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Biomedical subjects

Y Monden

Publications and source records attributed to Y Monden.

At least 235 records · Page 13Linked to original sources

Primary tracheobronchial amyloidosis. A case report and review of reported cases.

A case of diffuse tracheobronchial amyloidosis in a 70-year-old woman thought clinically at first to have lung carcinoma is reported. Bronchoscopic biopsy was necessary to make a diagnosis. Amyloid was deposited markedly in the subepithelial layer. After Congo-red staining amyloid showed the usual apple-green birefringence under polarizing microscope. Electron microscopic study disclosed typical amyloid fibrillar structure. Amyloid protein of this patient was confirmed to be AL protein by immunoperoxidase study which showed specific staining by the anti-A lambda antiserum. When potassium permanganate reaction was used amyloid protein of this patient resisted to the reaction. We reviewed 19 cases from the previously reported cases of primary amyloidosis of the lower respiratory tract, and gave some description of pathologic and clinical aspects of this disease.

Aged↗

[A case of mediastinal parathyroid adenoma with primary hyperparathyroidism].

A 21-year-old man with a history of recurrent urolithiasis was admitted. Hypercalcemia was found and a diagnosis of primary hyperparathyroidism was made. Neck exploration was performed without success. Localization studies were done. Repeated selective arteriography revealed a mediastinal parathyroid adenoma. CT scan as well showed the adenoma in the anterior mediastinum. Ultrasonotomography, 201Tl-chloride and 131I scintigraphy with subtraction image and two venous samplings were negative. Mediastinal exploration with partial sternotomy was performed and a parathyroid adenoma was subsequently removed. Serum calcium and phosphorous levels were normalized, several postoperative days.

Adenoma↗

Functional indications for bullectomy of giant bulla.

Nineteen patients with giant bulla were followed for more than 1 year after bullectomy. They were divided into two groups according to their postoperative symptoms. Group 1 consisted of 16 patients who had no problems in their postoperative clinical course, while Group 2 included 3 patients who complained of severe dyspnea at 5 to 6 years of follow-up. Prior to operation, the forced expiratory volume in 1 sec over vital capacity (FEV1%) was 66.8 +/- in Group 1 and 27.6 +/- 5.4% in Group 2. Differences in preoperative and postoperative FEV1% were statistically significant within Group 1 and between the two groups. Postoperative FEV1% (Y) correlated significantly with preoperative FEV1% (X) (Y = 0.74X + 25.4; r = 0.836; p less than 0.001). Thus, we were able to predict the postoperative FEV1% from the preoperative value. Regional ventilation over volume was computed from the washout curve of xenon 133 after reaching equilibrium with rebreathing in a closed circuit (V/V dynamic). Group 2 had significantly lower regional ventilation over volume in all regions, both before and even after bullectomy, compared with normal subjects or Group 1 patients. Preoperative V/V dynamic was below 0.5 in all regions of Group 2. Furthermore, postoperative V/V dynamic (Y) correlated significantly with preoperative V/V dynamic (X) in the upper region (Y = 0.46X + 0.40; r = 0.638; p less than 0.02) and in the lower region (Y = 0.72X + 0.33; r = 0.869; p less than 0.001). We conclude that functional indications of bullectomy for giant bulla are that FEV1% should be greater than 40%, and that regional V/V dynamic should be greater than 0.5. On the other hand, symptomatic and functional improvement following bullectomy was reduced in patients whose FEV1% was less than 35% in whose V/V dynamic was remarkably disturbed in all regions of the involved hemithorax.

Adolescent↗

CT anatomy of hilar lymphadenopathy.

The normal distribution of lymph nodes in the pulmonary hili is diagrammatically shown, with a typical computed tomographic (CT) demonstration of hilar lymphadenopathy. On the basis of observations in anatomic cross sections of cadaver lungs, the lymph nodes in the right lung can be divided into four principal groups (right upper lobe, interlobar, middle lobe, and lower lobe) and in the left lung into three principal groups (left upper lobe, interlobar, and lower lobe). Most of the hilar lymph nodes are situated along the bronchi in close relation with the pulmonary vascular branches. Because of this close proximity, contrast-enhanced CT images are indispensable for precise CT interpretation of a hilar lymphadenopathy.

Humans↗