment. Recognizing these signs may aid the diagnosis of MAC-induced pleuritis.","PeriodicalId":19218,"journal":{"name":"Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society","volume":"49 12","pages":"885-9"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30474723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[A case of chylothorax in which thoracoscopy under local anesthesia and thoracic duct scintigraphy were useful to locate the leakage site]. 乳糜胸1例，局部麻醉下胸腔镜加胸导管显像可定位渗漏部位。

Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society Pub Date : 2011-12-01

Satoru Ishiii, Yuichiro Takeda, Kazuo Kubota, Satoshi Hirano, Masayuki Hojo, Haruhito Sugiyam, Nobuyuki Kobayashi

{"title":"[A case of chylothorax in which thoracoscopy under local anesthesia and thoracic duct scintigraphy were useful to locate the leakage site].","authors":"Satoru Ishiii, Yuichiro Takeda, Kazuo Kubota, Satoshi Hirano, Masayuki Hojo, Haruhito Sugiyam, Nobuyuki Kobayashi","doi":"","DOIUrl":"","url":null,"abstract":"Background: Detailed investigation of the cause of chylothorax and its treatment should be performed by thoracoscopy under general anesthesia, but if this is difficult due to multiple complications it is possible to perform a detailed investigation by combining thoracoscopy under local anesthesia and thoracic duct scintigraphy.Case presentation: A 74-year-old woman presented with exertional dyspnea. Chest X-ray films showed right pleural effusion, and thoracocentesis yielded a milky white pleural effusion, meeting the criteria of chylothorax, after excluding conditions such as malignant lymphoma, amyloidosis and trauma. Since the patient's medical history included pacemaker insertion, dialysis and diabetes, thoracoscopy was performed under local anesthesia rather than general anesthesia, to investigate the cause in detail. The pleural cavity was visualized, but no obvious tumor or other cause was present in the parietal pleura. There was partial adhesion of the lower lobe and chest wall, and the leakage of a milky white pleural effusion from this site was confirmed. We then performed thoracic duct scintigraphy, which revealed an area of enhancement corresponding to the leakage site near the right pulmonary hilum.Conclusion: We describe a case in which thoracoscopy under local anesthesia and thoracic duct scintigraphy were useful for determining the leakage site in chylothorax.","PeriodicalId":19218,"journal":{"name":"Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society","volume":"49 12","pages":"976-80"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30475664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Malignant pleural mesothelioma with multiple nodules]. 恶性胸膜间皮瘤伴多发结节。

Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society Pub Date : 2011-12-01

Michiko Asano, Kenichi Gemba, Nobukazu Fujimoto, Hideyuki Nishi, Koji Taguchi, Takumi Kishimoto

引用次数: 0

[A case of chronic tuberculous empyema with a fistula treated with an endobronchial Watanabe spigot before surgery]. 慢性结核性脓肿伴瘘管1例，术前支气管内Watanabe龙头治疗。

Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society Pub Date : 2011-12-01

Yuusuke Muranishi, Ueshima Yasuo

{"title":"[A case of chronic tuberculous empyema with a fistula treated with an endobronchial Watanabe spigot before surgery].","authors":"Yuusuke Muranishi, Ueshima Yasuo","doi":"","DOIUrl":"","url":null,"abstract":"A 78-year-old man was referred to our hospital because of pyrexia in October 2008. Chest X-ray films and chest computed tomography (CT) indicated chronic tuberculous empyema in the right hemithorax. His general condition was not improved by antibiotic treatment, and CT showed pyothorax with a niveau and bronchial fistulas in May 2009. We subsequently performed open window thoracostomy and decortication of the residual dead spaces, but the bronchial fistulas remained. As this approach makes it difficult to ensure the sterility of the cavity, we therefore performed fiberoptic bronchoscopy and occluded the bronchus with an endobronchial Watanabe spigot (EWS). However, the bronchial fistula recurred, and therefore we performed this treatment again. We continued to carefully wash the cavity and the leakage stopped, whereupon the cavity became sterile. We then performed omental pedicle and muscle flap closure and thoracoplasty in April 2010. The empyema was cured without any complications. These findings suggest that using an EWS before surgery can be highly effective in controlling chronic tuberculous empyema with fistulas.","PeriodicalId":19218,"journal":{"name":"Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society","volume":"49 12","pages":"917-21"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30474691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[A case of AIDS with Pneumocystis jirovecii pneumonia which required differentiation from ANCA-related lung disease]. [艾滋病合并乙氏肺囊虫肺炎1例，需与anca相关肺部疾病鉴别]。

Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society Pub Date : 2011-12-01

Nahoko Takeda, Hidenori Ichiyasu, Akiko Kijima, Daisuke Notsute, Naoki Saita, Hirotsugu Kohrogi

{"title":"[A case of AIDS with Pneumocystis jirovecii pneumonia which required differentiation from ANCA-related lung disease].","authors":"Nahoko Takeda, Hidenori Ichiyasu, Akiko Kijima, Daisuke Notsute, Naoki Saita, Hirotsugu Kohrogi","doi":"","DOIUrl":"","url":null,"abstract":"A 41-year-old man with fever, diarrhea and skin rash received a diagnosis of drug-induced lupus. He was given corticosteroids for 3 months and was subsequently admitted to a local hospital due to dyspnea. Pneumonia was then diagnosed and he was given a new quinolone antibacterial agent. Despite this treatment, his symptoms and signs gradually worsened and he was referred to our hospital. High resolution CT (HRCT) of the chest showed diffuse ground-glass opacities, reticular shadows, parenchymal abnormalities, traction bronchiectasis, a subpleural curvilinear shadow and septal lines. Serological examinations were positive for anti-myeloperoxidase antineutrophil cytoplasmic antibodies (MPO-ANCA) and subsequent HRCT findings were consistent with ANCA-related lung disease. However, the patient had complications such as previous syphilis infection, oral candidiasis, herpes zoster, hepatitis B virus and cytomegalovirus infection. Additionally, his serum was positive for HIV antibody and HIV-1 RNA, and therefore we diagnosed AIDS. His bronchoalveolar lavage fluid revealed Pneumocystis jirovecii. It is known that HIV infection is associated with many types of autoantibodies including MPO-ANCA. Therefore, in HIV/AIDS patients with interstitial lung diseases, it is important to differentiate opportunistic Pneumocystis pneumonia infection from collagen vascular disease-associated interstitial lung diseases.","PeriodicalId":19218,"journal":{"name":"Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society","volume":"49 12","pages":"929-35"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30474693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[A case of IgG4-related disease with marked thickening of the bronchial wall]. igg4相关疾病伴支气管壁明显增厚1例

Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society Pub Date : 2011-12-01

Masachika Hayashi, Masaaki Okajima, Takashi Shimizu, Natsue Shimizu, Kazuaki Morohashi, Jozi Toyama, Kazuhisa Mori

引用次数: 0

[Type A influenza pneumonia with diffuse alveolar damage diagnosed by increased antibody titers and immunohistochemical staining]. [通过抗体滴度升高和免疫组化染色诊断为伴有弥漫性肺泡损伤的甲型流感肺炎]。

Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society Pub Date : 2011-12-01

Takashi Ishiguro, Noboru Takayanagi, Yoshihiko Shimizu, Yoshinori Kawabata, Tsutomu Yanagisaw, Yutaka Sugita

{"title":"[Type A influenza pneumonia with diffuse alveolar damage diagnosed by increased antibody titers and immunohistochemical staining].","authors":"Takashi Ishiguro, Noboru Takayanagi, Yoshihiko Shimizu, Yoshinori Kawabata, Tsutomu Yanagisaw, Yutaka Sugita","doi":"","DOIUrl":"","url":null,"abstract":"A 58-year-old man presented to a local physician with cough, fever, myalgia and dyspnea. His chest X-ray film showed abnormal shadows and therefore he was admitted to our hospital. Chest computed tomography showed bilateral ground-glass opacities and bilateral consolidation. We suspected influenza pneumonia, but the results of both an influenza rapid antigen test and reverse transcriptase-polymerase chain reaction test for novel influenza (H1N1 2009) were negative. Transbronchial lung biopsy showed diffuse alveolar damage patterns. We diagnosed acute interstitial pneumonia and initiated corticosteroid therapy. Moreover, because influenza pneumonia could not be excluded according to his clinical picture, oseltamivir was administered. His condition improved and he was discharged. After discharge, the levels of antibody titers for influenza A virus significantly increased. We therefore re-evaluated his transbronchial lung biopsy specimen and found that immunohistochemical staining was positive for influenza A antigen in his bronchial and bronchiolar cells. We re-diagnosed his condition as influenza pneumonia. The possibility that influenza pneumonia may present in cases originally diagnosed as acute interstitial pneumonia must be considered.","PeriodicalId":19218,"journal":{"name":"Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society","volume":"49 12","pages":"942-8"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30474695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[An autopsied case of primary malignant pericardial mesothelioma diagnosed antemortally]. 【原发恶性心包间皮瘤尸检1例死亡诊断】。

Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society Pub Date : 2011-12-01

Motohiro Kodama, Hiroki Tateno, Sadatomo Tasak, Kenzo Soejima, Koichiro Asano, Yuichiro Hayashi

引用次数: 0

[An autopsy case of gastric cancer presenting as acute respiratory failure due to pulmonary tumor thrombotic microangiopathy with concomitant high serum level of vascular endothelial growth factor-D]. [尸检胃癌肺肿瘤血栓性微血管病变急性呼吸衰竭伴血清血管内皮生长因子- d增高1例]。

Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society Pub Date : 2011-12-01

Akio Takezaki, Toru Araiz, Yoshikazu Inoue, Akihide Nishiyam, Masanori Kitaichi, Seiji Hayashi

{"title":"[An autopsy case of gastric cancer presenting as acute respiratory failure due to pulmonary tumor thrombotic microangiopathy with concomitant high serum level of vascular endothelial growth factor-D].","authors":"Akio Takezaki, Toru Araiz, Yoshikazu Inoue, Akihide Nishiyam, Masanori Kitaichi, Seiji Hayashi","doi":"","DOIUrl":"","url":null,"abstract":"A 49-year-old man consulted our hospital several days after the onset of dyspnea and was admitted because it rapidly exacerbated 9 days after presentation. Diffuse centrilobular micronodular shadows and diffuse opacities in all lung fields were noted on high-resolution computed tomography of the chest. Severe pulmonary hypertension and dilatation of the right ventricle was observed on echocardiography. Although there was no evidence of thrombus in the central portion of the pulmonary artery or deep veins of the lower limbs, the patient's respiratory insufficiency rapidly progressed and he died about 14 hours after admission. A postmortem examination revealed widespread gastric cancer and tumor emboli in the pulmonary arterioles, complicated with intraluminal organization, which is consistent with pulmonary-tumor thrombotic microangiopathy (PTTM). His serum level of vascular endothelial growth factor-D (VEGF-D) was elevated, but VEGF-D was not detected by immunohistological staining. A possible pathophysiological association with PTTM and VEGF-D should be examined in future studies.","PeriodicalId":19218,"journal":{"name":"Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society","volume":"49 12","pages":"890-6"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30474724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0