Nihon Kyōbu Shikkan Gakkai zasshi
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Nihon Kyobu Shikkan Gakkai Zasshi · Dec 1995
[Frequency analysis of crackles recorded with a stethoscope-equipped recorder].
Crackles were recorded with one of two systems in a total of 58 cases and compared. In one system a stethoscope was attached to a microphone; in the other system no stethoscope was used (see reference 9). Coarse crackles were recorded with the stethoscope system in 11 patients, and with the microphone-only system in 12 patients. ⋯ For both kinds of equipment, the %Type II differed significantly between coarse and fine crackles (p < 0.01). The stethoscope-transmitted sound had components that could be used to differentiate fine crackles from coarse crackles. For clinical purposes, crackles recorded with a stethoscope are as useful as those recorded with a microphone only.
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Helical CT was used on a trial basis for secondary screening of lung cancer, and its clinical usefulness is discussed in this report. The subjects 157 patients with abnormal shadows on plain chest X-ray images acquired between November 1993 and August 1994. Imaging parameters used for screening CT were as follows: 50 mA, 120 kV, a couch-top movement speed of 20 mm/s, and a beam width of 10 mm. ⋯ Lung cancers in clinical stage I (3 patients) and stage IV (1 patient) were difficult to see on plain chest X-ray films. We conclude that screening CT is useful for early diagnosis of lung cancer because the entire lung field can be imaged during a single breath-hold. Therefore, helical CT can be expected to be useful in screening for lung cancer.
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Nihon Kyobu Shikkan Gakkai Zasshi · Dec 1995
[Mechanical ventilation and long-term respiratory care in the intensive care unit of a general hospital].
We studied the need for mechanical ventilation in 265 patients with respiratory failure who came to our medical ICU over the past 3 years. The time required for weaning from mechanical ventilation and the percentage of patients who needed oxygen therapy or mechanical ventilation at home after their condition was no longer acute were also studied. Of the patients treated in the medical ICU, 143 (54%) required mechanical ventilation; 104 (39%) had acute respiratory failure and the others had acute exacerbations of chronic respiratory failure. ⋯ Ten other survivors received home oxygen therapy. Chest physicians bear the greatest responsibility for managing mechanical ventilation in medical emergencies. Moreover, the prognosis for patients with chronic respiratory failure can be improved with a long-term program for respiratory care that includes home mechanical ventilation and home oxygen therapy.
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Nihon Kyobu Shikkan Gakkai Zasshi · Dec 1995
Randomized Controlled Trial Clinical Trial[High-dose inhaled beclomethasone dipropionate and maximal improvements in patients with stable chronic obstructive pulmonary disease].
High doses of inhaled beclomethasone dipropionate (BDP) are effective in some patients with chronic obstructive pulmonary disease (COPD). However, dose-response data for this agent are limited. To determine whether patients receive maximum benefit from 1600 micrograms of BDP, we performed a randomized, double-blind, placebo-controlled, cross-over trial. ⋯ In addition to end-point spirometric assessments daily peak expiratory flow rate, symptom scores, and scores on a chronic respiratory disease questionnaire were recorded for the last week of each 3-week period. Oral prednisolone did not improve FEV1, FVC, symptoms or scores on the questionnaire. We conclude that 1600 micrograms of BDP in addition to inhaled bronchodilators produces maximal improvements in stable patients with COPD.
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Nihon Kyobu Shikkan Gakkai Zasshi · Dec 1995
Clinical Trial[Bronchoscopy in the diagnosis of diffuse pulmonary infiltrates, and corticosteroid treatment in patients with acute respiratory failure].
Forty patients with acute respiratory failure underwent fiberoptic bronchoscopy for evaluation of diffuse pulmonary infiltrates. Immunohematological diseases were the commonest underlying conditions; they were present in 48% of patients. Twenty-five percent of patients had pulmonary disease. ⋯ The average initial dose was 851 +/- 373 mg, and more than 100 mg was administered for 8 +/- 6 days. Seventeen of these patients recovered from the pulmonary disease. A controlled randomized study is needed to reevaluate the role of corticosteroids in the treatment of acute respiratory distress syndrome.