Predictors of smoking cessation during pregnancy among the women of Yamato and Ayase municipalities in Japan.

Cigarette smoking during pregnancy affects the unborn fetus. This study aimed to investigate: (1) the smoking status of pregnant women before, during and after pregnancy in the Yamato and Ayase municipalities, Kanagawa, Japan; (2) the characteristics that differentiate successful spontaneous smoking quitters from continuous smokers during pregnancy; and (3) the awareness of risks of smoking that may influence smoking cessation during pregnancy. A community-based, cross-sectional survey of 420 postpartum women, who delivered their babies from July 2002 to October 2002, was performed. Out of 420 respondents, 275 (65.4%) did not smoke before and during pregnancy. Of the 145 women who smoked before pregnancy, 101 (69.3%) quit successfully while pregnant. Smoking prevalence during pregnancy was 10.4%. Out of 101 successful quitters during pregnancy, 22 (21.8%) women resumed smoking after childbirth. A multiple regression analysis showed that the independent predictors of smoking cessation during pregnancy were primiparous women and women living with non-smokers in the household. Although maternal age predicted smoking cessation in a simple regression analysis, this predictive value was lost in the multiple analysis. A simple analysis showed no significant association between the awareness of smoking risks and smoking cessation during pregnancy. It is suggested that Japanese smokers are more likely to quit while pregnant than women in other countries. In the future, smoking cessation programmes should be designed to help multiparous women and women living with smokers to give up smoking.

Rapidly progressive interstitial lung disease associated with dermatomyositis responding to intravenous cyclophosphamide pulse therapy.

Interstitial lung disease, especially the rapidly progressive type, carries a grave prognosis when associated with polymyositis (PM)/dermatomyositis (DM). We describe a case of rapidly progressive interstitial lung disease associated with DM. Pathological findings included bronchiolitis obliterans organizing pneumonia (BOOP) pattern in the right upper lung lobe and interstitial fibrosis with microscopic honeycomb lesions in the right lower lung lobe. The patient's respiratory distress was severe and persistent, and oral intubation with mechanical ventilation was transitionally introduced. The respiratory distress condition responded to intravenous cyclophosphamide pulse therapy.

[Clinico-pathological analysis of airway abnormalities in patients with chronic eosinophilic pneumonia].

Chronic eosinophilic pneumonia is characterized by infiltration of eosinophils into alveolar spaces. Patients with this condition may also have asthmatic episodes, chronic coughing, and bronchorrhea, even after the infiltrative opacity on the chest roentgenogram resolves. We used computed tomography, pulmonary function tests, and biopsies to evaluate the airways of 11 patients with chronic eosinophilic pneumonia. The tomograms showed bronchial wall thickening in all patients at the time of the onset of symptoms and ten months later. Centrilobular peribronchovascular interstitial thickening was detected in four patients, 10 months after the onset. Pulmonary function tests showed that small airway dysfunction remained 13 months after the onset. Pathological analysis revealed airway abnormalities that included basement membrane thickening and cellular infiltration 2 years after the onset. These results show that airway changes had not resolved even after roentgenographic opacities had disappeared. More attention should be given to treatment of airway disease associated with chronic eosinophilic pneumonia, and to whether these changes in the airway are similar to those seen in bronchiolitis obliterans organizing pneumonia.

[Clinical value of 67gallium single photon emission tomography].

To evaluate the clinical utility of 67gallium single photon emission tomography (SPECT), we prospectively compared 67Ga SPECT with gallium planar views and with compared tomography in 94 patients with diffuse lung diseases. Differences in the accumulation of gallium between slices and between the left and right sides of a single slice were easier to detect with 67Ga SPECT than with planar views. Three-dimensional information regarding accumulation was also obtained by SPECT. Information regarding active inflammation was more difficult to obtain by computed tomography than by SPECT. Diagnosing diffuse lung diseases will be easier with the introduction of gallium SPECT.