Nihon Kyōbu Shikkan Gakkai zasshi
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Nihon Kyobu Shikkan Gakkai Zasshi · Aug 1989
Case Reports[CT analysis of pulmonary emphysematous and fibrotic changes in patients with von Recklinghausen's disease].
Five cases of von Recklinghausen's disease were studied with regard to their association with chest diseases, especially pulmonary emphysematous and fibrotic changes. CT analysis revealed that four patients out of five had multiple pulmonary emphysematous lesions and that those lesions were seen in all segments. In two cases out of the four, it was difficult to detect their abnormalities by an ordinary chest roentgenogram, suggesting the possibility of higher incidence of emphysematous changes in von Recklinghausen's disease than has been expected. ⋯ TBLB was performed in one case, in whom no fibrotic changes were observed. Usually pulmonary fibrosis is associated with emphysematous bullae in patients with von Recklinghausen's disease. However, fibrotic and emphysematous changes may not always occur in combination in von Recklinghausen's disease.
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Nihon Kyobu Shikkan Gakkai Zasshi · Jul 1989
Case Reports[A case of neurogenic pulmonary edema with repeated deterioration due to subarachnoid hemorrhage].
A 55-year-old male was admitted to our hospital for subarachnoid hemorrhage complicated with liver cirrhosis on Jan. 8th, 1988. Chest X-ray film on admission showed bilateral infiltrative shadows, which disappeared on Jan. 10th. However the same type of shadow reappeared on Jan. 12th. ⋯ Cardiac function evaluated by ultrasonocardiography and right cardiac catheterization, and the composition and amount of plasma protein concentration were within normal limits. Although the mechanism of repeated appearance of the shadow was not clear, the edema was thought to be neurogenic. As this case showed, the control of water balance and the use of diuretics are essential for treatment of this neurogenic pulmonary edema.
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Nihon Kyobu Shikkan Gakkai Zasshi · Feb 1989
Case Reports[A case of primary pulmonary sporotrichosis].
We report the first case of primary pulmonary sporotrichosis in Japan. A 53-year-old man was admitted to our hospital for further examination of the abnormal shadows on chest X-ray film. Six months before admission, he was admitted to another hospital because of alcoholic liver disease and diabetes mellitus. ⋯ Now he receives miconazole intravenously and is still under careful observation. As far as we know, this is the first report of primary pulmonary sporotrichosis in Japan. The possibility of sporotrichosis should be considered in any cases of undiagnosed cavitary lung diseases.
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Nihon Kyobu Shikkan Gakkai Zasshi · Jan 1989
Case Reports[A case of necrotizing sarcoid granulomatosis diagnosed by open lung biopsy].
A 32-year-old female complained of productive cough and bloody sputum. Infiltrative shadows and cavitary lesions with thick and irregular wall in the bilateral lung fields and the swelling of mediastinal lymph nodes were pointed out on the chest radiography. Physical examination revealed no abnormal findings. ⋯ Open lung biopsy revealed numerous sarcoid granulomas with granulomatous vasculitis in the cavity wall, surrounding infiltrative lesions and hilar lymph nodes. After the administration of prednisolone, the infiltrative shadows and the cavitary lesions showed marked improvement. It was concluded that open lung biopsy is necessary for the diagnosis of NSG because the differential diagnosis between NSG and limited form of Wegener's granulomatosis is extremely difficult from such a small lung specimen as that obtained by trans-bronchial lung biopsy.