Nihon Kyōbu Shikkan Gakkai zasshi
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Nihon Kyobu Shikkan Gakkai Zasshi · Oct 1997
Case Reports[Bufferin-induced lung injury manifesting as acute eosinophilic pneumonia].
A 26-year-old woman was admitted to our hospital because of dyspnea and fever one day after taking medicines for the common cold. A chest roentgenogram and a computed tomogram revealed diffuse patchy infiltrates in both lung fields. Examination of a specimen obtained by transbronchial lung biopsy showed thickening of alveolar walls and infiltration of eosinophils. ⋯ We believe that this patient's pulmonary disease was caused by Bufferin. We should realize that this widely used analgesic can cause acute eosinophilic lung disease. The patient was not given corticosteroids, and her condition improved soon after she stopped taking Bufferin.
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Nihon Kyobu Shikkan Gakkai Zasshi · Oct 1997
[Usefulness and early detection of acute exacerbation by peak expiratory flow rate in the management of asthma].
The monitoring of peak expiratory flow (PEF) and maintenance of a symptom diary have been proposed as means to monitor asthma severity. This study assessed via longitudinal analysis, the usefulness and limitation of daily PEF monitoring (amplitude percent mean) as an index for asthma severity, and the usefulness of recording daily intake of beta-agonists as a measure of symptom severity. Nine subjects with moderate to severe asthma were treated with inhaled beclomethasone dipropionate (BDP). ⋯ When the minimum PEF was 80%, daily PEF variability was approximately 10%. When the minimum PEF was 40%, daily PEF variability was 46%, and the daily frequency of beta-agonist inhalation was 2.6. We concluded that, 1) The target values of minimum PEF and daily PEF variability are 80% and 10% respectively in the treatment of asthmatic patients, 2) The daily frequency of beta-agonist inhalation is recommended as an indicator for the severity of asthmatic symptoms, and 3) Daily PEF variability in combination with the daily frequency of beta-agonist inhalation is very useful in the management and early detection of acute asthma.
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Nihon Kyobu Shikkan Gakkai Zasshi · Oct 1997
Case Reports[Interstitial pneumonia associated with human adjuvant disease which developed 30 years after silicone augmentation mammoplasty].
A 51-year-old woman was admitted to our hospital with exertional dyspnea, swelling and stiffness in her fingers. Raynaud's phenomenon and mammary and axillary lymphadenopathy. She had received silicone augmentation mammoplasty 30 years ago, and had since noticed bilateral mammary and axillary lymphadenopathy that was stable in size. ⋯ In addition, chest roentgenogram and HRCT (which revealed decreased lung volumes and interstitial opacities with no honeycombing, present predominatly in the subpleural space), pulmonary function tests (decreased VC and DLco), bronchoalveolar lavage (elevated total cell count and neutrophil and eosinophil fractions), and transbronchial lung biopsy specimens (unevently distributed alveolitis with fibrosis) indicated concurrent interstitial pneumonia. The clinical correlation between exacerbation of silicone lymphadenopathy and the development of connective tissue disease with accompanying interstitial pneumonia strongly suggested human adjuvant disease (HAD) as the pathogenesis. To our knowledge, interstitial pneumonia associated with HAD is rare.
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Nihon Kyobu Shikkan Gakkai Zasshi · Sep 1997
[Outcomes of noninvasive positive-pressure ventilation in patients with acute hypercapnia complicating chronic respiratory failure].
We used noninvasive positive-pressure ventilation to treat hypercapnea due to acute exacerbations of chronic respiratory failure (21 episodes in 19 patients; COPD, 4; pulmonary tuberculosis sequelae, 4; silicosis, 3; silicotuberculosis, 3; bronchiectasis, 3; others, 2). All patients had acute onsets of severe hypercapnea (PaCO2 > 45 Torr), acute decreases in pH (< 7.35), and tachypnea, paradoxical breathing or both. During the first 2 to 4 hours of bi-level positive airway pressure, PaCO2 decreased from 72 to 61 Torr (p < 0.0005), pH increased from 7.26 to 7.31 (p < 0.001), and respiratory rate decreased from 30 to 25 breaths/min (p < 0.005). ⋯ In 17 of the 21 episodes (81%) gas exchange improved and intubation was not necessary. In those 17, the mean duration of noninvasive positive-pressure ventilation was 6.3 days. We conclude that noninvasive positive-pressure ventilation can improve gas exchange in patients with acute hypercapnea complicating chronic respiratory failure.
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Nihon Kyobu Shikkan Gakkai Zasshi · Aug 1997
Case Reports[Necrotizing sarcoid granulomatosis diagnosed by video thoracoscopic lung biopsy].
A 28-year-old woman was admitted to our hospital because of chest pain. A chest roentgenogram and a chest computed tomogram revealed many nodular shadows on both sides. Examinations of specimens obtained by and by transbronchial lung biopsy during fiberoptic bronchoscopy were not diagnostic, and therefore video thoracoscopic lung biopsy was done. ⋯ We therefore diagnosed necrotizing sarcoid granulomatosis, and began to administer prednisolone. The nodular shadows disappeared within four weeks. In this case video thoracoscopic lung biopsy was useful in the diagnosis of necrotizing sarcoid granulomatosis in the lung.