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2008 Volume 57 Issue 12 Pages
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2008 Volume 57 Issue 12 Pages
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Tatsuya Horikawa, Atsuko Adachi
Article type: Article
2008 Volume 57 Issue 12 Pages
1245-1251
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Yasuto Kondo
Article type: Article
2008 Volume 57 Issue 12 Pages
1252-1258
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Article type: Appendix
2008 Volume 57 Issue 12 Pages
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Kazue Nishioka
Article type: Article
2008 Volume 57 Issue 12 Pages
1260-1264
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Yusei Ohshima
Article type: Article
2008 Volume 57 Issue 12 Pages
1265-1269
Published: December 20, 2008
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Tetsuo Shiohara
Article type: Article
2008 Volume 57 Issue 12 Pages
1270-1274
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Kumiya Sugiyama, Hironori Sagara, Mitsuru Adachi, Kenji Minoguchi, Aki ...
Article type: Article
2008 Volume 57 Issue 12 Pages
1275-1283
Published: December 20, 2008
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Background: In asthmatic patients, first asthmatic symptoms are not often typical. In those cases, it takes long time before asthma diagnosis, and the severities are progressed in some patients. For early intervention, we tried to make the diagnostic criteria for asthma, which are useful to diagnose as early stage of asthma. Methods: Three hundred and eighty eight of asthmatic patients, who were recorded first their symptoms in asthma, were enrolled. Their first symptoms and examinations were analyzed. Results: In first asthmatic symptoms, 79% of patients had cough, 68% patients had wheezing, 49% patients had dyspnoea, and 15% of patients did not have typical asthmatic symptoms in the early stage. The percentages of abnormal in first examinations were 99% in airway hypersensitivity, 92% of low %V_<25>, 82% of eosinophila in sputum and 77% of low %V_<50>. Low FEV_<1%> and reversible airway obstruction were not seen in a lot of patients. Conclusion: We advocate that the diagnostic criteria for early stage of asthma are the following three elements. First criterion is spasmodic cough, wheezing and dyspnoea. Second criterion is airway hypersensitivity, or over 3% of eosinophils in sputum, or under 70% of %V_<50>, or under 50% of %V_<25>, or effect of bronchodilator. Effect of bronchodilator will be required, when the symptom is cough only. Third criterion is the exclusion of other lung and heart diseases.
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Naoto Watanabe, Sohei Makino, Norio Kihara, Takeshi Fukuda
Article type: Article
2008 Volume 57 Issue 12 Pages
1284-1292
Published: December 20, 2008
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Background: In the guideline for asthma management, it is important to find the personal best value of peak expiratory flow (best PEF). Recently, we have substituted the highest value of PEF in daily life under good control (daily highest PEF) for the best PEF. Aim: In the present study, we considered whether the daily highest PEF could be used as the best PEF or not. Method: Subjects were 30 asthmatics who were well controlled but whose baseline PEF values were less than 80 percent of predicted values. We compared the daily highest PEF and the highest of PEF obtained after repeated inhaled β2-agonist (salbutamol MDI every 20 minutes three times). All subjects then received 1600μg/day of beclomethasone dipropionate (BDP) for 4 to 8 weeks. We studied the effect of high-dose inhaled steroid treatment on each PEF value and compared the daily highest PEF and the highest PEF obtained after using repeated salbutamol MDI during high dose inhaled steroid therapy on the examination day again. Result: The baseline PEF, daily highest PEF and the highest PEF obtained after salbutamol MDI were significantly less than the each values obtained after high-dose BDP. The best PEF value of them was the value obtained after repeated salbutamol MDI during high dose BDP. Discussion: We suggest that the daily highest PEF under good control is not a substitute for best PEF because it changes according to the degree of improvement of airway inflammation. We recommend that a course of high dose inhaled steroid is effective in finding the best value of PEF for each individual with moderate asthma.
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Takahiro Tsuburai, Naomi Tsurikisawa, Noritaka Higashi, Ai Higashi, So ...
Article type: Article
2008 Volume 57 Issue 12 Pages
1293-1301
Published: December 20, 2008
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Background: The fraction of exhaled nitric oxide (FeNO) is a useful marker of asthma control. The FeNO measurement with our offline method using SIEVERS bag collection kit may be more affordable, but there have been no studies to show the effect of anti-asthmatic therapy on FeNO with our offline method. Methods: The study population comprised 36 steroid-naive asthmatics at our outpatient clinic. We treated them according to asthma prevention and management guideline 2006, Japan. We also measured eNO levels by our offline method and spirometory on baseline, 4 weeks, and 12 weeks of treatment. Results: All asthmatics were symptom-free on 12 weeks of treatment. The levels of FeNO FEV_1/FVC were significantly decreased on 4 weeks and 12 weeks of treatment, compared with that on first visit. We classified the subjects into two groups; (A) FEV_1/FVC<70% (n=11) or (B) FEV_1/FVC≧70% (n= 25) on baseline. In (A) group, the level of FeNO and FEV_1/FVC were significantly improved on 4 and 12 weeks of treatment. In (B) group, on 4 weeks of treatment, the level of FEV_1/FVC was significantly increased but the level of FeNO was not significantly changed. On 12 weeks of treatment, the levels of FeNO was significantly decreased, but the level of FEV_1/FVC was not significantly changed. Conclusion: The levels of FeNO were decreased by antiasthmatic therapy, so that offline monitoring of eNO will facilitate the management of bronchial asthma in patients treated with these drugs.
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Hiroko Watanabe, Toshio Katsunuma, Naomi Kondo, Akira Akasawa, Yukihir ...
Article type: Article
2008 Volume 57 Issue 12 Pages
1302-1316
Published: December 20, 2008
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Purpos: We developed the Health related QOL questionnaire which is specific for a caregiver of an asthmatic child, who has been treated based on JPGL (Japanese Pediatric Guideline for the Treatment and Management of Asthma). Method: Based on the answers collected anonymously or with interviews concerning caregivers' quality of life influenced by having children with asthma, the multipul choice secondary questionnaire was made. Through psycho-analytic procedures of the data from secondary survey 24-item questionnaire (QOLCA-24) has been developed. Result: Factor analysis revealed 11 factor structure of QOLCA-24. Internal consistency (cronbach α) of whole 24 items was 0.942. κ value which showed repetition plasticity was 0.27-0.53. The responsiveness associated with change of symptoms were significant in the items of factor 1 (Fear of asthma attack) and factor 7 (Job related burden of the caregiver). The score of most factors in QOLCA-24 were correlated with score of each item in SF-8. Conclusion: QOLCA-24 is thought to be useful as a tool to evaluate QOL of caregivers with asthmatic children.
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Hikari Kato, Shigeharu Ueki, Wataru Ito, Masahide Takeda, Takahito Chi ...
Article type: Article
2008 Volume 57 Issue 12 Pages
1317-1324
Published: December 20, 2008
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Background: Eosinophils are major effector cells in the pathogenesis of allergic inflammation such as bronchial asthma, and eosinophil migration to sites of inflammation is an important step. To date, several approaches have been developed to study eosinophil chemotaxis. Among them, the Boyden chamber method has been widely used, although this system requires a relatively large number of cells, and it usually provides no longitudinal information. In this study, we investigated real-time eosinophil chemotaxis using EZ-TAXIScan, a novel horizontal microchannel device. Methods: Eosinophils were isolated from subjects with mild eosinophilia by modified CD16-negative selection. Eosinophil chemotaxis and migration speed induced by various chemoattractants including eotaxin, RANTES, PAF, and prostaglandin (PGD_2) were measured by EZ-TAXIScan. We also determined the time course of chemotaxis using Boyden chambers. Result: By using EZ-TAXIScan, rapid (a few minutes after stimulation) and fast (20-30μm/min) eosinophil chemotactic responses were observed by stimulation with PAF or PGD_2, although eosinophils stimulated with eotaxin or RANTES showed relatively late (60 minutes after stimulation) and slow (15μm/min) responses. In contrast, using a Boyden Chamber, the chemotactic responses we tested showed a similar time course peaking at 20〜60min. Conclusion: The availability of EZ-TAXIScan for investigation of eosinophil chemotaxis was confirmed. However, it should be noted that EZ-TAXIScan showed a different response to certain chemoattractants compared with the conventional method.
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[in Japanese]
Article type: Article
2008 Volume 57 Issue 12 Pages
1325-1328
Published: December 20, 2008
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Article type: Appendix
2008 Volume 57 Issue 12 Pages
1329-1375
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Article type: Appendix
2008 Volume 57 Issue 12 Pages
1376-1387
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Article type: Appendix
2008 Volume 57 Issue 12 Pages
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Article type: Appendix
2008 Volume 57 Issue 12 Pages
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Article type: Appendix
2008 Volume 57 Issue 12 Pages
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Article type: Appendix
2008 Volume 57 Issue 12 Pages
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Article type: Appendix
2008 Volume 57 Issue 12 Pages
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Article type: Appendix
2008 Volume 57 Issue 12 Pages
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Article type: Appendix
2008 Volume 57 Issue 12 Pages
1394-1395
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Article type: Index
2008 Volume 57 Issue 12 Pages
1396-1407
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Article type: Index
2008 Volume 57 Issue 12 Pages
1408-1411
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Article type: Index
2008 Volume 57 Issue 12 Pages
1412-1415
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Article type: Bibliography
2008 Volume 57 Issue 12 Pages
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Article type: Appendix
2008 Volume 57 Issue 12 Pages
1417-1418
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Article type: Appendix
2008 Volume 57 Issue 12 Pages
1419-1421
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Article type: Appendix
2008 Volume 57 Issue 12 Pages
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Article type: Appendix
2008 Volume 57 Issue 12 Pages
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2008 Volume 57 Issue 12 Pages
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2008 Volume 57 Issue 12 Pages
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2008 Volume 57 Issue 12 Pages
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2008 Volume 57 Issue 12 Pages
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2008 Volume 57 Issue 12 Pages
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Article type: Cover
2008 Volume 57 Issue 12 Pages
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