High-resolution CT findings of patients with pulmonary nocardiosis

High-resolution CT findings of patients with pulmonary nocardiosis


http://www.jthoracdis.com/article/view/637

Naoki Tsujimoto, Takeshi Saraya, Ken Kikuchi, Saori Takata, Yasuyuki Kurihara, Sayuki Hiraoka, Hiroshi Makino, Shota Yonetani,
Koji Araki, Haruyuki Ishii, Hajime Takizawa, Hajime Goto

Abstract
Background: Opportunistic pulmonary infection with Nocardia species is rare in humans, and only a few studies have radiologically analyzed patients with pulmonary nocardiosis using high-resolution computed tomography (HRCT).
Methods: We retrospectively reviewed the medical records of patients with pulmonary nocardiosis at our hospital between April 2006 and December 2011 to assess HRCT and clinical findings.
We also searched the medical literature for pulmonary nocardiosis reported in Japan between 2002 and 2011 for comparison.
Results: We identified seven patients at our institution and 33 reported infections in Japan. Four of our patients were immunocompetent, whereas the other three had impaired cellular immunity due to type 2 diabetes mellitus or having been inappropriately treated with steroid. Thoracic HRCT revealed no zonal predominance, but tropism for distribution from the middle to the peripheral area, and radiological findings of nodules, cavitation, mass, consolidations, bronchial wall thickening, septal line thickening and ground glass opacity (GGO) were evident. The main HRCT finding in our study comprised nodules (n=5, 71.4%) <30 mm and four patients had multiple nodules as described in other reports. Furthermore, we discovered a crazy paving appearance (CPA) around nodules, cavities, masses or consolidations in five patients (71.4%).
Conclusions: Multiple nodules distributed from the middle to the peripheral area on HRCT might reflect pulmonary nocardiosis, and CPA seemed to be a worth paying attention to the diagnosis.

Guillain-Barré syndrome

Guillain-Barré syndrome in two patients with respiratory failure and a review of the Japanese literature

http://www.jthoracdis.com/article/view/640

Erei Sohara, Takeshi Saraya, Kojiro Honda, Atsuko Yamada, Toshiya Inui, Yukari Ogawa, Mitsuru Sada,
Naoki Tsujimoto, Masuo Nakamura, Akiko Tsuchiya, Masaki Saito, Chizuko Oishi, Atsuro Chiba,
Hajime Takizawa, Hajime Goto

Abstract
We described two patients with Guillain-Barré syndrome and respiratory failure with or without mechanical ventilation. Case 1 was a 44-year-old man who treated as pneumonia under mechanical ventilation for a month and transferred to our hospital with unsuccessful weaning trials because of phrenic nerve palsy. Case 2 was a 74-year-old man who presented with aspiration pneumonia because of bulbar palsy. The present two cases with review of the Japanese literature showed that antecedent infection with initial symptoms within the most recent 5 to 46 days is a clinical clue to the diagnosis even in patients with Guillain-Barré syndrome accompanied by respiratory failure.

Malignant peritoneal mesothelioma

http://www.jthoracdis.com/article/view/489

A case of malignant peritoneal mesothelioma revealed with limitation of PET-CT in the diagnosis of thoracic metastasis

Author Takeshi Saraya, Takuma Yokoyama, Haruyuki Ishii, Yasutaka Tanaka, Naoki Tsujimoto, Yukari Ogawa, Erei Sohara,
Akira Nakajima, Toshiya Inui, Hiraoka Sayuki, Masachika Fujiwara, Teruaki Oka, Riken Kawachi, Tomoyuki Goya, Hajime Takizawa, Hajime Goto


Abstract
A 47-year-old man was referred to our hospital because of a 2-month history of dry cough, 2-kg weight loss, and a feeling of abdominal fullness. The PET-CT scan depicts the intense standard uptake values (SUVs) of the anterior and subphrenic lymphnodes, and intraperitoneal cavity, especially in the omentum, while, no uptake was found in the pleural cavity. Based on the pathological findings of the open lung biopsy specimens, he was diagnosed with malignant peritoneal mesothelioma of epithelioid type with thoracic metastasis. The present case demonstrated the some of the limitations of PET-CT in the diagnosis of malignant mesothelioma, which failed to detect pleural involvement despite aggressive invasion by this tumor.

MP Extract Induces an IL-17-Associated Inflammatory Reaction in Murine Lung: Implication for MP

http://www.ncbi.nlm.nih.gov/pubmed/23001692

Inflammation. 2012 Sep 22. [Epub ahead of print]
Mycoplasma pneumoniae Extract Induces an IL-17-Associated Inflammatory Reaction in Murine Lung: Implication for Mycoplasmal Pneumonia.

Kurai D, Nakagaki K, Wada H, Saraya T, Kamiya S, Fujioka Y, Nakata K, Takizawa H, Goto H.

Department of Respiratory Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan.

Abstract
Mycoplasma pneumoniae (Mp) may cause immune cell reactions as pivotal aspects of this clinically common respiratory pathogen. Our aim is to determine if Mp extract induces a cellular immune response associated with interleukin (IL)-17, leading to lung inflammation and lung injury. BALB/c mice were immunized with Mp extract intraperitoneally followed by its intratracheal administration, to mimic repeated Mp infection found in humans (repeated inoculation, RI group). Those with a single inoculation were compared as single inoculation group (SI group). Analysis of bronchoalveolar lavage fluid (BALF) demonstrated that keratinocyte-derived cytokine, tumor necrosis factor-α, and IL-6 were produced and peaked on days 0.5 or 1, followed by IL-17 on day 2. Levels of these mediators in BALF were higher in RI group than SI group (P < 0.05). Further, significantly more neutrophils were recruited to the lungs of the RI group (P < 0.05). These observations suggest that IL-17 is involved in the prolonged induction of neutrophils in mice treated with Mp extract.

Pulmonary actinomycosis diagnosed by VATS with a growing fungus ball within a small cavity

Pulmonary actinomycosis diagnosed by video-assisted thoracic surgery with a growing fungus ball within a small cavity

http://journal.kyorin.co.jp/journal/ajrs/detail.php?-DB=jrs&-recid=16658&-action=browse

Ichiro Hirukawa, Takeshi Saraya, Ryota Tanaka, Masachika Fujiwara,
Haruyuki Ishii and Hajime Goto

Department of Respiratory Medicine, Kyorin University School of Medicine
Department of Surgery, Kyorin University School of Medicine
Department of Pathology, Kyorin University School of Medicine