JaLCDOI 10.18926/15314
Title Alternative 気管支肺胞洗浄液中に一過性の好中球増多をきたしたアトピー型喘息
FullText URL 064_052_059.pdf
Author Tanizaki, Yoshiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Sugimoto, Keisuke| Yokota, Satoshi| Hiramatsu, Junichi| Kawaraya, Masashi| Nakagiri, Yoshiyasu| Tada, Shinya| Kimura, Ikuro|
Abstract Clinical course of one asthma patient (64 years old, female), who had an increased proportion of neutrophils in bronchoalveolar lavage (BAL) fluid, was observed in relation to the proportion of BAL cells and ventilatory function. The patient had large asthma attacks two times during her clinical course for 15 months observed. 1. An increased proportion of BAL neutrophils and suppression of ventilatory function were found after her first large asthma attacks. The increased proportion of BAL neutrophils continued for more than 5 months. A reduction in the proportion of BAL neutrophils was found 3 months after her second large asthma attack, accompanied by improvement of clinical symptoms and ventilatory function. The numbers of total cells and neutrophils in BAL fluid were also reduced. Transient increase in number of BAL lymphocytes was found 13 months after the first large attack when the number of BAL neutrophils was markedly decreased. The number of BAL eosinophils did not change during her clinical course.
Abstract Alternative 経過中に気管支肺胞洗浄(BAL)液中に一過性の好中球増多が観察されたアトピー型喘息症例について,若干の臨床的観察を加えた。症例は,64才の女性で,臨床症状,および血清IgE高値,ハウスダストに対するIgE抗体陽性などから,アトピー型喘息と診断された。なお,経過観察し得た15ヵ月の間に2回の大発作が観察された。1.第1回の大発作後,BAL液中好中球増多と換気機能の低下が観察された。そして,このBAL液中好中球頻度は明らかな改善が見られた。BAL液中の総細胞数および好中球の絶対数も徐々に減少傾向を示し,好中球頻度と同様,第2回目の大発作3ヵ月後には著明な減少が観察された。同時にこの時期には,BAL液中リンパ球の増加も見られた。しかし,BAL液中好酸球数は15ヵ月の経過観察中ほとんど変化は見られなかった。
Keywords Bronchial asthma (気管支喘息) transient BAL neutrophilia(一過性BAL液中好中球増多) ventilatory function (換気機能)
Publication Title 岡大三朝分院研究報告
Published Date 1993-06
Volume volume64
Start Page 52
End Page 59
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307805
JaLCDOI 10.18926/15310
Title Alternative 気管支喘息の臨床分類とその細胞性および液性因子の特徴
FullText URL 064_036_042.pdf
Author Tanizaki, Yoshiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Sugimoto, Keisuke| Yokota, Satoshi| Hiramatsu, Junichi| Kawaraya, Masashi| Nakagiri, Yoshiyasu| Tada, Shinya| Kimura, Ikuro|
Abstract Characteristics of each asthma type classified by clinical symptoms and findings were studied in 72 patients with bronchial asthma. 1. Ventilatory function tests showed that the values of % MMF, % V(50) and % V(25) were significantly lower in patients with bronchiolar obstruction (type II) compared to the values of those with simple bronchoconstriction type (type Ia) and those with bronchoconstriction + hypersecretion (type Ib). 2. The proportion of neutrophils in bronchoalveolar lavage (BAL) fluid was significantly higher in type II than in type Ia and type Ib. Several patients with type Ib showed higher proportion of BAL eosinophils. 3. The release of LTC(4) from leucocytes was significantly lower in type II compared with type Ia and type Ib. There was no significant difference in the release of histamine and LTB(4) among the three asthma types.
Abstract Alternative 気管支喘息72例を対象に,その臨床病態の特徴を,気道炎症性の細胞および化学伝達物質の観察により検討した。1.気道反応の特徴を換気機能の面から検討すると,II細気管支閉塞型において,MMF,V(50)やV(25)などの小ないし細気管支領域の換気障害を示すパラメーターの値は,Ia型,Ib型に比べ 有意の低下を示した。2.気道細胞反応では,II型において,他の臨床病型に比べ,BAL液中好中球の出現頻度の有意の増加が観察された(Ia, p<0.001 ; Ib, p<0.01)。好酸球の出現頻度は,Ib過分泌型において著しい増加傾向を示す症例が見られたが,その平均出現頻度には3病型間に有意の差は見られなかった。3.好中球からのメジェー夕ー遊離では,ヒスタミン遊離は,Ia単純性気管支撃縮型において最も高い値が示されたが,推計学的には3病型間に有意の差は見られなかった。ロイコトリエンC(4)では,Ia型においてII型に比べ有意に高い遊離が観察された(p<0.05)。ロイコトリエンB(4)遊離には,3病型間に差は見られなかった。
Keywords Bronchial asthma Asthma classification BAL fluid chemical mediators
Publication Title 岡大三朝分院研究報告
Published Date 1993-06
Volume volume64
Start Page 36
End Page 42
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307662
JaLCDOI 10.18926/15308
Title Alternative 老年者気管支喘息における液性および細胞性免疫反応について
FullText URL 064_075_082.pdf
Author Tanizaki, Yoshiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Sugimoto, Keisuke| Yokota, Satoshi| Hiramatsu, Junichi| Kawaraya, Masashi| Ochi, Koji| Harada, Hideo| Tada, Shinya| Kimura, Ikuro|
Abstract Humoral and cellular immune responses in bronchial asthma were examined by comparing the results of older asthmatics (group OA) with those of older healthy subjects (group OH) and of younger asthmatics (group YA). In humoral immune response, IgE-mediated immune system expressed by elevated serum IgE levels and IgE antibodies for house dust mite (HDm) and/or Candida albicans was clearly found in older asthmatics, while there was no finding showing the presence of IgE-mediated immune response in older healthy subjects. There was no significant difference in levels of serum IgG and IgA among the three groups. However, the serum IgM level was significantly lower in older asthmatics than in younger asthmatics. IgE antibodies to HDm and/or Candida albicans were more frequently found in older asthmatics compared with older healthy subjects. In contrast, IgG(4) antibodies to HDm were not different among the three groups. IgG(4) antibodies to Candida albicans were significantly higher in both older groups than in younger group. However, there was no significant difference between asthmatic and healthy subjects in the elderly. Delayed skin reaction to PPD was significantly more decreased in older asthmatics. These results show that bronchial asthma in the elderly is characterized by the presence of IgE-mediated immune response and by the changes of immune response with aging.
Abstract Alternative 気管支喘息における液性および細胞性免疫反応について,老年者気管支喘息,老年者健常人,および若年者気管支喘息の間で比較検討を行った。1.まず,液性免疫では,血清IgE値高値,ハウスダストやカンジダに対するIgE抗体陽性などのIgE系反応は,老年者気管支喘息においては明らかに観察されたが,老年者健常人では全く観察されなかった。血清IgGおよびIgA値には3者間に有意の差は見られなかったが,血清IgMは,若年者喘息に比べ老年者喘息で有意に低い値を示した。2.ハウスダストやカンジダに対するIgE抗体は老年者喘息において老年者健常人に比べより高い頻度で陽性であったが,一方,ハウスダストに対するIgG(4)抗体は3者聞に有意の差は見られなかった。また,カンジダに対するIgG(4)抗体は,老年者喘息および健常人において,若年者喘息に比べ有意の高値を示した。しかし,老年者の喘息と健常人との間には有意の差は見られなかった。3.PPDによる遅延型皮膚反応は,若年者喘息に比べ老年者喘息において有意の減弱傾向を示した。これらの結果は,老年者喘息はIgE系反応を有していること,そして,加齢による免疫反応の変化の影響を受けること,を示している。
Keywords IgE IgG(4) Immunoglobulings (免疫グロブリン) PPD Bronchial asthma (気管支喘息) 加齢
Publication Title 岡大三朝分院研究報告
Published Date 1993-06
Volume volume64
Start Page 75
End Page 82
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307261
JaLCDOI 10.18926/15305
Title Alternative 気管支喘息における気道炎症反応の臨床的意義。慢性閉塞性細気管支炎との比較検討
FullText URL 064_024_030.pdf
Author Tanizaki, Yoshiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Sugimoto, Keisuke| Yokota, Satoshi| Hiramatsu, Junichi| Kawaraya, Masashi| Ochi, Koji| Harada, Hideo| Tada, Shinya| Kimura, Ikuro|
Abstract Clinical significanoce of airway inflammation was assessed in 28 patients with bronchial asthma, and the results were compared with those in 9 patients with chronic obstructive bronchiolitis (COB). 1. Total cell number in bronchoalveolar lavage(BAL) fluid was markedly increased in patients with COB (51.0×10(6)), which was significantly greater than that in those with bronchial asthma (9.6×10(6) ). 2. The proportion of BAL macrophages was significantly higher in patients with bronchial asthma than in those with COB. However, the, absolute number of BAL macrophages was not significantly different between them. 3. The proportion of BAL lymphocytes was higher in patients with bronchial asthma than in those with COB, but this difference was not signifcant. In contrast, the absolute number of BAL lymphocytes was significantly greater in patients with COB than in those with bronchial asthma. 4. The proportion and the number of BAL neutrophils were markedly increased in patients with COB compared to those with bronchial asthma. 5. The proportion and the number of BAL eosinophils were higher in patients with bronchial asthma than in those with COB, although these defferences were not significant. The results suggest that airway inflammation in bronchial asthma is not so intensive as that in COB.
Abstract Alternative 気管支喘息28例および慢性閉塞性細気管支炎9例を対象に,気道炎症反応の臨床的意義について検討を加えた。1.気管支肺胞洗浄(BAL)液中の総細胞数は,慢性閉塞性細気管支炎において著明に増加しており(51.0×10(6)),気管支喘息(9.6×10(6))との間に有意の差が見られた。2.BAL液中マクロファージの頻度は気管支喘息において,慢性閉塞性細気管支炎に比べ有意に高い値を示したが,絶対数での比較では両疾患群間に有意の差は見られなかった。 3.BAL液中リンパ球の頻度は,気管支喘息においてやや高い傾向が見られたが,絶対数の比較では慢性閉塞性細気管支炎において有意に高い値であった。 4.BAL液中の好中球は,その頻度および絶対数とも慢性閉塞性細気管支炎において著明に増加しており,これは気管支喘息と比べ有意に高い値であった。 5.BAL液中好酸球の頻度および絶対数は,気管支喘息においてやや高い値であったが,両疾患群間に有意の差は見られなかった。以上の結果より,気管支喘息における気道炎症反応は,慢性閉塞性細気管支炎ほど高度ではない ことが明らかにされた。
Keywords airway inflammation (気道炎症反応) bronchial asthma (気管支喘息) chronic obstructive bronchiolitis (慢性閉塞性細気管支炎) lymphocytes (リンパ球) neutrophils (好中球)
Publication Title 岡大三朝分院研究報告
Published Date 1993-06
Volume volume64
Start Page 24
End Page 30
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307730
JaLCDOI 10.18926/15303
Title Alternative 気管支喘息におけるActivated Tリンパ球について,喘息発作との関連
FullText URL 064_011_016.pdf
Author Tanizaki, Yoshiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Sugimoto, Keisuke| Yokota, Satoshi| Hiramatsu, Junichi| Kawaraya, Masashi| Harada, Hideo| Tada, Shinya| Kimura, Ikuro|
Abstract The number of CD4(+) T-Iymphocytes, CD4/CD8 ratio, and the number of IL2R(+) T-Iymphocytes (CD25) were examined in 14 patients with bronchial asthma, and the results were compared in three different asthma stages : symptom-free stage, wheeze stage, and attack stage. 1. The proportion of blood CD4(+) T-lymphocytes was more decreased in patients with asthma attacks than in those without symptoms. The CD4/CD8 ratio was also more decreased in patients with attacks than in those without symptoms. However, these differences were not significant. 2. The proportion of blood activated T cells (IL2R(+) cells, CD25) was significantly increased in patients with attacks than in those without symptoms. The proportion of activated T cells in 5 asthma patients was 2.9±0.8% in symptom-free stage and 6.6±1.1% in attack stage(p<0.001). These findings show that numbers of activated T-lymphocytes in peripheral blood were increased during asthma attacks, and this increase suggests the participation of activated T cells in the pathogenesis of asthma.
Abstract Alternative 気管支喘息14例を対象に,末梢血CD4(+)リンパ球の頻度,CD4/CD8比およびIL2R(+)Tリンパ球の頻度について,喘息発作との関連のもとに検討を加えた。1.CD4(+)リンパ球の頻度は,非発作時の症例で最も高く,喘鳴のみの症例,発作の見られる症例へと順次低くなる傾向が見られたが,推計学的には有意の差は見られなかった。CD4/CD8比も同様に,非発作時に最も高く,発作を有する症例では非発作時に比べ低い値を示したが,推計学的には有意の差は見られなかった。2.IL2R(+)Tリンパ球(activated Tリンパ球)の頻度は,非発作時の症例で最も低く(3.5±1.1%),喘鳴のみをともなう症例(3.8±1.1%),発作の見られる症例(5.8±1.9%)へと順次高くなる傾向を示し,発作のある症例では,非発作および喘鳴のみの症例に比べ有意に高い値 を示した。また,非発作時と発作のある時期にIL2R(+)Tリンパ球を観察し得た5症例では,非発作時2.9±0.8%,発作のある時期6.6±1.1%であり,発作のある時期に有意の高値を示した(p<0.001)。これらの結果は,発作のある時期にはactivated Tリンパ球の頻度が増加すること,そして,この増加はactivated Tリンパ球が喘息発作の病態と密接な関連を有していることを示唆するものと考えられた。
Keywords CD4(+) T cells (CD4(+)リンパ球) CD4/CD8 ratio (CD4/CD8比) IL2R(+) T cells (IL2R(+)Tリンパ球) bronchial asthma (気管支喘息)
Publication Title 岡大三朝分院研究報告
Published Date 1993-06
Volume volume64
Start Page 11
End Page 16
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307394
JaLCDOI 10.18926/15301
Title Alternative 気管支喘息における副腎皮質ホルモン長期投与による免疫抑制と気管支肺胞洗浄液中好中球増多との関連
FullText URL 064_017_023.pdf
Author Tanizaki, Yoshiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Sugimoto, Keisuke| Yokota, Satoshi| Hiramatsu, Junichi| Kawaraya, Masashi| Harada, Hideo| Kimura, Ikuro|
Abstract Cellular composition of bronchoalveolar lavage (BAL) fluid was compared between two age-matched steroid-dependent intractable asthma (SDIA) groups : 17 group A patients (serum IgG level < 1000mg/dℓ) whose immunity was regarded as being suppressed by long-term glucocorticoid therapy and 17 group B patients (serum IgG level > 1200mg/dℓ). 1. The levels of serum IgA and IgM were significantly decreased in group A compared to the levels in group B patients. 2. The number of blood lymphocytes was also significantly lower in group A than in group B patients. However, the number of blood neutrophils was not different between the two asthma groups. 3.The number of BAL lymphocytes was significantly lower in group A than in group B patients. 4. BAL neutrophilia (more than 1.5×10 (4)/mℓ) was observed in 6 of the 17(35.3%) patients in group A, but not observed in any patients in group B. The number of BAL neutrophils was significantly greater in group A than in group B patients. These results suggest that there is a correlation between immunosuppression by glucocorticoids and BAL neutrophilia in patients with bronchial asthma.
Abstract Alternative ステロイド依存性重症難治性喘息を,免疫抑制の見られる症例(血清IgG値1000mg/dℓ以下)(グループA)と抑制の見られない症例(血清IgG値1200mg/dℓ以上)(グループB)の2群に分け,気管支肺胞洗浄液中の細胞成分について比較検討した。1.血清IgAおよびIgM値は,グループBに比べ免疫抑制の見られるグループAにおいて有意に低い値であった。2.末梢血リンパ球数は,グループAにおいて,グループBに比べ有意に少ない傾向が見られた。しかし,末梢血好中球数は両群間に有意の差は見られなかった。3.BAL液中リンパ球数は,グループBに比べ免疫抑制の見られるグループAにおいて有意に少 ない数であった。4.BAL液中好中球増多(1.5×10(4)/mℓ以上)を示す症例は, グループAの17例中6例(35.3%)に見られたが,グループBでは全く 見られなかった。また,BAL液中好中球数は,グループAにおいてグループBに比べ有意に多い数であった。以上の結果により,副腎皮質ホルモン長期投与 による免疫抑制とBAL液中好中球増多とはある程度関連があることが明らかにされた。
Keywords immunosuppression (免疫抑制) BAL neutrophilia (BAL好中球増多) glucocorticoids (副腎皮質ホルモン) bronchial asthma (気管支喘息)
Publication Title 岡大三朝分院研究報告
Published Date 1993-06
Volume volume64
Start Page 17
End Page 23
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307882
JaLCDOI 10.18926/15299
Title Alternative ステロイド依存性重症難治性喘息に対する温泉療法の重要性。過去10年間の181例を対象に。
FullText URL 064_001_010.pdf
Author Tanizaki, Yoshiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Sugimoto, Keisuke| Yokota, Satoshi| Hiramatsu, Junichi| Kawaraya, Masashi| Ochi, Koji| Harada, Hideo| Tada, Shinya| Kimura, Ikuro|
Abstract Characteristics of 181 patients with steroid-dependent intractable asthma (SDIA) who were admitted to our hospital and had spa therapy for last 10 years were examined in relation to the methods of spa therapy. For last 10 years, three kinds ofspa therapies were administered: spa therapy A (swimming training in a hot spring pool) in the first atage (1982-1985), spa therapy B (swimming training + inhalation of iodine salt solution) in the middle stage (1986 -1989), and spa therapy C (swimming training + inhalation of iodine salt solution + fango therapy) in the last stage (1990-1991) of this study. 1. The number of patients with SDIA who were admitted to our hospital and had spa therapy tended to increase from 2 in 1986 to 35 in 1991. 2. The number of SDIA patients over the age of 60 or over the age at onset of 40 tended to increase from the first stage to the last stage. 3. The proportion of patients from distant areas (prefectures other than Tottori) was decreasing for the last stage, although the number of these patients was increasing in recent years. 4. The proportions of patients divided by serum IgE levels and by clinical asthma types did not change for last 10 years. 5. The proportion of type Ib and type II asthma was considerably high in patients with SDIA for last 10 years. 6. Clinical effects of spa therapy were observed in 21 of the 30 (70.0%)patients with SDIA in the first stage (1982-1985) with spa therapy A, 68 of the 83 (74.7%) patients with SDIA in the middle stage (1986-1989) with spa therapy B, and 61 of the 68 (89.7%) patients with SDIA in the last stage (1990-1991) with spa therapy C.
Abstract Alternative 最近10年間に三朝分院へ入院し,温泉療法を受けたステロイド依存性重症難治性喘息181例を対象に,温泉療法の方法との関連のもとに,対象患者の背景について検討を加えた。最近10年間に3種類の温泉療法が行われた。温泉療法A(温泉プール水泳訓練)は初期(1982-1985),温泉療法B(水泳訓練+ヨードゾル吸入)は中期(1986-1989),また,温泉療法C(水泳訓練+ヨードゾル吸入+鉱泥湿布療法)は後期(1990-1991)に行われた。1.当院へ入院し,温泉療法を受けたステロイド依存性重症難治性喘息(SDIA)患者の数は,1986年の2例から1991年の35例へと増加の傾向を示した。2.SDIA患者のうち,60才以 上の症例および40才以降の発症症例の数は,1986年以降急激な増加傾向を示した。3.鳥取県以外の他県(遠隔地)からの入院患者の頻度は,近年減少の傾向を示したが,その絶対数は増加の傾向であった。4.血清IgE値はいずれの時期においても200IU/mℓ以下の症例が多い傾向が見られた。5.臨床病型では,通常の喘息に比べIb型およびII型の頻度が高い傾向が見られた。6.温泉療法の臨床効果は,温泉療法Aが行われた初期では70.0%,温泉療法Bの中期では74.7%,温泉療法Cの後期では89.7%であった。
Keywords swimming training in a hot spring pool (温泉プール水泳訓練) inhalation of iodine salt solution (ヨードゾル吸入) fango therapy (鉱泥湿布療法) SDIA
Publication Title 岡大三朝分院研究報告
Published Date 1993-06
Volume volume64
Start Page 1
End Page 10
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307391
Author Mifune, Takashi| Kawaraya, Masashi| Hiramatsu, Junichi| Yokota, Satoshi| Sugimoto, Keisuke| Kajimoto, Kazuhiro| Mitsunobu, Fumihiro| Kitani, Hikaru| Tanizaki, Yoshiro|
Published Date 1993
Publication Title 岡山医学会雑誌
Volume volume105
Issue issue5-6
Content Type Journal Article
Author Mitsunobu, Fumihiro| Kitani, Hikaru| Mifune, Takashi| Kajimoto, Kazuhiro| Sugimoto, Keisuke| Yokota, Satoshi| Hiramatsu, Junichi| Kawaraya, Masashi| Tanizaki, Yoshiro|
Published Date 1993
Publication Title 岡山医学会雑誌
Volume volume105
Issue issue5-6
Content Type Journal Article