Bronchial Schwannoma Masquerading as Cause of Hemoptysis in a Patient with Pulmonary Embolism / General Medicine

A 78-year-old woman who had a history of left deep venous thrombosis was referred to our hospital with a sudden hemoptysis. Thoracic computed tomography showed a solitary pulmonary nodule in the right lower lobe. Based on her medical history of deep venous thrombosis, she was tentatively diagnosed as having pulmonary embolism and successfully treated by inserting an inferior vena cava filter and anticoagulant therapy with warfarin [Please confirm whether previous sentence is correct]. However, the lung nodule on thoracic computed tomography was still depicted four months later. With suspicion of a malignant tumor, including possible lung cancer, a right segmentectomy was performed. Pathological assessment of the resected specimen showed the tumor was derived from the right bronchial wall, but was not ruptured into the intratracheal lumen, as well as coexistence with intraalveolar hemorrhage near the tumor. The lung nodule was diagnosed as bronchial schwannoma. Thus, the origin of the hemoptysis was found to be pulmonary embolism due to deep vein thrombosis, and not by bronchial schwannoma, which was also present in the lung.

Effect of Boi-Ogi-to Administration for Osteoarthritis of the Knee. A clinica study of "frog abdominal symptom" / 日本東洋医学雑誌

Boi-ogi-to is frequently prescribed to relieve pain for osteoarthritis in the therapy of Kampo formulation. However, it has been pointed out that the evaluation of this formulation differs among the patients. It is often showed lower effectiveness and/or non-effectiveness in the patients with advanced roentgenographic deformity, obesity, and suffering from more severe pain.<br>We thought that it was resulted from ingoring the abdominal-sho (symptom). Therefore, in this study, we defined the abdominal-sho of Boi-ogi-to as “frog abdominal-sho”, and administered Boi-ogi-to to 17 patients with osteoarthritis of the knee who had frog abdominal sho. As a result, in the patients with frog abdominal-sho, the formulation was moderately or even better effective in relieving pain in 77% of these patients. It was acknowledged that the effect was independent of the severity of pain, the degree of obesity, and whether the roentgenographic deformity was slight or moderate.