※一部利用できない機能があります
| 1.
論文 |
論文
|
清水, 淳三 ; 渡辺, 洋宇 ; 林, 義信 ; 小田, 誠 ; 岩, 喬 ; 高松, 秀行 ; 藤村, 政樹 ; 水上, 勇治 ; Shimizu, Junzo ; Watanabe, Yoh ; Hayashi, Yoshinobu ; Oda, Makoto ; Iwa, Takashi ; Takamatsu, Hideyuki ; Fujimura, Masaki ; Mizukami, Yuji
概要:
Leiomyoma of the trachea and bronchus is a rare tumor. Only 45 cases have been reported in the Japanese literature. We report here a case of leiomyoma of the intermediate bronchus which was successfully operated on. A 45-year-old man
…
suffered from a repeated episode of pneumonia in the right lower lobe. Bronchoscopy revealed a polypoid mass on the intermediate bronchus. The diagnosis of leiomyoma was made by bronchoscopic biopsy. Sleeve resection of the intermediate bronchus including the tumor and end-to-end anastomosis was performed. His postoperative course was uneventful and bronchoscopic findings showed clear healing of the anastomotic site. The resected specimen contained a tumor with smooth surface having protrusion into the bronchial lumen with 6 x 5 x 4 mm in size. The final pathological diagnosis was leiomyoma of the intermediate bronchus with no evidence of malignancy.
続きを見る
|
||||
| 2.
論文 |
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
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
|
||||
| 3.
論文 |
論文
|
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
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
|
||||
| 4.
論文 |
論文
|
Tanaka, Rie ; Sanada, Shigeru ; Fujimura, Masaki ; Yasui, Masahide ; Tsuji, Shiro ; Hayashi, Norio ; Nanbu, Yuko ; Matsui, Osamu
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
|
||||
| 5.
論文 |
論文
|
Heki, Utako ; Fujimura, Masaki ; Ogawa, Haruhiko ; Matsuda, Tamotsu ; Kitagawa, Masanobu
概要:
金沢大学医薬保健研究域医学系<br />A 57-year-old man was admitted to our hospital because of dyspnea and abnormal shadow on chest roent
…
genogram. He had received two herbal drugs: Saikokeisikankyou-tou (SKT) for one month and Licium Halimifolium Mil (LHM) for two weeks. After admission, all medication was stopped and his symptoms were gradually diminished. Transbronchial lung biopsy specimens showed interstitial pneumonia. Lymphocyte stimulation test, skin test and challenge test were positive to these herbal drugs. We diagnosed him as drug-induced pneumonitis. This is the first report on pneumonitis caused by Saikokeisikankyou-tou diagnosed by lymphocyte stimulation test, skin test and challenge test.
続きを見る
|
||||
| 6.
論文 |
論文
|
新屋, 智之 ; 笠原, 寿郎 ; 藤村, 政樹 ; 丹保, 裕一 ; 田森, 俊一 ; 曽根, 崇 ; 中尾, 眞二 ; Araya, Tomoyuki ; Kasahara, Kazuo ; Fujimura, Masaki ; Tanbo, Yuichi ; Tamori, Shunichi ; Sone, Takashi ; Nakao, Shinji
概要:
金沢大学医薬保健研究域医学系<br />Background. Skeletal muscle metastases from lung cancer are considered to be extremely rare. We enco
…
untered 3 cases of lung cancer associated with skeletal muscle metastases on initial medical examination or during disease progression. Cases. Case 1: A 46-year-old man was trismic due to metastasis of lung adenocarcinoma to the lateral pterygoid muscle. He was resistant to radiotherapy and chemotherapy, and died 9 months after the occurrence of symptoms. Case 2: A 57-year-old man had a large cell lung carcinoma or poorly differentiated lung adenocarcinoma. He had metastasis to the right femoral muscle in addition to multiple metastases to many other organs. His disease was also resistant to any treatment, and died 7 months after he became symptomatic. Case 3: A 64-year-old man with adenocarcinoma had a single metastasis to the biceps muscle. He died 3 months after the diagnosis of muscle metastasis due to resistance to therapy. Conclusion. Upon diagnosis of tumorous lesions of skeletal muscles, whole body examination and subsequent percutaneous biopsy of muscle involvement are required to determine the possibility of skeletal muscle metastasis of lung cancer. 背景.肺癌の骨格筋転移は極めて稀とされているが,今回我々は,初診時もしくは経過中に骨格筋転移を来した非小細胞肺癌の3症例を経験した.症例.症例1は46歳男性,肺腺癌の外側翼突筋転移のために開口障害を来した.放射線及び化学療法に対して抵抗性であり,原疾患の悪化により症状発現から約9ヶ月の経過で死亡した.症例2は57歳男性,肺大細胞癌もしくは低分化腺癌の症例で右大腿部の筋転移に加え,他臓器への広範な転移を認めた.治療抵抗性で症状出現より約7ヶ月の経過で死亡した.症例3は64歳男性,腺癌の症例で,右上腕二頭筋に転移を来し,治療抵抗性の経過で筋転移出現より約3ヶ月で死亡した.結論.骨格筋の腫瘤性病変の診断の際には転移性悪性腫瘍,特に肺癌の骨格筋転移を念頭に置き,全身精査と病変部位の生検により速やかな確定診断が必要と考えられた.
続きを見る
|
||||
| 7.
論文 |
論文
|
Yoshimoto, Akihiro ; Nakamura, Hiroyuki ; Fujimura, Masaki ; Nakao, Shinji
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
|
||||
| 8.
論文 |
論文
|
Takato, Hazuki ; Yasui, Masahide ; Ichikawa, Yukari ; Fujimura, Masaki ; Nakao, Shinji ; Zen, Yoh ; Minato, Hiroshi
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
|
||||
| 9.
論文 |
論文
|
Fujimura, Masaki ; Myou, Shigeharu
概要:
金沢大学医薬保健研究域医学系
|
||||
| 10.
論文 |
論文
|
Ishiguro, Takashi ; Yasui, Masahide ; Takato, Hazuki ; Kimura, Hideharu ; Katayama, Nobuyuki ; Kasahara, Kazuo ; Fujimura, Masaki
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
|
||||
| 11.
論文 |
論文
|
Shibata, Kazuhiko ; Kitagawa, Shunsuke ; Fujimura, Masaki ; Matsuda, Tamotsu
概要:
金沢大学医薬保健研究域医学系<br />We report a rare case of a woman with inflammatory carcinoma, an unusual type of cutaneous metastasi
…
s, arising from signet-ring cell carcinoma of the stomach, who developed chylothorax as the skin lesion progressed over the chest. No thoracoabdominal lymphadenopathy which can cause obstruction of the thoracic duct was shown by computed tomography. Although a very rare condition, inflammatory carcinoma could be a cause of non-traumatic chylothorax.
続きを見る
|
||||
| 12.
論文 |
論文
|
Ishiguro, Takashi ; Kimura, Hideharu ; Araya, Tomoyuki ; Minato, Hiroshi ; Katayama, Nobuyuki ; Yasui, Masahide ; Kasahara, Kazuo ; Fujimura, Masaki
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
|
||||
| 13.
論文 |
論文
|
Watanabe, Kazuyoshi ; Fujimura, Masaki ; Kasahara, Kazuo ; Yasui, Masahide ; Myou, Shigeharu ; Kita, Toshiyuki ; Watanabe, Akira ; Nakao, Shinji
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
|
||||
| 14.
論文 |
論文
|
Bando, Takuma ; Fujimura, Masaki ; Noda, Yatsugi ; Hirose, Jinichiro ; Ohta, Goroku ; Matsuda, Tamotsu
概要:
金沢大学医薬保健研究域医学系<br />A 65-year-old man developed respiratory failure with diffuse interstitial shadow, bilateral pleural
…
effusion, and bilateral hilar lymphadenopathy on chest X-ray and CT, after intravenous administration of minocycline. Corticosteroid therapy was effective. The findings from bronchoalveolar lavage (BAE) and transbronchial lung biopsy were compatible with eosinophilic pneumonia. Provocation test supported this diagnosis, but the lymphocyte stimulation test was negative. A review of the literature and the diagnoses of drug-induced pulmonary diseases are discussed..
続きを見る
|
||||
| 15.
論文 |
論文
|
Kita, Toshiyuki ; Fujimura, Masaki ; Sone, Takashi ; Inuzuka, Kanako ; Myou, Shigeharu ; Nakao, Shinji
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
|
||||
| 16.
論文 |
論文
|
Fujimura, Masaki ; Ohkura, Noriyuki ; Abo, Miki ; Furusho, Shiho ; Waseda, Yuko ; Ichikawa, Yukari ; Hara, Johsuke
概要:
金沢大学大学院医薬保健研究域医学系<br />Background and objective: Atopic cough (AC) is an established clinical entity in Japan, in which
…
patients present with a chronic persistent non-productive cough. Exhaled nitric oxide (NO) is a biomarker of eosinophilic airway inflammation. The present study examined whether exhaled NO levels were increased in AC in comparison with cough variant asthma (CVA) and bronchial asthma (BA). Methods: Consecutive patients presenting with an isolated cough lasting at least 8 weeks were enrolled in the study. The aetiology of the chronic cough was determined according to the Japanese Respiratory Society guidelines for management of cough. Exhaled NO, capsaicin cough sensitivity (capsaicin concentration eliciting five or more coughs (C5)) and bronchial reversibility were measured at the patients' first visit. Bronchial responsiveness (PC20 to methacholine) was measured at their second visit following a 6-day course of bronchodilator therapy. Results: There were 58 patients recruited and fully investigated; of these 9 and 11 patients were diagnosed with AC and CVA, respectively, as single causes of chronic cough. Ten patients with BA who had not received corticosteroid therapy in the previous 4 weeks and who attended the same clinic in the same time period acted as controls. Exhaled NO levels in patients with AC were significantly lower than those in patients with CVA and BA. There was no significant difference in the exhaled NO levels between patients with CVA and BA. Conclusions: Exhaled NO may reflect eosinophilic inflammation of peripheral airways and its measurement may be useful in differentiating CVA from AC and other causes of chronic non-productive cough. © 2008 The Authors.
続きを見る
|
||||
| 17.
論文 |
論文
|
Fujimura, Masaki ; Hara, Johsuke ; Myou, Shigeharu
概要:
金沢大学大学院医学系研究科機能再生学<br />Background Cough variant asthma (CVA) is a cause of chronic cough and a precursor of typical ast
…
hma. We retrospectively examined the longitudinal change in bronchial responsiveness and cough reflex sensitivity in CVA patients with respect to the effect of long-term inhaled corticosteroids (ICS). Methods Provocative concentration of methacholine causing a 20% fall in forced expiratory volume in one second (PC20-FEV1) and provocative concentration of capsaicin eliciting 5 or more coughs (C5) were measured before treatment and during a follow up period following relief of cough (median; 2.0 (range; 0.5 to 8.0) years after the initial visit) in a total of 20 patients with CVA (7 males and 13 females, mean ± SD age of 49.9 ± 12.9 years). Results Three of 8 patients not taking long-term ICS developed typical asthma compared to none of 12 patients taking ICS (p = 0.0171). PC20-FEV1 significantly (p < 0.0001) increased from 1.80 (GSEM, 1.35) to 10.7 (GSEM, 1.63) mg/ml in patients taking ICS but did not change in patients not taking ICS [2.10 (GSEM, 1.47) compared to 2.13 (GSEM, 1.52) mg/ml]. Cough threshold did not change in patients whether taking or not taking ICS. Conclusion Long-term ICS reduces bronchial hyperresponsiveness in CVA as recognized in typical asthma. Cough reflex sensitivity is not involved in the mechanism of cough in CVA.
続きを見る
|
||||
| 18.
論文 |
論文
|
Ishiura, Yoshihisa ; Fujimura, Masaki ; Nobata, Kouichi ; Oribe, Yoshitaka ; Abo, Miki ; Myou, Shigeharu
概要:
金沢大学大学院医学系研究科機能再生学<br />Inflammatory mediators are involved in the pathogenesis of airway inflammation, but the role of
…
prostaglandin I2 (PGI2) remains obscure. This study was designed to investigate the role of PGI2 in cough reflex sensitivity of the asthmatic airway, which is characterized by chronic eosinophilic airway inflammation. The effect of beraprost, a chemically and biologically stable analogue of PGI2, on cough response to inhaled capsaicin was examined in 21 patients with stable asthma in a randomized, placebo-controlled cross over study. Capsaicin cough threshold, defined as the lowest concentration of capsaicin eliciting five or more coughs, was measured as an index of airway cough reflex sensitivity. The cough threshold was significantly (p < 0.05) decreased after two weeks of treatment with beraprost [17.8 (GSEM 1.20) μM] compared with placebo [30.3 (GSEM 1.21) μM]. PGI2 increases cough reflex sensitivity of the asthmatic airway, suggesting that inhibition of PGI2 may be a novel therapeutic option for patients with asthma, especially cough predominant asthma.
続きを見る
|
||||
| 19.
論文 |
論文
|
Hara, Johsuke ; Fujimura, Masaki ; Myou, Shigeharu ; Oribe, Yoshitaka ; Furusho, Shiho ; Kita, Toshiyuki ; Katayama, Nobuyuki ; Abo, Miki ; Ohkura, Noriyuki ; Herai, Yoriko ; Hori, Akihiro ; Ishiura, Yoshihisa ; Nobata, Kouichi ; Ogawa, Haruhiko ; Yasui, Masahide ; Kasahara, Kazuo ; Nakao, Shinji
概要:
金沢大学大学院医学系研究科機能再生学<br />Background Late asthmatic response is observed following antigen challenge in actively, but not
…
passively, sensitized guinea pigs. Although cough reflex sensitivity is increased after antigen challenge in actively sensitized guinea pigs, it is unknown whether the antigen-induced increase in cough reflex sensitivity develops in passively sensitized animals. The aim of this study was to compare the cough reflex sensitivity to inhaled capsaicin after an inhaled antigen challenge between actively and passively sensitized guinea pigs. Methods Measurement of number of coughs elicited by increasing concentrations of capsaicin (10-6 and 10-4 M) and bronchial responsiveness to ascending concentrations of methacholine, and analysis of bronchoalveolar lavage fluid (BALF) were separately performed 24 h after an antigen challenge in actively and passively sensitized guinea pigs. Results Percentage of eosinophils in BALF and bronchial responsiveness to methacholine were increased 24 h after the antigen challenge in both actively and passively sensitized animals compared with saline-challenged actively and passively sensitized animals, respectively. Absolute number of eosinophils in BALF from actively sensitized and antigen-challenged guinea pigs was significantly greater than that from passively sensitized and antigen-challenged animals. Cough response to capsaicin and concentration of substance P in BALF were increased 24 h after the antigen challenge in actively sensitized guinea pigs, but not in passively sensitized guinea pigs. Bronchial responsiveness, cough reflex sensitivity and substance P concentration and total cells in BALF were increased in actively sensitized and saline challenged guinea pigs compared with passively sensitized and saline challenged animals. Conclusion The results suggest that active sensitization per se increases cough reflex sensitivity accompanied by increased inflammatory cells and substance P level in BALF, and antigen challenge further increases them, while simple IgE- and/or IgG-mediated allergic reaction per se or the low intensity of eosinophil infiltration in the airway itself may not affect cough reflex sensitivity in guinea pigs.
続きを見る
|
||||
| 20.
論文 |
論文
|
Ishiura, Yoshihisa ; Fujimura, Masaki ; Nobata, Kouichi ; Abo, Miki ; Oribe, Takayoshi ; Myou, Shigeharu ; Nakamura, Hiroyuki
概要:
金沢大学大学院医学系研究科機能再生学<br />Aims Cough is a common symptom of bronchial asthma, a chronic inflammatory airway disease. Recen
…
tly, the therapeutic effects of selective phosphodiesterase (PDE) inhibitors have been focused on bronchial asthma. This study was designed to investigate the clinical effect of PDE 3 inhibition on cough reflex sensitivity in elderly patients with bronchial asthma. Methods Effects of cilostazol, a PDE 3 inhibitor, on cough response to inhaled capsaicin were examined in 11 patients over 70 years with stable asthma in a randomized, placebo-controlled cross over study. Capsaicin cough threshold, defined as the lowest concentration of capsaicin eliciting five or more coughs, was measured as an index of airway cough reflex sensitivity. Results The cough threshold was significantly (p < 0.05) increased after two-week treatment with cilostazol (100 mg twice a day orally) compared with placebo [48.8 (GSEM 1.4) vs. 29.2 (GSEM 1.3) μM]. Conclusion These findings indicate that PDE 3 inhibition may be a novel therapeutic option for elderly patients with asthma, especially for their cough symptoms.
続きを見る
|
||||
| 21.
論文 |
論文
|
Ogawa, Haruhiko ; Kurashima, Kazuyoshi ; Namura, Masanobu ; Kanaya, Hounin ; Kawamura, Youichi ; Ohka, Takio ; Kurumaya, Hiroshi ; Yasui, Masahide ; Fujimura, Masaki ; Matsuda, Tamotsu
概要:
金沢大学医薬保健研究域医学系<br />An increasing number of drugs have been implicated in the etiology of eosinophilic pneumonia charact
…
erized by the development of pulmonary infiltrates, and peripheral blood eosinophilia. Naproxen is a commonly used nonsteroidal anti-inflammatory drug which may be added to the growing list of pharmacologic agents associated with infiltrative pulmonary lesions. A case of eosinophilic pneumonia induced by Naproxen is described. The results of TBLB, a lymphocyte stimulation test, and a challenge test supported this diagnosis.
続きを見る
|
||||
| 22.
論文 |
論文
|
Ogawa, Haruhiko ; Fujimura, Masaki ; Takeuchi, Yasuo ; Makimura, Koichi
概要:
金沢大学医薬保健研究域医学系<br />We herein report a case of sinobronchial allergic mycosis (SAM) caused by basidiomycetous (BM) fungi
…
(probably Phanerochaete velutina). The patient with bronchial asthma that accompanied allergic fungal sinusitis (AFS) fulfilled all 6 criteria for diagnosing SAM. In this case, the BM fungus may act as an allergen, reacting continually in both the upper and lower respiratory tract. The antifungal drug (itraconazole 50 mg/ day) seemed to achieve a partial response. Basidiomycetous fungi may attract attention because of the possibility as a causative antigen in this new clinical concept of SAM. © 2011 The Japanese Society of Internal Medicine.
続きを見る
|
||||
| 23.
論文 |
論文
|
Nobata, Kouichi ; Kasai, Takahiko ; Fujimura, Masaki ; Mizuguchi, Masayuki ; Nishi, Kouichi ; Ishiura, Yoshihisa ; Yasui, Masahide ; Nakao, Shinji
概要:
金沢大学医薬保健研究域医学系<br />Nodular and reticular opacities were detected in both lower lung fields of a 75-year-old man in 2000
…
. Bronchoscopy revealed pulmonary sarcoidosis. In 2002, nodular and reticular opacities were shown in the right upper lobe, and video-assisted thoracoscopic surgery was performed. The histological findings revealed usual interstitial pneumonia (UIP)-like lesions, whereas non-caseous granulomas were not detected. In the present case of pulmonary sarcoidosis, nodular and reticular opacities were predominantly distributed in both lower lung fields, and the histological findings obtained by video-assisted thoracoscopic surgery showed UIP-like lesions. These findings may enlighten the assist in understanding of the process of development of pulmonary sarcoidosis. © 2006 The Japanese Society of Internal Medicine.
続きを見る
|
||||
| 24.
論文 |
論文
|
Fujimura, Masaki ; Azuma, Hiroshi ; Uotani, Kouhei ; Mifune, Jun-ichiro ; Tanaka, Takashi ; Matsuda, Tamotsu
概要:
金沢大学医薬保健研究域医学系<br />The additive bronchodilating effect of isoproterenol-phenylephrine aerosol following ipratropium bro
…
mide was examined in seven intrinsic asthmatic patients and seven chronic bronchitic patients. FVC, FEV1 and Zrs were measured before and 30 min. after inhalation of ipratropium, 40 μg. Then inhalation of isoproterenol, 600 μg and phenylephrine, 570 μg was added and the pulmonary functions were measured 30 min. later. The age, baseline values of FVC and FEV1, and the increases in FEV1 and 1/Zrs with ipratropium did not differ between the two. Isoproterenol-phenylephrine aerosol following ipratropium produced further increases in FEV1 and 1/Zrs in asthmatic patients but no additive increases in bronchitic patients. These findings indicate that the role of autonomic nervous system, especially adrenergic system, on airway obstruction maybe different between asthmatic and bronchitic patients arid the method applied in this study may be helpful in differentiating these airway disorders。
続きを見る
|
||||
| 25.
論文 |
論文
|
Tanaka, Rie ; Sanada, Shigeru ; Fujimura, Masaki ; Yasui, Masahide ; Hayashi, Norio ; Tsuji, Shiro ; Okamoto, Hiroyuki ; Nanbu, Yuko ; Matsui, Osamu
概要:
金沢大学医薬保健研究域保健学系<br />Pulmonary blood flow is reflected in dynamic chest radiographs as changes in X-ray translucency, i.
…
e., pixel values. Thus, decreased blood flow should be observed as a reduction of the variation of X-ray translucency. We performed the present study to investigate the feasibility of pulmonary blood flow evaluation with a dynamic flat-panel detector (FPD). Sequential chest radiographs of 14 subjects were obtained with a dynamic FPD system. The changes in pixel value in each local area were measured and mapped on the original image by use of a gray scale in which small and large changes were shown in white and black, respectively. The resulting images were compared to the findings in perfusion scans. The cross-correlation coefficients of the changes in pixel value and radioactivity counts in each local area were also computed. In all patients, pulmonary blood flow disorder was indicated as a reduction of changes in pixel values on the mapping image, and a correlation was observed between the distribution of changes in pixel value and those in radioactivity counts (0.7 ≤ r, 3 cases; 0.4 ≤ r < 0.7, 7 cases; 0.2 ≤ r < 0.4, 4 cases). The results indicated that the distribution of changes in pixel value could provide a relative measure related to pulmonary blood flow. The present method is potentially useful for evaluating pulmonary blood flow as an additional examination in conventional chest radiography. © 2009 Japanese Society of Radiological Technology and Japan Society of Medical Physics.
続きを見る
|
||||
| 26.
論文 |
論文
|
Yoshimoto, Akihiro ; Ichikawa, Yukari ; Waseda, Yuko ; Yasui, Masahide ; Fujimura, Masaki ; Hebisawa, Akira ; Nakao, Shinji
概要:
金沢大学医薬保健研究域医学系<br />A 57-year-old man consulted our hospital with a history of the gradual onset of dyspnea and a produc
…
tive cough. Chest computed tomographic (CT) scans showed a nodular shadow in a cavity lesion, and reticulonodular, cystic, and ground-grass opacities in the bilateral lung fields with honeycombing. He was diagnosed as having pulmonary aspergilloma and idiopathic pulmonary fibrosis (IPF). As an outpatient, he suffered from dyspnea upon physical exertion with exacerbation of the high-resolution CT (HRCT) opacities. An inhalation provocation test for Aspergillosis fumigatus was positive and chronic hypersensitivity pneumonitis (CHP) caused by Aspergillus was finally diagnosed. Insidious CHP is sometimes misdiagnosed as IPF. The diagnosis of insidious CHP should be made on the basis of a detailed history, specific HRCT findings, and lymphocyte-dominant bronchoalveolar lavage fluid cell findings.
続きを見る
|
||||
| 27.
論文 |
論文
|
Shinagawa, Shunji ; Fujimura, Masaki ; Mizuhashi, Keiichi ; Takahashi, Shigeo ; Noda, Yatsugi ; Hirose, Takae ; Matsuda, Tamotsu
概要:
金沢大学医薬保健研究域医学系<br />This is the first case report of exacerbation of tracheobronchitis due to nontoxigenic Corynebacteri
…
um diphtheriae in which tracheal pseudomembrane was identified and oral erythromycine therapy was very successful.
続きを見る
|
||||
| 28.
論文 |
論文
|
Sakai, Asao ; Iwasa, Keiichi ; Maeda, Yoshinobu ; Kimura, Hideharu ; Kasahara, Kazuo ; Fujimura, Masaki
概要:
金沢大学大学院医学系研究科細胞移植学講座<br />Background. Even though the head and neck are common metastatic sites in lung cancer patients,
…
paranasal metastases are rare. We report a patient with lung cancer who had paranasal sinus metastases. Case. A 56-year-old man with lung cancer presented with nasal hemorrhage 1.5 years after the initiation of chemotherapy. On CT, mass shadows were seen in bilateral frontal sinuses, maxillary antra, the left ethmoidal sinus, the sphenoidal sinus, and the nasal cavity. Biopsies of the lesion in the nasal cavity showed adenocarcinoma, confirming that the lesions in the paranasal sinuses were lung cancer metastases. The cranial MRI done at the time of the first admission was reviewed, and a small nodule was found in left ethmoidal sinus. Conclusion. Paranasal sinus metastases are found in a patient with NSCLC who don't have symptoms related to the paranasal sites. Paranasal sites should be carefully evaluated in patients with advanced NSCLC. © 2008 The Japan Lung Cancer Society. [背景]肺癌の頭頸部への転移は比較的高い頻度で認められるが、副鼻腔転移は極めて稀である。今回われわれは、経過中に副鼻腔転移を認めた症例を経験した。[症例]症例は56歳、男性。1年半にわたる肺癌治療経過中に鼻出血が出現した。頭部CTでは両側前頭洞、左側篩骨洞・上顎洞・鼻腔にかけて腫瘤性病変を認めた。生検による病理組織像は原発巣と同一の腺癌であった。初回入院時の頭部MRIをレトロスペクティブに検討したところ、左篩骨洞に腫瘤陰影があり、初診時にすでに副鼻腔転移を認めていたものと考えられた。[結論]副鼻腔転移は治療経過中に認められる報告が多いが、初診時にも無症状の副鼻腔転移を有する場合があり、慎重に診断して観察する必要がある。全文公開201010
続きを見る
|
||||
| 29.
論文 |
論文
|
Fujimura, Masaki ; Sakamoto, S. ; Matsuda, Tamotsu
概要:
金沢大学医薬保健研究域医学系<br />The number of atopic patients presenting only chronic non-productive cough appears to be increasing.
…
This study was conducted to confirm the existence of non-asthmatic cough associated with atopy. We prospectively examined atopic findings, therapeutic effects of inhaled procaterol, azelastin, and/or glucocorticoids, improvement of FEV1 by bronchodilator therapy and bronchial responsiveness to methacholine in 20 patients. The cough was relieved by inhaled procaterol in 10 patients (Group 2) but not in the other 10 patients (Group 1). The increase in FEV1 by inhaled salbutamol following aminophylline injection was significantly less in Group 1 than in Group 2. Bronchial responsiveness to methacholine was normal in Group 1 while that in Group 2 was hyperreactive. These findings indicate that there is atopic non-asthmatic bronchodilator-resistive cough (Group 1) which is a different entity from bronchodilator-responsive cough (Group 2), or the so-called 'cough variant asthma'.<br />原稿を準備中.
続きを見る
|
||||
| 30.
論文 |
論文
|
Tomikawa, Saori ; Okumura, Hirokazu ; Yoshida, Takashi ; Mochizuki, Hiroyasu ; Miwa, Atsuo ; Takayanagi, Koretatsu ; Yoshino, Tadashi ; Ohtake, Shigeki ; Fujimura, Masaki ; Nakamura, Shinobu ; Matsuda, Tamotsu
概要:
金沢大学医薬保健研究域医学系<br />We present a case of primary prostatic lymphoma referring to a 57-year-old man, who was admitted wit
…
h the symptom of bladder outlet obstruction, and had a history of urination difficulty for two years. The symptoms and signs were compatible with a diagnosis of benign prostatic hypertrophy (BPH). The pathology of the specimen obtained from transurethral prostatectomy showed B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type. The patient has been asymptomatic and under complete remission after completion of chemotherapy consisting of doxorubicin, cyclophosphamide, vincristine and prednisone for 6 cycles.
続きを見る
|
||||
| 31.
論文 |
論文
|
Ishiguro, Takashi ; Kasahara, Kazuo ; Matsumoto, Isao ; Waseda, Ryuichi ; Minato, Hiroshi ; Kimura, Hideharu ; Katayama, Nobuyuki ; Yasui, Masahide ; Ohta, Yasuhiko ; Fujimura, Masaki
概要:
金沢大学医薬保健研究域医学系<br />Primary malignant tumors of the pulmonary arteries occur infrequently. The clinical presentation and
…
diagnostic imaging features of the tumor are usually nonspecific and correct diagnosis is often delayed. In this report, we present a case of pulmonary artery sarcoma. MRI and PET-CT were found to be useful for differentiating the tumor from a thromboembolism. © 2007 The Japanese Society of Internal Medicine.
続きを見る
|
||||
| 32.
論文 |
論文
|
Ishiguro, Takashi ; Yasui, Masahide ; Nakade, Yusuke ; Kimura, Hideharu ; Katayama, Nobuyuki ; Kasahara, Kazuo ; Fujimura, Masaki
概要:
金沢大学医薬保健研究域医学系<br />A 22-year-old woman was admitted with symptoms of dyspnea and fever with pulmonary infiltrates noted
…
on her chest X-ray study. She developed these symptoms in the workplace; her job included the removal of body hair using a diode-laser with 1,1,1,2-tetrafluoroethane (HFC134a, an alternative to chlorofluorocarbon) as a coolant. A chest X-ray examination revealed ground-glass opacities in the lower lung fields, and a chest computed tomographic study showed diffuse centrilobular opacities. An examination of the bronchoalveolar lavage fluid revealed increased lymphocytes with a slight increase in the number of eosinophils. An examination of the transbronchial biopsy specimens revealed eosinophil infiltration. A peripheral blood eosinophilia was also seen. The patient's symptoms, chest X-ray findings, and arterial blood gas analysis all returned to normal within a week. A challenge test of 1,1,1,2-tetrafluoroethane (HFC134a) inhalation was performed, which resulted in an elevation of body temperature, the development of a cough, and laboratory data indicating increased inflammation. We then determined the patient's diagnosis to be extrinsic allergic alveolits with eosnophil infiltration, caused by HFC134a. © 2007 The Japanese Society of Internal Medicine.
続きを見る
|
||||
| 33.
論文 |
論文
|
Ogawa, Haruhiko ; Fujimura, Masaki ; Takeuchi, Yasuo ; Makimura, Koichi
概要:
Background: The sensitization and exposure to fungal allergens have been reported to be associated with asthma. The aim
…
of this study was to clarify the impact of sensitization to Schizophyllum commune (S. commune) on the severity and exacerbations of asthma. Methods: Ninety-two patients with asthma of various levels of severity [mild (n = 18), moderate (28), and severe (46)] and exacerbation severity [moderate (n = 43) and severe (6)] were retrospectively examined with regard to fungal sensitization such as specific IgE or intradermal skin reactions against S. commune and other common allergens. We also classified the patients into three groups: (1) three or more asthma attacks during the past year (F-BA) (n = 29),(2) one or two asthma attacks (NF-BA) (n = 20), and (3) no asthma attack (C-BA) (n = 43). Results: The positive rate of late cutaneous reactions to S. commune was higher in patients with severe asthma (41.2%) than with moderate (26.1%) or mild asthma (6.7%), and was significantly different among the three groups (P < 0.05). Although the ratio did not show a significant difference between the patients with severe (83.3%) or moderate (36.1%) exacerbation, it was higher in F-BA (60.9%) than in NF-BA (21.1%) and C-BA patients (10.0%), and it was significantly different among the three groups (P = 0.0002). Multivariate analysis identified positive results for late-phase skin reactions to S. commune and the age of the patients as an independent determinant of asthma severity, and the skin results and %FVC an independent determinant of exacerbation frequency. Conclusion: This study demonstrated that S. commune is an environmental fungus that appears to enhance both the severity of asthma and the exacerbation frequency. © 2011 Springer Science+Business Media, LLC.
続きを見る
|
||||
| 34.
論文 |
論文
|
Nakade, Yusuke ; Fujimura, Masaki ; Ohkura, Noriyuki ; Nakata, Masako ; Nanbu, Yuko ; Oe, Hiroyasu ; Horita, Hiroshi ; Sakai, Yoshio ; Wada, Takashi
概要:
Objective Partial expiratory flow-volume curves have the potential to detect mild bronchoconstriction because they are n
…
ot affected by the modulatory effects of deep inspiration. The aim of this study was to investigate the relationship between the efficacy of bronchodilator therapy (BDT) in treating the cough and to assess the increase in the expiratory flow of the partial flow-volume curve at 40% above the residual volume level (PEF40) caused by treatment with a short-acting beta-2 agonist (SABA) in patients with chronic nonproductive cough. Methods We measured the reversibility of PEF40 caused by a SABA in 42 patients with chronic nonproductive cough at visit 1 (day 0). The patients received BDT for six days. The visual analogue scale (VAS) was used to assess the efficacy of BDT in treating coughing at visit 2 (day 7) (0 mm, 'no cough;' 100 mm, 'no change in coughing'). Results Reversibility of the PEF40 was correlated (r=0.690, p<0.001) with the VAS score determined at visit 2 and was higher in the patients with cough variant asthma (CVA) (44.9±18.3%) than in those with atopic cough (13.4±10.4%) (p<0.01). Conclusion Reversibility of the PEF40 predicted the efficacy of BDT in patients with chronic nonproductive cough and helped to identify patients with CVA.
続きを見る
|
||||
| 35.
論文 |
論文
|
Ogawa, Haruhiko ; Fujimura, Masaki ; Takeuchi, Yasuo ; Makimura, Kouichi ; Satoh, Kazuo
概要:
[Objective]The aim of the present study was to clarify the influence of sensitization to Bjerkandera adusta(B. adusta)on the clinical manifestation in patients with fungus-associated chronic cough(FACC).[Methods]Seventeen patients
…
with FACC who underwent bronchoprovocation tests using an antigenic solution of B. adusta were selected from among 21 FACC patients. We compared the allergological findings and clinical characteristics of the FACC patients who showed a positive reaction to the bronchoprovocation test(Allergic fungal cough sensitized to B. adusta; AFC-Bj)with the remaining FACC patients(non AFC-Bj)retrospectively.[Results]The eleven patients with AFC-Bj had a median age of 52(range, 22-70)years, and 45.5% were female. The respective values for six patients with non AFC-Bj were 47.5(range, 36-60)years of age, and 33.3% were female. The positive ratios for an immediate cutaneous reaction(45.5%; p<0.05)and the lymphocyte stimulation test(63.6%; p<0.05)to B. adusta were found to be significantly higher in the AFC-Bj group than in the non AFC-Bj group. The total time required for complete remission of cough symptoms was longer(median 20, range 12-43 weeks; p=0.0009), and the recurrence ratio of coughing was more frequent in the AFC-Bj group in comparison to those in non AFC-Bj group(2, range 1-3 times and 0.5, range 0-1 times, respectively).[Conclusions]This study demonstrated that B. adusta, a basidiomycetous is an environmental fungus attracting attention because of its possible role in enhancing the cough severity of FACC patients via the sensitization to this fungus.
続きを見る
|
||||
| 36.
論文 |
論文
|
Ogawa, Haruhiko ; Fujimura, Masaki ; Takeuchi, Yasuo ; Makimura, Koichi
|
||||
| 37.
論文 |
論文
|
Ishiura, Yoshihisa ; Fujimura, Masaki ; Yamamoto, Hiroki ; Ohkura, Noriyuki ; Myou, Shigeharu
概要:
Background: Sinobronchial syndrome is a cause of chronic productive cough. Inflammatory mediators are involved in the pa
…
thophysiology of chronic productive cough. Accumulating evidences indicate that cyclooxygenase (COX)-2, one of the inducible isoforms of COX, is a key element in the pathophysiological process of a number of inflammatory disorders. However, little is known about the role of COX-2 in chronic productive cough in patients with sinobronchial syndrome known as neutrophilic bronchial inflammation.Methods: The effect of etodolac, a potent COX-2 inhibitor, on cough response to inhaled capsaicin was examined in 15 patients with sinobronchial syndrome in a randomized, placebo-controlled cross-over study. Capsaicin cough threshold, defined as the lowest concentration of capsaicin eliciting five or more coughs, was measured as an index of airway cough reflex sensitivity.Results: The cough threshold was significantly (p < 0.03) increased after two-week treatment with etodolac (200 mg twice a day orally) compared with placebo [37.5 (GSEM 1.3) vs. 27.2 (GSEM 1.3) μM].Conclusions: These findings indicate that COX-2 may be a possible modulator augmenting airway cough reflex sensitivity in patients with sinobronchial syndrome. © 2010 Ishiura et al; licensee BioMed Central Ltd.
続きを見る
|
||||
| 38.
論文 |
論文
|
Hori, Akihiro ; Fujimura, Masaki ; Ohkura, Noriyuki ; Tokuda, Akira
概要:
Background: Exhaled nitric oxide (ENO) is elevated in bronchial asthma patients, and inhaled corticosteroid therapy lowe
…
rs the elevated ENO levels in such patients. ENO appears to be an inflammatory marker, but its role in the pathophysiology of cough remains unclear. This study aimed to elucidate the relationship between NO and increased cough reflex sensitivity induced by allergic airway reactions.Methods: Cough reflex sensitivity to inhaled capsaicin was observed under NO depletion caused by NO synthase (NOS) inhibitors in non-sensitized and ovalbumin (OVA)-sensitized guinea pigs. The bronchoalveolar lavage fluid (BALF) was analyzed in an NO depletion setting using the inducible NOS (iNOS) inhibitor ONO1714 in OVA-sensitized guinea pigs.Results: NO depletion by the non-selective NOS inhibitor L-NAME suppressed cough reflex sensitivity in non-sensitized guinea pigs and OVA-induced increase in cough reflex sensitivity in sensitized guinea pigs; however, iNOS inhibition caused by ONO1714 partially suppressed the OVA-induced increase in cough reflex sensitivity, but not the normal cough response in non-sensitized guinea pigs. ONO1714 did not change BAL cell components in OVA-sensitized guinea pigs.Conclusions: The results suggest that NO may be involved not only in the normal cough reflex circuit, but also in the OVA-induced increase in cough reflex sensitivity, possibly via a different mechanism of action. Further studies are needed to clarify the precise mechanism. © 2011 Hori et al; licensee BioMed Central Ltd.
続きを見る
|
||||
| 39.
論文 |
論文
|
Tokuda, Akira ; Ohkura, Noriyuki ; Fujimura, Masaki ; Furusho, Shiho ; Abo, Miki ; Katayama, Nobuyuki
概要:
金沢大学医薬保健研究域医学系<br />Background: Macrolides are antibiotics that have anti-inflammatory activities. Hence, they are used
…
for both acute and chronic inflammatory airway diseases. However, the effects of these agents on allergic airway disorders presenting with an isolated chronic cough, such as non-asthmatic eosinophilic bronchitis and eosinophilic tracheobronchitis with cough hypersensitivity (atopic cough), still remain to be elucidated. Objective: To determine if macrolides are effective in the management of chronic cough caused by eosinophilic airway inflammation. Methods: The cough reflex sensitivity to inhaled capsaicin was measured at 48 h after challenge with an aerosolized antigen in actively sensitized guinea pigs. The 14-, 15- or 16-membered macrolides (erythromycin, azythromycin, or josamycin, respectively) were given intraperitoneally every 12 h after the antigen challenge. Bronchoalveolar lavage and the resection of the tracheal tissue were performed immediately after the measurement of the cough response to capsaicin. Results: The antigen-induced increase in the number of coughs elicited by capsaicin inhalation was significantly reduced by treatments with erythromycin and azythromycin, but not with josamycin. Erythromycin dose-dependently inhibited the increases in the substance P, prostaglandin E2 and leukotriene B4 levels, but not the histamine levels, in the bronchoalveolar lavage fluid. However, erythromycin did not influence the antigen-induced decrease in the neutral endopeptidase (NEP) activity in the tracheal tissue. Conclusions: Both 14- and 15-membered, but not 16-membered, macrolides could reduce the antigen-induced cough reflex hypersensitivity by inhibiting the antigen-induced release of the afferent sensory nerve sensitizers. These macrolides may be therapeutically useful for the treatment of isolated chronic cough based on cough reflex hypersensitivity in allergic airway diseases such as non-asthmatic eosinophilic bronchitis and atopic cough. © 2009 Elsevier Ltd. All rights reserved.
続きを見る
|
||||
| 40.
論文 |
論文
|
Higashi, Tomomi ; Kambayashi, Yasuhiro ; Ohkura, Noriyuki ; Fujimura, Masaki ; Nakanishi, Sayaka ; Yoshizaki, Tomokazu ; Saijoh, Kiyofumi ; Hayakawa, Kazuichi ; Kobayashi, Fumihisa ; Michigami, Yoshimasa ; Hitomi, Yoshiaki ; Nakamura, Hiroyuki
概要:
The health effects associated with Asian dust have attracted attention due to the rapid increase in the number of Asian
…
dust events in East Asia in recent years. The aim of this study was to investigate the associations between Asian dust and daily cough, as well as allergic symptoms, in adult patients who suffer from chronic cough. We enrolled 86 adult patients from Kanazawa University Hospital, Japan, who were diagnosed with asthma, cough variant asthma, atopic cough or a combination of these conditions. From January to June 2011, subjects recorded their symptoms in a diary every day. Asian dust and non-Asian dust periods were defined according to the dust extinction coefficient, measured using the light detection and ranging (LIDAR). The daily levels of total suspended particulates, polycyclic aromatic hydrocarbons (PAHs) and coexisting factors related to allergies, such as the Japanese cedar pollen count, were measured. McNemar's test showed that there were significantly more cough-positive patients during Asian dust periods than during the non-Asian dust period (p = 0.022). In addition, during Asian dust periods when the daily levels of Japanese cedar pollen, Japanese cypress pollen and PAHs were elevated, there were significantly more patients who experienced itchy eyes than during the non-Asian dust period (p < 0.05). On the other hand, there were no significant differences in the allergic symptoms, including sneezing or a runny nose and nasal congestion. This is the first report to show that Asian dust triggers cough and allergic symptoms in adult patients with chronic cough. © 2014 Elsevier Ltd. All rights reserved.
続きを見る
|
||||
| 41.
論文 |
論文
|
Inuzuka, Kanako ; Yasui, Masahide ; Waseda, Yuko ; Takato, Hazuki ; Ichikawa, Yukari ; Fujimura, Masaki
概要:
金沢大学医薬保健研究域医学系<br />A 39-year-old man, who had been working in an aluminum processing industry for 18 years, visited our
…
hospital for right chest pain on March 2, 2007. A relapse of right pneumothorax was found, and he was hospitalized. As the pneumothorax did not improve with conservative treatment, video-assisted thoracoscopic biopsy and suturing of the right upper lobe were successfully performed. The pulmonary parenchyma had collapsed, there was pulmonary fibrosis, and lymphocytes had gathered in follicules. Based on elemental analysis results, we diagnosed aluminum lung. It was thought that overexpansion of the lower lobe with the predominant upper lobe fibrosis was caused by the aluminum deposition. We judged his condition to be serious and we started treatment with 25 mg/day prednisolone (PSL), and 120 mg/day cyclosporine (CyA). At the time of writing, he is an outpatient, and is being monitored on a regimen of 5 mg/day PSL and 160 mg/day CyA without any progression of pulmonary fibrosis or relapse of pneumothorax.
続きを見る
|
||||
| 42.
論文 |
論文
|
Higashi, Tomomi ; Kambayashi, Yasuhiro ; Ohkura, Noriyuki ; Fujimura, Masaki ; Nakai, Satoshi ; Honda, Yasushi ; Saijoh, Kiyofumi ; Hayakawa, Kazuichi ; Kobayashi, Fumihisa ; Michigami, Yoshimasa ; Olando, Anyenda Enoch ; Hitomi, Yoshiaki ; Nakamura, Hiroyuki
概要:
Asian dust, known as kosa in Japanese, is a major public health concern. In this panel study, we evaluated the effects o
…
f 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 (0μg/m3) to 5 (over 100μg/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 2.5μm (PM2.5). Our findings demonstrate that kosa is an environmental factor which induces cough in a dose-response relationship. © 2014 Elsevier Ltd.
続きを見る
|
||||
| 43.
論文 |
論文
|
Araya, Tomoyuki ; Kasahara, Kazuo ; Nishikawa, Shingo ; Kimura, Hideharu ; Sone, Takashi ; Nagae, Hideo ; Ikehata, Yoshio ; Nagano, Isamu ; Fujimura, Masaki
概要:
Background: The effects of inductive hyperthermia on lung cancer have yet to be fully investigated. Magnetic nanoparticl
…
es used in inductive hyperthermia are made-to-order and expensive. This study was performed to investigate the use of ferucarbotran in inductive hyperthermia and to clarify whether inductive hyperthermia using ferucarbotran promotes antitumor effects in vivo using a lung cancer cell line. Methods: We injected A549 cells subcutaneously into the right thighs of BALB/c nu/nu nude mice. Forty mice with A549 xenografts were then classified into three groups. Group 1 was the control group. All mice in groups 2 and 3 had ferucarbotran injected into their tumors, and mice in group 3 were then subjected to alternating magnetic field irradiation. We evaluated tumor temperature during the hyperthermic procedure, the time course of tumor growth, histologic findings in tumors after hyperthermic treatment, and adverse events. Results: Intratumor temperature rose rapidly and was maintained at 43°C-45°C for 20 minutes in an alternating magnetic field. Tumor volumes in groups 1 and 2 increased exponentially, but tumor growth in group 3 was significantly suppressed. No severe adverse events were observed. Histologic findings for the tumors in group 3 revealed mainly necrosis. Conclusion: Inductive hyperthermia using ferucarbotran is a beneficial and promising approach in the treatment of lung cancer. Ferucarbotran is a novel tool for further development of inductive hyperthermia. © 2013 Araya et al, publisher and licensee Dove Medical Press Ltd.
続きを見る
|
||||
| 44.
論文 |
論文
|
Katayama, Nobuyuki ; Fujimura, Masaki ; Yasui, Masahide ; Ogawa, Haruhiko ; Nakao, Shinji
概要:
We report a case of hypersensitivity pneumonitis and asthma attacks caused by environmental fungi in a 75-year-old man. The diagnosis was established by inhalation challenge with Bjerkandera adusta and Aspergillus fumigatus. The
…
patient was admitted for treatment of fever, wheezing, and dyspnea. Chest computed tomography showed small nodular shadows with diffuse, partially patchy, ground-glass opacities. The findings of bronchoalveolar lavage fluid were compatible with hypersensitivity pneumonitis. His symptoms and objective findings, including chest radiographs, worsened after returning home, suggesting the existence of causative antigens in his house. B. adusta and A. fumigatus were isolated from the living room and bedroom. Based on the results of antigen inhalation bronchoprovocation test, he was given a diagnosis of hypersensitivity pneumonitis caused by B. adusta and bronchial asthma attacks caused by B. adusta and A. fumigatus. After cleaning the entire house, the patient has had no recurrence of the symptoms on returning home.
続きを見る
|
||||
| 45.
論文 |
論文
|
Ogawa, Haruhiko ; Fujimura, Masaki ; Takeuchi, Yasuo ; Makimura, Koichi
概要:
Background: There is a close link between fungal sensitization and asthma severity. Although Schizophyllum commune (S. c
…
ommune, "suehirotake" in Japanese), one of the basidiomycetous (BM) fungi, is a fungus that can cause allergic bronchopulmonary mycosis (ABPM) and allergic fungal sinusitis (AFS), whether the fungus causes or sensitizes subjects to asthma is unclear. Methods: The bronchial provocation test using S. commune antigen was performed in two asthmatics who had demonstrated positive skin reactions to the S. commune antigen, and low dose of itraconazole (50 mg/day) was prescribed as an adjunctive therapy for 2 weeks. The allergological features and clinical manifestations of these patients are herein evaluated and discussed. Results: Case 1 was a 71-year-old female, and case 2 was a 69-year-old male. Both patients demonstrated positive reactions to the inhalation test. A diagnosis of AFS or ABPM was excluded in both patients because of the lack of a history of pulmonary infiltrates, central bronchiectasis, a history of expectoration of brown plugs or flecks, or sinusoidal findings. Although the efficacy of itraconazole in our cases was unclear, the elevated titer of the specific IgG-for S. commune in case 2 gradually decreased during the period of antifungal therapy. Conclusions: The two patients described herein were diagnosed to have bronchial asthma caused by S. commune; so-called Schizophyllum asthma. S. commune may also be a causative fungal antigen of bronchial asthma. © 2011 Elsevier Ltd. All rights reserved.
続きを見る
|
||||
| 46.
論文 |
論文
|
Hosokawa, Kohei ; Yamazaki, Hirohito ; Nishitsuji, Masaru ; Kobayashi, Satoshi ; Takami, Akiyoshi ; Fujimura, Masaki ; Nakao, Shinji
概要:
We report a case of pulmonary veno-occlusive disease (PVOD) following allogeneic bone marrow transplantation (BMT) for t
…
he treatment of acute myeloid leukemia (AML) from an HLA mismatched mother using a reduced-intensity conditioning (RIC) regimen including gemtuzumab ozogamicin. The patient was a 21-year-old male who complained of dyspnea with hypoxemia followed by loss of consciousness. The abnormalities in chest CT and echocardiography were compatible with a diagnosis of PVOD. Treatment with 1 mg/kg of oral prednisolone resolved dyspnea and hypoxemia within a few days, and chest CT abnormalities disappeared in a week. This report is the first to describe PVOD following RIC stem cell transplantation. © 2012 The Japanese Society of Internal Medicine.
続きを見る
|
||||
| 47.
論文 |
論文
|
Okazaki, Akihito ; Araya, Tomoyuki ; Sakai, Asao ; Sone, Takashi ; Kasahara, Kazuo ; Fujimura, Masaki
概要:
Background. Evidence of gastric metastasis from lung cancer is rarely observed at initial diagnosis. Case 1. A 74-year-o
…
ld woman with anorexia was referred to our hospital due to upper lobe atelectasis of the left lung noted on a chest X-ray film. Bronchoscopic examination revealed obstruction of the left upper bronchus by a tumor. A biopsy specimen from the mass demonstrated small cell cancer. Upper gastrointestinal endoscopy showed an elevated lesion forming a central depression ("bull's eye") in the antrum. Immunohistochemical examination confirmed metastasis from small cell lung cancer. Despite chemotherapy with carboplatin and etoposide, the patient did not respond to treatment and died of lung cancer 3 months after admission. Case 2. A 76-year-old man with a chief complaint of epigastralgia was given a diagnosis of small cell lung cancer of the right lower lobe. Endoscopic examination revealed an elevated lesion forming a "bull's eye" in the gastric corpus. A biopsy specimen from the tumor demonstrated metastasis from small cell lung cancer, and he died of lung cancer 1 month after diagnosis. Conclusion. Opportunities to identify gastric metastasis from lung cancer are likely to increase with the increasing incidence of lung cancer. On diagnosis of gastric metastasis, upper gastrointestinal endoscopy is useful for proper staging and treatment. The possibility of gastric metastasis should be considered when patients complain of anorexia or epigastralgia at initial diagnosis. © 2012 The Japan Lung Cancer Society.
続きを見る
|
||||
| 48.
論文 |
論文
|
Tambo, Yuichi ; Fujimura, Masaki ; Yasui, Masahide ; Kasahara, Kazuo ; Nakatsumi, Yasuto ; Nakao, Shinji
概要:
金沢大学附属病院呼吸器内科<br />A 72 year-old man. He was diagnosed with rheumatoid arthritis in 2002. In January 2005 he noted produ
…
ctive cough and fever; he was diagnosed as eosinophilic pneumonia (EP). We discontinued administration of bucillamine and methotrexate and started to treat with oral prednisolone 30 mg daily. To rule out drug-induced EP, prednisolone was tapered by 10 mg per week. Consolidation occurred in the right lower lobe when prednisolone was decreased to 5 mg daily. After increasing the dose of prednisolone to 30 mg daily again, consolidation was promptly resolved. It was considered to be important to rule out drug-induced EP. © 2008 The Japanese Society of Internal Medicine.
続きを見る
|
||||
| 49.
論文 |
論文
|
藤村, 政樹 ; Fujimura, Masaki
概要:
金沢大学医薬保健研究域医学系<br />基礎的研究：気管支収縮による咳嗽反応は、C-fiberではなく、RARsにより介在されていることを明らかにした。さらに、この咳嗽反応にはプロスタグランディンE2が重要な役割を果たしていることを示した。
…
臨床的研究：メサコリン誘発気管支収縮反応時の咳嗽反応が、咳喘息患者では亢進していることを明らかにした。この咳嗽反応は、治療によって咳嗽が軽快した時には正常化していた。したがって、気管支収縮に対する咳嗽反応の亢進が、咳喘息の生理学的基本病態であることが明らかとなった。この気管支収縮に対する咳嗽反応は、咳喘息の診断に対して感受性が81.0% 、特異性が89.7%だった。<br />Basic study: Beta2-agonists abolished both the methacholine-induced bronchoconstriction and cough. Capsaicin desensitization had no effect on the bronchoconstriction or the number of coughs. Moguisteine inhibited the number of coughs but not the bronchoconstriction. It is concluded that bronchoconstriction causes cough via RARs, but not C-fibers. Furthermore, prostaglandin E2 takes a role to enhance the methacholine-induced cough response as protection of bronchoconstriction.Clinical study: Cough response to bronchoconstriction induced by Meth was heightened in cough variant asthma patients. The increased cough response recovered to normal range after treatment. Thus, we identified heightened cough response to bronchoconstriction as a fundamental physiologic feature of cough variant asthma. Sensitivity and specificity of cough responsiveness to Mch for discrimination of cough variant asthma from chronic non-productive cough were 81.0% and 89.7%, respectively.<br />研究課題/領域番号:23591142, 研究期間(年度):2011-2013
続きを見る
|
||||
| 50.
論文 |
論文
|
藤村, 政樹 ; Fujimura, Masaki
概要:
咳嗽反応の末梢機序には少なくとも以下の2つ経路が存在することが明らかとなった。(1)気道表層の気管支上皮間や上皮下に存在する知覚神経終末(咳受容体)の感受性亢進(アトピー咳嗽)あるいは過剰刺激による咳嗽反応(副鼻腔気管支症候群)、(2)気管
…
支壁深層の平滑筋層の中または周囲に存在する知覚神経終末(Aδ線維)の平滑筋収縮に対する過剰反応(咳喘息)、あるいは過剰な平滑筋収縮による過刺激(気管支喘息)。<br />It has been disclosed that there are at least two pathway of cough reflex : (1) increased cough receptor sensitivity (atopic cough) or hyper-stimulation to cough receptors (sinobronchial syndrome) which are present in inter- and sub epithelium of airway, (2) increased response of sensory nerve endings (Adelta-fibers) in intra- and peri-smooth muscle layer to the smooth muscle contraction (cough variant asthma) or hyper-stimulation (strong smooth muscle contraction) to the nerve endings.<br />研究課題/領域番号:20590916, 研究期間(年度):2008-2010
続きを見る
|
||||
| 51.
論文 |
論文
|
藤村, 政樹 ; Fujimura, Masaki
概要:
I.臨床的検討1.環境真菌Basidlomycetes属の重要性1)従来の検討によって、重要な環境真菌としてBasldiomycetes属が同定されていたが、難治性慢性咳嗽患者の誘発喀痰中から培養された真菌のDNAシークエンスによる解析によ
…
って、我々の注目している環境真菌がBasidiomycetes属に属するBjerkanderaadusta(和名:ヤケイロタケ)であることが判明した。2)アトピー咳嗽患者では、咽頭拭い液の爽菌培養によって、Basidiomycetes属はカンジダの次に多く(約20%)検出された。3)Basidiomyctets属の抗原抽出液に対する即時型皮内反応の検討では、アトピー咳嗽患者では陽性率が約20%程度でり、非アトピー健常者の5%以下に比較して高率だった。4)喀痰からBjerkandera adustaが培養同定された難治性慢性咳嗽患者8例の検討では、同真菌の抽出抗原に対するリンパ球刺激試験と抗原吸入負荷試験が陽性であったが、皮膚反応は3例のみが陽性を示し、IgE非依存性のアレルギー反応の重要性が示された。2.アトピー咳嗽における呼気一酸化炭素(NO)濃度の検討好酸球性気道炎症のバイオマーカーである呼気NO濃度は、喘息や咳喘息に比べて、アトピー咳嗽では低値を示した。II.基礎的検討1)モルモットを用いて、アトピー咳嗽と咳喘息のデルを作成し、その病態の比較を行った。アトピー咳嗽ではニューロキニンとヒスタミンが重要であるが、咳喘息ではロイコトリエンが重要であることが示された。2)咳発作による気道への圧ストレスが咳感受性に対して増幅回路を形成することが明らかとなった。すなわち、咳嗽は強力に止めることが治療の成功に必要であることが示された。<br />I. Clinical research1) Importance of environmental fungi, basidiomycetous fungi, in chronic cough(1) In previous studies basidiomycetous fungi had been documented as important environmental fungi in severer cases of atopic cough, The DNA sequence analysis revealed that the fungi which were cultured from sputum of patients with intractable chronic cough was Bjerkandera adusta.(2) Basidiomycetous fungi was detected from fungal culture of pharyngeal swab in 20% of patients with atopic cough. The rate was the second following Candida.(3) We succeeded to prepare the antigen extract of basidiomycetous fungi. Immediate type skin reaction using the antigen extract solution was positive in 20% of patients with atopic cough, which was significantly higher than that (5%) in non-atopic healthy subjects.(4) In 8 patients with intractable chronic cough whose sputum yielded Bjerkandera adusta cultured, lymphocyte stimulation test and inhalation provocation test using the fungal antigen were positive while the skin reaction was positive in only 3 patients. These findings suggest that lgE non-mediated allergic reaction is important in the fungal-associated chronic cough.2) Exhaled nitric oxide (NO) concentration in atopic coughExhaled nitric oxide (NO) is a biomarker of eosinophilic airway inflammation and the levels have been shown to be elevated in bronchial asthma, cough variant asthma and non-asthmatic eosinophilic bronchitis. We investigated whether the exhaled NO levels were increased in atopic cough in comparison with those in bronchial asthma and cough variant asthma. The exhaled NO levels were significantly lower in atopic cough compared with bronchial asthma and cough variant asthma.II. Basic research1) We developed guinea pig models of atopic cough and cough variant asthma. Neurokinins and histamine were important in the atopic cough model while leukotrienes were important in the cough variant asthma model.2) We hypothesized that cough attacks are mechanical stress to the airways and influence the cough reflex sensitivity. Transient rapid negative pressure was repeatedly given to anesthetized and artificially ventilated guinea pigs. Cough reflex sensitivity to inhaled capsaicin was increased 6 hours after the negative pressure stress which was associated with neutrophilic airway inflammation. Cough stress to airway makes a self-perpetuating cough-reflex cycle, in which antigen-induced increase in cough reflex sensitivity results in pathologic cough, and the cough in turn amplifies cough reflex sensitivity.<br />研究課題/領域番号:17607003, 研究期間(年度):2005-2007<br />出典：「アトピー咳嗽におけるIgE非依存性機序と環境真菌の重要性」研究成果報告書 課題番号17607003 (KAKEN：科学研究費助成事業データベース（国立情報学研究所）) 本文データは著者版報告書より作成
続きを見る
|
||||
| 52.
論文 |
論文
|
藤村, 政樹 ; Fujimura, Masaki
概要:
I.基礎的研究1.モルモットを用いてアトピー咳嗽と咳喘息それぞれの動物モデルの作成に成功した。1)アトピー咳嗽モデルに関する研究によって、咳感受性の亢進には、ニュートラルエンドペプチダーゼ活性の阻害によるサブスタンスPが重要な役割を担ってお
…
り、ヒスタミンがサブスタンスPとの相互作用によって関与することが解明された。2)咳喘息モデルに関する研究によって、本モデルの抗原誘発咳嗽は気管支平滑筋収縮によって発生し、ロイコトリエンが関与するも、タキキニンは関与しないことが解明された。2.咳感受性に与える気道への機械的圧ストレスの影響咳発作を想定した気道への定量的圧負荷装置を開発し、気道への圧負荷が咳感受性を亢進させ、さらに気道への好中球浸潤を引き起こすことを発見した。すなわち、咳嗽発作が咳感受性性をさらに亢進し、好中球性気道炎症を惹起することによって、咳嗽と咳感受性亢進に増幅回路(悪循環回路)が形成されることが明かとなった。II.臨床的研究1.アトピー咳嗽と咳喘息は、生理学的および病理学的基本病態が異なることに加えて、予後も異なることを明らかにした。すなわち、咳喘息は数年の内に約30%の患者が喘息を発症するが、アトピー咳嗽は喘息を発症しないことが明かとなった。2.咳喘息から喘息を発症する危険因子が、気道過敏性亢進と長期吸入ステロイド療法を実施しないことの2つであることがわかった。3.慢性咳嗽の原因疾患の頻度多施設共同前向き研究によって検討した結果、慢性咳嗽の三大原因疾患は咳喘息、アトピー咳嗽、副鼻腔気管支症候群であることが明かとなり、本邦におけるアトピー咳嗽の重要性が確認された。<br />I. Basic research1. guinea pig models for atopic cough and cough variant asthma have been developed.1) Using the atopic cough model, it has been disclosure d that increased level of substance P resulted from antigen-induced inactivation of neutral endopeptidase is important in the antigen-induced increase in cough sensitivity, and that there may bean interaction between histamine and substance P.2) Using the cough variant asthma model, It is clarified that cough is elicited via antigen-induced bronchoconstridion, and that leukotrienes, but not tachykinins, are involved in the cough.2. We developed a apparatus to give quantitative mechanical pressure stress to guinea pig airway. The Mechanical pressure stress to airway induced cough reflex hypersensitivity associated with airway neutrophilic inflammation., suggesting self-perpetuating cycle between cough and cough hypersensitivity.II. Clinical research1. In addition to the difference of pathophysiologic feature between atopic cough and cough variant astluna, we elucidated the long-term outcome is also different between these two condition.: Nearly 30% patients with cough variant asthma develops typical asthma within several years but no patient with atopic cough does.2. Bronchial hyperresponsiveness and no use of long-tern inhaled corticosteroids were risk factors of typical asthma onset from cough variant asthma.3. Our prospective study confirmed that cough variant asthma, atopic cough and sinobronchial syndrome are common causes of chronic cough in Japan.<br />研究課題/領域番号:14570546, 研究期間(年度):2002-2004<br />出典：「慢性咳嗽の病態解明に基づく診断・治療法の開発」研究成果報告書 課題番号14570546 (KAKEN：科学研究費助成事業データベース（国立情報学研究所）) 本文データは著者版報告書より作成
続きを見る
|
