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Article type: Cover
2007 Volume 29 Issue 6 Pages
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Article type: Appendix
2007 Volume 29 Issue 6 Pages
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Article type: Appendix
2007 Volume 29 Issue 6 Pages
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Article type: Index
2007 Volume 29 Issue 6 Pages
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Article type: Index
2007 Volume 29 Issue 6 Pages
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[in Japanese]
Article type: Article
2007 Volume 29 Issue 6 Pages
329-330
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[in Japanese]
Article type: Article
2007 Volume 29 Issue 6 Pages
331-332
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[in Japanese]
Article type: Article
2007 Volume 29 Issue 6 Pages
333-
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[in Japanese]
Article type: Article
2007 Volume 29 Issue 6 Pages
334-335
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Takahiro Nakajima, Kazuhiro Yasufuku, Taiki Fujiwara, Hidemi Suzuki, K ...
Article type: Article
2007 Volume 29 Issue 6 Pages
337-341
Published: November 25, 2007
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Purpose. We performed a comparison with mediastinoscopy and EBUS-TBNA, in particular about medical costs. Methods. According to the investigation of the Socialized Medicine Medical Care Act in 2003, mediastinoscopy was performed in approximately 1,000 cases in Japan. We hypothesized that all patients who underwent mediastinoscopy are candidates for EBUS-TBNA and that only predicted false negative cases by EBUS-TBNA would receive mediastinoscopy. We calculated the medical costs related to each diagnostic modality, mediastinoscopy and EBUS-TBNA, and compared the total costs of these examinations. We set the diagnostic accuracy of EBUS-TBNA at 96.3% based on our previous report. Results. The total medical cost of mediastinoscopy for one examination was estimated at 271,220 yen. This was based on the assumption that the examination time was 90 minutes and hospitalization for four days for mediastinoscopy. In contrast, we estimated the total medical cost for one EBUS-TBNA examination to be 64,700 yen. There was a 206,520 yen difference between mediastinoscopy and EBUS-TBNA per one examination. The estimated medical care expense reduction was 196,480,000 yen. Conclusion. EBUS-TBNA will reduce the medical cost by approximately 200,000,000 yen per year for patients requiring mediastinal staging by mediastinoscopy. Since the indications for mediastinoscopy are limited in Japan, the economic impact will be overwhelmingly enormous.
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Chiyuki Furukawa, Masaki Hanibuchi
Article type: Article
2007 Volume 29 Issue 6 Pages
342-346
Published: November 25, 2007
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Case. A 47-year-old man who was treated with prednisolone and mizoribine due to systemic lupus erythematosus and lupus nephritis was referred to our division to receive further examinations for a chest abnormal shadow on a chest X-ray film. Although he was asymptomatic, chest radiograph on admission showed multiple nodular shadows in the left upper lung field. As cryptococcal antigen in the bronchoalveolar lavage fluid was positive and pathological findings of specimens obtained by transbronchial lung biopsy revealed cryptococcal microorganisms, a diagnosis of secondary pulmonary cryptococcosis was made. He was successfully treated with fluconazole and the chest abnormal shadows were dramatically diminished. Conclusion. We reported a case of secondary pulmonary cryptococcosis accompanied with systemic lupus erythematosus. Bronchoalveolar lavage and transbronchial lung biopsy seem to be useful tools for the diagnosis of pulmonary cryptococcosis.
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Terumasa Sowa, Hideo Kita, Hirotaka Yasuba, Megumi Kudo, Yoshiki Kobay ...
Article type: Article
2007 Volume 29 Issue 6 Pages
347-352
Published: November 25, 2007
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Background. Primary malignant lymphoma arising from the trachea or bronchus is rare. We report a case of primary tracheal malignant lymphoma, whose positive results of ^<18>F-fluorodeoxy glucose-positron emission tomography (^<18>FDG-PET) allowed detection of this disease. Case. A 65-year-old man was admitted to our hospital with productive cough. The chest X-ray showed no abnormalities, but the chest CT showed anterior tracheal wall thickening. A second CT scan 1 month later showed the increase of wall thickening. ^<18>FDG-PET showed abnormal uptake in the same lesion. Bronchoscopy showed a glossy polypoid mass with a smooth surface resembling a bunch of grapes two tracheal cartilage below the glottis on both sides of the trachea. Pathological findings showed diffuse invasion of small lymphocyte in the submucosal lays. These cells infiltrated the epithelium and formed lymphoepithelial lesions. B-cell origin was demonstrated immunohistochemically by positive CD20 stain. Flowcytometry showed the monoclonality of the tumor cells. We diagnosed mucosa-associated lymphoid tissue (MALT) lymphoma. After chemotherapy with rituximab, the tumors disappeared. Conclusion. We reported a rare case of tracheal MALT lymphoma detected by chest CT and ^<18>FDG-PET.
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Toshiyuki Katoh, Masaaki Sano, Masaru Iwata
Article type: Article
2007 Volume 29 Issue 6 Pages
353-357
Published: November 25, 2007
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Background. Pulmonary endometriosis is a rare disease, but it is the one disorder that causes hemoptysis or bloody sputum. The main symptom was catamenial hemoptysis that coincided with the menstruation. Case. A 38-year-old woman complained of hemoptysis. This symptom recurred concurrently with menstruation for one year. Chest CT scan revealed a ground glass opacity in the right upper lobe. Bronchoscopic examination confirmed intrapulmonary hemorrhage from the right B2b. Both hemoptysis and ground glass opacity disappeared at the end of menstruation. Considering these findings, her clinical course and her past history of artificial abortion, pulmonary endometriosis was diagnosed. She was treated with leuprorelin. Hemoptysis accompanying menstruation disappeared after treatment. Conclusion. We report a case of pulmonary endometriosis with recurrent catamenial hemoptysis.
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Masahiro Shinoda, Hideo Kobayashi, Soichiro Kanoh, Kazuo Motoyoshi, Sh ...
Article type: Article
2007 Volume 29 Issue 6 Pages
358-361
Published: November 25, 2007
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Background. Several cases of bronchiolitis obliterans organizing pneumonia (BOOP) occurring after radiation therapy for breast cancer had been reported recently. Case. A 52-year-old woman underwent conserving surgery for breast cancer and received radiation therapy to the remaining part of the breast. About 3 months after the radiation therapy, cough and fever developed. The X-ray and chest CT showed an infiltrative shadow in the upper and middle right lung. BOOP was identified in the transbronchial lung biopsy specimen. Steroid therapy showed a remarkable improvement. In the course of follow-up, new infiltrative shadows developed in the lower right lung. Steroid therapy again showed a remarkable improvement and there has been no recurrence. Conclusion. We report a case of BOOP primed by radiation to the breast cancer who showed the radiological recurrence and the migrating infiltrative opacity.
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Seiichiro Sakao, Yuichi Takiguchi, Shunsuke Ishizaki, Toshiaki Yano, Y ...
Article type: Article
2007 Volume 29 Issue 6 Pages
362-365
Published: November 25, 2007
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Spontaneous regression of a pulmonary lesion in patients with Wegener's granulomatosis (WG) is rare, and only a few such reports have been published. We describe a rare case of a patient with WG in which the pulmonary lesion regressed spontaneously. The patient was a 76-year-old man presenting with fever, sputum and cough. On serial CTs, he had a solitary nodule in the right lung that regressed spontaneously while new multiple nodules developed during a 1-month interval. Biopsy of the new lesions by video-assisted thoracostomy (VATS) established a diagnosis of WG. Treatment with glucocorticoid and cyclophosphamide significantly ameliorated his condition. Concordant with similar previous reports, the mechanisms behind spontaneous regression of pulmonary lesions in the present case seemed to include spontaneous improvement of infection or infarction caused by vasculitis, in addition to regression of the WG lesion itself. Although it occurs rarely, physicians should be aware of the phenomenon that pulmonary lesions in WG could progress and regress spontaneously.
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Shuichi Suzuki, Takashi Suzuki, Ryousuke Usuda, Mikio Masuda, Yoshito ...
Article type: Article
2007 Volume 29 Issue 6 Pages
366-368
Published: November 25, 2007
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Background. Idiopathic azygos vein aneurysm is a relatively rare disease, and most cases are asymptomatic. Surgical therapy and other approaches for this disease are controversial. Case. A 37-year-old man presented with an abnormal shadow on his chest radiograph taken during a routine physical examination. Contrast CT revealed a thrombus in the dilated azygos vein. It was feared that the thrombus might result in pulmonary embolism. Since the thrombus did not extend to the superior vena cava from the azygos vein. We chose an approach of video-assisted thoracoscopic surgery (VATS) and successfully resected the aneurysm with the thrombus. The patient has had an uneventful postoperative course for 10 years. Conclusion. Resection of the azygos vein aneurysm with the thrombus not extending to the superior vena cava was successfully performed under VATS. We think there must be a significant reason to determine the indication for resection of an azygos vein aneurysm, such as the large size of the aneurysm or an accompanying thrombus in it. The extension of the thrombus was important information for us to employ VATS.
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
369-
Published: November 25, 2007
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
369-
Published: November 25, 2007
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
369-
Published: November 25, 2007
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
369-370
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
370-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
370-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
370-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
370-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
370-371
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
371-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
371-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
371-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
371-372
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
372-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
372-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
372-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
372-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
372-373
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
373-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
373-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
373-
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Article type: Article
2007 Volume 29 Issue 6 Pages
373-374
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
374-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
374-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese]
Article type: Article
2007 Volume 29 Issue 6 Pages
374-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
374-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
374-375
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
375-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
375-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
375-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
375-376
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[in Japanese], [in Japanese], [in Japanese]
Article type: Article
2007 Volume 29 Issue 6 Pages
376-
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Article type: Article
2007 Volume 29 Issue 6 Pages
376-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2007 Volume 29 Issue 6 Pages
376-
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