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Article type: Cover
1986 Volume 8 Issue 2 Pages
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Published: June 25, 1986
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Article type: Cover
1986 Volume 8 Issue 2 Pages
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Published: June 25, 1986
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Article type: Appendix
1986 Volume 8 Issue 2 Pages
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Article type: Index
1986 Volume 8 Issue 2 Pages
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Article type: Index
1986 Volume 8 Issue 2 Pages
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Article type: Appendix
1986 Volume 8 Issue 2 Pages
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Published: June 25, 1986
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[in Japanese]
Article type: Article
1986 Volume 8 Issue 2 Pages
181-
Published: June 25, 1986
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Article type: Appendix
1986 Volume 8 Issue 2 Pages
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Article type: Appendix
1986 Volume 8 Issue 2 Pages
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Published: June 25, 1986
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Shinya Abe, Hiroshi Okitsu, Osamu Taira, Nobuhiko Takizawa, Chimori Ko ...
Article type: Article
1986 Volume 8 Issue 2 Pages
183-190
Published: June 25, 1986
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We have been attempting to induce malignant tracheal tumor in adult male beagles in order to examine the process of carcinogenesis by 3-methylcholanthrene (3-MC). We employed a submucosal method in order to stimulate bronchial gland cells and basal cells without stimulation of the mucosal epithelium. Silicone rubber pellets containing 3-MC were surgically implanted in the submucosal layer of the cervical trachea. Monthly bronchoscopical observation was performed for a year. Squamous metaplasia of bronchial gland cells and proliferation of basal cells occurred within a year but there was no particular change in control dogs which only received implantation of silicone rubber pellets. These results suggest that the basal cells and bronchial gland cells may be sites of effectiveness of 3-MC. However, the submucosal implantation method is not useful for long-term experiments because it is difficult to prevent ulcer formation and subsequent exposure and exfoliation of the pellet. On the other hand, we also examined the cytological influence of immuno-suppression on the tracheal epithelium by methylprednisolone acetate. Atypical squamous cell metaplasia could be seen in all immuno-suppressed beagles but not in non immuno-suppressed beagles. It seems that corticosteroids are related to atypical squamous cell metaplasia of the tracheal epithelium.
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Jun Tamaoki, Michio Katayama, Masahiko Kawakami, Takao Takizawa, Minak ...
Article type: Article
1986 Volume 8 Issue 2 Pages
191-197
Published: June 25, 1986
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In order to study pulmonary defence mechanism and mucociliary transport system reflected by morphological alterations in Mycoplasma pneumoniae infections, ultrastructural observations were made on hamster tracheal epithelium inoculated with Mycoplasma pneumoniae FH strain. One hour post-inoculation, M. pneumoniae attached to the ciliary membrane with a characteristic tip were identified accompanied by bleb formation of cilia and destruction of ciliary membrane. This tip was composed of a dense central core surrounded by a lucent space enclosed by the organism's limited membrane. Seventy-two hours after inoculations, the tracheal epithelium showed clumping of microvilli, extruded fragments of ciliated cells, and reduction in the density of cilia when compared with uninfected controls. These degenerative changes of epithelial cells progressively developed, and marked sloughing of cilia with completely denuded appearance of the cell surface was observed 14 days after infections, which may responsible for upper respiratory tract symptoms. In the regenerative process following, the density of cilia gradually increased by 20 and 30 days after infection, accompanied by the appearance of many protruding axonemes with a single ciliary membrane. This finding suggested the formation of compound cilia, and because these cilia are considered to be immobile, pulmonary mucociliary transport may be disturbed, with resultant prolonged cough and sputum in patients of Mycoplasma pneumonia.
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Tsuneo Suzuki, Akira Nakano, Takashi Arai
Article type: Article
1986 Volume 8 Issue 2 Pages
198-203
Published: June 25, 1986
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We investigated the degree of dislocation and deformity of the left lower bronchus after left upper lobectomy and also studied how much the degree of the fomer had influenced the pulmonary function of residual lung. Bronchofiberscopic findings showed that the left main bronchus was dislocated upwards markedly and that there was stenosis of the orifice of the basal bronchus. Comparing left upper lobectomy and the left lower lobectomy, the residual left lung had greater ventilation-perfusion ratio mismatch and shunt effect in the former than the latter. In the contralateral lung, lobectomy had some influence but the degree of ventilation-perfusion mismatch and shunt effect was a less in left upper lobectomy than in left lower lobectomy.
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Tetsuya Ida, Masao Ogihara, Kazuo Hayakawa, Masaharu Horiguchi
Article type: Article
1986 Volume 8 Issue 2 Pages
204-211
Published: June 25, 1986
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Bronchoscopic findings in 22 patients with chronic bronchitis were classified into four types ; edematous type, hypertrophic type, transition type, and atrophic type. The transition type in the classification was particularly characterized by findings of rough mucosal surface, thickened longitudinal mucosal folds, enlarged submucosal gland openings, narrow bronchial lumen, distorted cartilage, and irregular bifurcation. Fourteen biopsy specimens of the bronchus which were obtained using a bronchoscope were observed with a scanning electron microscope and two types were classified in relation to their clinical symptoms ; poorly regenerated type and well regenerated type. The latter was subclassified into four stages ; namely, nonciliated stage, early stage of regeneration, mid stage of regeneration, and completely regenerated stage. These four stages coincided with clinical symptom.
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Katsuhiko Kamei, Kazuo Kusumoto, Toshimitsu Suzuki
Article type: Article
1986 Volume 8 Issue 2 Pages
212-217
Published: June 25, 1986
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Fiberoptic bronchoscopy was performed in 73 patients (30 men and 43 women) with airway bleeding and almost normal chest roentgenograms. The diagnosis of the causative factor was acute bronchitis (40%), chronic bronchitis (36%), bronchiectasis (11%), some other diseases as old tuberculosis, pneumoconiosis, paragonimiasis, sarcoidosis, et al. One case of lung cancer with no other symptoms was detected, which indicated the importance of fiberoptic bronchoscopy in airway bleeding cases. Airway inflammatory disease (acute bronchitis and chronic bronchitis) was the major cause, especially among women. The location of bleeding was found out in 32% of all cases and 13% showed normal bronchoscopic findings. The rest revealed inflammatory changes of bronchial mucosa redness, edema, and capillary dilatation, atrophic change, or localized bronchial secretion, the last of which was highly suggestive of bronchiectasis. In male cases no specific tendency was seen in terms of bleeding location, but in female cases 77% of the bleeding was detected in the left airway, which may be indicative of mucosal weakness of the left airway in women.
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Masashi Mikami, Hisashi Notoya, Masatoshi Amaya, Yuh Mitsuhashi, Hirok ...
Article type: Article
1986 Volume 8 Issue 2 Pages
218-228
Published: June 25, 1986
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BAL is a widely used technique in the diagnosis and evaluation of various pulmonary diseases, but the procedure has not been uniform among institutes, particularly in terms of the volume of instilled fluid and lavage times. This study was performed in order to investigate optimal lavage procedures using computed tomography (CT) and fractional alterations of cellular and biochemical components. We carried out BAL under observation with CT 20 times in 15 subjects (7 times in 3 healthy volunteers and 13 times in 12 patients with pulmonary diseases) to detect the lavage area. Numbers of cells and surfactant apoprotein content were also measured in each lavage fraction of BALF obtained by 6 sequential 50 ml lavages. When sequentially increasing volume of 10, 20, 30, 40, 50, 60, 70 and 80 ml of normal saline were instilled in healthy volunteers, the distribution area gradually extended and reached the subpleural lung region at volumes over 40 ml. Instillation volumes over 60 ml frequently provoked cough and caused spillover of the fluid. In repeated lavage with 50 ml, the density of the fluid distributed in the lung increased sequentially on CT, however the area already was extensive after the first instillation. Numbers of cells and surfactant apoprotein were greatest in fraction 2 and thereafter decreased gradually. The surfactant apoprotein content in fraction 5 and 6 decreased to less than 10% of the total. It is considered that lavage over 4 times has little significance concerning in the alveolar lining layer. Therefore procedure of 4 sequential 50 ml lavages is recommended. However in cases such as chronic bronchitis or pneumoconiosis, the lavage area did not reach subpleural lung region, and extended only to the proximal peribronchial region. These cases demonstrated a lower recovery rate of BALF. Unrecovered fluid was almost completely absorbed within 3 hours after BAL in healthy volunteers, however it still remained 7 hours after BAL in patients with diffuse panbronchiolitis, farmer's lung, sarcoidosis and interstitial pneumonia associated with rheumatoid arthritis. Concentration of cells was significantly (p<0.05) lower in BALF obtained by 5 sequential 20 ml lavages in comparison with that by 4 sequential 50 ml lavages, however differential cell counts and lymphocytes subpopulations showed no significance (p>0.1) between them. This suggests that 4 sequential 50 ml lavages are superior to 5 sequential 20 ml lavages not only in lavage area but also in effectiveness of lavage.
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Makoto Nagata, Akira Yoshida, Hidenori Kiuchi, Kaoru Kuramitsu, Tadash ...
Article type: Article
1986 Volume 8 Issue 2 Pages
229-236
Published: June 25, 1986
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Concentrations of type III procollagen N-terminal peptide (PC-III-P) in bronchoalveolar lavage fluid (BALF) were determined in 16 patients with idiopathic interstitial pneumonia (IIP). The concentrations of PC-III-P in BALF in the patients with IIP in the active stage were significantly higher than those in both cases of IIP in the inactive stage and control subjects. Although serum concentrations of PC-III-P in patients with IIP tended to be higher than those in the controls, there was no significant difference in serum concentration of PC-III-P between the patients with IIP and the controls, and also there was no significant difference between the patients with IIP in the active stage and those in the inactive stage. The pretreatment levels of concentrations of PC-III-P in BALF were higher in the patients treated effectively by glucocorticoid therapy than in those not effectively treated. These results suggest that the determination of concentrations of PC-III-P in BALF is useful as a method for evaluating the activity of IIP, and also for predicting the efficacy of glucocorticoid therapy for patients with IIP.
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K. Nishimura, T. Mio, M. Furue, J. Chihara, M. Kado, T. Izumi, S. Oshi ...
Article type: Article
1986 Volume 8 Issue 2 Pages
237-242
Published: June 25, 1986
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Selective alveolo-bronchography (SAB) has been routinely used to evaluate anatomical changes in the bronchiole and its distal air spaces. A narrowing of the bronchiole and abnormal pooling of contrast medium in the destroyed air space are the prime findings. Since the object of radiography is extremely thin, direct magnification radiography is mandatory to obtain radiologic details. However, the problem with this technique is that radiographic quality varies depending upon the size of the patient and the concentration of contrast medium to be introduced in the lung. This study had two goals. One was to improve the image quality of SAB by Fuji Computed Radiography (FCR). FCR provides radiographs with a good contrast and stable density throughout a wide range of exposure factors which occur in the use of SAB. The other goal was to separately evaluate morphological abnormalities in the outer and inner zones of the lung using X-ray CT. This idea was derived from our observations in positron emission tomographyusing ^<13>Nwhich revealed air trapped in the outer layer of the lung in diffuse panbronchiolitis. Fourteen patients underwent SAB, including two cases of bronchiectasis, one of cancer, one of silicosis, one of post-inflammatory scar, four of diffuse panbronchiolitis and five of chronic pulmonary emphysema. Of these fourteen cases ten and twelve cases received FCR and CT examinations, respectively.
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Shun Ikeda, Takaaki Tategami, Seiji Tomiguchi, Kokusi Yasuda, Kouji Na ...
Article type: Article
1986 Volume 8 Issue 2 Pages
243-250
Published: June 25, 1986
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A selective bronchial artery embolization (S-BAE) utilizing a "new" minicoil and infusion catheter set (ICS) was employed in two patients with repeated hemoptysis. Bronchial arteriography (BAG) was carried out using the Seldinger technique. A6.5 F normal diagnostic catheter with tapered tip was inserted and positioned in the thoracic aorta. A search was made to selectively enter the bronchial arteries on the affected side. The initial diagnostic arteriogram in two patients showed the common trunk with the right bronchial and the 2nd-3rd intercostal arteries. This arteriogram showed hypervascularity and a shunting pattern to right pulmonary vessels originated from the bronchial artery. A S-BAE was carried out using a "new" minicoil and ICS. The ICS consists of a strait thin-wall Teflon catheter (3F) and a stainless steel guide wire (0.025 inch). The ICS was inserted into a 6.5 F diagnostic catheter and was pushed until it arrived at the right bronchial artery forming the common trunk with the intercostal artery. The steel guide wire was then pulled out from the Teflon catheter. The second diagnostic arteriogram was taken for confirmation of the Teflon catheter selectively positioned in the right bronchial artery. The right bronchial artery was selectively embolized by transporting "new" minicoils through the Teflon catheter by pushing steel guide wire. Several disadvantages of BAE using Gelfoam as a vascular occlusive agent have been reported. (1) Spinal arteries have communication with the bronchial arteries through the intercostal trunk in about 5% of patients, and this communication is more common on the right side. The embolization of the right intercostobronchial trunk using Gelfoam has the possibility of injury in the spinal cord. (2) The catheter tip may recoil from the selective position during repeated injection of the small cubes of Gelfoam through the standard angiographic catheter. Such recoil of the catheter eventually leads to peripheral embolization. (3) Embolization using Gelfoam is only a palliative treatment because recanalization may occur due to reab sorption of the occlusive agent. These three drawbacks can be overcome with when using our S-BAE technique. Our S-BAE technique, which not only saves time but also eliminates the possibility of displacement of the catheter, is especially excellent in the occlusion of the right bronchial artery forming the common trunk with the intercostal artery.
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Takehiko Fujisawa, Yutaka Yamaguchi, Hiroaki Hongo, Mitsutoshi Shiba, ...
Article type: Article
1986 Volume 8 Issue 2 Pages
251-257
Published: June 25, 1986
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Based on extensive animal experiments, we performed intratumoral injection of 99.5% ethanol via a flexible bronchofiberscope for 11 unresectable lung cancer patients with stenosis or obstruction of central airways in order to evaluate its effects on airway dilatation and hemostasis. The results obtained were as follows : 1) Bronchofiberscopic findings revealed that the tumor changed faintly white immediately after injection of ethanol intratumorally, with slight regression of tumor and promising effect was demonstrated on patients with bleeding from tumors. The injected tumor turned necrotic within several days and histological examination revealed no viable tumor cells in necrotic tissues. 2) This endoscopic treatment was very effective in polypoid tumor protruding intratracheobronchial lumen, but was ineffective in stenosis or obstruction due to compression. 3) Animal experimental studies with muscle relaxant elucidated that intramural injection of ethanol demonstrated no significant change of PaO_2, but its instillation into alveolar space, even in slight amounts, caused hemorrhagic pneumonia with a significant decrease of PaO_2. 4) A small amount of ethanol leaking from the tumor caused a transient cough attack but no severe side effects at all including pneumonia or hypoxemia were demonstrated clinically. 5) Biochemical analysis showed no abnormal data not only experimentally during 6 hours follow-up after intramural injection, but also clinically during and after this therapy. 6) In conclusion, intratumoral injection of ethanol is considered to be a promising endoscopic treatment for malignat diseases invading the central airway.
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Muneaki Waku, Hitoshi Tokuda, Junichi Mori, Akira Koyama, Hiroshi Anno
Article type: Article
1986 Volume 8 Issue 2 Pages
258-262
Published: June 25, 1986
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A total of 155 patients with hemoptysis over a 3-year period were reviewed. In 124 cases, abnormal findings on chest roentgenograms were detected and final diagnoses could be obtained by bronchoscopy. In the remaining 31 cases (20%), no abnormal findings on chest roentgenograms were detected. Bronchoscopic examination was carried out in these cases and was useful only in 3 cases ; (1) Recurrent cancer at the bronchial stump (2) broncholithiasis (3) idiopathic massive pulmonary bleeding Almost all of the remaining cases were estimated to have been bronchial inflammation on the grounds of follow-up study. On condition that the case does not belong in the high-risk group, a patient with X-ray negative hemoptysis can safely not undergo a bronchoscopic examination because bronchial inflammation is almost always the cause.
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Hiromi Wada, Shigeki Hitomi, [in Japanese], [in Japanese], [in Japanes ...
Article type: Article
1986 Volume 8 Issue 2 Pages
263-266
Published: June 25, 1986
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Recently pulmonary tuberculosis is less common. However in such cases, surgery is often the only alternative to treat peripheral atelectasis caused by obstruction or stenosis of the bronchial tree. Untill now nine such cases of bronchial stenosis or obstruction have been operated in our institute. All cases were female aged 20-65 (36.8±14.8) y.o. The highest incidence was seen in the left main bronchus (6 of 9, 67%). When atelectasis caused by bronchial stenosis or obstruction had continued for more than 5 months, re-expansion of that lobe was difficult to obtain. If the period were 2 months or less, re-expansion was successful. Only 4 cases were operated by bronchoplasty method, one of which one later developed re-stenosis. The reason might have been the short period of pre-operative medication of antituberculosis agents.
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Yoichi Nakanishi, Osamu Katoh, Hozumi Yamada, Tsuneko Yamaguchi, Kenya ...
Article type: Article
1986 Volume 8 Issue 2 Pages
267-273
Published: June 25, 1986
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Two cases of tracheal injury caused by blunt chest trauma were presented with particular references to their bronchoscopic findings. Case No.1, a 21-year-old male, had fallen half asleep driving a car, and collided head on with a bus. The steering wheel hit his chest and he developed acute respiratory distress. Bronchoscopy revealed tracheal disruption 6 cm above the carina. The trachea was sutured and he recovered with moderate stricture. Previous reporters pointed out two major mechanisms of tracheobronchial injuries. The first is that the injuries occur because of a decrease in the anterior diameter of thorax with a concomitant widening of the transverse diameter. Lateral motion pulls the two lungs apart, producing traction on the trachea at the carina. The second mechanism is that the glottis is closed when impact occurs. A sudden increase of intratracheal pressure is produced by compression of air within the tracheobronchial tree. When the elasticity of the tracheobronchial tree is exceeds a certain level injury occurs. These mechanisms explain the fact that most tracheobronchial injuries occur within 2 cm of the carina. The tracheal disruption of case No.1 occured 6 cm above the carina, which is unusual. Possibly his special condition at impact, half asleep, caused a sudden hyperextension of the neck without the increase of intratracheal pressure because of the lack of glottis closure. It is believed that complete disruption of the trachea occurs if there is been hyperextension of the neck. Case No.2, a 18-year-old male, ran into a car on a motorcycle and his chest was crushed. His chest roentgenogram showed severe subcutaneous emphysema in the chest and neck. His left clavicle was dislocated and bilateral multiple ribs were fractured. Bronchoscopy revealed many oval shaped mucosal hematomas located between cartilaginous rings 2 to 4 cm above the carina. Each hematoma had a longitudinal laceration in the center where bleeding was seen. They disappeared completely 10 days after injury without any special treatment. In this case, it is considered that the crushing force might injure the trachea directly when multiple ribs were fractured. This mechanisms could result in the formation of the mucosal hematomas. These two cases indicated that blunt chest traumas present different features of tracheal injuries in site and nature. It is very important to perform bronchoscopy in cases of blunt chest trauma in order to clarify the exact condition before treatment.
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Norimi Maiya, Ataru Daibo, Yoshikatsu Nemoto, Atsushi Komuro, Nobukazu ...
Article type: Article
1986 Volume 8 Issue 2 Pages
274-278
Published: June 25, 1986
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Two cases of tracheobronchopathia osteochondroplastica are described. Case 1. A 30 year-old man experienced duodenal ulcer two months prior to admission to our hospital. He gave a history of a suffocating feeling for over 2 years. Laboratory tests on admission showed a high level of lgM (301mg/dl) and low level of lgG (837mg/dl). At bronchofiberscopy a large number of hard, nodules and plaque were seen in the anterolateral wall of the trachea. The posterior membranous portion of the trachea was normal. Histologic examination of biopsy specimens from right B^6 showed cartilagenous tissue with marked calcification under the superficial respiratory epithelium. A bony nodule was also found in the other specimen. Case 2. A 47 year-old woman had a history of chronic sinitis for over 24 years, and had experienced lung tuberculosis 22 years prior to the present admission. She suffered from persistent cough for over 17 years, and she was admitted to our hospital with a complaint of recurrent episodes of hemoptysis. There was no significant finding in the laboratory data. Bronchofiberscopy revealed numerous hard nodules and plaque in the trachea and major bronchi, but the posterior membranous trachea was normal. Biopsy specimens from the right main bronchus showed squamous metaplasia with chronic inflammatory cell infiltration and hyaline cartilages under the superficial respiratory epithelium. The other specimen showed bony tissue and fatty marrow formation. Tracheobronchopathia osteochondroplastica is a rare disease with accumulation of bony and cartilagenous nodules in the tracheal and major bronchial mucosa. The disease was first described by Rokitanski in 1855, and Wilks in 1857. Until 1985, only 44 cases of tracheobronchopathia osteochondroplastica had been reported in Japan. Although the etiology of the disease is unknown, chronic inflammation may be directly or indirectly involved.
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Hirohisa Toga, Nobuo Ohya, Tetsuhiko Noguchi, Shigeru Sakurai, Masafum ...
Article type: Article
1986 Volume 8 Issue 2 Pages
279-285
Published: June 25, 1986
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Two cases of tracheobronchopathia osteochondroplastica were reported. Case 1 was a 54-year-old woman who had complained of dry cough and hoarseness. Her chest X-ray film showed irregularity in the tracheal wall and narrowing of the tracheal lumen. Her flow volume loop suggested a typical pattern of upper airway obstruction. A fiberoptic bronchoscopic examination revealed multiple irregular nodular lesions in the trachea and the main bronchi. The biopsy specimen of the nodular lesion disclosed submucosal bony tissue covered with normal bronchial epithelium. Case 2 was also a 54-year-old woman who consulted an otolaryngologist because of productive cough and hoarseness. In a fiberoptic examination of the larynx, multiple small nodular lesions were serendipitously found in the trachea. Her chest X-ray film was essentially normal. Bronchofiberscopy revealed multiple firm nodular lesions on the tracheal cartilages. Diagnosis was confirmed by the histopathologic study of the biopsy specimen.
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Yasufumi Hayashi, Jun Shinada, Mitsutaka Kadodura, Keizo Inagaki, Taka ...
Article type: Article
1986 Volume 8 Issue 2 Pages
286-290
Published: June 25, 1986
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A 70 year-old woman was admitted to our hospital because of bloody sputum. Chest X-ray films showed a tumor-like shadow in the right lower lobe. A granulation with epitheloid cells, which was indicative of tuberculosis or sarcoidosis, was revealed by TBLB. Lung cancer was strongly suspected, even though no malignant cells were found by TBLB, and therefore sputum examination for cytology was repeated. At last, one month after TBLB, malignant cells were found in the sputum. Right lower lobectomy with mediastinal lymphnode dissection was performed. Histological examination of the resected lung revealed a moderatedly differentiated adenocarcinoma, which was surrounded with a granulomatous tissue with epitheloid cells and giant cells. It was considered to be a sarcoid-like reaction with the carcinoma. No metastasis and no sarcoid-like reaction was found in the dissected regional lymphnodes. This case is indicates the possibility for TBLB to reveal only granulation, when granulation of sarcoidlike reaction is coexists with carcinoma of lung. This fact must be always kept in mind in the diagnosis of lung cancer by TBLB.
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Shigeki Hatakeyama, Tomoshi Minamimoto, Tadashi Uyama, Toshikatsu Tani ...
Article type: Article
1986 Volume 8 Issue 2 Pages
291-296
Published: June 25, 1986
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The patient was a 33 year-old male with severe stenosis of the right main bronchus due to tuberculosis. Sleeve lobectomy of the right upper lobe was performed. The cicatricial lesion in the trachea was 6 cm from the carina, so anastomosis was performed at that site. We performed lung function tests before and after the operation. Vital capacity, FEV_<1.0> and flow-volume curves improved after the operation. The mediastinal swing which was seen before surgery improved on chest cinematography. The same phenomenon was confirmed by the fluorospiro graphy. In the lung ventilation scanning, the prolonged mean transit time in the right lung noted before the operation improved. In our case, the functional improvement was so good that we recommend relatively conservative operation, even if it means that the anastomosis site is at the site of a cicatricial lesion.
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[in Japanese]
Article type: Article
1986 Volume 8 Issue 2 Pages
297-
Published: June 25, 1986
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1986 Volume 8 Issue 2 Pages
298-
Published: June 25, 1986
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1986 Volume 8 Issue 2 Pages
298-299
Published: June 25, 1986
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[in Japanese], [in Japanese], [in Japanese], [in Japanese]
Article type: Article
1986 Volume 8 Issue 2 Pages
299-
Published: June 25, 1986
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1986 Volume 8 Issue 2 Pages
299-
Published: June 25, 1986
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
1986 Volume 8 Issue 2 Pages
299-
Published: June 25, 1986
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[in Japanese], [in Japanese]
Article type: Article
1986 Volume 8 Issue 2 Pages
299-300
Published: June 25, 1986
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Article type: Appendix
1986 Volume 8 Issue 2 Pages
App3-
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Article type: Appendix
1986 Volume 8 Issue 2 Pages
App4-
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Article type: Appendix
1986 Volume 8 Issue 2 Pages
App5-
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Article type: Appendix
1986 Volume 8 Issue 2 Pages
App6-
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Article type: Cover
1986 Volume 8 Issue 2 Pages
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