Long-term follow-up CT scan evaluation in patients with pulmonary sarcoidosis.

Objectives: The aim of the present study was to determine how the pattern and extent of sarcoidosis changes over time on serial high-resolution CT (HRCT) scans and to identify CT scan findings that might be helpful in predicting the prognosis of patients with the disease.

Methods: The initial and last HRCT scan findings of 40 patients with pulmonary sarcoidosis during a mean follow-up period of 7.4 years (range, 3 to 18 years) were evaluated retrospectively.

[A case of infected bulla caused by Mycobacterium kansasii].

A 62-year-old man was referred to our hospital because of persistent sub-fever. A pulmonary fungal infection was suspected owing to the elevation of the serum-D-glucan level. Since a chest radiograph and a CT scan revealed intrabullous fluid in the right upper lobe, percutaneous needle aspiration was performed.

[Four cases of Mycobacterium xenopi pulmonary disease].

Mycobacterium xenopi is very rare pathogen in Japan. We reported herein four cases of M. xenopi pulmonary disease.

[Long-term outcome of patients treated by home mechanical ventilation].

To investigate the long-term survival of 95 patients treated by home mechanical ventilation, we prospectively analyzed the outcomes of their cases (treatments: 34, tracheostomy; 61, non-invasive methods) using the database of the local registration system in Aichi Prefecture. The annual actuarial probability of continuing home mechanical ventilation for the tracheostomized patients was 97.0% in the first year, 79.

[Hospital infection control practice for tuberculosis].

In Japan, annual incidence rate of tuberculosis was 31.0/10,000 population in 2000. But that of some hot spots, such as Osaka prefecture(61.

[Present trends of drug-resistant tuberculosis and how to manage it by mycobacterial laboratories].

Global, domestic, and local trends of drug-resistant tuberculosis and how to manage increase in the resistance by mycobacterial laboratories were discussed based on literatures and our own data. At first, how to make drug-resistant tuberculosis was explained. Genetic drug-resistant bacteria were emerged spontaneously by mutation of the genome and were selected by inadequate treatment(mono-therapy or functional mono-therapy): acquired drug resistance(single, and then multi-drug resistance).

Chronic eosinophilic pneumonia due to visceral larva migrans.

A 38-year-old woman presented with worsening cough, blood eosinophilia, and pulmonary infiltrates. Bronchoalveolar lavage showed 96.4% eosinophils.

[Induction therapy for non-small cell lung cancer].

Induction therapy for non-small cell lung cancer was reviewed. Surgical therapy remains the treatment of choice for resectable non-small cell lung cancer. However, postoperative survival of the patients with locally advanced NSCLC is far from acceptable.

Expression and prognostic significance in lung cancer of human tumor-associated antigen RCAS1.

A new monoclonal antibody (MAb), 22-1-1, acts against a novel tumor-associated antigen (Ag) strongly expressed in human uterine cervical adenocarcinomas. A cDNA encoding the Ag recognized by the 22-1-1 MAb has been isolated and called RCAS1 (receptor-binding cancer antigen expressed on SiSo cells). RCAS1 can induce growth arrest and apoptosis in RCAS1 receptor-positive cells including T cells and natural killer cells in vitro.

Unsuspected lung cancer accompanied by catamenial pneumothorax.

A 45-year-old nonsmoking woman with repeated coughing and dyspnea on effort was admitted to our hospital diagnosed with right-sided pneumothorax on chest X-ray. Chest computed tomography showed neither bullae nor nodules. Chest drainage failed to completely reexpand the lung, necessitating video-assisted thoracic surgery.

Intrapulmonary mature teratoma.

Intrapulmonary teratoma is reported in a 22-year-old male. A chest X-ray in a physical examination showed a round shadow in the left hilum of a 22-year-old man who, on admission, reported slight malaise and a decrease in body weight. Computed tomographic scan and magnetic resonance imaging of the chest showed a heterogeneously dense cystic lesion.

Paragonimiasis miyazakii associated with bilateral pseudochylothorax.

A 37-year-old man who suffered from bilateral pleural effusions, subcutaneous abdominal induration and blood eosinophilia, was admitted to our hospital. He had ingested raw crabs at a pub-restaurant before the onset of his symptoms. His pleural effusions were chyliform containing cholesterol crystals, and a high level of immunoglobulin E (36,580 IU/ml) and anti-Paragonimus miyazakii antibody were detected.

[Evaluation of eosinophilic cationic protein levels in patients with eosinophilic pneumonia].

We investigated the significance of eosinophilic cationic protein (ECP) as a biological indicator of disease activity in patients with eosinophilic pneumonia (EP). ECP levels were measured in serum and bronchoalveolar lavage fluid (BALF) samples from patients with EP or other diffuse interstitial lung diseases and from healthy subjects. Also we performed immunohistochemical staining of lung tissue sections from patients with EP using anti-EG 2 antibody, and computed the correlation between the number of EG 2-positive cells in lung tissues and ECP levels in serum and BALF from patients with EP.

Circulating KL-6 predicts the outcome of rapidly progressive idiopathic pulmonary fibrosis.

Searching for early predictive markers of the therapeutic effects of high-dose corticosteroids ("pulse therapy") on patients with rapidly progressing idiopathic pulmonary fibrosis (IPF), we evaluated 14 such patients, who had received weekly pulse therapy for at least 3 wk. Eight patients responded to the treatment and survived. However, six patients failed to respond, and all of them died within 3 mo after treatment.

Which type of diffuse emphysema is adequately contracted by the Nd:YAG laser. An ex-vivo experiment.

Diffusely emphysematous lungs are not always effectively contracted by laser therapy; however, which type of diffuse emphysema that responds to laser therapy remains unclear. We macroscopically and histopathologically examined human lung tissue, which was resected from patients with carcinoma, after irradiation with an Nd:YAG laser. Forty-six lung lobes were irradiated with a non-contact mode Nd:YAG laser at a power setting 15 watts.

KL-6 as a serologic indicator of Pneumocystis carinii pneumonia in immunocompromised hosts.

KL-6, a serum marker for interstitial pneumonitis, was evaluated in patients with Pneumocystis carinii pneumonia (PCP). Patient 1 was a 56-year-old woman with rheumatoid arthritis treated with immunosuppressive drugs and corticosteroids. Patient 2 was a 59-year-old man with a glioblastoma who received anti-cancer drugs and corticosteroids.

Histopathological features of pulmonary asbestosis with particular emphasis on the comparison with those of usual interstitial pneumonia.

We examined 40 autopsy cases of pulmonary asbestosis which were defined by occupational history, lung fibrosis and asbestos bodies (ABs) to clarify histopathological features. Thirty four patients were males and six were females. The mean age was 64.

[High levels of elastolytic activity in bronchoalveolar lavage fluid from a patient with idiopathic interstitial pneumonia].

A 63-year-old female with acure exacerbution of idiopathic interstitial pneumonia (IIP) showed high levels of elastolytic activity in bronchoalveolar lavage fluid (BALF). She was admitted to our hospital with progressive dyspnea. Arterial blood gas analysis and pulmonary function tests were abnormal.

[Chronic eosinophilic pneumonia successfully treated with suplatast tosilate].

The patient was a 45-year-old woman in whom a chest X-ray film obtained on admission showed bilateral infiltrative shadows. A chest CT scan revealed areas of consolidation and ground-glass opacities. Examination of bronchoalveolar lavage fluid revealed many eosinophils, and specimens obtained by transbronchial lung biopsy showed thickened alveolar septa with infiltration of eosinophils.

[The role of surgery for chronic empyema of the advanced ages].

Chronic empyema, a sequelae of pulmonary tuberculosis, is now a only tuberculosis-related disease which was remained to be treated surgically. The candidates who have basically poor respiratory function are now attained advanced age. Over a 15 years period (1980-95), 22 patients 70 years of age or older underwent surgical intervention for chronic empyema at our hospital.

[KL-6 in patients with interstitial pneumonitis].

Levels of KL-6 are high in serum and in bronchoalveolar lavage fluid (BALF) from patients with interstitial pneumonitis. To examine the usefulness of the KL-6 level as a marker of disease activity in interstitial pneumonitis, KL-6 was measured in serum and in BALF from patients with this disease. Correlations between KL-6 levels and the number of cells in BALF and between KL-6 levels and pulmonary function were computed.

[Two cases of von Recklinghausen's disease with diffuse pulmonary changes].

Two patients with von Recklinghausen's disease had diffuse pulmonary diseases. The pulmonary diseases were interstitial fibrosis and emphysematous bullae. In case 2, examination of a specimen obtained by transbronchial lung biopsy revealed fibrotic interstitial thickening and adenomatous hyperplasia.

Pulmonary hyalinizing granuloma with Castleman's disease.

A case of pulmonary hyalinizing granuloma (PHG) with Castleman's disease in a 43-year-old man is presented. He was asymptomatic, but the disease was recognized due to a routine chest roentgenographic study. Anemia, multiple lymphadenopathy, hypoalbuminemia and polyclonal hypergamma-globulinemia were observed.

[Diagnostic value of bronchoalveolar lavage(BAL)--the comparative study with open lung biopsy and BAL].

Since the introduction of bronchoalveolar lavage (BAL) by Reynolds, et al. in 1974, this method has gained widespread use as a diagnostic tool in interstitial lung diseases. BAL is a safe means of retrieving cells from the distal airway and alveoli for cytological, immunocytochemical and biochemical examination, although there is still controversy on the significance of the finding and it is a subject of current research.