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Article type: Cover
2001 Volume 23 Issue 1 Pages
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Published: January 25, 2001
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Article type: Cover
2001 Volume 23 Issue 1 Pages
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Article type: Appendix
2001 Volume 23 Issue 1 Pages
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Article type: Appendix
2001 Volume 23 Issue 1 Pages
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Article type: Index
2001 Volume 23 Issue 1 Pages
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Article type: Index
2001 Volume 23 Issue 1 Pages
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[in Japanese]
Article type: Article
2001 Volume 23 Issue 1 Pages
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[in Japanese]
Article type: Article
2001 Volume 23 Issue 1 Pages
2-3
Published: January 25, 2001
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Kazuhiko Sugita, Yasunori Ikeda, Sensuke Nagai, Koichiro Shimada
Article type: Article
2001 Volume 23 Issue 1 Pages
4-10
Published: January 25, 2001
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To evaluate the usefulness of intravenous anesthesia with laryngeal mask airway(LM)for bronchoscopic procedures, 159 patients who had bronchoscopy in our hospital were examined retrospectively. Patients were divided into four groups according to the type of anesthesia. Group I; local anesthesia (58 cases), Group IIa; intravenous anesthesia with LMA(40 cases), Group IIb; inhalation anesthesia with LMA(36 cases), Group IIc; inhalation anesthesia with enhdotracheal intubation(25 cases). In each group, serial hemodynamic evaluation included(1)heart rate, (2)systolic blood pressure, (3)rate presssure product and (4)complications due to the procedures. In summary, patients in Group IIa showed minimum changes of heart rate, systolic pressure, and rate pressure product. Thus, intravenous anesthesia with LMA can reduce the load on patients and we conclude that this is the most useful type of anesthesia for bronchoscopy.
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Mitsunori Hino, Yasushi Ono, Yutaka Kokubo, Tomoyuki Soma, Yousuke Tan ...
Article type: Article
2001 Volume 23 Issue 1 Pages
11-15
Published: January 25, 2001
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Seventeen, mechanically ventilated acute respiratory failure patients with diffuse pulmonary shadows were studied. The diagnostic efficacy and safety of bronchioloalveolar lavage(BAL) were examined for these early stage severe respiratory failure patients. Our results showed that BAL could be performed extremely safely in patients with severe respiratory failure. Weaning from mechanical ventilation was successful in 8 patients(47.2%). The most important predictive factor for weaning was the percentile of eosinophils in BAL fluids.
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Futoru Toyoda, Akihito Todate, Takashi Yamada, Kazumasa Yasuda
Article type: Article
2001 Volume 23 Issue 1 Pages
16-20
Published: January 25, 2001
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The role of thoracoscopy in determining pleural effusion due to tuberculosis was evaluated. The evaluation was conducted on 9 cases of pathologically proven tuberculous pleural lesions. Clinical and laboratory tests suggested tuberculous pleuritis in 7 out of the 9 cases. The thoracoscopic findings in those cases revealed diffuse small white nodules on their parietal and visceral pleura, and these nodules were found to contain tuberculous granulomas pathologically. For the other two cases determined as tuberculous empyema, clinical and laboratory examinations could not suggest any specific pathogen. Thoracoscopy revealed multilocular fibropurulent lesions and white purulent tunica. Pleural lesions sampled by thoracoscopic biopsy did not present any tuberculous granulomas pathologically. Although it is thought that the thoracoscopic findings of diffuse small white nodules on the pleura are specific to tuberculous pleuritis, it is difficult to detect these lesions by thoracoscopy in tuberculous empyema. In conclusion, thracoscopic evaluation is very useful for the diagnosis of tuberculous pleuritis, but may have less value for tuberculous empyema.
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Wataru Saito, Hiroto Takahashi
Article type: Article
2001 Volume 23 Issue 1 Pages
21-24
Published: January 25, 2001
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A 33-year-old man with mild symptoms of upper respiratory infection was admitted for evaluation of a right hilar mass shadow on his chest X-ray film. Both computed tomography and magnetic resonance imaging showed a sharply defined subcarinal mass (4.5 cm in diameter) with homogeneous contents that was poorly enhanced by contrast medium. There was no mediastinal lymphadenopathy, and there was no finding suggesting malignancy. We performed Transtracheal endoscopic ultrasonography(TUS) to assess further morphology of the mass. Below the membranous portion of the right main bronchus, TUS demonstrated a 37.5 X 19.9 mm hypoechogenic mass, which was compatible with a cyst. Based on the TUS findings, elective cystectomy using video-assisted thoracoscopy was performed. The histopathological diagnosis was bronchogenic cyst. The clinical utility of TUS and its limitations has not been established. Our case indicates that TUS is not only an alternative imaging method but has the potential to increase diagnostic capability with regard to mediastinal tumors.
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Takeshi Horiuchi, Yoichi Watanabe, Keisuke Matsuo, Akihiko Tamaoki, Sy ...
Article type: Article
2001 Volume 23 Issue 1 Pages
25-30
Published: January 25, 2001
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Three cases of intractable pneumothorax were treated successfully by bronchial embolization using silicon(BEUS). They were all elderly men and had severe pulmonary emphysema. Surgery was thought to be very difficult and risky. Thoracic tube drainage was performed but the leakage continued. We therefore performed BEUS and the air leakafge was malkedly reduced in 1 case and stopped in 2 cases. After BEUS procedure their pulmonary condition improved. It is thought that BEUS provides more effective and longer bronchial embolization than other ordinary embolization methods. BEUS in thought to be indicatal in cases of intractable pneumothorax in which operation should be avoided because of severe pulmonary condition, poor general condition on other reasons.
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Hiroshi Kuraishi, Minehiko Yamada, Hirotake Kijima, Fumiko Saito, Tosh ...
Article type: Article
2001 Volume 23 Issue 1 Pages
31-35
Published: January 25, 2001
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We report on a patient treated with immunosuppressants who contracted Peumocystis carinii pneumonia, in whom bronchoalveolar lavage(BAL) was useful for early diagnosis. Gallium scintigraphy was also helpful in achieving early detection. The patient was a 43-year-old man under follow-up at another hospital for malignant lymphoma and chronic hepatitis B. He was transferred to our hospital because of exacerbation of the chronic hepatitis B. Treatment was started with 150 mg/day lamivudine, 100 mg/day cyclosporin A and 30mg/day prednisolone and the chronic hepatitis B was improved. On day 25 of the treatment, the patient developed fever. CT showed no abnormalities in the pulmonary area; however, gallium scintigraphy showed uptake through the entire pulmonary area. BAL was conducted for diagnostic purposes and the PCR for Pneumocystis carinii was positive. Discontinuation of the immunosuppressant administration and treatment with a sulfamethoxazole/trimethoprim(ST)mixture improved the patient's condition. He is currently under outpatient follow-up.
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Tetsushi Suito, Akira Yoshizu, Takaaki Ikeda, Genichi Tani, Kazuhisa A ...
Article type: Article
2001 Volume 23 Issue 1 Pages
36-40
Published: January 25, 2001
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A 31-year-old woman had a chief complaint of fever. Her sputum was positive for tuberculosis. Atelectasis occured three months after commencement of anti-tubercular treatment. Obstruction of the left main bronchus was observed by bronchography and bronchial tuberculosis was diagnosed. A further months after the atelectasis was recognized, i. e. 6 months after commencement of anti tubercular treatment, tracheobronchial reconstruction to resect the left main bronchus was performed. In order to preserve the left lung, the resection was limited to the left main bronchus, then the tracheal bifurcation and the second carina were anastomosed. After the surgery the respiratory function recovered. In the case of long term atelectasis without inflammatory change, a lung-preserving operation is recommended if recovery of respiratory function can be anticipated.
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Niro Okimoto, Kouhichi Osaki, Yoshihiro Honda, Takako Sunagawa, Naoko ...
Article type: Article
2001 Volume 23 Issue 1 Pages
41-43
Published: January 25, 2001
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We report two cases of bronchial atresia in a 65-year-old woman and a 74-year-old man. The sites of atresia were the right upper lobe bronchus, which was very rare, and left B^<1+2> respectively. Their chest CT scans showed a pulmonary nodule accompanying peripheral hyperinflation in both cases. We considered the etiology of the bronchial atresia were to be congenital in both cases.
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Toshiaki Masaoka, Ryo Ishihara
Article type: Article
2001 Volume 23 Issue 1 Pages
44-48
Published: January 25, 2001
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The patient was a 56-year-old man in whom infiltration of the right lower lung field was found on chest X ray film. Bronchoscopy revealed a large endobronchial tumor, obstructing the truncus intermedius. The tumor was about 2cm in diameter on chest CT. Though we could not obtain a definitive diagnosis by bronchoscopic biopsy, we suspected benign endobronchial tumor and performed bronchoscopic removal under general anesthesia. The tumor contained multiple pieces of cartilage, and was completely removed by vaporization with Nd-YAG laser, removal of cartilaginous fragment with forceps and electrosurgical snaring. The treatment which was repeated twice, required 5 hours and YAG laser irradiation amounted to 19139J. The histological findings were compatible with chondromatous hamartoma. Pulmonary hamartomas are believed to have low malignant potential. In cases of endobronchial hamartomas, bronchoscopic resection should be considered as an effective alternative treatment.
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Hidekazu Matsushima, Noboru Takayanagi, Ichiro Kawata, Tatsuhiko Sakam ...
Article type: Article
2001 Volume 23 Issue 1 Pages
49-54
Published: January 25, 2001
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We have recently encountered 2 cases of severe Legionella pneumonia. We examined bronchoalveolar lavage in both cases on admission, and we diagnosed Legionella pneumonia by Gimenez stain-positive rod-shaped bacteria in BALF. We started treatment for Legionella pneumonia from the first day of admission. Both cases eventually survived. We concluded that Gimenez stain of BALF was a useful method for the early diagnosis of Legionella pneumonia.
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Shinji Akamine, Tadayuki Oka, Takao Takahashi, Masafumi Morinaga, Take ...
Article type: Article
2001 Volume 23 Issue 1 Pages
55-59
Published: January 25, 2001
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Tracheostomy is frequently indicated in subglottic stenosis. However, patients with tracheostomy have a poor quality of life because of dysphonia. We reported treatment with T-tube tracheal stent for the patients of subglottic stenosis, which could improve the quality of life for the patients. The first patient was a 55-year-old women who had tracheal injury due to attempted suicide. She had injuries from the thyroid cartilage to the second tracheal cartilage. Surgical suture was made and then a T-tube stent was inserted to maintain the subglottic airway. The T-tube was removed 6 months later and no stenosis occurred. The second patient was a 63-year-old man who had had a coronary bypass operation. He suffered disturbance of expectoration and underwent sputum suction through crico-thyroid ligament for 8 days. He complained of dyspnea one month after operation, which was due to subglottic granulation. Tracheostomy was performed followed by T-tube insertion. He had good quality of life and could eat and speak without any problem 8 months after T-tube insertion. The distance of stenosis was measured exactly and then the T-tube was placed just under vocal cord to avoid adhesion. We concluded that the T-tube is useful for the management of subglottic stenosis and can provide good quality of life.
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Toshihide Wakamatsu, Tsutomu Hachiya, Satoru Nagano, Kazuyoshi Okada, ...
Article type: Article
2001 Volume 23 Issue 1 Pages
60-63
Published: January 25, 2001
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The cytology brush broke during fiberoptic bronchoscope examination in a 71-year-old man who had right middle lobe atelectasis on the chest roentgenogram. The tip of brush was lost in the trachea but was removed successfully with forceps passed through a fiberoptic bronchoscope. This brush was a reusable instrument and metal fatigue during repeated sampling was the probable cause. It is apparent that repeated use of brushes is dangerous and that they should be replaced at regular intervals. Breakage of a cytology brush is rare. However, careful inspection of equipment and insertion should reduce the chance of iatrogenically introducing a foreign body into the patient's airway.
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Haruhiko Aisaka, Michio Hirasawa, Orie Sakon, Mitsuo Otsuka, Hirofumi ...
Article type: Article
2001 Volume 23 Issue 1 Pages
64-68
Published: January 25, 2001
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A 72-year-old man, who had been suffering from tuberculous empyema since 25 years previously, was admitted because of left chest and back pain and a subcutaneous tumor in the left side of the chest wall. Chest CT and intrathoracic bronchoscopic findings revealed a tumor on the parietal pleura. Biopsy performed under intrathoracic observation yielded a diagnosis of squamous cell carcinoma. Following radiation therapy, the patient's condition improved and the size of the tumor decreased temporarily. Intrathoracic observation with a bronchoscope may be a useful bedside procedure.
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Nobuhisa Ishikawa, Yoshihiro Yokota, Yasuhiko Ikegami, Kazunori Fujita ...
Article type: Article
2001 Volume 23 Issue 1 Pages
69-73
Published: January 25, 2001
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[Background]Racemose hemangioma is known as a rare disease, which is characterized by vascularization with spasm and dilation of the bronchial artery and bronchial-pulmonary arterial shunt. [Case]A 59-year-old man was admitted to our hospital because of hemoptysis in November 1997. Bronchofiberscopy revealed a non-pulsatile bulging lesion covered by normal mocosa in the left B^6c. Left bronchial arteriogram showed vascularization with spasm and dilation of the bronchial artery in the left lower lobe, and bronchial-pulmonary arterial shunt was also shown. We performed bronchial artery embolozation(BAE), but two days after BAE, an emergency left lower lobectomy was perfomed because of the recurrence of hemoptysis. Microscopic findings of left B^6 showed abnormally thickened bronchial arteries, acute bronchopneumonia, and chronic inflammatory changes. A diagnosis of secondary racemose hemangioma of the bronchial artery was made. [Conclusions]It should be kept in mind that racemose hemangioma of the bronchial artery is the cause of massive homoptysis.
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Hermann Tonn
Article type: Article
2001 Volume 23 Issue 1 Pages
74-81
Published: January 25, 2001
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[in Japanese]
Article type: Article
2001 Volume 23 Issue 1 Pages
82-84
Published: January 25, 2001
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
85-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
85-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
85-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
85-86
Published: January 25, 2001
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
86-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese]
Article type: Article
2001 Volume 23 Issue 1 Pages
86-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
86-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
86-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
86-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese]
Article type: Article
2001 Volume 23 Issue 1 Pages
87-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
87-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
87-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
87-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
87-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
87-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
87-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
87-88
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
88-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
88-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
88-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
88-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
88-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2001 Volume 23 Issue 1 Pages
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