両側気胸を繰り返す上葉優位の肺線維化病変を呈したアルミニウム加

金沢大学医薬保健研究域医学系A 39-year-old man, who had been working in an aluminum processing industry for 18 years, visited our hospital for right chest pain on March 2, 2007. A relapse of right pneumothorax was found, and he was hospitalized. As the pneumothorax did not improve with conservative treatment, video-assisted thoracoscopic biopsy and suturing of the right upper lobe were successfully performed. The pulmonary parenchyma had collapsed, there was pulmonary fibrosis, and lymphocytes had gathered in follicules. Based on elemental analysis results, we diagnosed aluminum lung. It was thought that overexpansion of the lower lobe with the predominant upper lobe fibrosis was caused by the aluminum deposition. We judged his condition to be serious and we started treatment with 25 mg/day prednisolone (PSL), and 120 mg/day cyclosporine (CyA). At the time of writing, he is an outpatient, and is being monitored on a regimen of 5 mg/day PSL and 160 mg/day CyA without any progression of pulmonary fibrosis or relapse of pneumothorax

Airway wall structure assessed by endobronchial ultrasonography and bronchial hyperresponsiveness in patients with asthma

金沢大学医薬保健研究域医学系Background and Objective: The purpose of this study was to evaluate the relationship between the wall structure assessed by using endobronchial ultrasonography (EBUS) and bronchial hyperresponsiveness in patients with asthma. Methods: Twenty-four patients with stable asthma and 11 individuals without asthma were studied. EBUS was performed with a radial 20-MHz ultrasonic probe inserted into the intermediate bronchus undergoing flexible bronchoscopy to assess the airway wall structure. The percentage of airway wall thickness {WT%; defined as [(ideal outer diameter-ideal luminal diameter)/ideal outer diameter] × 100} was determined by EBUS. We measured bronchial hyperresponsiveness to methacholine [the provocative concentration of methacholine causing a decrease of 20% or more in forced expiratory volume in 1 s (PC20)]. Results: Percentage wall thickness measured by EBUS was significantly greater in patients with asthma than that in subjects without asthma (P < 0.01). The evaluation of the laminar structure using EBUS indicated that the thickness of the second layer in patients with asthma was greater than that in subjects without asthma (P < 0.05). PC20 was negatively correlated with the thickness of the second layer (r=0.52, P < 0.01) but was not significantly correlated with other layers in patients with asthma. Conclusions: The evaluation of the bronchial mural structure using EBUS might be advantageous for assessing the relationship between airway wall remodeling and bronchial hyperresponsiveness. © 2010 Lippincott Williams & Wilkins

Comparison of clinical and radiological features of pneumocystis pneumonia between malignancy cases and acquired immunodeficiency syndrome cases: A multicenter study

金沢大学医薬保健研究域医学系Background: The clinical features of pneumocystis pneumonia (PCP) differ according to the predisposing factors responsible for immunosuppression. Although PCP in patients with acquired immunodeficiency syndrome (AIDS) has been extensively described, its characteristics in non-AIDS patients, such as those with malignancies, are not thoroughly documented. Study objective: To characterize and compare the clinical and imaging features of PCP in patients with malignancies with those in AIDS patients. Design: A multi-center retrospective study. Patients and Measurements: We evaluated the clinical and radiological features of PCP in 21 patients with malignancies and in 17 with AIDS. Clinical presentation, serum markers, oxygenation, CT findings, and outcome were examined. Results: The patients with malignancies showed shorter durations of symptoms before PCP was diagnosed. The levels of serum markers and the oxygenation index did not differ. CT showed diffuse or widespread ground-glass opacity (GGO) in all of the patients evaluated. None of the AIDS patients demonstrated consolidation, whereas half of the patients with malignancy showed consolidation along with GGO. The extent of GGO scored on CT images was significantly greater in the AIDS patients. No correlation was observed between the CT findings and other clinical parameters. All of the AIDS patients recovered from PCP, whereas six patients with malignancies died within a month after the onset of PCP. Conclusion: The characteristics of the CT images differed between the patient groups with different underlying disorders, although it remains to be determined whether CT findings are associated with other clinical features or are predictive of the outcome of PCP. © 2010 The Japanese Society of Internal Medicine

Angiotensin II type 2 receptor antagonist reduces bleomycin-induced pulmonary fibrosis in mice-4

M + olmesartan medoxomil 1 mg/kg group. Increased fibrosis with definite damage to the lung structure and formation of small fibrous masses were partially observed. (c) BLM + PD 5 mg/kg group. Increased fibrosis with definite damage to the lung structure and formation of small fibrous masses were partially observed. (d) Control group. The normal alveolar structure is visible. (Azan-Mallory × 40)<p><b>Copyright information:</b></p><p>Taken from "Angiotensin II type 2 receptor antagonist reduces bleomycin-induced pulmonary fibrosis in mice"</p><p>http://respiratory-research.com/content/9/1/43</p><p>Respiratory Research 2008;9(1):43-43.</p><p>Published online 23 May 2008</p><p>PMCID:PMC2409315.</p><p></p

Angiotensin II type 2 receptor antagonist reduces bleomycin-induced pulmonary fibrosis in mice-5

*p < 0.05.<p><b>Copyright information:</b></p><p>Taken from "Angiotensin II type 2 receptor antagonist reduces bleomycin-induced pulmonary fibrosis in mice"</p><p>http://respiratory-research.com/content/9/1/43</p><p>Respiratory Research 2008;9(1):43-43.</p><p>Published online 23 May 2008</p><p>PMCID:PMC2409315.</p><p></p