Akira Ido

Effect of inhaled nitric oxide on cardiovascular response to catecholamine in heart failure.

We examined the dose responses to continuous infusion of isoproterenol (ISO) and norepinephrine (NE) in normal (control) and procainamide-induced heart failure dogs with or without inhalation of 70 ppm nitric oxide (NO). Inhaled NO affected neither left ventricular (LV) function nor hemodynamics at baseline in both control and heart failure dogs. There were no significant differences in the responses to ISO and NE with or without inhaled NO in the control. The responses of LV dP/dt to ISO and NE were significantly enhanced in heart failure; however, they were not affected by inhaled NO. In contrast, LV pressure and dimension at end diastole were significantly increased, and pulmonary vascular resistance (PVR) was significantly decreased by inhaled NO during infusion of both ISO and NE in heart failure. In conclusion, the positive inotropic response to cathecholamine is not affected by inhaled NO even in heart failure. Inhaled NO decreases PVR, but potentially increases LV preload in the presence of additional stress of cathecholamine in heart failure.

A case of primary fibrous histiocytoma of the lung.

きわめてまれな肺原発の良性線維性組織球腫の1例を経験したので報告した.症例は52歳女性で, 健康診断にて胸部X線写真上異常陰影を指摘され入院した. 右下葉に径30mm×25mmのだ円形で辺縁鮮明・均一な濃度を有するcoinlesionを認め, 諸検査の結果, 悪性腫瘍の疑いが否定できなかったので, 腫瘤摘出術を施行した. 腫瘤は表面平滑・弾性硬で, 組織学的にBFHと診断した. 細胞所見は, 核異型に乏しい線維芽細胞様細胞と組織球様細胞が混在して認められ, 細胞集塊はstoriform patternに類似した細胞配列を呈していた.本疾患は, 肺に原発することはきわめてまれで, さらに術前診断は容易ではないと考えられるが, 細胞診にてstoriform patternを呈する線維芽細胞様細胞および組織球様細胞を認めた場合, 本症の可能性を考慮して細胞所見を検討する必要があると考えられた.