Hideo Kobayashi - Academia.edu (original) (raw)
Papers by Hideo Kobayashi
The American review of respiratory disease, 1988
The value of ultrasonic examination and ultrasonically guided needle biopsy (UGNB) of mediastinal... more The value of ultrasonic examination and ultrasonically guided needle biopsy (UGNB) of mediastinal masses was investigated in 45 patients. Fifteen of the masses were malignant and 30 were benign. The diagnoses were histologically confirmed by examination of surgical or autopsy specimens. Only teratoma could be confidently diagnosed by ultrasonography alone. Diagnosis of other types of mediastinal masses required examination of tissue samples. Using ultrasonically guided aspiration biopsy (UGAB), we were able to diagnose 13 of 15 malignant tumors and 18 of 27 benign mediastinal masses. Ultrasonically guided cutting biopsy was performed in conjunction with UGAB in 11 patients, and the diagnosis was histologically confirmed in 9 cases. Complications with UGNB occurred in only 1 case. Our results indicate that UGNB is a safe, simple technique that can be applied to most of the mediastinal masses. We believe that it is the method of choice in such cases.
Kekkaku Tuberculosis, May 1, 2010
Primary pulmonary Mycobacterium avium-intracellulare complex (MAC) disease was evaluated from the... more Primary pulmonary Mycobacterium avium-intracellulare complex (MAC) disease was evaluated from the viewpoint of chronological change. From 1993 to March 2009, 130 patients with primary-type MAC disease were divided into three groups according to the period of time when they were diagnosed as below, and compared between groups by retrospective review. Average numbers of cases per year were 5.12 patients in the 1st period (from 1993 to 2002), 10.98 in the 2nd period (from 2002 to 2006), 15.87 in the 3rd period (from 2006 to 2009). The number of cases per year gradually increased with time, while the percentage of females gradually decreased with time (84.1%, 74.4%, 69.8% for each period, p < 0.05). Patient BMIs (body mass indexes) showed an upward trend while CRP (C-reactive protein) and ESR (erythrocyte sedimentation rate) showed downward trends though these changes were not significant. Though primary-type MAC disease typically affects mid-elderly and slender women, the authors demonstrated that it is increasing among male and non-slender females. Changes in the clinical features of primary-type MAC disease over time were also observed.
Internal Med, 2005
A scaffold constructor lost consciousness at work, leading to emergency admission to our hospital... more A scaffold constructor lost consciousness at work, leading to emergency admission to our hospital. He had noted gradual worsening of exertional dyspnea over the previous 1 month. Chest radiography showed localized oligemia and enlarged hilar vessels. Pulmonary perfusion scintigraphy confirmed the existence of multiple perfusion defects, so a diagnosis of pulmonary thromboembolism was made. Upper and lower limb venography disclosed interruption of the right subclavian vein (so-called Paget-Schroetter syndrome). However, there was no difference in appearance between the right and left upper extremities. Five years after starting anticoagulant therapy, his symptoms have resolved, but serial perfusion scintigraphy and upper extremity venography revealed the persistence of abnormalities. In patients with pulmonary thromboembolism, lifestyle factors (especially heavy manual labor) should be considered and the possibility of subclavian vein thrombosis should be kept in mind.
Nihon Kokyūki Gakkai Zasshi the Journal of the Japanese Respiratory Society, May 1, 2004
We report a case of pulmonary thromboembolism, in which obstruction of the right subclavian vein,... more We report a case of pulmonary thromboembolism, in which obstruction of the right subclavian vein, also called Paget-von Schroetter syndrome, was detected. The patient was a 39-year-old man (a scaffold constructor). He lost consciousness at work, and was admitted as an emergency case to our hospital. He had noticed gradually worsening dyspnea for 1 month. Chest radiography showed Westmark's sign in the lungs and enlarged hilar vascular markings on both sides. Pulmonary perfusion scintigraphy confirmed multiple flow defects. Upper and lower limb venography disclosed interruption of the right subclavian vein, leading to a diagnosis of pulmonary thromboembolism secondary to upper limb vein thrombosis. In patients who have pulmonary thromboembolism without an apparent underlying disease, the lifestyle and work habits should be considered and the possibility of subclavian vein thrombosis should be kept in mind.
Biomarkers Biochemical Indicators of Exposure Response and Susceptibility to Chemicals, Jun 1, 2008
Serum surfactant protein (SP)-A offers a useful clinical marker for interstitial lung disease (IL... more Serum surfactant protein (SP)-A offers a useful clinical marker for interstitial lung disease (ILD). However, SP-A is occasionally elevated in non-ILD pulmonary patients. The present study was conducted to investigate factors that affect serum SP- A levels in respiratory medicine. Serum SP-A, serum SP-D, serum Klebs von den Lungen (KL)-6 and pulmonary function tests were evaluated in 929 patients (current smokers, n=255; ex-smokers, n=242; never-smokers, n=432) without ILD or pulmonary alveolar proteinosis. Serum SP-A was significantly higher in current smokers than in never- or ex-smokers (p<0.01 and p<0.05, respectively). Serum SP- A was significantly higher in chronic obstructive pulmonary disease (COPD) and pulmonary thromboembolism than in other diseases (p<0.01). Serum SP-A correlated positively with amount of smoking (p<0.01) and negatively with forced expiratory volume in 1 s/forced vital capacity (p<0.05). Serum SP-D and KL-6 were unaffected by smoking. Smoking should be taken into account when evaluating serum SP-A levels, and different baseline levels of serum SP-A should be established for smokers and non-smokers. Serum SP-A may also represent a useful marker for predicting COPD in the preclinical stage.
Bronchoscopic lung volume reduction (BLVR) for emphysematous lung diseases has attracted clinical... more Bronchoscopic lung volume reduction (BLVR) for emphysematous lung diseases has attracted clinical attention. We evaluated the newly developed procedure of BLVR performed by transbronchial infusion of autologous blood. The subjects were 4 patients with a mean age of 57 years with emphysematous lung diseases, consisting of 1 with emphysematous bulla, 1 with lymphangioleiomyomatosis and 2 with advanced emphysema. Informed consent was obtained from all patients, and the Institutional Review Board of Ethics approved the treatment protocol. Intervention was performed as follows: A catheter was inserted into the target area through a flexible bronchoscope under fluoroscopic guidance, and autologous blood followed by thrombin solution was infused via the catheter. This simple procedure was repeated to several different areas as necessary. This BLVR therapy was well tolerated in all 4 patients. There were no severe complications. Symptomatic improvement was noted in all patients. Spirometry showed a mean increase in FVC from 2.68 to 2.75L and FEV1 from 1.10 to 1.25 L, whereas body plethysmography showed a mean reduction in FRC from 5.09 to 4.75L and TLC from 7.18 to 6.80 L. No consistent change in D(Lco)/VA was observed. Arterial blood gas value and the 6-minute walk distance improved in 3 and 2 patients, respectively. This bronchoscopic approach is minimally invasive, easy and inexpensive. BLVR by injection of autologous blood appears to represent a good therapeutic option, and warrants further investigation.
Journal of Bronchology, 2002
JSME international journal, 1987
ABSTRACT
Journal of Thoracic Imaging, 1994
Lasers in Surgery and Medicine, 2000
Background and Objectives: Primary blast injury is produced by shock waves. Blast injuries to lun... more Background and Objectives: Primary blast injury is produced by shock waves. Blast injuries to lungs are extremely critical threats to survival, but their etiology is largely undefined. The majority of animal models for these injuries use explosive or complex experimental settings, limiting the laboratory study of blast injury. The aim of this study was to establish a small-animal model for blast injuries, using laser-induced stress waves (LISWs) with high controllability, high reproducibility, and easy experimental settings. Study Design/Materials and Methods: LISWs were used to produce isolated pulmonary blast effects in mice. An LISW was generated by the irradiation of an elastic laser target with 532-nm nanosecond laser pulses of a Q-switched Nd:YAG laser. Histopathological evaluations of damage to lung tissue were conducted to estimate the relevance between peak pressure and trauma intensity. Blood pressure, heart rate, and percutaneous oxygen saturation were monitored for 60 minutes. Results: We could flexibly control the peak pressure of the shock wave by varying the laser energy. Non-lethal doses of LISWs caused pulmonary contusions with alveolar hemorrhages depending on peak pressure. Pulmonary contusion was observed only in areas that were exposed to LISWs, allowing study of isolated injuries without concomitant ones. These injuries caused decreased blood pressure, heart rate, and percutaneous oxygen saturation, immediately after LISW exposure. Conclusion: Mice exposed to thoracic LISWs showed pathologic and physiologic changes similar to those seen in other studies in this area, and in clinical practice. Our newly developed model allows fine management of trauma intensity, and concomitant injuries of the exposed animals were limited. This novel mouse model of blast injury using LISWs is suitable for detailed studies of blast lung contusion and other blast injuries in the laboratory. Lasers Surg. Med. 42:313-318,
Internal Medicine, 1992
A 44-year-old female was admitted with the complaint of choking. On fiberbronchoscopic examinatio... more A 44-year-old female was admitted with the complaint of choking. On fiberbronchoscopic examination, multiple, polypoid lesions with a smooth surface were exhibited at the cervical trachea. Histological diagnosis was B-cell malignant lymphoma, diffuse, medium sized cell type (LSG classification). No other lesions were detected in the systemic evaluation. After combined chemotherapy and regional irradiation, the tumor disappeared. The clinical and pathological characteristics of this case are similar to those of malignant lymphoma of mucosa-associated lymphoid tissue (MALT).
European Journal of Nuclear Medicine and Molecular Imaging, 2000
The purpose of this study was to evaluate the effects of gravity and lung volume on regional pulm... more The purpose of this study was to evaluate the effects of gravity and lung volume on regional pulmonary perfusion using technetium-99m macroaggregated albumin ( 99m Tc MAA) single-photon emission tomography (SPET). Twenty-five subjects were classified into three groups according to their position during the injection of the tracer [11 subjects sitting, six supine and eight both supine and prone (S+P) positions]. All of these subjects were injected with the tracer during normal tidal breathing. In the S+P group, half of the tracer was injected while the subject was in each position. The remaining 11 subjects were classified into two groups according to their lung volume during the injection. Supine patients were instructed to hold their breath at residual volume (RV) (five subjects) or total lung capacity (TLC) (six subjects) while receiving the tracer injection. A region of interest with a ventrodorsal axis was defined in the centre of each lung. Profile curves were produced by plotting and normalizing the perfusion values as a percentage of the maximum value. The perfusion distributions for the sitting and S+P positions and at RV were relatively uniform. However, the distributions for the supine position and at TLC showed a gravitational influence [sitting vs TLC: 87.8%±10.4% vs 67.3%±8.7% for % maximum perfusion at +5 pixels from the midpoint of the upper lobe (P<0.00002)]. The gravity-related perfusion inhomogeneity was more prominent in the lower lobe than in the upper lobe. It is concluded that the physiological vertical gravitational gradient should be taken into consideration during the interpretation of lung SPET images. Preferably, patients should be injected with the tracer twice, once in the supine position and once in the prone position, while breathing normally. Alternatively, they may be injected with the tracer once while in the supine position and holding their breath at RV. Either of these protocols should ensure a uniform distribution of tracer.
Annals of Nuclear Medicine, 2002
Whole-body 2-fluoro-2-D-[ 18 F]deoxyglucose [FDG] positron emission tomography (WB-PET) may be mo... more Whole-body 2-fluoro-2-D-[ 18 F]deoxyglucose [FDG] positron emission tomography (WB-PET) may be more cost-effective than chest PET because WB-PET does not require conventional imaging (CI) for extrathoracic staging. Methods: The cost-effectiveness of WB-PET for the management of Japanese patients with non-small-cell lung carcinoma (NSCLC) was assessed. Decision-tree sensitivity analysis was designed, based on the two competing strategies of WB-PET vs. CI. WB-PET was assumed to have a sensitivity and specificity for detecting metastases, of 90% to 100% and CI of 80% to 90%. The prevalences of M1 disease were 34% and 20%. One thousand patients suspected of having NSCLC were simulated in each strategy. We surveyed the relevant literature for the choice of variables. Expected cost saving (CS) and expected life expectancy (LE) for NSCLC patients were calculated. Results: The WB-PET strategy yielded an expected CS of 951USto951US to 951USto1,493US per patient and an expected LE of minus 0.0246 years to minus 0.0136 years per patient for the 71.4% NSCLC and 34% M1 disease prevalence at our hospital. PET avoided unnecessary bronchoscopies and thoracotomies for incurable and benign diseases. Overall, the CS for each patient was 833USto833US to 833USto2,010US at NSCLC prevalences ranging from 10% to 90%. The LE of the WB-PET strategy was similar to that of the CI strategy. The CS and LE minimally varied in the two situations of 34% and 20% M1 disease prevalence. Conclusions: The introduction of a WB-PET strategy in place of CI for managing NSCLC patients is potentially cost-effective in Japan.
European Respiratory Journal, Sep 1, 2013
Number: 2206 Publication Number: P841 Abstract Group: 5.2. Monitoring Airway Disease Keyword 1: B... more Number: 2206 Publication Number: P841 Abstract Group: 5.2. Monitoring Airway Disease Keyword 1: Biomarkers Keyword 2: COPD -diagnosis Keyword 3: Smoking Title: Sputum biomarkers of inflammation in smokers and subjects with COPD Mrs. Jing
European Respiratory Journal, Sep 1, 2013
Number: 2206 Publication Number: P841 Abstract Group: 5.2. Monitoring Airway Disease Keyword 1: B... more Number: 2206 Publication Number: P841 Abstract Group: 5.2. Monitoring Airway Disease Keyword 1: Biomarkers Keyword 2: COPD -diagnosis Keyword 3: Smoking Title: Sputum biomarkers of inflammation in smokers and subjects with COPD Mrs. Jing
A 70-year-old man was admitted with a nodule adjacent to a cystic lesion in the right lower lung ... more A 70-year-old man was admitted with a nodule adjacent to a cystic lesion in the right lower lung field. Diagnosis of lung cancer was made by transbronchial biopsy. A series of chest radiographs revealed that a cystic lesion had presented 8 years before, and that a nodule appeared on the hilar side of the cyst 5 years later. The cyst may have been formed by the check-valve mechanism due to the lung cancer.
The American review of respiratory disease, 1988
The value of ultrasonic examination and ultrasonically guided needle biopsy (UGNB) of mediastinal... more The value of ultrasonic examination and ultrasonically guided needle biopsy (UGNB) of mediastinal masses was investigated in 45 patients. Fifteen of the masses were malignant and 30 were benign. The diagnoses were histologically confirmed by examination of surgical or autopsy specimens. Only teratoma could be confidently diagnosed by ultrasonography alone. Diagnosis of other types of mediastinal masses required examination of tissue samples. Using ultrasonically guided aspiration biopsy (UGAB), we were able to diagnose 13 of 15 malignant tumors and 18 of 27 benign mediastinal masses. Ultrasonically guided cutting biopsy was performed in conjunction with UGAB in 11 patients, and the diagnosis was histologically confirmed in 9 cases. Complications with UGNB occurred in only 1 case. Our results indicate that UGNB is a safe, simple technique that can be applied to most of the mediastinal masses. We believe that it is the method of choice in such cases.
Kekkaku Tuberculosis, May 1, 2010
Primary pulmonary Mycobacterium avium-intracellulare complex (MAC) disease was evaluated from the... more Primary pulmonary Mycobacterium avium-intracellulare complex (MAC) disease was evaluated from the viewpoint of chronological change. From 1993 to March 2009, 130 patients with primary-type MAC disease were divided into three groups according to the period of time when they were diagnosed as below, and compared between groups by retrospective review. Average numbers of cases per year were 5.12 patients in the 1st period (from 1993 to 2002), 10.98 in the 2nd period (from 2002 to 2006), 15.87 in the 3rd period (from 2006 to 2009). The number of cases per year gradually increased with time, while the percentage of females gradually decreased with time (84.1%, 74.4%, 69.8% for each period, p &amp;amp;amp;amp;amp;lt; 0.05). Patient BMIs (body mass indexes) showed an upward trend while CRP (C-reactive protein) and ESR (erythrocyte sedimentation rate) showed downward trends though these changes were not significant. Though primary-type MAC disease typically affects mid-elderly and slender women, the authors demonstrated that it is increasing among male and non-slender females. Changes in the clinical features of primary-type MAC disease over time were also observed.
Internal Med, 2005
A scaffold constructor lost consciousness at work, leading to emergency admission to our hospital... more A scaffold constructor lost consciousness at work, leading to emergency admission to our hospital. He had noted gradual worsening of exertional dyspnea over the previous 1 month. Chest radiography showed localized oligemia and enlarged hilar vessels. Pulmonary perfusion scintigraphy confirmed the existence of multiple perfusion defects, so a diagnosis of pulmonary thromboembolism was made. Upper and lower limb venography disclosed interruption of the right subclavian vein (so-called Paget-Schroetter syndrome). However, there was no difference in appearance between the right and left upper extremities. Five years after starting anticoagulant therapy, his symptoms have resolved, but serial perfusion scintigraphy and upper extremity venography revealed the persistence of abnormalities. In patients with pulmonary thromboembolism, lifestyle factors (especially heavy manual labor) should be considered and the possibility of subclavian vein thrombosis should be kept in mind.
Nihon Kokyūki Gakkai Zasshi the Journal of the Japanese Respiratory Society, May 1, 2004
We report a case of pulmonary thromboembolism, in which obstruction of the right subclavian vein,... more We report a case of pulmonary thromboembolism, in which obstruction of the right subclavian vein, also called Paget-von Schroetter syndrome, was detected. The patient was a 39-year-old man (a scaffold constructor). He lost consciousness at work, and was admitted as an emergency case to our hospital. He had noticed gradually worsening dyspnea for 1 month. Chest radiography showed Westmark's sign in the lungs and enlarged hilar vascular markings on both sides. Pulmonary perfusion scintigraphy confirmed multiple flow defects. Upper and lower limb venography disclosed interruption of the right subclavian vein, leading to a diagnosis of pulmonary thromboembolism secondary to upper limb vein thrombosis. In patients who have pulmonary thromboembolism without an apparent underlying disease, the lifestyle and work habits should be considered and the possibility of subclavian vein thrombosis should be kept in mind.
Biomarkers Biochemical Indicators of Exposure Response and Susceptibility to Chemicals, Jun 1, 2008
Serum surfactant protein (SP)-A offers a useful clinical marker for interstitial lung disease (IL... more Serum surfactant protein (SP)-A offers a useful clinical marker for interstitial lung disease (ILD). However, SP-A is occasionally elevated in non-ILD pulmonary patients. The present study was conducted to investigate factors that affect serum SP- A levels in respiratory medicine. Serum SP-A, serum SP-D, serum Klebs von den Lungen (KL)-6 and pulmonary function tests were evaluated in 929 patients (current smokers, n=255; ex-smokers, n=242; never-smokers, n=432) without ILD or pulmonary alveolar proteinosis. Serum SP-A was significantly higher in current smokers than in never- or ex-smokers (p&amp;amp;amp;amp;amp;lt;0.01 and p&amp;amp;amp;amp;amp;lt;0.05, respectively). Serum SP- A was significantly higher in chronic obstructive pulmonary disease (COPD) and pulmonary thromboembolism than in other diseases (p&amp;amp;amp;amp;amp;lt;0.01). Serum SP-A correlated positively with amount of smoking (p&amp;amp;amp;amp;amp;lt;0.01) and negatively with forced expiratory volume in 1 s/forced vital capacity (p&amp;amp;amp;amp;amp;lt;0.05). Serum SP-D and KL-6 were unaffected by smoking. Smoking should be taken into account when evaluating serum SP-A levels, and different baseline levels of serum SP-A should be established for smokers and non-smokers. Serum SP-A may also represent a useful marker for predicting COPD in the preclinical stage.
Bronchoscopic lung volume reduction (BLVR) for emphysematous lung diseases has attracted clinical... more Bronchoscopic lung volume reduction (BLVR) for emphysematous lung diseases has attracted clinical attention. We evaluated the newly developed procedure of BLVR performed by transbronchial infusion of autologous blood. The subjects were 4 patients with a mean age of 57 years with emphysematous lung diseases, consisting of 1 with emphysematous bulla, 1 with lymphangioleiomyomatosis and 2 with advanced emphysema. Informed consent was obtained from all patients, and the Institutional Review Board of Ethics approved the treatment protocol. Intervention was performed as follows: A catheter was inserted into the target area through a flexible bronchoscope under fluoroscopic guidance, and autologous blood followed by thrombin solution was infused via the catheter. This simple procedure was repeated to several different areas as necessary. This BLVR therapy was well tolerated in all 4 patients. There were no severe complications. Symptomatic improvement was noted in all patients. Spirometry showed a mean increase in FVC from 2.68 to 2.75L and FEV1 from 1.10 to 1.25 L, whereas body plethysmography showed a mean reduction in FRC from 5.09 to 4.75L and TLC from 7.18 to 6.80 L. No consistent change in D(Lco)/VA was observed. Arterial blood gas value and the 6-minute walk distance improved in 3 and 2 patients, respectively. This bronchoscopic approach is minimally invasive, easy and inexpensive. BLVR by injection of autologous blood appears to represent a good therapeutic option, and warrants further investigation.
Journal of Bronchology, 2002
JSME international journal, 1987
ABSTRACT
Journal of Thoracic Imaging, 1994
Lasers in Surgery and Medicine, 2000
Background and Objectives: Primary blast injury is produced by shock waves. Blast injuries to lun... more Background and Objectives: Primary blast injury is produced by shock waves. Blast injuries to lungs are extremely critical threats to survival, but their etiology is largely undefined. The majority of animal models for these injuries use explosive or complex experimental settings, limiting the laboratory study of blast injury. The aim of this study was to establish a small-animal model for blast injuries, using laser-induced stress waves (LISWs) with high controllability, high reproducibility, and easy experimental settings. Study Design/Materials and Methods: LISWs were used to produce isolated pulmonary blast effects in mice. An LISW was generated by the irradiation of an elastic laser target with 532-nm nanosecond laser pulses of a Q-switched Nd:YAG laser. Histopathological evaluations of damage to lung tissue were conducted to estimate the relevance between peak pressure and trauma intensity. Blood pressure, heart rate, and percutaneous oxygen saturation were monitored for 60 minutes. Results: We could flexibly control the peak pressure of the shock wave by varying the laser energy. Non-lethal doses of LISWs caused pulmonary contusions with alveolar hemorrhages depending on peak pressure. Pulmonary contusion was observed only in areas that were exposed to LISWs, allowing study of isolated injuries without concomitant ones. These injuries caused decreased blood pressure, heart rate, and percutaneous oxygen saturation, immediately after LISW exposure. Conclusion: Mice exposed to thoracic LISWs showed pathologic and physiologic changes similar to those seen in other studies in this area, and in clinical practice. Our newly developed model allows fine management of trauma intensity, and concomitant injuries of the exposed animals were limited. This novel mouse model of blast injury using LISWs is suitable for detailed studies of blast lung contusion and other blast injuries in the laboratory. Lasers Surg. Med. 42:313-318,
Internal Medicine, 1992
A 44-year-old female was admitted with the complaint of choking. On fiberbronchoscopic examinatio... more A 44-year-old female was admitted with the complaint of choking. On fiberbronchoscopic examination, multiple, polypoid lesions with a smooth surface were exhibited at the cervical trachea. Histological diagnosis was B-cell malignant lymphoma, diffuse, medium sized cell type (LSG classification). No other lesions were detected in the systemic evaluation. After combined chemotherapy and regional irradiation, the tumor disappeared. The clinical and pathological characteristics of this case are similar to those of malignant lymphoma of mucosa-associated lymphoid tissue (MALT).
European Journal of Nuclear Medicine and Molecular Imaging, 2000
The purpose of this study was to evaluate the effects of gravity and lung volume on regional pulm... more The purpose of this study was to evaluate the effects of gravity and lung volume on regional pulmonary perfusion using technetium-99m macroaggregated albumin ( 99m Tc MAA) single-photon emission tomography (SPET). Twenty-five subjects were classified into three groups according to their position during the injection of the tracer [11 subjects sitting, six supine and eight both supine and prone (S+P) positions]. All of these subjects were injected with the tracer during normal tidal breathing. In the S+P group, half of the tracer was injected while the subject was in each position. The remaining 11 subjects were classified into two groups according to their lung volume during the injection. Supine patients were instructed to hold their breath at residual volume (RV) (five subjects) or total lung capacity (TLC) (six subjects) while receiving the tracer injection. A region of interest with a ventrodorsal axis was defined in the centre of each lung. Profile curves were produced by plotting and normalizing the perfusion values as a percentage of the maximum value. The perfusion distributions for the sitting and S+P positions and at RV were relatively uniform. However, the distributions for the supine position and at TLC showed a gravitational influence [sitting vs TLC: 87.8%±10.4% vs 67.3%±8.7% for % maximum perfusion at +5 pixels from the midpoint of the upper lobe (P<0.00002)]. The gravity-related perfusion inhomogeneity was more prominent in the lower lobe than in the upper lobe. It is concluded that the physiological vertical gravitational gradient should be taken into consideration during the interpretation of lung SPET images. Preferably, patients should be injected with the tracer twice, once in the supine position and once in the prone position, while breathing normally. Alternatively, they may be injected with the tracer once while in the supine position and holding their breath at RV. Either of these protocols should ensure a uniform distribution of tracer.
Annals of Nuclear Medicine, 2002
Whole-body 2-fluoro-2-D-[ 18 F]deoxyglucose [FDG] positron emission tomography (WB-PET) may be mo... more Whole-body 2-fluoro-2-D-[ 18 F]deoxyglucose [FDG] positron emission tomography (WB-PET) may be more cost-effective than chest PET because WB-PET does not require conventional imaging (CI) for extrathoracic staging. Methods: The cost-effectiveness of WB-PET for the management of Japanese patients with non-small-cell lung carcinoma (NSCLC) was assessed. Decision-tree sensitivity analysis was designed, based on the two competing strategies of WB-PET vs. CI. WB-PET was assumed to have a sensitivity and specificity for detecting metastases, of 90% to 100% and CI of 80% to 90%. The prevalences of M1 disease were 34% and 20%. One thousand patients suspected of having NSCLC were simulated in each strategy. We surveyed the relevant literature for the choice of variables. Expected cost saving (CS) and expected life expectancy (LE) for NSCLC patients were calculated. Results: The WB-PET strategy yielded an expected CS of 951USto951US to 951USto1,493US per patient and an expected LE of minus 0.0246 years to minus 0.0136 years per patient for the 71.4% NSCLC and 34% M1 disease prevalence at our hospital. PET avoided unnecessary bronchoscopies and thoracotomies for incurable and benign diseases. Overall, the CS for each patient was 833USto833US to 833USto2,010US at NSCLC prevalences ranging from 10% to 90%. The LE of the WB-PET strategy was similar to that of the CI strategy. The CS and LE minimally varied in the two situations of 34% and 20% M1 disease prevalence. Conclusions: The introduction of a WB-PET strategy in place of CI for managing NSCLC patients is potentially cost-effective in Japan.
European Respiratory Journal, Sep 1, 2013
Number: 2206 Publication Number: P841 Abstract Group: 5.2. Monitoring Airway Disease Keyword 1: B... more Number: 2206 Publication Number: P841 Abstract Group: 5.2. Monitoring Airway Disease Keyword 1: Biomarkers Keyword 2: COPD -diagnosis Keyword 3: Smoking Title: Sputum biomarkers of inflammation in smokers and subjects with COPD Mrs. Jing
European Respiratory Journal, Sep 1, 2013
Number: 2206 Publication Number: P841 Abstract Group: 5.2. Monitoring Airway Disease Keyword 1: B... more Number: 2206 Publication Number: P841 Abstract Group: 5.2. Monitoring Airway Disease Keyword 1: Biomarkers Keyword 2: COPD -diagnosis Keyword 3: Smoking Title: Sputum biomarkers of inflammation in smokers and subjects with COPD Mrs. Jing
A 70-year-old man was admitted with a nodule adjacent to a cystic lesion in the right lower lung ... more A 70-year-old man was admitted with a nodule adjacent to a cystic lesion in the right lower lung field. Diagnosis of lung cancer was made by transbronchial biopsy. A series of chest radiographs revealed that a cystic lesion had presented 8 years before, and that a nodule appeared on the hilar side of the cyst 5 years later. The cyst may have been formed by the check-valve mechanism due to the lung cancer.