[Two cases of refractory asthma presenting chest pain, which were successfully treated with noninvasive positive pressure ventilation].

We report here two cases of refractory asthma presenting chest pain, which were successfully treated by using intermittent noninvasive positive pressure ventilation (NPPV). Both patients were women, and were diagnosed to have bronchial asthma with the reversibility of airway contraction after administration of a bronchodilator. Although both patients were treated with several medicines for "treatment step 4" based on the guideline in Japan, their asthma could not be controlled well and their symptoms including the chest pain eroded their quality of life.

Inhibitory effects of pitavastatin on fibrogenic mediator production by human lung fibroblasts.

Aims: Idiopathic pulmonary fibrosis continues to be a devastating clinical disorder for which there are few therapeutic options, and the pathogenesis of this disease remains largely unknown. Statins are inhibitors of 3-hydroxy-3-methylglutaryl-coenzyme A reductase in cholesterol biosynthesis, and they have been reported to exert pleiotropic effects on the cellular signaling involved in tissue inflammation and in organ fibrosis/remodeling. We examined the preventive effects of statins on fibrogenic mediator expression and production in normal human lung fibroblasts (NHLF).

Protocol-based noninvasive positive pressure ventilation for acute respiratory failure.

Purpose: Noninvasive positive pressure ventilation (NPPV) has been suggested to be associated with adverse outcomes in emergency patients with acute respiratory failure (ARF), possibly because of a delay in tracheal intubation (TI). We hypothesized that protocol-based NPPV (pNPPV) might improve the outcomes, compared with individual physician-directed NPPV (iNPPV).

Methods: To guide decision making regarding the use of NPPV, we developed an NPPV protocol.

[A case of hepatopulmonary syndrome with elevated exhaled nitric oxide].

A 76-year-old man was admitted to our hospital because of dyspnea. Three years before admission, dyspnea was recognized and had been given a diagnosis of interstitial pneumonia by a general physician. A year later, he received home oxygen therapy.