The lung in polyarteritis nodosa: a pathologic study of 10 cases.

Polyarteritis nodosa (PAN) is characterized by necrotizing arteritis of medium-sized and small arteries in various organs. Pulmonary artery involvement in PAN has been considered rare. Previously, it also has been thought that patients with PAN do not have interstitial pneumonitis and fibrosis.

Cathepsin L activity is increased in alveolar macrophages and bronchoalveolar lavage fluid of smokers.

Elastinolytic enzymes derived from alveolar macrophages (AM) are considered to play an important role in the development of emphysema associated with cigarette smoking. In this study, the enzyme activity and mRNA expression of cathepsin L were quantitated in AM and bronchoalveolar lavage (BAL) fluid obtained from current smokers and compared with those from nonsmokers. Activity was measured with the synthetic substrate Z-Phe-Arg-MCA combined with a novel cathepsin B inhibitor, CA-074.

Evaluation of cor pulmonale on a modified short-axis section of the heart by magnetic resonance imaging.

Magnetic resonance imaging (MRI) of a modified short-axis section of the heart, in 36 patients with chronic pulmonary diseases, consisting of 19 patients with pulmonary hypertension (PH group; mean pulmonary arterial pressure > or = 20 mm Hg) and 17 patients without pulmonary hypertension (non-PH group) was evaluated to study the configuration of the right ventricle. Parameters of right ventricular hypertrophy, including right ventricular wall thickness (RVWT) and the ratio of RVWT to left ventricular posterior wall thickness (RVWT/LVPWT), with this method were significantly larger in the PH group than in the non-PH group (p < 0.01).

[Application of ultrasonography in chest diseases--usefulness of ultrasonography and physiologic evaluation of low pressure vascular system].

Air and bones, which limit echo penetration to the lesion, are the major components of the thorax. Recently, however, there have been many reports concerning the valid application of ultrasonography for evaluation of chest diseases. In this paper, we report the usefulness of ultrasonography to analyze thoracic lesions based on our experience.

[Structures and functions of adhesion molecules--involvement of adhesion molecules in the pathogenesis].

Previous studies have revealed that adhesion molecules are involved in immune responses, such as the interaction between T cells and antigen presenting cells. Recent investigations demonstrated that one of these molecules, integrins, which was concerned with cell-cell adhesion and cell-extracellular matrix proteins, was prominently expressed on lymphocytes and neutrophils in inflammatory diseases. In addition, administration of monoclonal antibodies against integrins in vivo abrogated the inflammatory responses completely in rats.

[Graphic evaluation of the significance band for hypercapnia in pulmonary disorders].

Alveolar hypoventilation due to the chronic obstruction of the airway such as pulmonary emphysema, or severe restrictive dysfunction due to sequela of pulmonary tuberculosis causes chronic hypercapnia (chronic respiratory acidosis). Ninety-five percentile of significance band of chronic and acute hypercapnia of both experimental and clinical setting is introduced in the graphic display of the acid-base balance. On acute exacerbation of these disorders, examination of arterial blood gas in series are usually plotted along the significance band of hypercapnia.

[Alpha 1-antitrypsin genes in patients with alpha 1AT deficiency in Japan: mutational analysis and allelic background].

Deficiency of alpha 1-antitrypsin (alpha 1AT), a plasma serine protease inhibitor, increases the risk of precocious pulmonary emphysema. Patients with alpha 1AT deficiency in Japan are extremely rare and no Z type alpha 1AT deficiency, which is one of the most frequent genetic disorders among Caucasians, are reported in Japan at the level of gene analysis. It is not yet clear why Z type alpha 1AT is rare among Japanese.

[An autopsy case of Marfan syndrome with bronchiectasis and multiple bullae].

We report an autopsy case (27-year-old male) with Marfan syndrome, who died of chronic respiratory failure due to bronchiectasis and multiple bullae in both lungs. He had suffered from expectoration of massive amounts of sputum since the age of 15 years. At this time, chest roentgenogram had revealed bronchiectatic changes in the bilateral lower lung fields.

Gene analysis of heterozygous protein C deficiency in a patient with pulmonary arterial thromboembolism.

A 16-yr-old male patient with heterozygous protein C deficiency developed acute pulmonary thromboembolism. The patient had low levels of plasma protein C antigen and activity (33 and 35% of normal, respectively). Analysis of the protein C gene by polymerase chain reaction (PCR) and direct sequencing revealed a nucleotide substitution (Arg169CGG----Trp169 TGG) in exon VII.

[A case of mediastinal lymphatic cyst possibly originating from the right thoracic duct].

A 33-year-old male was admitted to our hospital because of an abnormal shadow in the right superior mediastinum on chest X-ray, which was first noted about half a year before his admission. Several diagnostic procedures, including fiber bronchoscopy, CT scan and MRI; however, no final diagnosis could be made. Thoracotomy was performed with the presumed diagnosis of benign mediastinal cystic tumor.

[A case of recurrent pulmonary alveolar proteinosis treated by pulmonary lavage: were the remissions due to the natural course or due to the lavage?].

We report a 39-year-old male with pulmonary alveolar proteinosis. Although no abnormal shadows were seen on regular check-up chest roentgenogram one year previously, diffuse alveolar filling shadows were noted on admission, suggesting fairly acute progression of the disease. He was treated with bronchoalveolar lavage of each segment of both lungs by flexible fiberoptic bronchoscope under local anesthesia.

[Three cases of surgical treatment of dumbbell neurogenic tumor of the mediastinum--evaluation of intraspinal extension in cases without clinical symptoms].

Three cases of dumbbell neurogenic tumor of the posterior mediastinum are reported. None of these cases had any clinical symptoms, and an abnormal mass shadow of the mediastinum had been detected on routine chest roentgenogram. In these three cases, however, myelogram and/or CT findings were suggestive of tumor extension to the spinal canal in various degrees.

[A case of hypersensitivity pneumonitis due to isocyanate exposure showing progression even two months after removal of the antigen].

A 68-year-old male developed dry cough and exertional dyspnea after handling paint spray containing isocyanates (TDI, MDI) for three months. Initially, the symptoms fluctuated according to whether he was at work or not. He was admitted to our hospital on February 7, 1990, because of progressive worsening of symptoms.

[Mediastinitis with bilateral empyemas following neck phlegmon].

A 46-year-old male complaining of fever and neck swelling was transferred to our department because of bilateral empyemas in the pleural spaces following neck phlegmon. A culture of the right pleural effusion obtained at his local hospital revealed Gram-positive anaerobic cocci. Chest roentgenogram showed bilateral effusions and widening of the upper mediastinum.

Detection of human T-cell lymphotropic virus type I-related antibodies in patients with lymphocytic interstitial pneumonia.

Lymphocytic interstitial pneumonia (LIP) is a rare form of interstitial pneumonia with infiltration of mononuclear cells in the interstitium, the pathogenesis of which is unknown. We studied six patients with LIP to investigate the immunologic characteristics of lymphocytes in the lower respiratory tract and the possible involvement of human T-cell lymphotropic virus type I (HTLV-I), which is endemic in the southwestern region of Japan. Lymphocyte surface antigen phenotyping in peripheral blood (PB) and bronchoalveolar lavage fluid (BALF) cells revealed a predominance of CD8 positive (suppressor/cytotoxic) T-lymphocytes (PB: 51.

Enhanced neutrophil functions in a patient with colony-stimulating activity-producing lung cancer.

We studied neutrophil functions in a patient with colony-stimulating activity (CSA)-producing lung cancer. A 59-year-old man had an abnormal chest X-ray and leucocytosis, predominantly with neutrophils. Pneumonectomy was performed, and the histological diagnosis of the tumour was large-cell carcinoma of the lung.

Siiyama (serine 53 (TCC) to phenylalanine 53 (TTC)). A new alpha 1-antitrypsin-deficient variant with mutation on a predicted conserved residue of the serpin backbone.

alpha 1-antitrypsin (alpha 1AT), a plasma serine protease inhibitor, increases the risk of precocious pulmonary emphysema in individuals when deficient. Although more than 25 years have passed since a deficiency in the serum level of alpha 1AT was reported, it is only recently that the consequence of the amino acid replacement which leads to the deficient state has been discussed in terms of the crystallographic structure of alpha 1AT and the amino acid residues conserved in the superfamily to which it belongs. Our case involved a 38-year-old Japanese male with alpha 1AT deficiency which was analyzed and identified as a new deficient variant.

[A case of diffuse panbronchiolitis, performed an open lung biopsy after improvement with 6 years medication].

A 51-year-old male was hospitalized in June 1983, complaining of productive cough and dyspnea. Diffuse panbronchiolitis (DPB) was diagnosed on the basis of the physical examination, chest roentgenogram, chest CT and transbronchial lung biopsy (TBLB). The patient underwent surgery for chronic sinusitis and deviated nasal septum, and received Pseudomonas aeruginosa vaccine, ampicillin and erythromycin.

Soluble interleukin-2 receptor in sera of patients with pulmonary tuberculosis.

Interleukin-2 receptor, the complex of IL-2R-alpha and/or IL-2R-beta, is expressed mainly on T-lymphocytes, and the soluble form of IL-2R-alpha (sIL-2R-alpha) has been reported to be detected in the serum of patients with lymphoproliferative disorders or disease characterized by the cellular immune reaction. We measured serum sIL-2R-alpha levels among patients with pulmonary diseases and found that sIL-2R-alpha levels were significantly elevated in patients with active pulmonary tuberculosis (1,327 +/- 209 U/ml) and sarcoidosis (1,037 +/- 115 U/ml) when compared with healthy volunteers (468 +/- 49 U/ml, p less than 0.01).

Respiratory nicotine absorption in non-smoking females during passive smoking.

The aim of this study was to measure nicotine concentrations in inspired and expired air so as to learn more about respiratory (nasopharyngeal cavity and lung) nicotine absorption from inspired air and to estimate the nicotine intake during passive smoking. A total of 17 young non-smoking women were exposed to experimental passive smoking. Inspired and expired air was sucked at a constant rate into samplers filled with acid-treated diatomite (Uniport-S) to absorb nicotine in the air.

Sequential changes of perivascular edema cuffs in models of permeability and hemodynamic pulmonary edema.

The areas of perivascular edema cuffs surrounding pulmonary arteries and veins were sequentially measured as an index of the fluid transport unit in lung interstitium (FTULI) in epinephrine-induced and oleic acid-induced pulmonary edema in rats. The former edema represents a model of hemodynamic edema and the latter, permeability pulmonary edema, respectively. In epinephrine-induced pulmonary edema, both the ratio of edema cuff area to cross-sectional area of the pulmonary artery (Rr) and the ratio of lung weight to body weight (L/B) were increased in parallel, reached maximum levels at 0.

[Measurement of oil mists by a portable sampler and subjective symptoms among machine workers: a field investigation of machine workshops].

Machine oils are widely used in metal processing and many workers are exposed to oil mists in the work environment. Some investigators have pointed out such health hazards due to prolonged exposure to oil mist as respiratory disorders, dermatitis, and possible carcinogenesis. In Japan, a permissible limit of oil mists of 3 mg/m3 was recommended in 1977 by the Japan Association of Industrial Health (JAIH) mainly based on the hazardous effects on the respiratory system.