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2011 Volume 60 Issue 5 Pages
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2011 Volume 60 Issue 5 Pages
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2011 Volume 60 Issue 5 Pages
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Junichi Ishitoya, Yasunori Sakuma
Article type: Article
2011 Volume 60 Issue 5 Pages
535-545
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2011 Volume 60 Issue 5 Pages
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Takahiro Satoh
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2011 Volume 60 Issue 5 Pages
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Motohiro Ebisawa
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2011 Volume 60 Issue 5 Pages
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Tsuneyasu Kaisho
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2011 Volume 60 Issue 5 Pages
559-565
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Masafumi Arima
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2011 Volume 60 Issue 5 Pages
566-574
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Masayuki Hojo, Tomonori Mizutani, Motoyasu Iikura, Atsuhito Sugiyama, ...
Article type: Article
2011 Volume 60 Issue 5 Pages
575-585
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Background: The clinical usefulness of fixed dose maintenance therapy using a combination inhaler containing budesonide and formoterol (FBC) has already been established, still evidence concerning anti-inflammatory effect by maintenance therapy with fix-dosed FBC, in comparison with other ICS and LABA combination therapy including salmeterol/fluticasone combination inhaler, is lacking. Methods: Moderate persistent adult asthmatics who has received combination therapy of ICS (200-500μg/day FP equivalent) and LABA (salmeterol 100μg/day) for more than 6 months and under well-control conditions by asthma control test (ACT) have been recruited. FeNO, as a marker of airway inflammation, ACT score, and the results of spirometry have been evaluated after switching to maintenance therapy by FBC 640/18μg/day for 8 weeks. Results: The fixed dosed FBC therapy resulted in superior primary outcome, as compared with previous ICS/LABA combination therapy, as assessed by measuring FeNO, 44.0±26.5 to 31.3±15.4ppb (p<0.01, paired-t test). ACT score also improved significantly, 22.22±1.57 to 23.88±1.57 (p<0.01). The number of patients who used SABA more than once a week has decreased 13 to 0 with FBC treatment. Conclusion: The airway anti-inflammatory effect by 8 weeks maintenance therapy with fix-dosed FBC 640/18μg/day (2 puffs twice a day) has been strongly suggested.
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Atsushi Isozaki, Tetsuo Shoda, Sho Mimura, Norifumi Ogawa, Takeshi Nom ...
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2011 Volume 60 Issue 5 Pages
586-592
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Background: It has been estimated that there are several phenotypes constituting wheezy infants, in addition to true asthma. Objective: The aim of this study is categorized wheezy infants and young children by cluster analysis and to turn out of categorized frequency. Subjects and Methods: The study included 53 subjects aged less than 2 years old who were admitted with wheezy exacerbation. Based on clinical factors, we classified these subjects into several clinical phenotypes using cluster analysis. Results: The following four phenotypes were identified; cluster 1: almost all were exacerbated by RSV infection without previous wheezy episodes; cluster 2: almost all were younger, males, without previous wheezy episodes, sensitized to allergens and parental asthma, who tended to be exposed to passive smoke and have no siblings; cluster 3: almost all were slightly older males with recurrent wheezy episodes who tended to be sensitized to various allergens; cluster 4: almost all were younger females with exposure to passive-smoke, whose mother or father has a history of asthma. Cluster 4 patients tended to attend a day-care center and to be exclusively breast-fed. Conclusion: Although this study covers only a limited number of subjects, cluster analysis is a new and useful method of categorizing heterogeneous wheezy infants and young children. Further analysis may establish clinical classifications of these patients.
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Misa Iio, Yukihiro Ohya, Yutaka Morisawa, Hiroko Watanabe, Masami Nari ...
Article type: Article
2011 Volume 60 Issue 5 Pages
593-603
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Purpose: To identify the factors influencing parental medication control behaviors (inhaling corticosteroids and medication-taking) in pediatric asthma management. Methods: A specially-designed questionnaire survey was conducted on 942 parents with asthmatic children in hospitals and elementary schools. Results: Factor analysis on inhalation behaviors resulted in five factors: understanding of benefit, mastering on inhalation skills and medication management, family support, anxiety of side effects, and explanation from a doctor (cumulative contribution ratio=51.3%). Factor analysis on medication-taking behavior resulted in five factors: understanding of medication effectiveness and benefit, family support, anxiety of side effects, skills on giving medicines, and family routine (cumulative contribution ratio=50.6%). Conclusion: The results indicate the importance of recognizing factors influencing parental medication control behaviors in developing education strategies to maintain and reinforce their asthma management behaviors.
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Katsutoshi Ando, Yoshihiro Ohkuni, Akina Komatsu, Ryo Matsunuma, Kei N ...
Article type: Article
2011 Volume 60 Issue 5 Pages
604-609
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A 64-year old male who had been treated with oral predisolone for severe bronchial asthma had started the treatment of omalizumab administration every 4 weeks since December 2009 and his symptoms had prominently improved. However, he complained the recurrence of his symptoms 4 weeks after administration of omalizumab and the mean times of SABA use had also increased from 0.61/day (1-2w) to 0.95/day (4w). Therefore, we had shortened the interval of omalizumab to 3 from 4 weeks since April 2010. Consequently, his symptoms have improved with increase of Asthma Control Test (15.67→21.33) and it has been possible to reduce the oral prednisolone. Recently, we can use the omalizumab and have extended the choice of treatment for severe bronchial asthma. However, it is predicted that there are some patients who have clinical problems for continuing the recommendation dose or intervals. We report a case with a brief review of the literature.
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[in Japanese]
Article type: Article
2011 Volume 60 Issue 5 Pages
610-613
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Article type: Appendix
2011 Volume 60 Issue 5 Pages
614-628
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2011 Volume 60 Issue 5 Pages
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2011 Volume 60 Issue 5 Pages
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2011 Volume 60 Issue 5 Pages
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2011 Volume 60 Issue 5 Pages
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2011 Volume 60 Issue 5 Pages
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2011 Volume 60 Issue 5 Pages
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2011 Volume 60 Issue 5 Pages
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2011 Volume 60 Issue 5 Pages
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2011 Volume 60 Issue 5 Pages
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2011 Volume 60 Issue 5 Pages
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2011 Volume 60 Issue 5 Pages
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2011 Volume 60 Issue 5 Pages
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