Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society
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Nihon Kokyuki Gakkai Zasshi · Dec 2011
Case Reports[A case of acute respiratory distress syndrome associated with pandemic influenza A (H1N1) pneumonia which was aggravated by the cessation of corticosteroid therapy].
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. ⋯ 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.
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Nihon Kokyuki Gakkai Zasshi · Dec 2011
[Relationship between intermittent negative pressure level and tidal volume during biphasic cuirass ventilation in normal subjects].
The aim of this study was to investigate the effects of inspiratory negative pressure by biphasic cuirass ventilation on tidal volume and the relationship between pressure level and tidal volume in 15 normal subjects. We measured tidal volume during inspiratory negative pressures of -5, -10, -20 and -30 cm H2O. An inspiratory negative pressure of -30 cm H2O was necessary to increase tidal volume. We conclude that -30 cm H2O of biphasic cuirass ventilation significantly increases tidal volume in normal subjects.
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Nihon Kokyuki Gakkai Zasshi · Nov 2011
[Effective glucocorticoid treatment in a case of idiopathic fibrosing mediastinitis].
A 54-year-old man was admitted to Saga University hospital with dyspnea on effort and a sensation of pressure in the chest. Chest CT images showed a low-density mass in the mediastinum surrounding the carina and left hilus, causing narrowing of both the left pulmonary artery and left main bronchus. The pathological findings from a surgical biopsy showed markedly fibrotic tissue with lymphocytes and plasmacytes, and we diagnosed idiopathic fibrosing mediastinitis, stage II. ⋯ The patient was given low-dosage glucocorticoids as maintenance treatment. Previous reports indicated that idiopathic fibrosing mediastinitis with severe tissue fibrosis is difficult to control with glucocorticoid monotherapy. Here, we report a case of idiopathic fibrosing mediastinitis that was effectively treated with glucocorticoids.
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Nihon Kokyuki Gakkai Zasshi · Oct 2011
[Endobronchial ultrasonic-guided transbronchial needle aspiration (EBUS-TBNA) for lung cancer diagnosis].
Although bronchoscopy has an important role in the diagnosis of lung cancer, more invasive procedures, such as CT-guided biopsy or surgery, are needed when transbronchial approaches fail. ⋯ EBUS-TBNA is a safe and useful approach for the diagnosis of lung cancer together with staging.
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Nihon Kokyuki Gakkai Zasshi · Sep 2011
Case Reports[A case of pulmonary benign metastasizing leiomyoma from the uterus].
We report here a case of pulmonary benign metastasizing leiomyoma (BML) from the uterus. A 48-year-old woman was admitted to our hospital because of multiple pulmonary nodules on the chest radiograph 7 years after total hysterectomy with removal of the left ovarium for uterine leiomyoma. A specimen of the lesion obtained by a thoracoscopic lung biopsy was consistent with leiomyoma. ⋯ Immunohistological staining for both estrogen and progesterone receptors on the lung tissue was positive. Based on these results, we diagnosed the pulmonary lesions as BML. The patient received no treatment and has shown no evidence of exacerbation of disease during 6 years of follow up.