A 76-year-old man was admitted to our hospital because of dyspnea. Three years before admission, dyspnea was recognized and had been given a diagnosis of interstitial pneumonia by a general ...physician. A year later, he received home oxygen therapy. After admission, we found that he had alcoholic liver cirrhosis and an increased alveolar-arterial oxygen level in his arterial blood gas. Moreover, he had an intrapulmonary vascular shunt, detected by contrast-enhanced echocardiography and perfusion scan with 99mTc-macroaggregated albumin. These results confirmed hepatopulmonary syndrome. Furthermore, exhaled nitric oxide (NO) was elevated in the patient although he had never had bronchial asthma or any other allergic diseases. Animal models of hepatopulmonary syndrome have shown that exhaled NO is associated with dilated vessels. To the best of our knowledge, this paper describes the first case of hepatopulmonary syndrome with elevated exhaled NO in Japan.
We present 3 cases of rapidly progressive interstitial pneumonia (RPIP) associated with clinically amyopathic dermatomyositis (C-ADM) that were treated with two courses of direct hemoperfusion with ...polymyxin B-immobilized fiber column (PMX-DHP). Despite initial treatment with high-dose corticosteroids, pulsed cyclophosphamide, and cyclosporine, the lung disease and hypoxemia deteriorated in all the patients. After PMX-DHP treatment, the PaO
2
/FiO
2
ratio and serum LDH and KL-6 were improved, the abnormal shadows in chest high-resolution computed tomography (HRCT) scans gradually decreased, and, finally, all patients survived. These findings indicate that PMX-DHP treatment could be effective in the management of RPIP in patients with C-ADM in combination with conventional therapy.
Background/Objective: Nutrition therapy is essential for continuing effective weight loss in obese patients who have undergone laparoscopic sleeve gastrectomy (LSG); however, in a clinical setting, ...quite a few patients have been unable to adequately execute diet therapy. To understand the barriers to accomplishing nutrition therapy after LSG in obese patients, we evaluated the caloric intake, nutritional value, and changes in the amounts and preferences of various foods. Method: The Brief-type Self-administered Diet History Questionnaire (BDHQ) was performed before LSG and 6, 12 and 18 months after in 6 obese patients with type 2 diabetes. Results: The percentage of the caloric intake loss calculated from the BDHQ at 18 months after LSG was 28.1±22.6 %. The ratios of protein and fat calories to the total caloric intake were significantly increased, whereas that of carbohydrates was significantly decreased. Of note, although the analysis of food preference shows that the intakes of rice/bread/noodles, high-fat foods and vegetables were significantly decreased, the snack intake, including both sweet and salty foods, versus the total caloric intake was not significantly changed. Conclusion: These results suggest that obese patients seem to retain skewed food preferences after undergoing LSG.
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