Nihon Kyōbu Shikkan Gakkai zasshi
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Nihon Kyobu Shikkan Gakkai Zasshi · Jan 1994
[Clinical usefulness of visual analog scale for assessment of dyspnea at rest in patients with chronic respiratory diseases].
To evaluate the validity and clinical usefulness of the visual analog scale (VAS) for the measurement of dyspnea at rest, we employed the 150 mm VAS in 29 chronic respiratory disease patients who were clinically stable, and repeated the measurement 4 weeks and 8 weeks later for the evaluation of reproducibility. For the 8-week period, the individual medical treatments remained generally unchanged in all patients. Two patients were excluded from the study due to infection and pneumothorax. ⋯ However, the intensity of dyspnea was distributed widely within each Fletcher category. These results lead to the conclusion that VAS shows good reproducibility over a period of as long as 8 weeks and that VAS measurements can reveal patient-to-patient individual differences in dyspnea intensity which cannot be detected by the Fletcher dyspnea category. We propose that measuring dyspnea at rest using VAS is a useful method to obtain a valid clinical parameter.
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Nihon Kyobu Shikkan Gakkai Zasshi · Dec 1993
Review Case Reports[Case report and review of literature on seasonal distribution and pathogenesis of acute eosinophilic pneumonia in Japan].
A 49-year-old female was admitted because of high grade fever and dyspnea. Chest roentgenogram revealed diffuse reticulo-linear shadows. Laboratory findings showed peripheral blood eosinophilia, and blood gas analysis demonstrated severe hypoxemia. ⋯ Eleven of 22 cases were tested for precipitating antibodies to several fungi, 3 of which showed positive results against Trichosporon cutaneum, Trichoderma viride and Aspergillus species. The clinical features of acute eosinophilic pneumonia resemble those of summer type hypersensitivity pneumonitis. Therefore, it is important to diagnose AEP on the basis of clinical symptoms, and precipitating antibody, viral titer and pathological findings.
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Nihon Kyobu Shikkan Gakkai Zasshi · Dec 1993
[Lung preserving operation for bronchogenic carcinoma--segmentectomy and bronchoplastic lobectomy].
The results of segmentectomy and bronchoplastic lobectomy for bronchogenic carcinoma were reported. Until December 1992, 920 patients underwent lung resection for primary lung cancer at our institution. Among them, 70 patients (7.6%) had segmentectomy and 149 (16.2%) had bronchoplastic lobectomy. ⋯ Five-year survival rates of those with bronchoplasty were 33.9% in total, 51.1% in those with Stage I, 29.1% in those with Stage IIIA and 39.0% in those with squamous cell carcinoma. Respiratory function was well preserved in patients with segmentectomy and bronchoplastic lobectomy. Lung-preserving operations such as segmentectomy and bronchoplastic lobectomy are meaningful as a curative procedure for primary lung cancer for selected patients.
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Nihon Kyobu Shikkan Gakkai Zasshi · Dec 1993
[Coagulation and fibrinolysis systems in bronchoalveolar lavage fluid in irradiated lung of rabbits].
Pulmonary fibrin deposition suggests the involvement of coagulation and fibrinolysis in pulmonary inflammation. The present study was designed to investigate the alterations of coagulation and fibrinolysis in rabbits that received thoracic irradiation. Serial bronchoalveolar lavage (BAL) was performed after the irradiation, and procoagulant activity (PCA) and tissue plasminogen activator (t-PA) were measured in BAL fluids. ⋯ T-PA also increased with a significant difference at 4 weeks compared to controls. Although irradiation activated both PCA and t-PA, PCA increased prior to t-PA and the elevation lasted longer. It was concluded that activation of the coagulation system promotes pulmonary fibrin deposition and may contribute to the progression of pulmonary injury.
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Nihon Kyobu Shikkan Gakkai Zasshi · Nov 1993
Case Reports[A case of chronic aspiration pneumonia after total gastrectomy caused by gastroesophageal reflux revealed by a "modified-salivagram"].
A 76-year-old male patient suffered from recurrent bacterial pneumonia of the right upper lobe and both lower lobes since 2 years after total gastrectomy for gastric cancer. He was treated with antibiotics repeatedly without complete remission. Meanwhile, chronic cough, purulent sputum, and persistent bilateral pulmonary infiltration developed gradually. ⋯ Chronic aspiration resulting from GER is an important cause of chronic airway infection. Even if a patient with reflux esophagitis is asymptomatic, chronic aspiration pneumonia should be suspected in cases of recurrent or persistent pneumonia in both lower lobes. The "modified-salivagram" is a sensitive test to detect aspiration and GER in hypoacidic states, such as in total gastrectomy and elderly patients.