Ubukata M

High resolution CT and bronchial reversibility test for diagnosing COPD

Background:  COPD is defined by airflow limitation that is not fully reversible and is associated with relevant risk factors. The diagnosis requires that other causes of chronic airflow limitation (CAL) be excluded. We assessed the diagnostic utility of high resolution thoracic CT (HRCT) and bronchodilator reversibility to assist in making a diagnosis of COPD.

Effect of early versus late intervention with inhaled corticosteroids on airway wall thickness in patients with asthma

Background and objective:  The aim of this study was to determine whether early versus late initiation of long‐term inhaled corticosteroid (ICS) therapy decreases airway wall thickness in patients with asthma.

Multiple tracheobronchial mucosal lesions in two cases of Churg–Strauss syndrome

Abstract:  Churg–Strauss syndrome (CSS) is characterized by hypereosinophilia and a systemic necrotizing vasculitis seen almost exclusively in patients with asthma. The most common pathological findings in the chest in CSS are eosinophilic pneumonia, necrotizing vasculitis and granulomatous inflammation (extravascular granuloma). However, tracheobronchial mucosal lesions have rarely been reported in CSS. The authors report two patients with CSS who had multiple tracheobronchial mucosal lesions that were found by fibreoptic bronchoscopy. They were tiny nodular lesions and necrotizing bronchial inflammation with many eosinophils was observed upon pathological examination. The authors concluded that tracheobronchial mucosal lesions may be one of the manifestations of vasculitis seen in CSS.

Changes in lung function and health status in patients with COPD treated with tiotropium or salmeterol plus fluticasone

Background and objective:  The effects of tiotropium, a long‐acting anticholinergic drug, were compared with those of the combination of salmeterol, a long‐acting β2‐agonist, and fluticasone, an inhaled corticosteroid, in patients with COPD.

Serum IgG and IgA antibodies to Chlamydia pneumoniae and severity of emphysema.

Objective:  Chronic Chlamydia pneumoniae infection has been identified serologically in patients with COPD. The aim of this study was to examine whether the severity of emphysema is related to elevated antibody titres against C. pneumoniae.

Effectiveness of Tc-99m MIBI scintigraphy in diagnosing lung cancer

The use of Tc-99m hexakis 2-methoxy isobutyl isonitrile (MIBI) scintigraphy for qualitative diagnosis was examined. A total of 36 lesions from 31 patients with respiratory disease (19 lesions from 19 primary lung cancer patients, 8 lesions from 3 metastatic lung cancer patients and 10 lesions from benign lung disease patients) were examined. Positive results were seen in 89.4% of the primary lung cancer lesions, 50.0% of the metastatic lung cancer lesions, and 20.0% of the benign lung disease lesions. The positive rate of 77.7% for malignant lung cancer was significantly higher (P<0.01) than that for benign lung cancer. In particular, for lesions with a tumor diameter of 1.0 cm or more, the positive rate for malignant lung cancer lesions (95.2%) was significantly higher (P<0.001) than that for benign lung disease lesions (25.0%). These results thus indicate Tc-99m MIBI scintigraphy to be useful for qualitative diagnosis of lung peripheral coin lesions with a diameter of 1.0 cm or more.

Pulmonary nocardiosis during immunosuppressive therapy for idiopathic pulmonary fibrosis

Nocardiosis is a subacute or chronic suppurative infection caused by Nocardia species. Although it is more common in immunocompromised hosts, idiopathic pulmonary fibrosis (IPF) has not been recognized as a predisposing factor for nocardial infection. We report a case of IPF, in which pulmonary nocardiosis developed during treatment with prednisolone and cyclophosphamide. The risk of pulmonary nocardiosis may be increased in cases of IPF on immunosuppressive therapy. Since IPF often accompanies lung carcinoma, it is important to correctly differentiate nocardiosis from carcinoma.