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2008 Volume 57 Issue 8 Pages
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Article type: Index
2008 Volume 57 Issue 8 Pages
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Article type: Appendix
2008 Volume 57 Issue 8 Pages
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Tatsuo Sakamoto
Article type: Article
2008 Volume 57 Issue 8 Pages
949-959
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Sawako Masuda
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2008 Volume 57 Issue 8 Pages
960-966
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Article type: Appendix
2008 Volume 57 Issue 8 Pages
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Zenro Ikezawa
Article type: Article
2008 Volume 57 Issue 8 Pages
968-988
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Kenji Nakanishi
Article type: Article
2008 Volume 57 Issue 8 Pages
989-994
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Chie Sotozono, Mayumi Ueda
Article type: Article
2008 Volume 57 Issue 8 Pages
995-999
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Hiroyuki Ohbayashi, Mitsuru Adachi
Article type: Article
2008 Volume 57 Issue 8 Pages
1000-1011
Published: August 30, 2008
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Background: As the clinical importance of treatment to asthmatic distal airway has been recognized, this study aimed to evaluate the efficacy of the 10% hypertonic saline-induced 15 minutes longinhaled method to assess the inflammatory situation in the distal airways. Methods: The subjects were 16 healthy volunteers and 29 patients with well controlled asthma. They inhaled 5% or 10% hypertonic saline for 15 minutes and the sputum induction rates and induced times were measured. We also investigated the values of surfactant protein D (SP-D) and eosinophil cationic protein (ECP) both in early- and late-phase induced sputum, together with pulmonary function indexes, and the patients'impressions of the method. Results: The sputum induction rates with 10% hypertonic saline inhalation in both healthy volunteer group and well controlled asthmatic patients group were significantly high compared with those with 5% hypertonic saline inhalation; 75.0% (p=0.004) and 75.9% (p=0.007), respectively. The SP-D levels in late-phase sputum in both healthy volunteer group and well controlled asthmatic patients group significantly elevated compared with those in the early-phase: p=0.045 and p=0.007, respectively. The SP-D levels in late-phase sputum significantly correlated to those of ECP in the well controlled asthmatic patients group (r=0.527, p=0.017). The pulmonary function index FEV 1.0% of 18 well controlled asthmatic patients (62.1%) attenuated 2.9±2.5% soon after finishing the 10% hypertonic saline inhalation, and recovered after an additional 15 minutes rest. 70〜80% of the subjects in both groups answered that they felt no strain in using the inhaled method. Conclusion: The late-phase sputum obtained by the 10% hypertonic saline-induced 15 minutes longinhaled method may be useful in evaluating the inflammatory situation in the distal airways.
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Takahiro Tsuburai, Naomi Tsurikisawa, Toyota Ishii, Noritaka Higashi, ...
Article type: Article
2008 Volume 57 Issue 8 Pages
1012-1021
Published: August 30, 2008
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Background: Because both allergic rhinitis and asthma are caused by eosinophilic airway inflammation, using the same method to measure the eosinophilic inflammation of both the upper and lower airway would be advantageous. The levels of nitric oxide in exhaled air (FeNO) and nasal air (nNO) are useful as noninvasive markers of eosinophilic airway inflammation. Although the off-line method of measuring these parameters is easier and more useful than the on-line method, studies using the off-line method are rare in Japan. Methods: In Study 1, we measured the levels of nNO and FeNO in 9 healthy controls and 9 subjects with allergic rhinitis, to validate the methodology for using the off-line method to measure nNO. In Study 2, we measured the nNO and FeNO levels of and performed spirometry on 69 stable asthmatics treated with inhaled corticosteroid. Results: In Study 1, nNO levels were significantly increased in patients with allergic rhinitis compared with healthy subjects (31.0 [20.8 to 41.2] versus 7.4 [0.0 to 14.8] ppb {median [95% confidence interval]}, p=0.018). The 69 patients with asthma that comprised the study population in Study 2 were classified as asthmatics with rhinitis (treatment-naive, n=14; treated with antiallergic drugs, n=11; treated with intranasal corticosteroid, n=19) and asthmatics without rhinitis (n=15). Although FeNO did not differ among groups, nNO was significantly increased in treatment-naive asthmatics with rhinitis compared with patients with asthma only (26.5 [17.1 to 35.9] versus 8.0 [-1.1 to 17.1] ppb, p=0.033). Conclusion: nNO levels measured by the off-line method are useful markers of allergic rhinitis.
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Naomi Kondo, Koichiro Hirayama, Eiko Matsui, Takahide Teramoto, Hideo ...
Article type: Article
2008 Volume 57 Issue 8 Pages
1022-1033
Published: August 30, 2008
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Background: The QOL questionnaire version 2001 for pediatric patients with bronchial asthma and their parents or caregivers includes 15 questions for patients under the age of 4 years and 20 questions for patients over the age of 4 years. We have already reported that the QOL questionnaire version 2001 reflects reliability (including reproducibility), factorial validity, and changes in paroxysmal attacks of asthma. In this study, we revised the questionnaire for use in routine medical practice. Methods and Results: In this study, based on the data of a previous report, the number of questions was reduced further and it was revised to the questionnaire the short form by integrated data. The revised version 2008 (Gifu) consisted of emotional burden, asthma attack, instability of symptoms and proper acceptance of asthma as a common factor, moreover 4 or more years old added load of exercise factor which consisted of two questions in each factor. This QOL short form questionnaire version 2008 (Gifu) is a disease specific questionnaire in comparison with health control, bronchial asthma and non-asthmatic patients, such as atopic dermatitis and allergic rhinitis. Conclusion: Although Cronbach's alpha fell with reduction of the number of questions, we conclude that it was acceptable in the clinical practice.
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Junichiro Tezuka, Chikako Motomura, Junko Ikei, Koji Ide, Naoyuki Kand ...
Article type: Article
2008 Volume 57 Issue 8 Pages
1034-1042
Published: August 30, 2008
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Objective: This study evaluated the efficacy and safety of Budesonide Inhalation Suspension (BIS) nebulazation by mesh nebulizer in children ages 6 months to 4 years with moderate to severe persistent asthma. Method: This 12-week, randomized, open study involved 30 asthmatic children. They were randomized 3 different nebulizer groups, Pari TurboBoy^[○!R] + LC Plus nebulizer^[○!R], Pari eMotion^[○!R] and Omron MicroAir NE-22U^[○!R]. BIS administered 0.25mg once daily (qd). Efficacy was assessed by daily card. Safety was assessed by adverse event, plasma cortisol and growth. Result: Baseline concentrations of plasma cortisol were significantly high in the group of Omron MicroAir NE-22U^[○!R] compared to other group. Plasma cortisol were decreased significantly at 4week in Omron MicroAir NE-22U^[○!R] compared with baseline, but those in no subjects decreased under normal range. Asthma symptoms were improved significantly from baseline to 12-week. Conclusion: This study demonstrate that usage of mesh nebulizer in BIS 0.25mg qd is effective and safe in young asthmatic children.
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Komei Ito, Masaki Futamura, Yuri Takaoka, Masashi Morishita, Kumiko Na ...
Article type: Article
2008 Volume 57 Issue 8 Pages
1043-1052
Published: August 30, 2008
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Background: A method for open food challenge test to determine food allergy has not been established in an evidence-based manner. Methods: We conducted an analysis of 438 open food challenges of raw milk (n=133, mean age 2.7±1.9 years), boiled egg white (n=216, 2.8±2.1 years) or udon noodles (n=89, 2.7±1.7 years) for the patients aged 1 year or more. Doses were increased (trace amounts, 1g, 2g, 5g, 10g, 20-30g) every 20 minutes. Results: In total, 151 (38.5%) of food challenges were positive. The positive rates of milk, egg and wheat challenges were 35.8%, 42.4% and 33.3%, respectively. Of these, 76.2%, 32.5%, 27.8% and 0.7% had, respectively, skin, respiratory, gastrointestinal and cardiovascular symptoms. Although the prevalence of positive challenge increased with level of specific IgE, it did not correlate with the threshold amount of positive food challenge or the severity of symptoms. Among the challnege positive patients, 10.6% required injection of antihistamines, corticosteroids or adrenalines for the treatment of the symptoms. Conclusions: This challenge protocol seemed to be appropriate and safe.
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Teppei Tani, Satoshi Seno, Masakazu Hanamitsu, Takeshi Shimizu
Article type: Article
2008 Volume 57 Issue 8 Pages
1053-1060
Published: August 30, 2008
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Background: Laser-assisted inferior turbinoplasty has become accepted as a common treatment for patients displaying allergic rhinitis with severe nasal obstruction. Coblation-assisted inferior turbinoplasty has recently been reported. The aim of this study was to evaluate the effectiveness of coblation-assisted inferior turbinoplasty, compared with laser surgery. Methods: Between November 2004 and May 2007, a total of 29 patients were treated with coblation-assisted inferior turbinoplasty. We evaluated symptom scores at 1 month, 1 year and 2 years after surgery, compared with the results of Nd: YAG laser surgery. Results: At 1 month after surgery, improvement rates of symptom scores were good and similar between coblation- and laser-assisted surgery. At 1 year after surgery, improvement rates of laser surgery had significantly decreased. However, improvement rates of coblation surgery had not changed at 1 and 2 years (sneeze, 64%; nasal discharge, 71%; nasal obstruction, 79%) after surgery. Conclusion: Coblation-assisted inferior turbinoplasty appears effective for the treatment of patients with allergic rhinitis and nasal obstruction.
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Hirokazu Taniguchi, Hitoshi Abo, Masayoshi Touge, Hideki Shinnou, Hide ...
Article type: Article
2008 Volume 57 Issue 8 Pages
1061-1066
Published: August 30, 2008
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A 58-year-old Japanese female consulted our staff with multiple localized ground-glass opacities in chest CT. She underwent video assisted thoracoscopic surgery for diagnosis. Histopathologic finding from surgery specimen in one of ground-glass opacities revealed bronchioloalveolar carcinoma. Six months later, we performed second video assisted thoracoscopic surgery, and histopathologic finding of all other ground-glass opacities revealed pulmonary alveolar proteinosis. Serum anti GM-CSF antibody elevated, and she was diagnosed as having idiopathic pulmonary alveolar proteinosis . A case of idiopathic pulmonary alveolar proteinosis presenting multiple localized ground-glass opacities is rare. And, differentiating ground-glass opacities of pulmonary alveolar proteinosis and bronchioloalveolar carcinoma by chest CT is difficult.
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Article type: Appendix
2008 Volume 57 Issue 8 Pages
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2008 Volume 57 Issue 8 Pages
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2008 Volume 57 Issue 8 Pages
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2008 Volume 57 Issue 8 Pages
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2008 Volume 57 Issue 8 Pages
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2008 Volume 57 Issue 8 Pages
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2008 Volume 57 Issue 8 Pages
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2008 Volume 57 Issue 8 Pages
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2008 Volume 57 Issue 8 Pages
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Article type: Cover
2008 Volume 57 Issue 8 Pages
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