[An analysis of nutritional status and pulmonary hypertension in patients with sequela of pulmonary tuberculosis and chronic obstructive pulmonary disease].

The prognostic value of hypercapnia and/or pulmonary hypertension differs in patients with sequela of pulmonary tuberculosis (TBseq) and those with chronic obstructive pulmonary disease (COPD) who are receiving home oxygen therapy (HOT). In an attempt to identify the factors, if any, that might explain this difference, we first compared nutritional status, respiratory function test results, dyspnea indexes, and other data for hypercapnic patients (PaCO2 > or = 45 Torr) and normocapnic patients (PaCO2 < 45 Torr) receiving HOT. Second, we examined the relationship between the degree of pulmonary hypertension and several respiratory function parameters for patients in each disease category. In 44 patients with TBseq, nutritional status estimated by body mass index and serum albumin was significantly better in the hypercapnic patients than in the normocapnic patients. However, this difference was not observed in 37 patients with COPD. In 30 patients with TBseq, the degree of pulmonary hypertension correlated significantly only with PaO2; in 32 patients with COPD, however, significant correlations were observed not only with PaO2 but also with PaCO2, %VC, and FEV1. These differences distinguishing groups of patients with the 2 diseases may provide an explanatory basis for the difference in prognostic value of hypercapnia and/or pulmonary hypertension in patients receiving HOT.

[A case of primary endobronchial mucosa-associated lymphoid tissue lymphoma with middle lobe atelectasis].

A 60-year-old woman was admitted for evaluation of an abnormal shadow in her chest X-ray. A chest roentgenogram revealed middle lobe atelectasis and a tomogram showed masses mainly in the right intermediate bronchus. In bronchoscopy, the bronchus was severely narrowed by irregularly surfaced masses. Microscopic examinations of transbronchial biopsy specimen showed the mucosal and submucosal tissue diffusedly infiltrated mainly by lymphocytes composed of small lymphocytes, centrocyte-like cells and monocytoid cells. The B-cell origin was suggested by a positive L-26 stain. Monoclonality of lymphocytes was proven by Southern blot analysis and in situ hybridization. The diagnosis was primary endobronchial lymphoma of mucosa-associated lymphoid tissue. The case was treated with chemotherapy protocol (CAMBO-VIP) and has been in complete remission for 20 months.

[Clinical experience of therapeutic use of cefmetazole (cefmetazon) or bronchopneumonia (author's transl)].

1. Therapeutic effects of cefmetazole (cefmetazon, CMZ) were examined in 22 cases of bronchopneumonia. 2. Among the 22 cases, 17 cases (77%) showed better response than 'effective'. However, 10 cases (91%) showed better response than 'effective' if a daily of 4 g (11 cases) was taken into consideration. 3. No particular symptomatic side effect of CMZ was shown. Abnormality in such laboratory tests as transaminase (1 case of GOT, and 2 cases of GPT) and 1 case of alkaline phosphatase were observed, and the abnormality was ascribable to CMZ administration.

Comparison between pulmonary emphysema and chronic bronchitis: an assessment by selective alveolo-bronchography.

In order to elucidate the interrelationship between pulmonary emphysema and chronic bronchitis, 23 adult patients with chronic obstructive pulmonary disease were examined during life by selective alveolo-bronchography. They were classified according to radiologic criteria as centrilobular or panlobular emphysema or chronic bronchitis and according to clinical criteria as A, B or X types. A and B clinical types proposed by Burrows and Fletcher were almost in agreement respectively with emphysema and chronic bronchitis based on x-ray criteria. However, no correlation between A-type and panlobular emphysema or between B-type and centrilobular emphysema were observed. Centrilobular emphysema was diagnosed in 4 patients who had no history of findings of bronchitis. This suggests that inflammation of airways is not necessarily a cause of centrilobular emphysema. As a result, selective alveolo-bronchography was thought to be useful method to diagnose the type and severity of emphysema.