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The influence of cigarette smoke on pulmonary function, airflow, lung volume, and transfer factor in patients with asthma was examined in 40 subjects over the age of 70 years (20 ever-smokers and 20 never-smokers), and 20 patients with pulmonary emphysema over age 70 (all ex-smokers). The ventilatory parameters showing airflow limitation (% FEV(1) and FEV(1)%) were not significantly different between ever-smokers and never-smokers of elderly asthmatics. In contrast, % FEV(1) and FEV(1) % values were significantly lower in patients with pulmonary emphysema than in those with asthma with or without a history of smoking. The % RV value was significantly larger and % DLco value was significantly more decreased in ever-smokers compared with neversmokers of the elderly asthmatics. However, there were no significant differences in % RV and % DLco values between asthmatics with a history of smoking and patients with pulmonary emphysema. The results show that cigarette smoke inflluences % RV and % DLco, but not % FEV(1) and FEV(1) %, suggesting airflow limitation of large and moderate size airways., 高齢者気管支喘息40例(20年以上の喫煙者20例,非喫煙者20例)および肺気腫(全症例喫煙者)20例を対象に,長期間喫煙の肺機能,airflow,lung volume およびlung transfer factor,に及ぼす影響について検討した｡まずFVC値は,喘息の喫煙例,非喫煙例,および肺気腫症例の間に有意の差は見られなかった｡% FEV(1)およびFEV(1)/FVC値は,喫煙例,非喫煙例いずれの喘息症例も肺気腫と比 べ有意に高い値を示したが,喘息の喫煙例と非喫煙例の間には有意差は見られなかった｡一方,% RVおよびDLco値は,喘息の非喫煙例に比べ,喫煙例および肺気腫症例で有意に低い値を示した｡ これらの結果は,長期間の喫煙は% FEV(1)やFEV(1)/FVCにはあまり影響しないこと, しかし,% RVや% DLcOにはかなり影響することを示している｡

The influence of cigarette smoking on the pathophysiology of asthma in the elderly remains controversial. In this study, the inluence of cigarette smoking on IgE - mediated allergy including the generation of leukotrienes B4 (LTB4) and C4 (LTC4) was examined in forty asthmatics over the age of 70 years (20 ex-smokers and 20 never-smokers), and 20 patients with pulmonary emphysema over age 70 (all ex - smokers). The frequency of patients with serum IgE more than 200 IU/ml was significantly larger in smoking asthmatics than in non - smoking asthmatics. The incidence of patients with positive RAST score for inhalant allergens, was also significantly higher in patients with a history of smoking than in those without a smoking history. There were no significant differences in the frequency of patients with positive RAST and those with serum IgE more than 200 IU/ml between non-smoking asthmatics and patients with pulmonary emphysema. The generation of leukotriene B4 (LTB4) by leukocytes was significantly more increased in ex-smokers than in never-smokers in the elderly asthmatics. The results suggest the possibility that cigarette smoking enhances IgE - mediated allergy in elderly patients with asthma., 高齢者喘息の病態に対する喫煙の影響については,なお不明な点が多い｡本研究では,70歳以上の気管支喘息40例(喫煙歴20年以上の症例20例,非喫煙症例20例)および70歳以上の肺気腫20例(全例喫煙者)を対象に,IgE-mediatedallergy(LTB4,LTC4の産生を含む)に対する喫煙の影響について検討した｡血清IgE値が200IU/ml以 上を示す症例の頻度は,喘息の喫煙例で非喫煙例や肺気腫症例と比べ有意に高い値を示した｡吸入抗原に対する特異的IgE抗体が陽性を示す症例の頻度は,喘息の喫煙例で非喫煙例や肺気腫に比べ有意に高い値を示した｡しかし,血清IgEが200IU/ml以上の症例の頻度およびRAST陽性例の頻度は,喘息の非喫煙例と肺気腫例の間には有意 の差は見られなかった｡LTB4の産生は,喘息の喫煙例で,非喫煙例と比べ有意の亢進が見られた｡また,肺気腫例では,喘息の非喫煙例に比べ,有意に高い産生が見られた｡しかし,LTC4の産生には喘息の喫煙例,非喫煙例,肺気腫例の間に有意の差は見られなかった｡

Influence of cigarette smoking on the pathogenesis of asthma in the elderly remains controversial. This study was undertaken to clarify the influence of cigarette smoking on IgE-mediated allergy, bronchial hyperresponsiveness, and the generation of leukotrienes B4 (LTB4) and C4 (LTC4) by leukocytes in 48 elderly patients (25 patients with a history of smoking for more than 20 years and 23 never-smokers) with asthma over the age of 70 years. 1. The incidence of positive IgE antibodies for inhalant allergens was significantly higher in asthmatics with a history of smoking than in never-smokers of asthmatics. 2. In bronchial hyperresponsiveness for methacholine, the Cmin was significantly lower in ever-smokers than in never-smokers of elderly asthmatics. 3. The generation of LB4 was significantly increased in patients with a history of smoking compared with those without a smoking history. However, the difference in LTC4 generation was not significant between ever-smokers and never-smokers of asthmatics. These results suggest that cigarette smoking increases bronchial hyperresponsiceness through IgE-mediated allergy and LTB4 generation., 高齢者喘息の病態におよぽす喫煙の影響についてはなお不明な点が多い｡本論文では,IgEにmediateされるアレルギー反応,気道過敏性,ロイコトリエンB4 (LTB4),C4(LTC4)産生に及ぼす喫煙の影響について,48例(20年以上の喫煙歴のある症例25例,非喫煙例23例)の70歳以上の高齢者喘息症例を対象に検討した｡ 1.吸入抗原に対する特異的IgE抗体の陽性頻度は,喫煙歴のある症例で,非喫煙例と比べ有意に高い値を示した｡ 2.メサコリンに対する気道過敏性の検討では,平均Cminは,喫煙例(949μg/ml)において非喫煙例(1677μg/ml)に比べ有意に低い値 を示し,喫煙例でより気道の過敏性が高いことが示された｡ 3.LTB4の産生は喫煙例で非喫煙例に比べ有意に高い傾向を示したが,LTC4に関しては両群間に有意の差は見られなかった｡以上の 結果より,長期間の喫煙は,IgEにmediateされるアレルギーやLTB4産生の亢進などを通じて気道過敏性を亢進させる可能性が示唆された｡

Background-The influence of cigarette smoking on the pathogenesis of asthma in the elderly remains controversial. This study attempts to estimate longitudinal changes in HRCT (high resolution computed tomography) parameters and pulmonary function parameters obtained for ex-smokers and never-smokers in asthmatics during 4-yr follow-up period. Methods-Fourteen asthmatics (6 ex-smokers and 8 never-smokers) were studied to determine the influence of aging and cigarette smoking on pulmonary function, and mean lung density (MLD) and the relative area of the lung showing attenuation values less than -950 HU (RA950) on HRCT scans. Results-The values of FVC and FEV1, were significantly more decreased in asthmatics without a smoking history during 4-yr follow-up period. The values of FVC, FEV1, FEV1/FVC and DLco/VA were significantly decreased and RV/TLC were significantly increased in asthmatics with a smoking history over 4 years, and annual decline in FEV1 ex-smokers was larger than that in never-smokers. In the upper lung field, inspiratory MLD was observed to shift in a negative direction and inspiratory RA950 was found to increase during 4-yr observation period in ex-smokers, but not in never-smokers. In the middle lung field, inspiratory RA950 was significantly enhanced in both two groups. Although expiratory MLD, expiratory RA950 and exp RA950/ins RA950 were observed to change significantly during the observation period in ex-smokers, no changes were observed in never-smokers. Conclusion-These results suggest that aging augments airspace enlargement predominantly in the middle lung field, while long term cigarette smoking further worsens emphysematous alterations in the upper lung field., 気管支喘息患者の肺高分解能CT所見に対する長期喫煙の影響を検討することを目的とした｡非喫煙喘息患者8名,喫煙歴を有する喘息患者6名を対象として,肺機能,肺平均CT値(MLD),-950HU以下のlow attenuation area(RA(950))について4年間の経過観察を行った｡ 4年間の観察中,非喫煙喘息患者では努力肺活量,1秒量の低下を認めた｡喫煙歴を有する喘息患者では努力肺活量,1秒量,1秒率,肺拡散能 の低下および残気率の増加を認めた｡喫煙歴を有する喘息患者では吸気において,上肺野MLDの有意の低下,RA(950)の有意の上昇を認めたが,非喫煙喘息患者では有意の変化は認めなかった｡中肺RA(950)は喫煙歴を有する喘息患者,非喫煙喘息患者ともに有意の上昇を認めた｡また,呼気において,喫煙歴を有する喘息患者でMLDの有意の低下,RA(950)の有意の上昇を認めたが,非喫煙喘息患者では有意の変化は認めなかった｡喘息患者において,加齢は主に中肺野のlow atenuation area,喫煙は上肺野のlow atenuation areaに影響を及ぼすことが示唆された｡

N-3 fatty acids are reportedly effective for asthma. In addition, spa therapy has been reported to be effective for patients with asthma. In the present study, the effects of spa therapy combined with perilla seed oil- rich diet (rich in n-3 fatty acid)were examined on asthma. A total of 14 asthmatic patients had a complex spa therapy and consumed a perilla seed oil- rich diet - rich in a -linolenic acid (alpha-LNA) for 8 weeks. Generation of leukotriene (LT) C4 by leucocytes, respiratory function were analyzed. The generation of LTC4 by leucocytes decreased significantly for 2, 4 and 8 weeks (P, N-3系脂肪酸は喘息に有効であることが報告されている｡また喘息に対する温泉療法の有効性も報告されている｡今回我々は温泉療法とn-3系脂肪酸を多く含むエゴマ油食の喘息に対する効果を検討した｡14名の喘息患者に温泉療法及びα-リノレン酸(n-3系)を多く含むエゴマ油食の摂取を8週間行い,その間の白血球ロイコトリエンC 4(LTC4)の産生能と呼吸機能の変化を検討した｡ その結果白血球LTC4の産生能は治療開始2過後より4,8過後と抑制された(P

The influence of aging on the pathophysiology of asthma in the elderly was examined in 40 patients (20 younger asthmatics under the age of 50 years, mean age 32.5 years and 20 elderly asthmatics over the age of 70 years, mean age 74.3 years), relating to IgE - mediated allergy, pulmonary function, low attenuation area (LAA) of the lungs on HRCT, and the generation of leukotrienes B4 (LTB4) and C4 (LTC4) by leukocytes. The frequency of patients with serum IgE of more than 200 IU/ml, and the incidence of those with a positive RAST score for inhalant allergens were significantly higher in younger patients than in elderly subjects. The values of % FVC, % FEV1 and FEV 1% were significantly larger in younger patients compared with elderly subjects. The % RV was significantly larger in elderly patients than in younger patients, however, the difference in % DLco was not significant between the two age groups. The LAA of the lungs on HRCT and the ratio of expiratory LAA (exp LAA) to inspiratory LAA (ins LAA) were also significantly larger in elderly asthmatics than in younger subjects. The generation of LTB4 and LTC4 was larger in younger patients than in elderly subjects, and LTB4 generation was significantly larger in younger subjects compared with elderly subjects. These results suggest that changes in IgE-mediated allergy, airflow and lung volume accompanied with hyperinflation are often observed in elderly asthmatics., 70歳以上の気管支喘息20例(平均年令74.3歳)および50歳以下の気管支喘息20例(32.5歳)を対象に,IgEにmediateされるアレルギー反応,肺機能,HRCT上の肺のLAAの程度,白血球によるLTB4,LTC4産生などに対する加齢の影響について検討した｡血清IgE値が200IU/ml以上の症例の頻度および吸入抗原に対するRAST scoreが陽性を示す症例の頻度は,いずれも若青年者喘息で高齢者喘息と比べ有意に高い傾向を示した｡ % FVC,% FEV(1),FEV(1) % 値はいずれも若青年者喘息で高 齢者喘息に比べ有意に高い値を示し,また,% RVは高齢者で有意に高い値が示された｡一方,% DLcoは両者間に有意の差は見られなかった｡ HRCT上の% LAAおよびLAA比(呼気/吸気)いずれも高齢者喘息で有意に高い値を示し,加齢により肺のLAAが明らかに影響を受けることが判明した｡LTC4の産生は若青年者喘息でやや高い値が示されたが,高齢者との間に有意差は見られなかった｡一方,LTB4産生は,若青年者喘息で高齢者喘息と比べ有意に高い値が示された｡これらの結果は,70歳以上の高齢者喘息では加齢による影響を広範囲にわたり受けている可能性が高いことを示している｡

The influence of cigarette smoking on the pathophysiology in elderly patients with asthma. Forty asthmatics over the age of 70 years (20 ex-smokers and 20 never-smokers), and 20 patients with pulmonary emphysema over age 70 (all ever-smokers) were studied to determine the influence of cigarette smoke on the low attenuation area (LAA), 70歳以上の気管支喘息40例(20例喫煙者,20例非喫煙者)および肺気腫20例を対象に,長期間喫煙のHRCT上の-950 HU以下の肺のlow atenuation area(LAA)に及ぼす影響について検討した。 HRCT上の肺の% LAAは,喘息の喫煙例で非喫煙例に比べ有意に高い値を示した｡また,この% LAAは,肺気腫症例で喘息の喫煙例に比べさらに高い値を示した｡LAA比(呼気時LAA/吸気時LAA)は,職息症例では喫煙例で非喫煙例比べ有意に高い値を示したが,肺気腫症例ではさらに高い値を示した｡LAA比0.5以上を示す症例は,喘息の非喫煙例では見られず,喫煙例で20例中10例,肺気腫症例では全例に見られた｡そして,喘息喫煙例でLAA比が0.5以上を示す症例は,0.5以下の症例に比べ,% RVは有意に高く,また% DLcoは有意に低い値を示した｡しかし,% RV,% DLco値いずれも喘息のLAA比0.5以上の症例と肺気腫の間には有意差は見られず,喘息における喫煙の影響の高いことが示唆された｡

The generation of leukotrienes B4 (LTB4) and C4 (LTC4) by leucocytes stimulated with Ca ionophore A23187 was examined in 67 patients with asthma. 1. The generation of leukotriene B4 (LTB4) by leucocytes was significantly more increased in patients with asthma than in those with pulmonary emphysema (PE) and healthy subjects. The generation of leukotriene C4 (LTC4) was also signficantly more increased in patients with asthma compared to the generation in those with PE and healthy subjects. The generation of both LTB4 and LTC4 was significantly more increased in patients with PE than in healthy subjects. 2. The generation of both LTB4 and LTC4 was larger in patients with asthma over age 70 than in those of other age groups, however, the difference was not significant. 3. The generation of LTC4 was significantly higher in attack stage than in non-attack stage in all age groups of patients with asthma, however, the generation of LTB4 was not significantly different between the two stages. 4. Bronchial hyperresponsiveness to methacholine in patients with asthma tended to decrease with aging, and the bronchial hyperresponsiveness was to a certain extent correlated with the generation of LTB4, but not LTC4. 5. The generation of LTC4 was correlated with value of FEV1.0%. These results may suggest that both LTB4 and LTC4 participate in the pathophysiology of asthma in the elderly., 気管支喘息67例を対象に, Ca ionophoreA23187刺激時の白血球からのロイコトリエンB4(LTB4)およびC4 (LTC4)の産生を観察し,高齢者喘息の臨床病態におけるLTB4,LTC4の役割について検討した｡ 1.LTB4の産生は,気管支喘息において肺気腫および健康人に比べ有意に高い値を示した｡LTC4の産生も同様に気管支喘息において,肺気腫,健康人に比べ有意に高い値30を示した｡LTB4,LTC4いずれの産生も,肺気腫症例において健康人と比べ有意に高い値が観察された。 2.LTB4,LTC4の産生は,70才以上の喘息症例において,他の年齢層の症例に比べより高い値が示されたが,推計学的な有意差は見られなかった｡ 3.高齢者を含めいずれの年齢層の気管支喘息においても,LTC4の産生は発作時に,非発作時に比べ有意の亢進が見られたが,LTB4に関しては発作時,非発作時の間に有意の差は見られなかった｡ 4.気道の過敏性は,年齢が高くなるにつれて低下する傾向が見られた｡そして,この気道の過敏性はLTB4産生とある程度関連していることが示されたが,LTC4との関連は見られなかった｡ 5.FEV1.0%値は,ある程度LTC4産生亢進と関連があることが示された｡ 以上の結果より,70才以上の喘息においても,LTB4,LTC4がその発作時病態に重要な役割を果していることが示唆された｡

Changes in the generation of leukotrienes B4 (LTB4) and C4 (LTC4) by leucocytes after spa therapy were examined in 30 patients with asthma. 1. The efficacy of spa therapy was marked in 8 (26.7%), and moderate in 16 (53.3%) of 30 patients with asthma, and slight or no efficacy of the therapy was observed in the residual 6 patients (20.0%). 2. Bronchial reactivity to methacholine was the highest in patients with slight or no efficacy of spa therapy, however. there were no significant differences among the three groups classified by clinical efficacy. 3. The generation of LTC4 was significantly higher in patients with slight or no efficacy compared with the generation in those with marked (p, 気管支喘息30例を対象に,温泉療法によるロイコトリエンB4 (LTB4),C4 (LTC4)産生の変動および気道過敏性と臨床効果との関連について検討を加えた｡ 1.温泉療法の臨床効果は,著効8例(26.7%),有効16例(53.3%),やや有 効あるいは無効6例(20.0%)であった｡ 2.メサコリンに対する気道過敏性は,やや有効あるいは無効例で高い傾向が見られたが,著効,有効例と比べ有意の差は見られなかった。 3.LTC4産生はやや有効あるいは無効例において著効例(P

The clinical significance of low attenuation area, 気管支喘息80例(全例非喫煙者)を対象に,high resolution computedt omography (HRCT)上の肺の-950HU以下のLow attenuation area (LAA)の臨床的意義について, 患者年齢, CT number,残気率(% RV),拡散能(% DLco)を含む肺機能検査,白血球のコイコトリエンB4,C4の産生能などとの関連のもとに検討を加えた｡ 1.% LAAは,年齢が高くなるにつれて増加する傾向を示し,60才以上の症例の% LAAは,49歳以下の症例に比べ有意に高い値を示した｡また,CT numberも,年齢が高くなるにつれて有意の増加を示した｡ 2.% FVC,% FEV1.0およびFEV1.0%値は,いずれも70才以上の症例で49歳以下の症例に比べ有意に低い値を示した｡ 3.残気率(% RV)は,年齢が高くなるにつれて増加する傾向を示し,70才以上の症例の% RVは,50-59才および49才以下の症例の% RVに比べ有意に高い値を示した｡ 4.一方,拡散能(% DLco)は,年齢が高くなるにつれて有意に低下する傾向を示し,70才以上の症例の% DLcoは,50-59才および49才以下の症例のDLcoに比べ有意に低い値を示した｡ 5.% LAAと% RVとの間には有意の相関が見られたが,% LAAと% DLco,および% LAAと換気機能(% FVC,% FEV1.0,FEV1.0%)との間には関連は見られなかった｡ 6.白血球のLTB4およびLTC4の産生能においては年齢による差は見られなかった｡これらの結果は,% LAAが年齢とともに増加すること,そして% LAAは% RVと密接な関連を有していることを示している｡

Effects of aging and glucocorticoid therapy on bronchoalveolar lavage (BAL) cells, particularly lymphocytes, neutrophils and eosinophils, were examined in 81 patients with asthma. 1. The proportion of BAL lymphocytes tended to increase with aging in asthmatics under age 69 years, and the proportion was significantly higher in patients with asthma between the ages of 60 and 69 than in those under age 39 and between the ages of 40 and 49. 2. The proportions of BAL neutrophils and eosinophils were not related to aging. 3. The proportion of BAL lymphocytes was higher in patients without glucocorticoid therapy than in those with steroid-dependent intractable asthma (SOIA) in those under age 69 years. In patients between the ages of 50 and 59, the proportion of BAL lymphocytes was significantly higher in patients without glucocorticoids than in those with SOIA. 4. The proportion of BAL neutrophils was higher in patients without glucocorticoid therapy than in those with SOIA, and the difference was significant in patients between the ages of 60 and 69. 5. The proportion of BAL eosinophils was not related to glucocorticoid therapy. These results suggest that the proportion of BAL lymphocytes and neutrophils is affected by aging and glucocorticoid therapy, but not BAL eosinophils., 気管支喘息81例を対象に,気管支肺胞洗浄(BAL)液中の細胞成分,特にリンパ球,好中球および好酸球に対する加齢および副腎皮質ホルモ ンの影響について検討を加えた｡ 1.BAL液中のリンパ球頻度は,69才以下の症例では加齢とともに増加する傾向を示し,60-69才の年齢層では,39才以下および40-49才の年齢層の症例に比べ有意に高い値を示した｡ 2.BAL液中の好中球および好酸球頻度と加齢との間には関連が見られなかった｡ 3.BAL液中のリンパ球頻度は,69才以下の症例では,ステロイド依存性重症難治性喘息(SDIA)に比べ,ステロイド非使用例で有意に高い値を示し,50-59才の年齢層ではその差は有意であった｡ 4.BAL液中好中球頻度は,ステロイド非使用例に比べSDIA症例において高い値を示し,60-69才の年齢層ではその差は有意であった｡ 5.BAL液中好酸球頻度は,ステロイド使用の有無との関連は見られなかった｡これらの結果は,BAL液中リンパ球および好中球頻度は加齢や副腎皮質ホルモン投与の影響を受けるが,BAL液中好酸球額度には影響しないことを示唆している｡

The purpose of this study is to establish a new, non - invasive diagnostic technique for peripheral circulation in patients with diabetes mellitus in the early stage of arteriosclerosis obliterans (ASO) as one of the complications of diabetes mellitus. We observed peripheral circulation quantitatively by thermography and Laser- Doppler blood flowmetry. The body surface peripheral circulation in 27 patients with diabetes mellitus, including 14 males and 13 females with a mean age of 67.4 years (range from 51-82 years), and with a mean hemoglobin A1C (HbA1C) 019.5% (range from 6.8%-13.0%), and who were suffering coldness, numbness or pain in their feet, was examined using thermography and Laser- Doppler blood flowmetry. Thermographic results were analyzed quantitatively by calculating a recovery ratio as : Recovery ratio= [Total counts of thermography (Pixels) over temperature (T) after cold -loading] + [Initial counts over T after hot-loading] Xl00 (%). Results of recovery ratios for 27 cases were 0% - 93.5%, and the average was 34.0%. At the same time, the blood flow after cold -loading was 0.91 - 5. 36ml/min/lOOg tissue and the average was 2.04ml/min/l00g tissue. We found that the recovery ratio and the blood flow were correlated (r=O. 634, p, 糖尿病患者における閉塞性動脈硬化症の合併を早期に診断,予知,予防する目的で末梢循環障害の程度を非侵襲的にかつ客観的に測定することを試みた｡非侵襲的測定方法としてサーモグラフィーとレ-ザードップラー血流計を同時に用い,得られた結果を数量化した｡症例は,下肢に冷え症,しびれ感,下肢痛を有した51歳から82歳までの 27症例(平均年齢67.4歳)であった｡性別は,男性14例,女性13例,HbA1Cは6.8%-13.0%,辛均9.5%であった｡サーモグラフィーで得られた結果は回復率として数量化して表示された｡回復率の算出方法は回復率-【20℃冷水負荷後の27℃以上の体表面温度のサーモグラフィーの画素(pixel)の総数】÷【36℃の温水負荷後の27℃以上の体表面温度のサーモグラフィーのPixelの総数】×100%で求めた｡ サ-モグラフィーにより測定された回復率は0%-93.5%の範囲にあった｡平均は34.0%であった｡レーザードップラー血流計により20℃冷水負荷後に測定された血流量は0.91-5.36ml/min/100g tissueの範囲にあった｡平均は2.04mi/min/100g tissueであった｡得られたサーモグラフィーの回復率とレ-ザードップラ-血流計の血流量との間には正の相関関係を認めた(p

Dietary sources of a -linolenic acid, such as perilla seed oil, may have the capacity to inhibit the generation of leukotrienes (LTs) by leucocytes in patients with asthma, as has been reported with the consumption of other long - chain n- 3 fatty a-cids. The factors affecting the suppression of leukotriene (LT) C4 generation by leucocytes were examined by comparing the clinical features of patients with asthma who had been given dietary perilla seed oil (n - 3 fatty acids). Group A consisted of patients in whom the leucocyte generation of dietary perilla seed oil LTC4 was suppressed by this procedure. Group B consisted of those in whom LTC4 generation was not suppressed. LTC4 generation by leucocytes significantly decreased in group A for two (P, エゴマ油のようなα-リノレン酸食が他のn-3系不飽和脂肪酸食において報告されてきた様に喘息患者の白血球ロイコトリエン(LTs)産生能を抑制すると考えられる｡そこでエゴマ油(n-3系脂肪酸)を摂取した気管支喘息患者の臨床所見を比較することによって白血球ロイコトリエン(LT)C4の抑制に影響する因子を検討した。A群はエゴマ油摂取により白血球LTC4の産生能が抑制された群であり､B群は白血球LTC4の産生能が抑制されなかった群である｡A群では食事摂取2週後(P

We present a case of a patient with asthma who developed yawning associated with anterior chest pain. She was admitted due to severe anterior chest pain, wheezing and dyspnea. Although the frequency of the symptoms decreased, she began to experience frequent episodes of yawning at night accompanied by tears. While she experienced yawning, although PEF (peak expiratory flow) decreased, no asthmatic symptoms, such as wheezing or dyspnea were observed. The yawning was improved markedly by bronchodilators and a leukotriene receptor antagonist, and moderately improved by corticosteroids. We speculated that yawning is a clinical manifestation of asthma that responds to treatment., 64歳の女性｡1993年2月に高度の前胸部痛,職場,呼吸困難を主訴として入院した｡入院後,前胸部痛,喘鳴,呼吸困難は徐々に軽快傾向であったが,夜間流涙を伴う`あくびが頻回に出現するようになった｡`あくび'が出現する時には,喘息症状(喘鳴,呼吸困難)は伴わないが,ピークフローに低下を認めた｡`あくび'に対する治療としては,気管支拡張剤,ロイコトリエン受容体結抗剤は著効,副腎皮質ステロイド剤は中等度 有効であった｡`あくび'は治療に反応する喘息の-症状であることが示唆された｡

To assess the role of the kidney dopamine system on the diuretic state induced by angiotensin-converting enzyme (ACE) inhibitors, we examined the changes in urinary excretion and plasma level of dopamine, and kidney dopamine receptors in spontaneously hypertensive rats (SHR) treated with cilazapril, an ACE inhibitor. We administered cilazapril 10 mg/kg orally to 13-week-old SHR daily for 21 days (CILAZA group). Systolic blood pressure was significantly decreased in the CILAZA group on Day 6 compared with that in vehicle-treated SHR (control group). The urine volume was three- to fivefold higher in the CILAZA group, and total urinary dopamine secretion was also increased compared with the control group. There was no significant difference in affinity and number of kidney dopamine receptors between the CILAZA and the control groups. In conclusion, the diuretic effect caused by cilazapril is partly mediated by inhibition of the water reabsorption via the increase of dopamine production in the kidney.