[en] To clarify clinical pictures of diffuse panbronchiolitis (DPB), many clinical examinations, including aerosol inhalation scintigraphy and aerosol inhalation cinescintigraphy, were conducted on 15 cases. 1. Clinical symptoms, together with chest X-rays, chest CT, bronchoscopy and bronchography, indicated damage to respiratory bronchioles and severe, widespread bacterial inflammation in the central airways. 2. The deposition pattern of inhaled areosols showed unhomogeneous distribution and widespread hot spots in all the cases of DPB, while healthy controls showed homogenous distribution. In addition, the distribution of hot spots showed mainly peripheral patterns in DPB. It is suggested that these abnormal distributions of inhaled aerosol were caused by extensive inflammatory changes of the central airways. 3. According to serial observation by aerosol inhalation cine-scintigraphy, mucociliary tracheal transports of aerosol-bolus were to the cephalad side and smooth in healthy controls, but no transports were observed in 14 cases of DPB. In one other case of DPB, it was observed that the transport of aerosol was caused only by coughing. The above data could prove clearly that DPB patients have had the worst impairment of mucociliary clearance of airways and chronic bacterial inflammatory changes. (author)

[en] In this paper we report our recent experience indicating usefulness of ⁶⁷Ga-citrate scintigraphy in 4 cases with inflammatory pulmonary diseases. These cases showed abnormal pulmonary ⁶⁷Ga uptake with normal chest radiographs. The first case with malignant lymphoma and the second one with lung cancer suffered from pulmonary infection following secondary immuno-insufficiency due to radiotherapy and chemotherapy. Pneumocystis carinii was suspected as causative agent in the first case, and gram negative bacilli in the second case. The third case with lung cancer developed radiation pneumonia after radiotherapy. The fourth case with acute bronchitis developed drug induced interstitial pneumonia presumably due to minocycline administration. It is concluded that ⁶⁷Ga-citrate scintigraphy is more sensitive for early detection of interstitial pneumonia than routine chest radiography. (author)

[en] ⁶⁷Ga uptake was studied in 61 cases of diffuse pulmonary diseases; 13 silicosis (Si), 11 asbestosis (As), 9 idiopathic interstitial pneumonia (IIP), 4 collagen disease (Col. IP), 2 hypersensitivity pneumonia (HP), 9 hilum type sarcoidosis (Sar.H), 4 pulmonary type sarcoidosis (Sar.P), 2 histiocytosis X (HX), 7 diffuse panbronchiolitis (DPB). High uptake was observed in patients with Si and Sar.P, moderate uptake in patients with Sar.H. Higher concentration of ⁶⁷Ga was observed in Col.IP than in IIP. Remarkably high concentration of ⁶⁷Ga was observed in one case of HP although we had examined only a couple of cases. In comparison to Japanese classification of radiographs of the pneumoconiosis, higher concentration of ⁶⁷Ga was observed in Category 3 and 4 than in Category 1 and 2 as to the patients with Si, but no relationships were found in concentration among the patients with As. As to the patients with IIP ⁶⁷Ga uptake was higher in radiological Type II (granular and ring-like shadow) than in radiological Type I (granular shadow). Thus in the present contribution. ⁶⁷Ga scintigram was proved to be useful in differential diagnosis and estimating the activity of every diffuse pulmonary disease, such activity is usually hard to be estimated by radiological findings. (author)

[en] Mucociliary transport and cough effect were studied in 10 healthy controls and 116 patients with respiratory diseases using aerosol inhalation cine-scintigraphy which permits visualization of the movement of inhaled aerosols. Additionally, the effectiveness of β-adrenergic stimulant on mucociliary transport was evaluated in 8 normal cases by this method. 1. In healthy controls, the aerosol-bolus moved to the cephalad side rapidly and smoothly in the main bronchus and the trachea, but in many cases of respiratory diseases, we recognized various abnormal patterns such as slow movement, spiral movement, regurgitation etc. We consider that the bolus movements can be used as an index of the mucociliary transport. 2. We found low grade abnormality of bolus movement in cases of atopic bronchial asthma, pulmonary emphysema, silicosis, interstitial pneumonia and asbestosis, but high grade abnormality in cases of bronchiectasis, pulmonary emphysema with chronic bronchitis, mixed or infectious bronchial asthma, chronic bronchitis and especially acute pulmonary infection and diffuse panbronchiolitis. Normal patterns were observed in atopic asthma patients in remission, but abnormal patterns in cases of attack. With larger daily volumes of sputum, the bolus movements showed higher greater abnormality. 3. Bolus movements by coughing were seen most frequently in patients who had produced moderate volumes of sputum and in whom the bolus had stopped at the first carina. Bolus movements by coughing were classified into three groups: expectoration, cephalad movement that stopped halfway, and regurgitation. When the bolus was in the trachea, especially located on the oral side, we observed that expectoration by coughing was more effective. Patients with obstructive pulmonary diseases had lower effciency of expectoration by coughing. 4. We confirmed that terbutaline (β-adrenergic stimulant) accelerated the mucociliary transport. (author)

[en] Aerosol inhalation cine-scintigraphy which is a new method for estimation of mucociliary clearance, was studied in patients with diffuse panbronchiolitis (DPB), pulmonary emphysema (PE), chronic bronchitis (CB) and normal controls. The deposition pattern of inhaled aerosols showed mainly a central pattern in PE, but mainly a peripheral pattern in DPB. According to serial observation of inhaled aerosols by cine-scintigraphy, tracheal transport of aerosol-bolus was in a cephalad direction and moved smoothly in normal controls, but transport was slow, zigzag and sometimes regurgitant in patients with PE and CB. Especially, no transport was observed in patients with DPB. Therefore, the authors considered that DPB had the worst impairment of mucociliary clearance, because of both ciliary abnormality and rheological disorders, in the diseases of respiratory tract. (author)