Takuya Nagata

Decreased computed tomographic lung density during exacerbation of asthma

Recently, it was shown that both mean lung density (MLD) and the relative lung area with an attenuation of <-950 HU (RA950) are related to severity of asthma in nonsmoking asthmatics. The aim of the present study was to examine whether reduced computed tomography (CT) lung density during exacerbation could change after treatment. A cross-sectional study was performed to compare CT lung density in 30 stable asthmatics, 30 unstable asthmatics and 25 control subjects. In order to investigate longitudinally the effect of treatment on decreased CT lung density, 17 asthmatics with an exacerbation were followed at the initiation of treatment and 2 months after relief. The MLD was significantly lower and the RA950 significantly higher in unstable asthmatics than in controls and stable asthmatics. Both MLD and RA950 changed significantly with administration of systemic glucocorticoid therapy. The changes in forced expiratory volume in one second correlated significantly with those in both MLD and RA950. The changes in residual volume also correlated significantly with those in both MLD and RA950. It was concluded that decreased computed tomographic lung density during an asthma exacerbation is at least partially reversible, and changes in mean lung density and the relative lung area with a radiation attenuation of <−950 HU are related to the change in forced expiratory volume in one second and residual volume.

Tumor-induced Hypercalcemia and Leukocytosis in Lung Cancer.

高カルシウム血症と白血球増多症は原発性肺癌において, どちらも比較的よく遭遇する腫瘍随伴症候群であり, 時に両者は併発する.今回我々は, 高カルシウム血症と白血球増多症の頻度, 予後との相関を検討するために, 1980年から1996年までに岡山大学第2内科に入院した原発性肺癌623例について検討した.初診時高カルシウム血症発現例は51例 (8.2%), 悪性腫瘍に伴う白血球増多症の発現例は6例 (1.0%) であった.また, 高カルシウム血症発現例の生存期間中央値 (MST) は4.4ヵ月, 白血球増多症発現例では2.9ヵ月であり, いずれも全肺癌症例 (MST;9.5ヵ月) また, 臨床病期IV期の肺癌症例 (MST;8.9ヵ月) に比べて, 有意に予後不良であった (p<0.01).高カルシウム血症と白血球増多症を併発していた2例の生存期間は, 1.0ヵ月, 1.5ヵ月と極めて短かった.これらの結果より, 肺癌における高カルシウム血症あるいは白血球増多症は予後不良因子である可能性が示唆された.