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1.
Tetsuro Sawata Masashi Bando Masayuki Nakayama Naoko Mato Hideaki Yamasawa Masaharu Takahashi Hiroaki Okamoto Yukihiko Sugiyama 《Respiratory investigation》2018,56(2):173-178
Background
Several studies have reported that viral infections are related to lung cancer. We previously reported the involvement of Torque teno virus (TTV) in patients with lung cancer and idiopathic pulmonary fibrosis. However, the role of TTV in lung cancer growth, and its influence on changes in TTV DNA titers due to idiopathic pulmonary fibrosis (IPF) in lung cancer patients are poorly understood.Methods
Serum TTV DNA titers were measured in serum samples obtained from patients with lung cancer. Forty-eight patients with primary lung cancer, including 8 patients with IPF, were enrolled. Serum TTV DNA titers were quantitated before and after chemotherapy. In addition, patients were classified into two groups according to the presence or absence of IPF, and clinical characteristics were compared between these two groups.Results
Among the 33 patients with partial response to treatment or stable disease in the lung cancer, the mean TTV DNA titer in 28 patients without IPF had significantly decreased after chemotherapy. In contrast, the mean TTV DNA titer in the 5 patients with IPF tended to increase after chemotherapy. In the 15 patients with progressive lung cancer, TTV DNA titers were significantly elevated in those with and without IPF.Conclusion
In lung cancer patients without IPF, changes in TTV titers may be correlated with tumor growth. However, in lung cancer patients with IPF, TTV titers were not consistently associated with chemotherapy responses. Therefore, IPF may have an influence on changes in TTV DNA titers. 相似文献2.
Hiroyoshi Machida Yoko Shibata Sumito Inoue Akira Igarashi Yoshikane Tokairin Keiko Yamauchi Tomomi Kimura Kento Sato Hiroshi Nakano Michiko Nishiwaki Maki Kobayashi Sujeong Yang Yukihiro Minegishi Kodai Furuyama Tomoka Yamamoto Tetsu Watanabe Tsuneo Konta Yoshiyuki Ueno Isao Kubota 《Respiratory investigation》2018,56(1):34-39
Background
Diabetes has been reported as a comorbidity of chronic obstructive pulmonary disease (COPD) in Western countries, but it has not been demonstrated in epidemiological reports in Japan. The purpose of this study was to clarify whether the relationship between airflow obstruction and diabetes can be confirmed in a Japanese general population.Methods
From 2004 to 2006, blood sampling and pulmonary function tests were performed on 3045 people over the age of 40 years in annual health check-ups held in Takahata, Yamagata Prefecture, Japan. Pulmonary function was re-evaluated in 2009 and 2011.Results
The prevalence of diabetes did not differ between subjects with and without airflow obstruction. Furthermore, although body mass index decreased, no increase in the prevalence of diabetes was observed with the progression of airflow obstruction. The annual changes in forced expiration volume in 1 s (FEV1) did not differ depending on the presence or absence of diabetes in the study population.Conclusion
There was no difference in the prevalence of diabetes between subjects with airflow obstruction and those without. As patients with COPD in Japan are thinner than in the West, diabetes may not be a common comorbidity in Japanese patients with COPD. 相似文献3.
Atsuhito Ushiki Shuhei Nozawa Masanori Yasuo Kazuhisa Urushihata Hiroshi Yamamoto Masayuki Hanaoka Keisaku Fujimoto 《Respiratory investigation》2017,55(1):33-38
Background
Field walk tests such as the incremental shuttle walk test (ISWT) are simple tests for assessing the degree of disability in individuals with chronic obstructive pulmonary disease (COPD). In the present study, the correlations between exercise performance in the ISWT, lung function, and health status were examined in patients with COPD of varying severities.Methods
A retrospective examination of 277 COPD patients was performed using the ISWT and lung function tests along with assessment of health status using St. George?s Respiratory Questionnaire (SGRQ). In addition, we assessed the correlations between the walking distance, lung function parameters, and SGRQ scores.Results
ISWT distances were poorly correlated with lung function parameters and SGRQ scores in mild COPD patients. In contrast, ISWT distances were significantly correlated with pulmonary function parameters, such as vital capacity (%predicted) and forced expiratory volume in one second, and SGRQ scores in moderate and severe COPD patients.Conclusions
The ISWT is more independent of health status and pulmonary function in patients with mild COPD compared to moderate or severe cases. Therefore, the exercise capacity of patients with mild COPD should be estimated by the ISWT. 相似文献4.
Naoko Iwakami Shin-ichiro Iwakami Munechika Hara Mitsuaki Sekiya Takashi Dambara Kazuhisa Takahashi 《Respiratory investigation》2018,56(3):238-242
Background
It is well known that ultrasound-guided needle-aspiration (USGNA) for intrapulmonary subpleural lesion in contact with the pleura is useful and safe, and its diagnostic yield is high. However, reports concerned with the analyses of cases with intrapulmonary subpleural lesion which could not be diagnosed using USGNA are limited. The objective of this study is to clarify the radiological properties of subpleural primary lung cancer which obstruct diagnosis by USGNA.Methods
The consecutive cases with subpleural primary lung cancer whose radiological properties could be confirmed by thoracic computed tomography (CT) without contrast enhancement (CE), and examined by USGNA at our hospital between January 1999 and December 2014 have been analyzed. All cases were given pathological diagnoses of primary lung cancer. The diagnostic yield by USGNA was calculated, and the properties of the lesions of the subjects were analyzed by means of thoracic CT without CE images and pathological findings.Results
87 consecutive cases (41–86 year olds, 75 males, 12 females) were analyzed. The overall diagnostic yield by USGNA was 86.2%. There was no statistically significant difference regarding the diagnostic yield concerning radiological properties such as cavities, small airspaces and low density areas in the lesions and their sizes. However, the diagnostic yield for the cases with squamous cell carcinoma was statistically significantly low (p=0.02).Conclusion
Although the diagnostic yield of USGNA is not distorted by the radiological properties of lesions, it is statistically significantly low in cases with squamous cell carcinoma. 相似文献5.
Taisuke Tsuji Kazunari Tsuyuguchi Kazunobu Tachibana Yohei Kimura Takehiko Kobayashi Shojiro Minomo Shinji Atagi Akihide Matsumura Seiji Hayashi Katsuhiro Suzuki 《Respiratory investigation》2017,55(1):45-50
Background
Although nontuberculous mycobacteria (NTM) lung diseases can occur in association with lung cancer, no study has evaluated the effect of lung cancer treatment on NTM lung diseases. Therefore, the present study aimed to retrospectively examine the effect of lung cancer treatment on NTM lung diseases.Methods
Patients diagnosed with NTM lung diseases in combination with cytologically or histologically proven lung cancer between January 1, 2010 and October 31, 2014 were enroled. The clinical history of eligible patients was retrospectively reviewed.Results
Seven hundred twenty-eight patients were diagnosed with NTM lung diseases. Among these patients, 29 (3.9%) also had lung cancer. Of the 29 patients with NTM and lung cancer, 62% had Mycobacterium avium complex as the pathogenic organism. The most common lung cancer histology was adenocarcinoma (62.1%). Anti-cancer cytotoxic chemotherapy was administered to seven patients, and the two patients who did not receive NTM treatment showed worsening of their NTM lung disease.Conclusion
Whether NTM lung disease should be treated during anti-cancer chemotherapy has not been not clarified by this study. Induction of anti-NTM therapy should be made after careful consideration, because the duration of anti-NTM treatment is long and anti-mycobacterial drugs have extensive effects on anti-cancer drugs. However, we think that anti-NTM therapy should be introduced after consideration of the worsening of symptoms and radiological findings associated with NTM lung disease. 相似文献6.
Yukiko Miura Takefumi Saito Toru Tanaka Hiroyuki Takoi Yohei Yatagai Minoru Inomata Takahito Nei Yoshinobu Saito Akihiko Gemma Arata Azuma 《Respiratory investigation》2018,56(1):72-79
Background
Idiopathic pulmonary fibrosis (IPF) is a disease with a worse prognosis than some types of cancer. In patients with IPF, lung cancer is critical because of the associated high mortality rate from its progression and fatal complications from anticancer treatments. Therefore, preventing lung cancer in patients with IPF is primordial. Pirfenidone is an anti-fibrotic agent that reduces the decline in forced vital capacity. This study aimed to assess the effect of pirfenidone in the development of lung cancer in patients with IPF.Methods
Data from 261 patients with IPF with and without pirfenidone were retrospectively reviewed, and the incidence of lung cancer was analyzed.Results
In the pirfenidone group, the incidence of lung cancer was significantly lower than in the non-pirfenidone group (2.4% vs. 22.0%, P < 0.0001). Multivariate Cox proportional hazards regression analysis demonstrated that pirfenidone decreased the risk of lung cancer (hazard ratio, 0.11; 95% confidence interval, 0.03 to 0.46; P = 0.003), whereas coexisting emphysema increased the incidence of lung cancer (hazard ratio, 3.22; 95% confidence interval, 1.35 to 7.70; P = 0.009).Conclusions
Pirfenidone might correlate with a decreased risk of lung cancer in patients with IPF. However, no definite conclusion can be drawn from this retrospective study, and a multicenter, prospective cohort study is still warranted to confirm the effect of pirfenidone on lung cancer in patients with IPF. 相似文献7.
Hai-jian Liu Jian Guo Qin-hua Zhao Lan Wang Wen-lan Yang Jing He Su-gang Gong Jin-ming Liu 《The American journal of the medical sciences》2017,353(3):216-223
Background
To study the relationship between chronotropic incompetence (CI) and disease severity and to assess the effect of CI on exercise capacity in patients with chronic obstructive pulmonary disease (COPD).Materials and Methods
Arterial blood gas analysis, pulmonary function test and cardiopulmonary exercise testing were conducted in 60 patients with stable COPD and 45 healthy volunteers. CI was defined using the chronotropic response index (CRI = (peak heart rate-resting heart rate) / (220-age-resting heart rate). Based on CRI, patients with COPD were divided into the normal chronotropic group (n = 23) and CI group (n = 37).Results
CI was present in 61.7% of the patients with COPD. Exercise capacity (peak oxygen uptake as percentage of predicted value, peak VO2%pred), peak heart rate and CRI were significantly lower in patients with COPD than in controls. However, resting heart rate was significantly higher than in controls. FEV1%pred and exercise capacity were significantly decreased in the CI group when compared with those in the normotropic group. There was significant association between CRI with FEV1%pred and peak VO2%pred. Multivariate regression analysis showed that CRI and FEV1%pred were independent predictors of exercise capacity in patients with COPD. A cutoff of 0.74 for the CRI showed a specificity of 94.1% in predicting patients with a peak VO2%pred < 60%.Conclusions
CRI was associated with disease severity in patients with COPD. CI may be an important parameter to reflect exercise capacity in patients with COPD. 相似文献8.
Keping Peng Zengnan Mo Guixiang Tian 《The American journal of the medical sciences》2017,353(3):236-241
Background
Dyslipidemia is a risk factor for nonalcoholic fatty liver disease (NAFLD). The aim of our study was to determine the associations of serum lipid indexes with NAFLD in adult males.Materials and Methods
In this cross-sectional study, 830 patients with NAFLD and 2,357 healthy individuals were assessed. Serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol and low-density lipoprotein cholesterol (LDL-C) levels were compared between patients with NAFLD and controls. The associations of dyslipidemia indexes with NAFLD occurrence were assessed by univariate analysis, and multivariate analysis was performed to identify independent dyslipidemia factors predictive of NAFLD.Results
Of the 3,187 study subjects, NAFLD occurred in 830 (26.04%), there were 504 (60.72%) patients with mild disease and 326 (39.28%) patients with moderate-to-severe disease. Although the frequency of normal TC, TG, LDL-C and high-density lipoprotein cholesterol levels in patients with NAFLD was similar to the controls, the frequencies of patients with NAFLD with marginally high and high TC, TG and LDL-C levels were significantly different when compared with controls. Interestingly, the association of the number of abnormal serum lipid indexes and NAFLD was highly significant with 2 abnormalities (odds ratio = 1.977; 95% CI: 1.436-2.722; P < 0.001) and ≥3 abnormalities (odds ratio = 3.505; 95% CI: 2.466-4.982; P < 0.001).Conclusions
A significant positive association was found between dyslipidemia characteristics and NAFLD in adult males. 相似文献9.
A. Jayedi K. Djafarian F. Rezagholizadeh A. Mirzababaei M. Hajimohammadi S. Shab-Bidar 《Diabetes & metabolism》2018,44(4):320-327
Aim
This study aimed to test the dose-response relationship between fasting blood glucose (FBG) levels and risk of prostate cancer.Methods
A systematic search was done of PubMed and Scopus from their inception up to January 2017. Prospective and retrospective studies reporting risk estimates of prostate cancer for two or more categories of blood glucose levels were identified, and two independent authors extracted the information. Relative risk (RR) was calculated using random-effects models and pooled.Results
Ten prospective cohort studies, one nested case-control study, one case-cohort study and three case-control studies (total n = 1,214,947) involving 12,494 cases of prostate cancer were reviewed. The pooled RR of prostate cancer for the highest vs. lowest category of FBG was 0.88 (95% CI: 0.78–0.98, I2 = 25.5%, n = 15 studies). A 10 mg/dL increment in FBG level was not associated with risk of prostate cancer (0.98, 95% CI: 0.96–1.00, I2 = 45.4%, n = 11 studies). Subgroup analyses yielded a significant inverse association only in the subgroup of cohort studies. Non-linear dose-response meta-analysis showed a very slight decrement in risk with increasing FBG levels. Sensitivity analyses using cohort studies showed a steep decrease in risk along with an increase in FBG from baseline levels of ≈ 70 mg/dL across prediabetes and diabetes ranges.Conclusion
Higher FBG levels are associated with lower risk of prostate cancer in cohort studies, but not in case-control studies, findings that limit interpretation of our present results. 相似文献10.
Tiejun Yang Yanlong Jia Yongkang Ma Liang Cao Xiaobing Chen Baoping Qiao 《The American journal of the medical sciences》2017,353(1):49-58
Background
Pulmonary fibrosis (PF) is a destructive pulmonary disease and the molecular mechanisms underlying PF are unclear. This study investigated differentially expressed proteins associated with the occurrence and development of PF in rat lung tissue with bleomycin-induced PF.Methods
Sixteen Sprague-Dawley rats were randomly divided into 2 groups: the PF model group (n = 8) and the control group (n = 8). After successfully establishing the rat PF model induced by bleomycin, the differentially expressed proteins in the 2 groups were identified through isobaric tag for relative and absolute quantitation coupled with liquid chromatography-mass spectrometry and bioinformatics analysis.Results
A total of 146 differentially expressed proteins were identified; 88 of which displayed increased abundance and 58 were downregulated in the PF rat model group. Most functional proteins were associated with extracellular matrix, inflammation, damage response, vitamin A synthesis and metabolism. Critical proteins related to PF development and progression was identified, such as type V collagen-3, arachidonic acid 12-lipoxygenase, arachidonic acid 15-lipoxygenase and cytochrome P4501A1. Kyoto Encyclopedia of Genes and Genomes pathway analysis showed that these differentially expressed proteins were enriched in extracellular matrix receptor interaction pathway, renin-angiotensin system and metabolic pathway of retinol.Conclusions
The proteins expressed in bleomycin-induced PF rat model provide important data for further functional analysis of proteins involved in PF. 相似文献11.
Shinobu Osanai Toshiyuki Ogasa Kazuhiro Sumitomo Naoyuki Hasebe 《Respiratory investigation》2018,56(1):21-27
Background
There is limited information about the respiratory function of ever-smokers without lung disorders. We sought to assess the effects of smoking habits on respiratory function in subjects without lung disorders.Methods
Subjects were recruited from among patients without any evidence of respiratory disorders who visited rural primary care clinics. Each participant was asked to answer a questionnaire that included questions smoking history. Their forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were measured.Results
We analyzed 802 subjects (364 men and 438 women). The means of the lambda-mu-sigma method derived z-score of FEV1 (zFEV1) both in current-smokers and ex-smokers were lower than that in never-smokers. The mean zFEV1 in the ever-smokers with more than 30 pack-years of smoking history were lower than that in the ever-smokers with less smoking history. Univariate analysis showed that there were significant negative correlations between pack-years and zFEV1 both in the ex-smokers and current-smokers. There was no significant correlation between the duration of smoking cessation and zFEV1 in the ex-smokers.Conclusions
Our data suggests that respiratory function in healthy ever-smokers is decreased based on smoking habits in a dose-dependent manner. Even after a long period of smoking cessation, the decreased respiratory function seems to be maintained in ex-smokers. 相似文献12.
Nian-Sheng Tzeng Chi-Hsiang Chung Fu-Huang Lin Chin-Bin Yeh San-Yuan Huang Ru-Band Lu Hsin-An Chang Yu-Chen Kao Wei-Shan Chiang Yu-Ching Chou Chang-Huei Tsao Yung-Fu Wu Wu-Chien Chien 《The American journal of the medical sciences》2017,353(3):197-206
Background
Primary headaches include migraines, tension-type headaches and other primary headache syndromes. Migraines and tension-type headaches are associated with patient discomfort and other diseases. This study aimed to investigate the association between primary headaches and the risk of developing dementia, and to clarify the association between different types of headaches and dementia.Materials and Methods
We conducted a nationwide matched cohort population-based study. A total of 3,620 patients with newly diagnosed primary headaches, including migraines and tension-type headaches, between January 1 and December 31, 2000 were selected from the National Health Insurance Research Database of Taiwan, along with 10,860 controls matched for sex and age. After adjusting for confounding factors, Fine and Gray?s competing risk analysis was used to compare the risk of developing dementia during 10 years of follow-up.Results
Of the study subjects, 170 (4.70 %) developed dementia compared with 433 (3.99%) of the controls. Fine and Gray?s competing risk analysis revealed that the study subjects were more likely to develop dementia (hazard ratio = 2.057; 95% CI: 1.718-2.462; P < 0.001). After adjusting for sex, age, monthly income, urbanization level, geographic region of residence and comorbidities, the hazard ratio for dementia was 2.048 (95% CI: 1.705-2.461, P < 0.001). Migraines and tension-type headaches were associated with nonvascular dementia but not vascular dementia.Conclusions
The patients with headaches had a 105% increased risk of dementia. Further studies are needed to elucidate the underlying mechanisms. 相似文献13.
Masahiro Shimada Atsuhisa Tamura Kyoko Yokosuka Kei Kusaka Hirotoshi Matsui Hideaki Nagai Ken Ohta 《Respiratory investigation》2018,56(4):365-368
Background
In current guidelines, the role of immune checkpoint inhibitors is not yet determined in the treatment strategy for NSCLC harboring ALK translocations.Case
A 51-year-old woman with lung adenocarcinoma harboring ALK translocation was treated with alectinib until PD. After the second (CDDP/PEM) and third (crizotinib) line treatment, a second biopsy was performed, revealing PD-L1 tumor proportion score of 70–80% and G1202R mutation of ALK. Pembrolizumab was selected for the fourth line, leading to PR for more than 6 months.Conclusions
While alectinib might induce resistance to ALK-TKI, it could increase PD-L1 positive cells to become sensitive to PD-1/PD-L1 inhibitors. 相似文献14.
Nian-Sheng Tzeng Chi-Hsiang Chung Feng-Cheng Liu Yu-Hsiang Chiu Hsin-An Chang Chin-Bin Yeh San-Yuan Huang Ru-Band Lu Hui-Wen Yeh Yu-Chen Kao Wei-Shan Chiang Chang-Hui Tsao Yung-Fu Wu Yu-Ching Chou Fu-Huang Lin Wu-Chien Chien 《The American journal of the medical sciences》2018,355(2):153-161
Background
Fibromyalgia is a syndrome of chronic pain and other symptoms and is associated with patient discomfort and other diseases. This nationwide matched-cohort population-based study aimed to investigate the association between fibromyalgia and the risk of developing dementia, and to clarify the association between fibromyalgia and dementia.Materials and Methods
A total of 41,612 patients of age ≥50 years with newly diagnosed fibromyalgia between January 1, and December 31, 2000 were selected from the National Health Insurance Research Database of Taiwan, along with 124,836 controls matched for sex and age. After adjusting for any confounding factors, Fine and Gray competing risk analysis was used to compare the risk of developing dementia during the 10 years of follow-up.Results
Of the study subjects, 1,704 from 41,612 fibromyalgia patients (21.23 per 1,000 person-years) developed dementia when compared to 4,419 from 124,836 controls (18.94 per 1,000 person-years). Fine and Gray competing risk analysis revealed that the study subjects were more likely to develop dementia (hazard ratio: 2.29, 95% CI: 2.16-2.42; P < 0.001). After adjusting for sex, age, monthly income, urbanization level, geographic region of residence and comorbidities the hazard ratio was 2.77 (95% CI: 2.61-2.95, P < 0.001). Fibromyalgia was associated with increased risk of all types of dementia in this study.Conclusions
The study subjects with fibromyalgia had a 2.77-fold risk of dementia in comparison to the control group. Therefore, further studies are needed to elucidate the underlying mechanisms of the association between fibromyalgia and the risk of dementia. 相似文献15.
Takeshi Saraya Kosuke Ohkuma Yayoi Tsukahara Takayasu Watanabe Daisuke Kurai Haruyuki Ishii Hirokazu Kimura Hajime Goto Hajime Takizawa 《Respiratory investigation》2018,56(4):320-325
Background
Mycoplasma pneumoniae (MP) is the primary cause of community-acquired pneumonia. We aimed to evaluate the correlation between clinical features, with special reference to hypoxemia and the total affected area obtained using high-resolution computed tomography (HRCT).Methods
Medical records of MP pneumonia patients > 15 years of age at Kyorin University Hospital between January 2006 and November 2013 were reviewed retrospectively and compared to patients with Streptococcus pneumoniae pneumonia, diagnosed between January 2013 and September 2014.Results
We identified 65 and 32 patients with MP- and S. pneumoniae pneumonia, respectively. HRCT data were available for 42 and 32 patients with MP- and S. pneumoniae pneumonia, respectively. Data were available for all hypoxemic patients. Hypoxemia was significantly higher in patients with S. pneumoniae (14/32, p = 0.008) than those with MP (5/39). Total visual score on HRCT correlated significantly with hypoxemia in both groups, but showed significantly higher scores with MP- than with S pneumoniae pneumonia in hypoxemic patients.MP pneumonia showed significant positive correlation between the total visual score and serum inflammatory markers (C-reaction protein [r = 0.43, p = 0.025] and lactate dehydrogenase [r = 0.466, p = 0.016]). In both groups, individual scores in the middle and lower lung fields were significantly higher than in the upper field, suggesting zonal predominance.Conclusions
This study provides the first evidence that the total affected area on lung HRCT was more with MP compared to S. pneumoniae pneumonia in hypoxemic patients and positively correlated with hypoxemia and serum inflammatory markers. 相似文献16.
Kento Sato Yoko Shibata Sumito Inoue Akira Igarashi Yoshikane Tokairin Keiko Yamauchi Tomomi Kimura Takako Nemoto Masamichi Sato Hiroshi Nakano Hiroyoshi Machida Michiko Nishiwaki Maki Kobayashi Sujeong Yang Yukihiro Minegishi Kodai Furuyama Tomoka Yamamoto Tetsu Watanabe Isao Kubota 《Respiratory investigation》2018,56(2):120-127
Background
Few studies are available regarding the annual decline of forced expiratory volume in 1 s (FEV1) in chronic obstructive pulmonary disease patients with mild airflow obstruction. This study sought to clarify to what extent cigarette-smoking individuals with mild airflow obstruction lose pulmonary function annually.Methods
From 2004 to 2006, pulmonary function tests were performed on people >40 years of age, during the annual health checkup held in Takahata, Yamagata, Japan (initial study population, n=3253). In 2011, pulmonary function tests were performed again on participants who agreed to undergo reexamination (follow-up study population, n=838).Results
Smokers have decreased pulmonary function in terms of percent forced vital capacity (FVC), %FEV1, and FEV1/FVC; the stages of airflow obstruction were also more severe in smokers than never-smokers. The annual decline in FEV1 was significantly greater in smokers than in never-smokers. The median annual decline in FEV1 was most significant in individuals with mild airflow obstruction. The annual decline in FEV1 was greater in smokers with mild airflow obstruction than in smokers with moderate airflow obstruction. In analyzing the decline in %FEV1, the annual change in smokers with mild airflow obstruction was greater than that in smokers with normal spirometric values.Conclusion
The annual decline in FEV1 was most significant in smokers with mild airflow obstruction in a Japanese general population. This highlights the importance of early detection of chronic obstructive pulmonary disease patients among the general population in order to prevent disease progression in undiagnosed patients. 相似文献17.
Yoshihisa Hiraishi Takehiro Izumo Shinji Sasada Yuji Matsumoto Toshiyuki Nakai Takaaki Tsuchida Hisashi Baba 《Respiratory investigation》2018,56(6):457-463
Background
Bronchoscopy is important to diagnose lung cancer. However, some patients who undergo bronchoscopic procedures develop respiratory tract infections. Little is known about the proportion of pathogen-positive results in bacterial cultures from diagnostic bronchoscopy samples in patients with suspected lung cancer. This study aimed to determine the rate of positive bacterial cultures after diagnostic bronchoscopy in patients with suspected lung cancer and the relationship among culture results, clinical characteristics, and respiratory tract infections.Methods
We retrospectively reviewed the medical records of all immunocompetent patients who underwent bronchoscopy and had culture and histological samples for the diagnosis of peripheral pulmonary lesions from September 2012 to August 2014 at the National Cancer Center in Tokyo. We analyzed data and classified radiological lesions into the following categories: calcifications, cavitations, low-density areas, margin irregularities, and satellite nodules.Results
The study population consisted of 328 patients (median age, 69 years). We found that 65.9% of patients had malignant lesions and 4.2% of patients had positive cultures for pathogenic bacteria. The number of calcifications (p = 0.002, 95% CI: 2.17–41.10) was significantly higher in patients with positive bacterial isolates, according to the multivariate analysis, and bacterial culture positivity was not associated with the development of respiratory complications after bronchoscopy. Of the three patients with respiratory complications, all presented with cavitations.Conclusion
Because of the low prevalence of positive bacterial cultures in patients with suspected lung cancer, bacterial culture may be limited to specific patients, such as those with calcifications. Lesions with cavitation warrant close monitoring. 相似文献18.
19.
Norichika Iga Hideyuki Nishi Nobukazu Fujimoto Takumi Kishimoto 《Respiratory investigation》2018,56(2):144-149
Background
Few studies have focused on the management of secondary spontaneous pneumothorax (SSP) as a complication of pneumoconiosis. The aim of this study was to investigate the clinical features and therapeutic course of SSP associated with silicosis.Methods
Between April 2005 and March 2015, 17 patients with silicosis underwent chest tube drainage for SSP in our institution. We retrospectively analyzed patient characteristics, type of treatment, clinical course, rate of recurrence, and survival time, and compared them with those of 30 patients diagnosed with chronic obstructive pulmonary disease (COPD) during the same period.Results
Fourteen patients with silicosis had performance status score ≥ 2 and modified Medical Research Council Grade ≥ 2; these were significantly different from those in patients with COPD (P = 0.047, P = 0.026). Patients with silicosis had a significantly longer duration of chest tube placement and hospital stay. Recurrent pneumothorax occurred in 47.1% of patients with silicosis, which was not significantly different from the proportion of patients with COPD (40.9%, P = 0.843). However, in the silicosis group, patients treated with chest tube drainage alone tended to have a higher rate of ipsilateral recurrence than those who had pleurodesis, although this was not statistically significant. The median overall survival time of patients with silicosis was 82.6 months, while that of patients with COPD was 104.1 months.Conclusions
Patients with silicosis had worse physical status and respiratory functions at the time of occurrence of pneumothorax than those with COPD. Pleurodesis could be an effective treatment for SSP complicating silicosis. 相似文献20.
Kathleen A. Clark J. Jay Flynn Wilfried J.J. Karmaus Lawrence C. Mohr 《The American journal of the medical sciences》2017,353(6):533-542