Nihon rinsho. Japanese journal of clinical medicine
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Efficacy of home oxygen therapy (HOT) is well established for patients with chronic obstructive pulmonary disease who fall into chronic respiratory failure. We should consider now how the quality of life improves with HOT in those patients. According to the guideline of the Japanese Respiratory Society, indications of HOT are as follows: 1) A PaO2 of less than 55 Torr at rest while breathing room air, 2) A PaO2 between 55 Torr and 60 Torr in the presence of clear evidence of cor pulmonale, pulmonary hypertension, or a long history of severe hypoxemia during sleep or during exercise. Further studies are definitely required to pick up the patients who do not necessarily meet these indications but who may benefit from HOT.
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Apoptosis is a critical mechanism controlling cellularity in various tissues. It is so far unknown whether apoptosis plays a critical role in the pathogenesis and development of chronic obstructive pulmonary disease (COPD). However, recent evidence suggests that apoptosis may occur in vascular endothelial cells and/or alveolar epithelial cells in COPD lungs, thereby potentially contributing to lung tissue destruction seen in COPD. Apoptosis may also influence cellular infiltrates into the lung, another pathologic feature of COPD, because the survival of inflammatory cells such as neutrophils, lymphocytes, and macrophages are critically determined by the mechanism of apoptosis.
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The function of the cystic fibrosis (CF) gene product, cystic fibrosis transmembrane conductance regulator (CFTR) is critical to normal lung defense. CFTR not only acts as a cAMP-dependent Cl-channel, but regulates other ion channels and several cellular functions. ⋯ Only a few cases have been reported in Japanese with no mutations including delta F508 identified. Those cases seem to be caused by unknown factors yet to be found.