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論文
Hara, Johsuke ; Fujimura, Masaki ; Ohkura, Noriyuki ; Sakai, Tamami ; Yamamura, Kenta ; Abo, Miki ; Koba, Hayato ; Watanabe, Satoshi ; Yoneda, Taro ; Nishikawa, Shingo ; Sone, Takashi ; Kimura, Hideharu ; Ishiura, Yoshihisa
出版情報: Experimental Lung Research.  43  pp.240-248,  2017-08-09.  Taylor and Francis Ltd
URL: http://hdl.handle.net/2297/48569
概要: Background: We demonstrated that heightened cough response to bronchoconstriction is a fundamental feature of cough vari ant asthma (CVA). To evaluate this physiological feature of CVA in daily clinical practice, it is necessary to clarify the cough response to bronchoconstriction in healthy subjects. We evaluated cough response to methacholine (MCh)-induced bronchoconstriction in healthy subjects. A forced oscillometry technique was used to measure airway resistance changes with Mch. Methods: Healthy never-smokers (21 men, 20 women; mean 22.3 ± 3.7 years) participated. None had a >3-week cough history, clinically significant respiratory or cardiovascular disorders, or disorders that might put subjects at risk or influence the study results or the subjects’ ability to participate. Twofold increasing concentrations of Mch chloride diluted in phosphate-buffered saline (0.039 to 160 mg/mL) were inhaled from nebulizers at 1-minute intervals during subjects’ tidal breathing after the baseline respiratory resistance (Rrs) was recorded. Mch inhalation continued until Rrs reached twice the baseline value and forced expiratory volume in 1 second (FEV1) decreased to <90% of baseline value. Spirometry was measured before Mch inhalation and immediately after Rrs had increased twofold. Coughs were counted during and for 30 minutes after Mch inhalation. The cough reflex sensitivity to capsaicin was also examined. Results: The number of coughs was 11.1 ± 14.3 (median, 7.0; range, 0 to 71; reference range, 0 to 39.7). There was no significant difference in the cough response between the sexes. The reproducibility of the cough response to bronchoconstriction was sufficient. No correlation existed between the bronchoconstriction-induced cough response and capsaicin cough-reflex sensitivity. Conclusions: Using the Astograph method, cough response to bronchoconstriction could be measured easily, safely and highly reproducibly in healthy subjects. © 2017 Taylor & Francis<br />Embargo Period 12 months 続きを見る
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Higashi, Tomomi ; Ohkura, Noriyuki ; Fujimura, Masaki ; Nakai, Satoshi ; Honda, Yasushi ; Saijoh, Kiyofumi ; Hayakawa, Kazuichi ; Kobayashi, Fumihisa ; Michigami, Yoshimasa ; Olando, Anyenda Enoch ; Hitomi, Yoshiaki ; Nakamura, Hiroyuki ; 東, 朋美 ; 大倉, 徳幸 ; 藤村, 政樹 ; 西條, 淸史 ; 早川, 和一 ; 小林, 史彦 ; 道上, 義正 ; 人見, 嘉哲 ; 中村, 裕之
出版情報: Atmospheric Environment.  97  pp.544-551,  2014-11-01.  Elsevier Ltd
URL: http://hdl.handle.net/2297/00049597
概要: 金沢大学医薬保健研究域医学系<br />Asian dust, known as kosa in Japanese, is a major public health concern. In this panel study, we eva luated the effects of exposure to kosa on daily cough occurrence. The study subjects were 86 patients being treated for asthma, cough variant asthma, or atopic cough in Kanazawa University Hospital from January 2011 to June 2011. Daily mean concentrations of kosa and spherical particles were obtained from light detection and ranging (LIDAR) measurements, and were categorized from Grade 1 (0 μg/m3) to 5 (over 100 μg/m3). The association between kosa and cough was analyzed by logistic regression with a generalized estimating equation. Kosa effects on cough were seen for all Grades with potential time lag effect. Particularly at Lag 0 (the day of exposure), a dose-response relationship was observed: the odds ratios for Grades 2, 3, 4, and 5 above the referent (Grade 1) were 1.111 (95% confidence interval (CI): 0.995-1.239), 1.171 (95% CI: 1.006-1.363), 1.357 (95% CI: 1.029-1.788), and 1.414 (95% CI: 0.983-2.036), respectively. Among the patients without asthma, the association was higher: the odds ratios for Grades 2, 3, 4 and 5 were 1.223 (95% CI: 0.999-1.497), 1.309 (95% CI: 0.987-1.737), 1.738 (95% CI: 1.029-2.935) and 2.403 (95% CI: 1.158-4.985), respectively. These associations remained after adjusting for the concentration of spherical particles or particulate matter with an aerodynamic diameter of less than 2.5 μm (PM2.5). Our findings demonstrate that kosa is an environmental factor which induces cough in a dose-response relationship. © 2014 Elsevier B.V.<br />Embargo Period 12 months 続きを見る
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論文
Tanaka, Rie ; Sanada, Shigeru ; Fujimura, Masaki ; Yasui, Masahide ; Tsuji, Shiro ; Hayashi, Norio ; Nanbu, Yuko ; Matsui, Osamu
出版情報: International Journal of Computer Assisted Radiology and Surgery.  4  pp.449-455,  2009-01-01.  Springer Verlag (Germany)
URL: http://hdl.handle.net/2297/19139
概要: 金沢大学医薬保健研究域保健学系<br />Purpose: Pulmonary ventilation and circulation dynamics are reflected on fluoroscopic images as cha nges in X-ray translucency. The purpose of this study was to investigate the feasibility of non-contrast functional imaging using a dynamic flat-panel detector (FPD). Methods: Dynamic chest radiographs of 20 subjects (abnormal, n = 12; normal, n = 8) were obtained using the FPD system. Image analysis was performed to get qualitative perfusion mapping image; first, focal pixel value was defined. Second, lung area was determined and pulmonary hilar areas were eliminated. Third, one cardiac cycle was determined in each of the cases. Finally, total changes in pixel values during one cardiac cycle were calculated and their distributions were visualized with mapping on the original image. They were compared with the findings of lung perfusion scintigraphy. Results: In all normal controls, the total changes in pixel value in one cardiac cycle decreased from the hilar region to the peripheral region of the lung with left-right symmetric distribution. In contrast, in many abnormal cases, pulmonary blood flow disorder was indicated as a reduction of changes in pixel values on a mapping image. The findings of mapping image coincided with those of lung perfusion scintigraphy. Conclusions: Dynamic chest radiography using an FPD system with computer analysis is expected to be a new type of functional imaging, which provides pulmonary blood flow distribution additionally. © CARS 2009. 続きを見る
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Yoshimoto, Akihiro ; Nakamura, Hiroyuki ; Fujimura, Masaki ; Nakao, Shinji
出版情報: Internal Medicine.  44  pp.710-716,  2005-07-01.  日本内科学会 = the Japanese Society of Internal Medicine
URL: http://hdl.handle.net/2297/14427
概要: 金沢大学医薬保健研究域医学系<br />Objective: To evaluate severe community-acquired pneumonia (SCAP) patients in an intensive care unit (ICU) with regard to risk factors for mortality and to compare ICU patients with matched non-ICU patients to evaluate whether our judgement for ICU admission was appropriate or not. Materials and methods: During a 7-year period, all patients with CAP who were admitted to the ICU were examined. They underwent clinical and radiographic evaluations, and two commonly used severity of illness scores were also calculated using the Simplified Acute Physiological Score (SAPS) and the Acute Physiology and Chronic Health Evaluation (APACHE) II methods. To detect risk factors for ICU admission using existing guidelines, each study patient was matched with two patients hospitalized in a general medical ward. Results: Seventy-two patients were identified during the study period. Their mean age was 72.9 years, and 35 patients (48.6%) subsequently died. For the univariate analysis, there were significant differences with the pulse rate ≥130/min, blood urea nitrogen ≥30 mg/dl, multilobar shadow, SAPS ≥43, APACHE II ≥23, and the occurrence of septic shock between the survivors and those who died. For the multivariate analysis, septic shock (p=0.0005, odds ratio of 26.6) and blood urea nitrogen ≥30 mg/dl (p=0.037, odds ratio of 5.38) were associated with mortality. Regarding the characteristics of different clinical predictions for ICU admission, the revised American Thoracic Society criteria might have been the most accurate. Conclusion: Septic shock was associated with high mortality, which is a more accurate and higher predictor of mortality than was physical examination, laboratory or radiographic findings. 続きを見る
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論文
Takato, Hazuki ; Yasui, Masahide ; Ichikawa, Yukari ; Fujimura, Masaki ; Nakao, Shinji ; Zen, Yoh ; Minato, Hiroshi
出版情報: Internal Medicine.  47  pp.291-294,  2008-02-15.  日本内科学会 = Japanese Society of Internal Medicine
URL: http://hdl.handle.net/2297/16803
概要: 金沢大学医薬保健研究域医学系<br />Recently, great attention has been drawn to IgG4-related diseases such as autoimmune pancreatitis (A IP) sclerosing sialadenitis, retroperitoneum fibrosis, sclerosing cholangitis. IgG4-related diseases are characterized by high serum IgG4 concentrations, sclerosing inflammation with numerous IgG4-positive plasma cells, and steroid sensitivity irrespective of their organs of origin. In this report, we describe a case of nonspecific interstitial pneumonia, in which possible involvement of IgG4 was suggested. The patient was 59-year-old man, who was found to have bilateral interstitial pneumonia. Laboratory tests revealed that he had antinuclear antibody and a high serum IgG4 concentration. Pathological examination of the video-assisted thoracic surgery biopsy taken from the right lower lobe showed interstitial thickening associated with lymphoplasmacytic infiltration containing many IgG4-positive plasma cells. He was effectively treated by corticosteroid. The present case had many clinical and clinicopathologic similarities to systemic IgG4-related autoimmune disease. There have been no descriptions on isolated interstitial pneumonia with IgG4-positive plasma cell infiltration. This case suggested that IgG4-related disorders could also occur in the lung, and interstitial pneumonia may be a pulmonary manifestation of systemic IgG4-related autoimmune disease © 2008 The Japanese Society of Internal Medicine. 続きを見る
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論文
Fujimura, Masaki ; Myou, Shigeharu
出版情報: Internal Medicine.  40  pp.557-558,  2001-01-01.  The Japanese Society of Internal Medicine = 日本内科学会
URL: http://hdl.handle.net/2297/24308
概要: 金沢大学医薬保健研究域医学系
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論文
Ishiguro, Takashi ; Yasui, Masahide ; Takato, Hazuki ; Kimura, Hideharu ; Katayama, Nobuyuki ; Kasahara, Kazuo ; Fujimura, Masaki
出版情報: Internal Medicine.  46  pp.1237-1241,  2007-08-02.  American Geophysical Union (AGU)
URL: http://hdl.handle.net/2297/16800
概要: 金沢大学医薬保健研究域医学系<br />We describe a 73-year-old woman with systemic sclerosis (SSc)-polymyositis (PM) overlap syndrome, pr imarily SSc followed by PM. She had suffered from SSc and had interstitial pneumonia (IP), which was stable. Eight years after the initial diagnosis of SSc, proximal muscle weakness, myalgia, and dyspnea on effort developed. A chest computed tomography (CT) showed reticular shadows, and serum markers of IP such as KL-6 and surfactant protein-D were elevated at 1,170 U/mL and 176 ng/ mL, respectively. Bronchoalveolar lavage fluid showed a remarkably increased number of lymphocytes. Exacerbation of SSc-IP 8 years after the initial diagnosis of SSc is not usual, and a marked increase in the number of lymphocytes in bronchoalveolar lavage fluid is also uncommon in SSc-IP, indicating overlap of another connective tissue disease. The diagnostic criteria for PM were satisfied; thus, SSc-PM overlap syndrome was diagnosed. We emphasize the need to investigate whether another connective tissue disease has developed when symptoms or laboratory findings cannot be explained by the usual clinical course of an existing connective tissue disease. © 2007 The Japanese Society of Internal Medicine. 続きを見る
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論文
Ishiguro, Takashi ; Kimura, Hideharu ; Araya, Tomoyuki ; Minato, Hiroshi ; Katayama, Nobuyuki ; Yasui, Masahide ; Kasahara, Kazuo ; Fujimura, Masaki
出版情報: Internal Medicine.  47  pp.1419-1423,  2008-01-01.  日本内科学会 = Japanese Society of Internal Medicine
URL: http://hdl.handle.net/2297/16798
概要: 金沢大学医薬保健研究域医学系<br />We herein report an 80-year-old man with prostatic carcinoma who developed eosinophilic pneumonia an d intrathoracic metastases. He presented with shortness of breath, cough, and fever as a chief complaint. Chest X-ray and computed tomography showed bilateral pulmonary nodules, intrathoracic lymphadenopathy, and right-sided consolidation. Positron emission tomography (PET) using F-fluorodeoxyglucose (FDG) showed poor uptake in these nodules and lymph nodes. The patient subsequently received a pelvic computed tomography scan, which revealed a massively enlarged prostate. The serum prostate specific antigen level was elevated to 4,181.2 ng/mL, and a transrectal biopsy revealed prostatic adenocarcinoma. Based on the morphological and immunohistochemical findings, the nodules in the lung and the lymph nodes were diagnosed as secondary neoplasm from the prostate. As for right-sided consolidation, remarkable bronchoalvelar lavage fluid eosinophilia was detected that was compatible with eosinophilic pneumonia. Eosinophilic pneumonia in this case disappeared and has not recurred by treatment of prostatic carcinoma and steroid therapy for a week, and was regarded to be tumor-associated. Although prostatic carcinoma with an initial manifestation of intrathoracic metastases and eosinophilic pneumonia is uncommon, physicians should suspect the condition. In addition, we should also keep in mind that prostatic carcinoma sometimes shows poor uptake in FDG-PET. © 2008 The Japanese Society of Internal Medicine. 続きを見る
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論文
Watanabe, Kazuyoshi ; Fujimura, Masaki ; Kasahara, Kazuo ; Yasui, Masahide ; Myou, Shigeharu ; Kita, Toshiyuki ; Watanabe, Akira ; Nakao, Shinji
出版情報: Internal Medicine.  41  pp.1016-1020,  2002-01-01.  The Japanese Society of Internal Medicine = 日本内科学会
URL: http://hdl.handle.net/2297/24303
概要: 金沢大学医薬保健研究域医学系<br />A 21-year-old woman presented with acute progressive dyspnea. Chest computed tomography (CT) reveale d diffuse bilateral infiltrates. Based on the results of transbronchial lung biopsy (TBLB) and bronchoalveolar lavage fluid (BALF) and her clinical course, she was diagnosed as having acute eosinophilic pneumonia. We suspected that the disease was related to smoking because she had started smoking ten days before the onset of symptoms. Therefore, a cigarette-smoking challenge test was done with the patient's informed consent. After the challenge, eosinophilic pneumonia was documented by BALF and TBLB findings, which were similar to those detected on admission, without significant radiographic findings. 続きを見る
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論文
Kita, Toshiyuki ; Fujimura, Masaki ; Sone, Takashi ; Inuzuka, Kanako ; Myou, Shigeharu ; Nakao, Shinji
出版情報: Journal of Bronchology.  17  pp.301-306,  2010-10-01.  Lippincott Williams & Wilkins
URL: http://hdl.handle.net/2297/26248
概要: 金沢大学医薬保健研究域医学系<br />Background and Objective: The purpose of this study was to evaluate the relationship between the wal l structure assessed by using endobronchial ultrasonography (EBUS) and bronchial hyperresponsiveness in patients with asthma. Methods: Twenty-four patients with stable asthma and 11 individuals without asthma were studied. EBUS was performed with a radial 20-MHz ultrasonic probe inserted into the intermediate bronchus undergoing flexible bronchoscopy to assess the airway wall structure. The percentage of airway wall thickness {WT%; defined as [(ideal outer diameter-ideal luminal diameter)/ideal outer diameter] × 100} was determined by EBUS. We measured bronchial hyperresponsiveness to methacholine [the provocative concentration of methacholine causing a decrease of 20% or more in forced expiratory volume in 1 s (PC20)]. Results: Percentage wall thickness measured by EBUS was significantly greater in patients with asthma than that in subjects without asthma (P < 0.01). The evaluation of the laminar structure using EBUS indicated that the thickness of the second layer in patients with asthma was greater than that in subjects without asthma (P < 0.05). PC20 was negatively correlated with the thickness of the second layer (r=0.52, P < 0.01) but was not significantly correlated with other layers in patients with asthma. Conclusions: The evaluation of the bronchial mural structure using EBUS might be advantageous for assessing the relationship between airway wall remodeling and bronchial hyperresponsiveness. © 2010 Lippincott Williams & Wilkins. 続きを見る