Nihon Kyōbu Shikkan Gakkai zasshi
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Nihon Kyobu Shikkan Gakkai Zasshi · Nov 1990
Case Reports[A case of idiopathic interstitial pneumonia with pneumothorax and pneumomediastinum, accompanied by rapid progression of cystic changes on CT].
A case of idiopathic interstitial pneumonia (IIP) with pneumothorax and pneumomediastinum was presented. A 52-year-old male was admitted with the complaint of cough, fever and dyspnea. Chest roentgenogram revealed bilateral reticulonodular shadow and right pneumothorax. ⋯ The mechanisms of pneumothorax and pneumomediastinum were speculated to be due to the rupture of those cystic lesions which had grown rapidly on follow-up CTs. It was suggested that the formation of honeycombing occurred within a few months and the increasing of honeycombing might be accompanied by so-called acute exacerbation of IIP. We propose that follow-up CTs were useful for the chronological study for interstitial lesions of IIP.
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A large amount of mucus and mucoid impaction are observed in the autopsied lungs of bronchial asthmatics. It is possible that mucus hypersecretion and accumulation of intrabronchial mucus result in bronchial obstruction and structural bronchial hyperresponsiveness. Bronchial gland plays a main role in human airway secretion. ⋯ Substance P which is released by an axon reflex in response to various stimuli and inflammations in the airways, also produced an increase in mucus secretion. Epithelial cells release an inhibitory factor to mucus glycoprotein secretion from bronchial glands. Epithelial cell damages due to inflammation in the airways may induced a reduction of the inhibitory factor release in bronchial asthmatics, resulting in mucus hypersecretion.
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Nihon Kyobu Shikkan Gakkai Zasshi · Aug 1990
Case Reports[Respiratory malignancies induced by asbestos exposure and evaluation of cases with typical pleural malignant mesothelioma and lung cancer with asbestosis].
Asbestos exposure induces lung fibrosis, i.e. asbestosis, and furthermore, pathological changes of pleura, i.e. asbestos pleurisy of pleural plaque. Generally, asbestosis is induced by massive exposure to asbestos and pleural changes are induced by low dose exposure to asbestos. The most important diseases which are induced by asbestos exposure are malignancies, especially malignant mesothelioma and lung cancer. ⋯ We do not know which elements may induce malignancies under asbestos exposure. Recently, some reports described that asbestos mediated the transformation of genes and this action induced malignancies. We should extend our study to the gene problem in cases of malignant mesothelioma and lung cancer induced by asbestos exposure.
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Nihon Kyobu Shikkan Gakkai Zasshi · Jun 1990
[The role of thoracoscopy in pleural biopsy in cases with pleural effusion].
Between April 1985 and July 1989, 125 cases with pleural effusion were admitted to our department. The causes of pleural effusion were carcinomatous pleurisy in 47 cases, infection without tuberculosis in 34 cases, tuberculous pleurisy in 17 cases, cardiac insufficiency and hypoproteinemia in 11 cases, trauma and pneumothorax in nine cases, collagen disease in two cases and unknown origin in five cases. Carcinomatous pleurisy and tuberculous pleurisy, the differential diagnosis of which is very important, comprised 37% and 14% of all cases, respectively. ⋯ For thoracoscopic pleural biopsies, a high positive ratio of 84% was achieved (in carcinomatous pleurisy, 13 out of 15 cases; in tuberculous pleurisy, three out of four cases). This procedure was performed with minimal patient discomfort and no serious complications. Therefore, thoracoscopic pleural biopsy is recommended as a diagnostic procedure for cases with pleural effusion.
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Nihon Kyobu Shikkan Gakkai Zasshi · Jun 1990
Case Reports[A case of bronchial asthma complicated with mediastinal, subcutaneous, peritoneal and epidural emphysema].
A case of a 16-year-old female with bronchial asthma complicated with mediastinal, subcutaneous, peritoneal and epidural emphysema was reported. The patient was admitted to our hospital because of dyspnea. ⋯ These findings disappeared about 10 days after recovery from the attack. Diagnostic methods and the pathogenesis of air leak were also discussed.