Japanese Journal of Allergology
Online ISSN : 1347-7935
Print ISSN : 0021-4884
ISSN-L : 0021-4884
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Volume 68, Issue 2
Displaying 1-9 of 9 articles from this issue
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One Point Reviews of Allergy Guidelines
Review Article
Original Article
  • IS IT NECESSARY TO PROHIBIT SIDE-HOLE CLOSURE IN USE OF THE DRY POWDER INHALERS?
    Tetsuri Kondo, Toshimori Tanigaki, Makoto Hibino, Sakurako Tajiri, Shi ...
    2019 Volume 68 Issue 2 Pages 96-100
    Published: 2019
    Released on J-STAGE: March 14, 2019
    DOIhttps://doi.org/10.15036/arerugi.68.96
    JOURNAL FREE ACCESS
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    Background: In use of Ellipta (EPT), Diskus (DKS) or Turbuhaler (TBH), an instruction not to close side holes is sometimes given, but validity of such instruction has not been proved.

    Method: Using an inhalation simulator we measured peak inhaled flow (PIF), peak inhaled pressure (PIP) and amount of the drug release from these DPIs before and after closure of side holes (SHC). In the case of EPT, incomplete obstruction was also assessed.

    Results: SHC increased internal resistance by 2.8 times in TBH, 1.0 in DKS, and 1.28 (incomplete obstruction) and 1.86 (complete) in EPT. Inhaled flows at pressure of -15cmH2O were 14L/min in TBH, 47 in DKS and 34 in EPT (incomplete obstruction). SHC suppressed drug release from TBH but statistical significance was not obtained. Drug release was not suppressed by SHC in DKS, while it was almost half during SHC in EPT. The level of PIF decreased by SHC was serious since fine particles generation is not expected. Such severe decreases were not found in DKS and EPT.

    Conclusion: SHC severely inhibited drug release from TBH, but almost no effects on DKS. Such negative effect was limited in usual use of EPT.

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Case Report
  • A CASE OF BRONCHIAL ASTHMA ASSOCIATED WITH BRONCHIOLAR EOSINOPHILIA AND TREATED WITH MEPOLIZUMAB
    Baku Oyama, Takahiro Tsuburai, Yuko Komase, Kohei Nishida, Hajime Tsur ...
    2019 Volume 68 Issue 2 Pages 101-106
    Published: 2019
    Released on J-STAGE: March 14, 2019
    DOIhttps://doi.org/10.15036/arerugi.68.101
    JOURNAL FREE ACCESS
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    A 68 year-old woman with dyspnea and cough had been treated with inhaled corticosteroids for X-15 years, but her symptoms worsened in X year. High-resolution chest CT revealed small centrilobular nodules in the right upper lobe in March X year. The patient was diagnosed with asthma and diffuse panbronchiolitis and treated with inhaled corticosteroids, a long-acting beta agonist, and clarithromycin, but her condition did not improve and her peripheral blood eosinophil count increased. In August X year, we performed a transbronchial biopsy of the right upper lung. Histopathological examination revealed eosinophilia in the bronchial secretions and mild nonspecific inflammatory changes. The diagnosis was bronchial asthma associated with bronchiolitis. The patient was treated successfully with mepolizumab.

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