Validation of the prediction rules identifying drug-resistant pathogens in community-onset pneumonia.

Background: Appropriate initial antibiotic treatment and avoiding administration of unnecessary broad-spectrum antibiotics are important for the treatment of pneumonia. To achieve this, assessment of risk for drug-resistant pathogens (DRPs) at diagnosis is essential.

Purpose: The aim of this study was to validate a predictive rule for DRPs that we previously proposed (the community-acquired pneumonia drug-resistant pathogen [CAP-DRP] rule), comparing several other predictive methods.

Risk factors for 30-day mortality in patients with pneumonia who receive appropriate initial antibiotics: an observational cohort study.

Background: Appropriate initial antibiotics are essential for the treatment of infectious diseases. However, some patients with pneumonia might develop adverse outcomes, despite receiving appropriate initial antibiotics. We aimed to clarify the risk factors for 30-day mortality in patients who received appropriate initial antibiotics and to identify potential candidates who would benefit from adjunctive therapy.

[Change of the patient characteristics among adult asthmatics hospitalized due to acute exacerbation].

Background: We analysed the patient characteristics among adult asthmatics hospitalized to our hospital to clearfy the residual problems in the prevention and treatment of asthma.

Methods: We identified the adult asthmatics hospitalized to our hospital during the period A: Jan 2004-Dec 2005 and the period B: Jan 2009-Dec2010 and analysed retrospectively around age, smoking history, and the use of ICS (including combination medicine) and so on.

Results: The total patient numbers were A: 161 and B: 88, decreasing to almost half.

Risk factors for drug-resistant pathogens in community-acquired and healthcare-associated pneumonia.

Rationale: Identification of patients with drug-resistant pathogens at initial diagnosis is essential for treatment of pneumonia.

Objectives: To elucidate clinical features of community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP), and to clarify risk factors for drug-resistant pathogens in patients with CAP and HCAP.

Methods: A prospective observational study was conducted in hospitalized patients with pneumonia at 10 institutions in Japan.

Mechanical stretch enhances IL-8 production in pulmonary microvascular endothelial cells.

In patients with acute respiratory distress syndrome, mechanical over-distension of the lung by a large tidal volume causes further damage and inflammation, called ventilator-induced lung injury (VILI), however, it is unclear how mechanical stretch affects the cellular functions or morphology in human pulmonary microvascular endothelial cells (HPMVECs). IL-8 has been proposed to play an important role in the progression of VILI by activating neutrophils. We demonstrated that HPMVECs exposed to cyclic uni-axial stretch produce IL-8 protein with p38 activation in strain- and time-dependent manners.

Idiopathic pulmonary veno-occlusive disease.

We report a case of idiopathic pulmonary veno-occlusive disease (PVOD). The patient experienced progressively worsening dyspnea. Heart catheterization revealed severe pulmonary hypertension.

Actin cytoskeleton regulates stretch-activated Ca2+ influx in human pulmonary microvascular endothelial cells.

During high tidal volume mechanical ventilation in patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), regions of the lung are exposed to excessive stretch, causing inflammatory responses and further lung damage. In this study, the effects of mechanical stretch on intracellular Ca(2+) concentration ([Ca(2+)](i)), which regulates a variety of endothelial properties, were investigated in human pulmonary microvascular endothelial cells (HPMVECs). HPMVECs grown on fibronectin-coated silicon chambers were exposed to uniaxial stretching, using a cell-stretching apparatus.

Regulation of endothelin-1-induced interleukin-6 production by Ca2+ influx in human airway smooth muscle cells.

Endothelin-1 is considered to be an important mediator in the pathophysiology of asthma because it induces contraction, hypertrophy, and proliferation in airway smooth muscle cells as well as inflammatory responses in the airway. Airway smooth muscle cells have been suggested to contribute to airway inflammation in asthma by producing cytokines. Nevertheless, the role of intracellular Ca(2+) signal in cytokine production in human airway smooth muscle cells is still unclear.

[Case of acute respiratory distress syndrome in which high-frequency oscillatory ventilation (HFOV) was effective for the management of severe hypoxemia].

A 69-year-old man was admitted to our hospital because of acute prostatitis. After admission he produced bloody sputum and chest radiograph showed bilateral infiltration of the upper lung fields. The fraction of neutrophils in the bronchoalveolar lavage fluid was 15.

[Surgical lung biopsy for interstital lung diseases: complications, diagnostic yield and mortality].

We retrospectively reviewed 110 consecutive patients with interstitial lung diseases (ILDs) who underwent surgical lung biopsy over 13 years from 1989-2002. Surgical procedures, medical records, surgical complications and outcome including post-operative exacerbation of ILDs were assessed in order to clarify the safety and efficacy of surgical lung biopsy. Forty-one patients underwent open lung biopsy (OLB), while 69 patients received videothoracoscopic lung biopsy (VTLB).

[Quality of life as an independent prognostic factor in advanced non-small-cell lung cancer in general practice].

Although quality of life (QOL) has become an important aspect of lung cancer trials, it has rarely been evaluated in general practice. We have been assessing QOL in patients with advanced non-small-cell lung cancer in general practice. In this study, we retrospectively analyzed factors of the baseline QOL score in relation to response to chemotherapy and survival in 43 consecutive advanced non-small-cell lung cancer patients who received chemotherapy.

[A case of Langerhans cell histiocytosis which resolved only on smoking cessation].

We report a case with Langerhans cell histiocytosis appearing as an extra-pleural tumor. A 20-year-old man was transferred to our hospital because of right chest pain and fever. His chest X-ray showed an extra-pleural mass and chest CT scan showed a mass lesion with right 7th rib fracture.