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Article type: Cover
1996 Volume 18 Issue 5 Pages
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Article type: Cover
1996 Volume 18 Issue 5 Pages
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Article type: Appendix
1996 Volume 18 Issue 5 Pages
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Article type: Appendix
1996 Volume 18 Issue 5 Pages
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1996 Volume 18 Issue 5 Pages
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1996 Volume 18 Issue 5 Pages
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1996 Volume 18 Issue 5 Pages
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1996 Volume 18 Issue 5 Pages
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1996 Volume 18 Issue 5 Pages
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1996 Volume 18 Issue 5 Pages
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Article type: Appendix
1996 Volume 18 Issue 5 Pages
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Article type: Index
1996 Volume 18 Issue 5 Pages
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Article type: Index
1996 Volume 18 Issue 5 Pages
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[in Japanese]
Article type: Article
1996 Volume 18 Issue 5 Pages
419-420
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[in Japanese]
Article type: Article
1996 Volume 18 Issue 5 Pages
421-422
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Masao Umemoto, Yukihito Saito, Hiroji Imamura, Seibun Yonezu
Article type: Article
1996 Volume 18 Issue 5 Pages
423-429
Published: July 25, 1996
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In 5 patients with malignant airway stenosis, 6 sessions of Dumon stent placement were performed. The primary disease was lung cancer in 4 patients and tracheal cancer in 1. Three patients died 5 to 8 months after placement. Two patients are alive, one 8 months, and the other 1 month after placement. All patients showed satisfactory quality of life after the stent placement, and 4 patients recovered to the outpatient level. In the course of observation, 3 patients developed difficulty in sputum expectoration. One patient developed Pseudomonas aeruginosa infection, which improved after administration of Clarithromycin (CAM). In one patient, stenosis occurred at the periphery of the stent due to invasion and growth of the tumor. Autopsy performed in 2 cases demonstrated satisfactory fixation and patency of the stent. Although a rigid bronchoscope is necessary, this stent is considered advantageous, because it offers an excellent airway dilating effect and satisfactory fixation, and is removable. A stent with sufficient diameter should be placed prophylactically.
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Takashi Seto, Hiroshi Semba, Yuji Fukai, Akimitu Uchimura, Ryouichi Ku ...
Article type: Article
1996 Volume 18 Issue 5 Pages
430-436
Published: July 25, 1996
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Although transbronchoscopic microwave electrodes for respiratory tract tumor coagulation had some disadvantages, i.e., the breath-holding time was longer than with lasers and it took a longer time to achieve effects compared with lasers, there were also many advantages. We experienced less bleeding and smoke, a larger area could be coagulated in single procedure, and in addition to the immediate superficial effects, there is a tumor necrotising effect extending to the layer above the airway cartilage. In addition, coagulation at an angle of 90 degree to the long tudinal airway axis is possible. It is also very economical. This method was effective in treating airway stenosis and obstruction, especially in maintaining the airway prior to stent insertion.
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Yasuhiro Gon, Hajime Suguro, Masahiko Inoue, Shouzou Koyama, Toshiya K ...
Article type: Article
1996 Volume 18 Issue 5 Pages
437-442
Published: July 25, 1996
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Broncholithiasis is a rare condition defined a presence of calcified material within the tracheobronchial tree. Since the time of the first report in 1929, approximately 150 cases of this disorder have been reported in Japan. We report 7 cases of broncholithiasis, and retrospectively review 85 cases reported in Japan from 1970 to 1994. In 92 patients, the common presenting symptom of the broncholithiasis was cough (75%) and other symptom included fever, sputum, bloody sputum, hemoptysis, chest pain, dyspnea, et al. The frequent site of broncholithiasis was the middle lobe bronchus (42%) and the mainly components of stone was Ca_2PO_4 (53%). Of 92 patients, 88 patients who were available for assessment of therapy were reviewed : 45 (51%) patients required a lobectomy, while bronchoscopic removal was successful in 26% patients. We discussed several clinical features and the indication of bronchoscopic stone removal in cases of broncholithiasis.
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Yuko Komase, Shigeki Momose, Yasuhiko Taira, Sumiho Kurisu, Takemasa N ...
Article type: Article
1996 Volume 18 Issue 5 Pages
443-450
Published: July 25, 1996
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Clindamycin phosphate was infused transbronchoscopically in 4 patients with lung abscess. The infusion was performed with 300mg to 600mg clindamycin in 20ml of saline once per week for 3 or 4 weeks. Before infusion, the abscess was washed with saline and bacteriological examination of the aspirated fluid revealed Peptostreptococcus, Staphylococcus aureus, and Streptococcus. Laboratory data, chest X-ray and clinical symptoms improved in all 4 cases with this treatment. No severe side effects were observed except for transient fever and moderate and reversible elevation of serum transaminase level. In normal volunteers, the maximum serum concentration of clindamycin was obtained at 2 hours after infusion, which level was approximately maintained for 8 hours. Transbronchial washing and infusion of clindamycin was considered to be a safe and useful treatment for lung abscess, especially for refractory cases.
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Tadahiko Mitsumune, Junichi Nakamura, Etsuo Senoh
Article type: Article
1996 Volume 18 Issue 5 Pages
451-454
Published: July 25, 1996
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Sixty-two patients undergoing bronchofiberscopy for the first time were analyzed with regard to the relationship between the discomfort they experienced on bronchofiberscopy and their egograms by means of a questionnaire. The discomfort group had a tendency to have a higher "CP" (Critical Parent), lower "AC" (Adapted Child), and high "FC" (Free Child) on egograms. It is necessary to try to reduce the discomfort during bronchofiberscopy of patients who have such egogram pattern.
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Miki Ohshima, Hiroshi Souda, Hiroshige Oda, Akifumi Watanabe
Article type: Article
1996 Volume 18 Issue 5 Pages
455-460
Published: July 25, 1996
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An 80-year-old female was admitted because of massive hemoptysis. Bronchoscopic examination revealed a blood clot in the lingular and middle lobe bronchi. Bronchial angiographs showed dilatation and convolution of the left bronchial artery and convolution of the right bronchial artery. In particular, hypervascularization was seen in the lingular and middle lobes. The patient was diagnosed as having primary racemose hemangioma of bilateral bronchial arteries, because there were no other diseases related to hemoptysis. The bilateral bronchial arteries were embolized, and hemoptysis has not recurred during the past three months.
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Koji Kawaji, Fumitaka Ogushi, Koji Maniwa, Takashi Haku, Yoichi Nakamu ...
Article type: Article
1996 Volume 18 Issue 5 Pages
461-464
Published: July 25, 1996
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A 40-year-old woman was admitted complaining of dyspnea on exertion and cough. Chest X-ray films showed bilateral diffuse small nodular shadows. Total cell count and the percentage of lymphocytes increased. The CD4/8 ratio in bronchoalveolar lavage fluid decreased. TBLB specimen showed non-caseous granuloma and infiltration of lymphocytes in the alveolar wall. Anti-Aspergillus antibodies were detected in the serum. She worked on an orchid farm and changed orchid culture medium in which Aspergillus fumigatus was detected. We diagnosed this case as occupational hypersensitivity pneumonitis caused by aspergillus fumigatus.
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Woon Joo Lee, Akio Niimi, Hiroto Shirayama, Ryoichi Amitani, Michiaki ...
Article type: Article
1996 Volume 18 Issue 5 Pages
465-470
Published: July 25, 1996
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A 21-year-old male university student had been repeatly treated for nephrotic syndrome (NS) with oral corticosteroids during episodes of exacerbation since the age of 8. In November, 1993, 60mg of prednisolone was administered daily for the fifth relapse of NS and was gradually tapered to 20mg on alternative days without any pulmonary symptoms. At an annual health examination in April 1994, a tumor-like shadow was found in the right lower lung field of the chest X-ray ; Chest CT confirmed the pulmonary opacity without satellite lesions. Transbronchial lung biopsy revealed a necrotic lesion surrounded with fibrotic changes and hemosiderin laden macrophages. A pulmonary perfusion scan with Tc^<99m>-MAA showed bilateral filling defects in both the right and the left lower lobes. Pulmonary ventilation scan with Xe^<133> revealed V^^-/Q^^- mismatch. Based upon these findings pulmonary embolism was diagnosed, and treatment with warfarin obtained improvement on the chest X-ray. Hypercoagulability might have triggered thrombus formation since no precipitating factor other than NS was found. We report a rare case of pulmonary embolism in which TBLB findings led to the diagnosis and which stresses the importance of treating clinically asymptomatic patients with caution.
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Takashi Shibusa, Hiroshi Tanaka, Eiji Ito, Kazuo Yokokawa, Michio Hira ...
Article type: Article
1996 Volume 18 Issue 5 Pages
471-476
Published: July 25, 1996
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A 46-year-old woman with a 16-year history of an intrapulmonary bronchogenic cyst was referred to our hospital because of productive cough and an abnormal shadow on chest X-ray. Radiologic examination showed a mass contiguous to the intrapulmonary bronchogenic cyst in the left lower lobe. Transbronchial lung biopsy and ultrasound guided percutaneous lung needle biopsy could not confirm the diagnosis. An open lung biopsy specimen confirmed adenocarcinoma of the lung. Fibrotic changes with hyperplastic epithelial changes were demonstrated around the cyst wall. It was thought that this tumor might have arisen from these lesions.
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Ryohei Yamashita, Mitsuyo Kosugi, Yusei Annen, Yoh Watanabe
Article type: Article
1996 Volume 18 Issue 5 Pages
477-482
Published: July 25, 1996
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We successfully treated a 43-year-old man with metachronous triple squamous cell carcinomas (SCC) of the lung by bilateral bronchoplasty and laser therapy. The patient initially underwent sleeve upper lobectomy for SCC(pT_3N_2) of the right upper lobe bronchus in October 1989, followed by adjuvant chemotherapy and radiotherapy. In October 1991, endobronchial SCC in the left main bronchus was recognized by bronchoscopy, and left main bronchial sleeve resection was performed. This second tumor was pT_2N_0 with slight invasion into the adventitia of the bronchus. In November 1992, a third SCC in the trachea was found by bronchoscopy. This tiny third tumor was diagnosed as early SCC. It was treated by neodymium-yttrium aluminum garnet(Nd-YAG) laser ablation. Throughout the above clinical course, there were no complications related to the treatments. As of December 1995, the patient is alive with no evidence of tumor recurrence. Hilar bronchial SCC has a tendency for multicentric growth. Therefore, in patients surviving an initial operation for hilar SCC, careful follow-up by sputum cytology and bronchoscopy is important for early detection and treatment of second or third primary SCC.
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Takao Tanimoto, Hideo Kobayashi, Takashige Kuraki, Yasuhide Uwabe, Nao ...
Article type: Article
1996 Volume 18 Issue 5 Pages
483-487
Published: July 25, 1996
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A 52-year-old asymptomatic man who had abnormal shadows on chest roentogenogram was admitted. Chest X-ray showed mass-like opacities in the right hilum and in the lower left lung field. Chest CT scan showed a mass-like opacity with an air bronchogram in the right middle lobe and a wedge-shaped shadow adjacent to the pleura in the lingular segment. Bronchoscopic findings showed mucosal flare, swelling, and stenosis of right B^6. BALF revealed increasing of IgG, lymphocyte fraction, and CD19 and CD20 positive cells. Cytological diagnosis was class IIIa. Specimens obtained by transbronchial biopsy(TBB) resulted in lymphoma, diffuse small cell type, IgG λ type. Gene rearrangement analysis of the specimens presented a rearranged band of the heavy chain. Gene rearrangement analysis of specimens obtained by TBB may be useful in the diagnosis of primary pulmonary lymphoma.
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Hiroshi Akusawa, Toshio Chin, Takako Yano, Ikumi Kurosu, Atsushi Kadot ...
Article type: Article
1996 Volume 18 Issue 5 Pages
488-491
Published: July 25, 1996
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A rare case of sarcoidosis with primary pulmonary cavities was reported and a review of the literature was made. A 28-year-old male was admitted to our hospital because of bilateral hilar lymphadenopathy and multiple cavitary shadows on chest roentogenogram. The value of angiotensin converting enzyme (ACE) was high. Bronchofiberscopic findings showed capillary vessel dilatation of the bronchial mucosa, and the specimens of transbronchial lung biopsy showed non-caseous epithelioid cell granulomas. Because fibrotic lesion and infectious findings were not demonstrated histologically and clinically, this case was diagnosed as sarcoidosis with primary cavities. These cavities disappeared about a year later without therapy.
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Hiroichi Ishikawa, Takefumi Saitoh, Masato Ohtsuka, Sadatomo Watanabe, ...
Article type: Article
1996 Volume 18 Issue 5 Pages
492-496
Published: July 25, 1996
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A 74-year-old woman was admitted to our hospital with cough and sputum. She had no underlying or respiratory disease. Chest X-ray films revealed a coin lesion in the left middle lung field. Bronchoscopic findings showed fungus balls in the bronchial lumen of left B^4 and B^5. Histological examination of the transbronchial biopsy demonstrated Aspergillus and endobronchial aspergilloma was diagnosed. The treatment with itraconazole, a triazole antifungal agent, was successful, the fungus balls disappeared and the bronchial lumen became much smaller. This case was thought to be a rare case of endobronchial aspergilloma and itraconazole seems to be a valuable tool in its treatment.
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Hiraku Ichiki, Kouzou Yamamoto, Kenji Nobuhara
Article type: Article
1996 Volume 18 Issue 5 Pages
497-501
Published: July 25, 1996
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A rare case of bronchial aspergillosis is reported. A 62-year-old man with diabetus mellitus was admitted complaining of cough and bloody sputum. Chest CT scan showed a nodular shadow conforming to the distribution of the left B^8 bronchus. Bronchofiberscopy revealed irregular mucosa and stenosis of the orifice of left B^<8+9>. These findings were similar to those of lung cancer. Two weeks later, the orifice of left B^<8+9> was coated and obstructed by white tissue. Histological examination revealed bronchial wall fungal invasion and the precipitin antibody for aspergillus was positive. Bronchial aspergillosis was diagnosed by these findings. He was treated with itraconazole and oral hypoglycemic agents. Six months later, bronchofiberscopic findings improved and the precipitin antibody for aspergillus became negative.
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Hirotoshi Horio, Hiroaki Nomori, Ryuichiro Kobayashi
Article type: Article
1996 Volume 18 Issue 5 Pages
502-506
Published: July 25, 1996
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A 62-year-old man was admitted with fever, cough and bloody sputum. Chest X-ray and CT scan revealed a consolidated mass in the apical segment of the right lung. The results of two transbronchial lung biopsies and one CT-guided transcutaneous lung biopsy indicated localized pneumonia caused by a pathogen of unknown origin. Following administration of levofloxacin, his symptoms began to subside and the shadow to disappear. Once the antibiotic was stopped, his condition worsened and the shadow re-expanded. A third transbronchial lung biopsy showed sulfur granules characteristic typical of actinomycosis. After administration of high-dose penicillin for 6 months, the shadow almost completely disappeared. We conclude that transbronchial lung biopsy is an useful method for diagnosis of pulmonary actinomycosis.
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Maki Ohi, Yosiya Nishide
Article type: Article
1996 Volume 18 Issue 5 Pages
507-511
Published: July 25, 1996
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Squamous cell carcinomain the right lung of 65-year-old man was detected. After radiotherapy and chemotherapy (BAI), an esophagobronchial fistula developed in the left main bronchus. In order to occlude the fistula, a silicone stent appeared preferrable over an expandable metallic stent, in view of its easier replacement or removal. Therefore an original hand-made silicon stent was inserted into the left main bronchus via a fiberoptic bronchoscope. Esophagography disclosed complete closure of the fistula. Pneumonia did not develop and oral intake of food could be resumed. There were no complications related to the stent for 10 months after the implantation. This new stent offered the advantages of low cost and an easy and simple insertion procedure.
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Masamichi Koganemaru, Kiminori Fujimoto, Shigenobu Meno, Emi Tabuchi, ...
Article type: Article
1996 Volume 18 Issue 5 Pages
512-518
Published: July 25, 1996
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We report a case of congenital bronchial atresia (CBA) in an asymptomatic 15-year-old male in whom an elliptical opacity was detected in the left lower lung field in a medical check-up. Chest CT revealed a lesion resembling mucoid impaction and hyperradiolucency in the S^9 and S^<10> of the left lung. The lesion showed high signal intensity on both T1- and T2-weighted MR images. Three-dimension CT (3D-CT) suggested obstruction proximal to the site of dilation bronchial (left B^9b). Bronchoscopy revealed obstruction of left B^9b. CBA was diagnosed but the patient has been asymptomatic. The frequency of CBA in the left lower lobe is 14.3%. 3D-CT is useful in the diagnosis of bronchial obstruction. We also reviewed 61 previously reported cases in Japan to more clearly define this unusual entity.
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1996 Volume 18 Issue 5 Pages
519-
Published: July 25, 1996
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1996 Volume 18 Issue 5 Pages
519-
Published: July 25, 1996
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1996 Volume 18 Issue 5 Pages
519-
Published: July 25, 1996
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1996 Volume 18 Issue 5 Pages
519-520
Published: July 25, 1996
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1996 Volume 18 Issue 5 Pages
520-
Published: July 25, 1996
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1996 Volume 18 Issue 5 Pages
520-
Published: July 25, 1996
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1996 Volume 18 Issue 5 Pages
520-
Published: July 25, 1996
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1996 Volume 18 Issue 5 Pages
520-521
Published: July 25, 1996
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1996 Volume 18 Issue 5 Pages
521-
Published: July 25, 1996
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1996 Volume 18 Issue 5 Pages
521-
Published: July 25, 1996
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1996 Volume 18 Issue 5 Pages
521-
Published: July 25, 1996
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1996 Volume 18 Issue 5 Pages
521-522
Published: July 25, 1996
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1996 Volume 18 Issue 5 Pages
522-
Published: July 25, 1996
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1996 Volume 18 Issue 5 Pages
522-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1996 Volume 18 Issue 5 Pages
522-
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[in Japanese], [in Japanese]
Article type: Article
1996 Volume 18 Issue 5 Pages
523-
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[in Japanese], [in Japanese], [in Japanese]
Article type: Article
1996 Volume 18 Issue 5 Pages
523-
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[in Japanese]
Article type: Article
1996 Volume 18 Issue 5 Pages
523-
Published: July 25, 1996
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