75-year-old man had the right lower lobe resected because of pulmonary adenocarcinoma (stage IIB) and received 4 courses of postoperative chemotherapy 4 years earlier. Thereafter, he continued to complain of cough, sputum, and progressive exertional breathlessness. The preoperative chest CT showed ground glass opacity (GGO) at the bottom of both lung fields, and over time the GGO changed to honeycombing with traction bronchiectasis. He was administered prednisolone, clarithromycin, and pirfenidone but with little improvement. He exhibited hypoxemia (PaO₂ 56 mmHg) and was admitted. An interview revealed that he had worked in the poultry farming business for 45 years having had contact with and breeding 3,000 game fowl at the time of hospitalization. We suspected bird-related hypersensitivity pneumonitis. Results of the reaction to pigeon dropping extracts (PDE) were high, with PDE IgG 0.697 and PDE IgA 0.445. He was diagnosed with chronic bird-related hypersensitivity pneumonitis. Although the chest CT appearance was difficult to distinguish from that of idiopathic interstitial pneumonia, the test for PDE and the interview were useful for reaching a diagnosis.

The purpose of this study was to evaluate the osteogenesis ability of osteogenic matrix cell sheets (OMCS) derived from old donor cells. Bone marrow stromal cells (BMSC) were obtained from young (7-week-old) and old (1-year-old) Fischer344 rats donors and cultured with modified Eagle's medium (MEM group) alone or containing dexamethasone (Dex; 10 nM) and ascorbic acid phosphate (AscP; 0.28 mM) (Dex/AscP group). We prepared four in vitro experimental groups: (1) young MEM, (2) young Dex/AscP, (3) old MEM and (4) old Dex/AscP. Cell proliferation and osteogenic marker mRNA expression levels were evaluated in vitro. To assess bone formation in vivo, the cells of each group were combined with beta tricalcium phosphate (TCP) disks followed by implantation in recipient rats. The in vitro study showed significant differences in the mRNA expression of osteocalcin, ALP, and BMP2 between MEM and Dex/AscP groups. Bone formation following implantation was observed upon histological analyses of all groups. TCP combined with OMCS (OMCS/TCP group) resulted in enhanced bone formation compared to that following combination with BMSC (BMSC/TCP). The osteocalcin content of the OMCS/TCP group 4 weeks after implantation was significantly higher than that in the BMSC/TCP construct for both young and old donors. The present study clearly indicated that OMCS could be generated from BMSCs of old as well as young donors using a mechanical retrieval method. Thus, through its usage of OMCS, this method may represent a potentially effective therapeutic option for cell-based therapy in elderly patients.
Aged ; Animals ; Ascorbic Acid ; Bone and Bones ; Bone Marrow ; Cell Proliferation ; Dexamethasone ; Humans ; In Vitro Techniques ; Mesenchymal Stromal Cells ; Methods ; Osteocalcin ; Osteogenesis ; Rats ; RNA, Messenger ; Tissue Donors

Central venous lesions are suspected in dialysis patients who present with increased venous pressure and severe swelling of the shunt arm. Here, we report a case where contrast computed tomography (CT) was useful for diagnosis. Iopamidol 300 (20 mL) was diluted 2-fold, 30 mL of which was injected into the vein in the shunt arm at 2.0 mL/s. Imaging was started 10 s later. Fixed stenosis caused by intimal proliferation can be assessed just as effectively using contrast CT and shunt angiography. However, contrast CT is more useful than shunt angiography in the assessment of stenosis due to compression by surrounding organs and lesions, because the position of vessels relative to surrounding organs can be depicted. Contrast CT allows for safer and shorter examination compared with shunt angiography, and the diagnostic performance of a single examination can be improved using 3-dimensional reconstruction (3D) and multiplanar reformation images. Precise information obtained using contrast CT will contribute to safe and effective percutaneous transluminal angioplasty.