Department of Respiratory Medicine, Tohoku University Graduate School of Medicine

[Major target diseases]

[Content of clinical practice and characteristics]

Respiratory Medicine Department provides treatment for internal diseases related to the respiratory organs. In April 2012, the respiratory center was newly established on the 16th floors of the East and West buildings, and we now work hard to treat respiratory diseases in cooperation with the Department of Thoracic Surgery. The diseases are diverse, including obstructive pulmonary diseases like bronchial asthma and emphysema and neoplastic respiratory diseases like lung cancer, interstitial lung disease，and respiratory infection. In particular, we intend to offer the latest and safest clinical care for refractory respiratory diseases providing evidence-based standard treatment and participating in clinical studies.

• Chronic obstructive pulmonary disease (COPD): COPD is suspected when middle-aged and the elderly with a history of smoking complain of sputum and shortness of breath on exertion; the diagnosis is made by spirometry and/or chest image. We provide comprehensive medical care with inhalation of bronchodilators, pulmonary rehabilitation, nutrition therapy, and home oxygen therapy, as well as smoking-cessation counseling.
• Bronchial asthma: Asthma is characterized by wheezing during the night and early morning, and the diagnosis is based on the ratio of eosinophils in the sputum and spirometry. This disease is mainly treated by inhaled corticosteroids. We instruct the patients to perform peak flow monitoring, and also provide life guidance. For the patients with refractory diseases, we provide treatment with anti-IgE antibody drugs.
• Sleep apnea syndrome: Persons with complaints of snoring and/or daytime sleepiness are screened with a questionnaire and a simple examination and then the diagnosis is made by polysomnography. We offer respiratory control using CPAP.
• Neoplastic respiratory diseases: For inoperative patients, we provide treatment in a multidisciplinary way combining chemotherapy, radiotherapy, and/or palliative therapy. Concerning the molecule targeting agent, customized treatment by genetic diagnosis has been introduced.
• Interstitial lung disease：We provide medical care for idiopathic interstitial pneumonia from an unknown cause, interstitial pneumonia due to collagen disease, hypersensitivity pneumonitis due to inhalation of antigen in the living environment, and drug-induced pneumonia.
• Sarcoidosis: The condition is detected from an abnormality in the chest radiographs and/or uveitis noted in the Department of Ophthalmology. A series of examinations necessary for diagnostic criteria are conducted and treatment with steroids is provided as indicated.
• Peculiar inflammatory pulmonary disease: The latest treatment, such as GM-CSF inhalation therapy and sirolimus therapy, is provided to pulmonary alveolar proteinosis and pulmonary lymphangioleiomyomatosis, respectively.
• Respiratory infection: Mainly for patients in whom satisfactory results were not obtained with the early treatment, we provide medical care by diagnosing pathogenic microorganisms using bronchoscopy.