著者
金田 正徳 竹内 義広 坂井 隆 並河 尚二 湯浅 浩 草川 實
出版者
社団法人 日本呼吸器学会
雑誌
日本胸部疾患学会雑誌 (ISSN:03011542)
巻号頁・発行日
vol.22, no.6, pp.468-473, 1984

Cases of primary lung cancer often have other pulmonary diseases involving the loss of pulmonary function. If a complicating disease is more pronounced in the noncancerous lung, unexpected postoperative respiratory insufficiency may appear. For this reason it is desirous to predict the postoperative lung function preoperatively. In this study the predicted postoperative vital capacity was calculated according to the following formulae from the spirometry data, bronchoscopy, bronchography and lung scintigram using <sup>81m</sup>Kr gas.<br>As for the summation of NNSS, two methods were employed. First was the evaluation of the number of obstructed sub-segmental bronchus by means of bronchoscopy or bronchography. The second method was summation from the count rate of the lung scanning. In younger patients both methods had equal accuracy. However in older patients the latter method had inevitable error, because the assumption for calculating NNSS did not hold in that patient group. We therfore accepted former method for the summation of NNSS.<br>As for the measurement of unilateral vital capacity (or VCc), <sup>81m</sup>Kr lung scintigram which visualizes the actual distribution of ventilation in the lung was useful in comparison with the cumbersome bronchospirometry.<br>To investigate the overall accuracy of our predicting formulae, 16 patients who were alive and cancer free 6 months after surgery were selected. However 5 had to excluded for the study because they had postoperative pulmonary complications which reliably are accompanied by loss of lung function. In the remaining 11 cases the predicted value was within&plusmn;10% deviation of the actually measured value. This accuracy was also acceptable for older patients whose respiratory function was impaired both in cancerous and non-cancerous lung. These formulae were considered to be useful in predicting postoperative lung function and very helpful in deciding surgical indications in cases of severely impaired pulmonary function. However careful management to avoid postoperative lung complications is necessary because the predicted postoperative vital capacity is a final result of the lung function when there are no another function-impairing factor.
著者
梅枝 愛郎 北市 正則 松井 茂 色川 正貴 片貝 重之 中沢 次夫 飯塚 邦彦 三浦 進 笛木 隆三 小林 節雄
出版者
社団法人 日本呼吸器学会
雑誌
日本胸部疾患学会雑誌 (ISSN:03011542)
巻号頁・発行日
vol.24, no.7, pp.804-809, 1986

「蚕 (カイコ)」体成分の吸入に起因する過敏性肺炎 (養蚕者肺症) の1例を報告した. 症例は48歳女性, 養蚕農家の主婦で咳, 痰, 労作時息切れ等が「繭かき」「ケバ取り」などの養蚕作業と関連して出現. 初診時軽いチアノーゼを認め, 胸部で捻髪音聴取. 血沈亢進, CRP (2+), 白血球増多, 低酸素血症, 胸部レ線でスリガラス様陰影を認め, 肺機能で拘束性障害と拡散能の低下がみられた. 免疫学的検査ではツベルクリン反応陰性で, 蚕体成分の一つである熟蚕尿に対する沈降抗体陽性であった. 肺組織には胞隔炎, 類上皮細胞肉芽腫, マッソン体が認められた. 入院後症状の自然改善が見られ, 血沈等が正常化し, ラ音の聴取されないことを確認して熟蚕尿による吸入誘発試験を行った. 吸入後捻髪音が出現し, 拡散能は前値に比し30%低下したため, 誘発試験陽性と判定した. 以上より本症例は蚕体成分である熟蚕尿に起因する過敏性肺炎 (養蚕者肺症) と診断した.
著者
福島 雅夫 吉村 一彦 久保 恵嗣 小林 俊夫 半田 健次郎 草間 昌三
出版者
社団法人 日本呼吸器学会
雑誌
日本胸部疾患学会雑誌 (ISSN:03011542)
巻号頁・発行日
vol.18, no.10, pp.753-757, 1980

22才男. 中岳 (3,084m) 登頂後呼吸困難, 意識障害が出現, 天候不順のため4日間山頂付近に滞留した. 救助時昏睡状態, 全身チアノーゼを認め, 全肺野で湿性ラ音を聴取した. 呼吸不全のため救助後約12時間で死亡. 剖検にて肺水腫の他に肺胞毛細血管, 肺動脈に微小血栓を認め, 脳白質にびまん性点状出血を認め注目された.

1 0 0 0 OA 気管支喘息 II