Nihon Kyōbu Shikkan Gakkai zasshi
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Nihon Kyobu Shikkan Gakkai Zasshi · Nov 1996
[Importance of interstitial lung disease in collagen vascular disease: analysis of outcome].
We studied length of survival and related clinical findings in 715 inpatients with collagen-vascular diseases (1984 through 1994), the diagnostic Kaplan-Meier analysis showed that patients with polymyositis/dermatomyositis and those with systemic sclerosis did not survive as long as those with other types of collagen-vascular disease. Of the patients who died 37% died of respiratory failure due to interstitial lung disease. ⋯ Among patients with interstitial lung disease, those who died of polymyositis/dermatomyositis did so within 1 year, but those who died of systemic sclerosis lived longer. Interstitial lung disease is an important prognostic factor in collagen-vascular disease, and needs further evaluation.
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Nihon Kyobu Shikkan Gakkai Zasshi · Dec 1994
Clinical Trial[Usefulness of twenty-four-hour home monitoring of oxygen saturation in patients with chronic obstructive pulmonary disease].
The clinical usefulness of 24 hr home monitoring of oxygen saturation (SaO2) with pulse oximeter was studied in 48 outpatients with COPD. In addition, doppler echocardiography for measurement of acceleration time (AcT), which inversely correlates with mean pulmonary arterial pressure, a 6-minute walk test, and an exercise study on a bicycle ergometer were performed in 26, 17, and 14 patients, respectively. Nadir SaO2 and the total time during which SaO2 was below 90% were calculated to estimate diurnal and nocturnal oxygen desaturation (diurnal nadir SaO2, diurnal TSaO2 < 90%, nocturnal nadir SaO2, and nocturnal TSaO2 < 90%). ⋯ Diurnal nadir SaO2 was similar to nadir SaO2 during the exercise tests. AcT, hemoglobin, and hematocrit correlated with diurnal oxygen desaturation but not with nocturnal oxygen desaturation. From the above findings, we conclude that pulmonary hypertension may be associated with diurnal oxygen desaturation, and that home monitoring of SaO2 is useful for the detection of oxygen desaturation not predicted from dyspnea grade and PaO2 while awake.
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Nihon Kyobu Shikkan Gakkai Zasshi · Aug 1996
Clinical Trial[Prognostic value of acute pulmonary vascular response to oxygen inhalation in patients with chronic obstructive pulmonary disease].
Seventy-two patients with chronic obstructive pulmonary disease (COPD) underwent right heart catheterization when they were clinically stable and the relationship between length of survival and acute pulmonary vascular response to 100% oxygen inhalation was studied. Oxygen inhalation significantly reduced mean pulmonary arterial pressure (PPA), cardiac index (CI), and pulmonary arteriolar resistance (PAR). The percent change in PAR (% delta PAR) was used as an index of the acute pulmonary vascular response to 100% oxygen inhalation. ⋯ However, FEV1 and VC were significantly lower in nonresponders than in responders. The % delta PAR was not significantly related to age, PPA, PAR on air inhalation, FEV1, FEV1%, VC or VC%. We conclude that the pulmonary vascular response to oxygen inhalation (% delta PAR) may be an independent prognostic factor in patients with COPD.
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Nihon Kyobu Shikkan Gakkai Zasshi · Aug 1996
Case Reports[Computed tomographic findings in septic pulmonary emboli secondary to renal abscess].
A 73-year-old woman with diabetes mellitus and hypothyroidism had been well until 4 days before she presented with fever, productive coughing, and general malaise. Dyspnea gradually worsened, and she was admitted to Kobe City General Hospital. She appeared toxic and was in moderate respiratory distress on admission. ⋯ Treatment with antibacterial drugs was effective against the lung lesions but not the renal abscess. A left nephrectomy was done. In the proper clinical setting, characteristic CT features of septic emboli can contribute to early diagnosis of this disease.
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Nihon Kyobu Shikkan Gakkai Zasshi · Sep 1993
Case Reports[A case of bronchogenic squamous cell carcinoma associated with Swyer-James syndrome].
Swyer-James syndrome is considered to be a relatively uncommon disease entity presenting with unilateral hyperlucent lung due to hypoplasia of a pulmonary artery and bronchiectasis of the affected lung. Association of bronchogenic carcinoma with Swyer-James syndrome has not apparently been reported in any previous literature, except for one Japanese case. In the present paper, we describe a 48-year-old male individual, who developed poorly differentiated squamous cell carcinoma of the right upper lobe bronchus after he had been diagnosed to have Swyer-James syndrome with unilateral hyperradiancy of the left lung. It is suggested that the bronchial epithelium of the unaffected lung in Swyer-James syndrome is likely to be more exposed to extrinsic carcinogens than that of the affected, underventilated lung, hence resulting in a higher risk of developing bronchogenic carcinoma.