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Stephen T. Holgate
1997 Volume 48 Issue 2 Pages
51-66
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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Y. Koga
1997 Volume 48 Issue 2 Pages
67-68
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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Shigenori Nakajima
1997 Volume 48 Issue 2 Pages
69-73
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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The nature of bronchial asthma is an important question since it is the starting point in search for the pathogenetical and pathophysiological studies of asthma.
I have investigated the pathophysiology of asthma, bronchial hypersensitivity, pulmonary function and pulmonary circulation. I have also studied pathogenesis, inhaled allergens, IgE antibody and allergic inflammations in patients with asthma and experimental animal models of asthma.
The second main field of research in asthma is new perspectives in treatment. For example, the so-called anti-allergic drugs or inhaled corticosteroids are in common use.
Asthmology has become a specialty but still needs the contribution of many scientists and specialists from other fields.
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T. Ishikawa, G. Mogi
1997 Volume 48 Issue 2 Pages
74-75
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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Yuichi Kurono, Naoko Sakamoto, Hideomi Kerakawauchi, Goro Mogi
1997 Volume 48 Issue 2 Pages
76-80
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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Adenoids and palatine tonsils are known to function as nasopharyngeal-associated lymphoreticular tissue for mucosal immune responses in the upper aerodigestive tract. In the present study, we investigated the immune responses of tonsillar lymphocytes in response to nontypeable
Haemophilus influenzae (NTHi). Adenoids, palatine tonsils and nasopharyngeal secretions were obtained from patients who had undergone adenoidectomy or palatine tonsillectomy, and the numbers of NTHi in the samples were quantitated. The antibody activities against P6, one of the outer membrane proteins of NTHi, were determined by ELISA and the numbers of P6-specific antibody-producing cells were determined by ELISPOT. Production of cytokines from CD4
+ T cells incubated with P6 was determined by ELISA and RT PCR. The results showed an increase of P6-specific IgA antibody activity and a decrease of NTHi in nasopharyngeal secretions with older age. The numbers of NTHi in the adenoids and the palatine tonsils decreased in samples having a large number of P6-specific IgA antibody-producing cells. CD4
+ T cells more frequently produced Th2 type cytokines than Th1 type cytokines. The findings suggest that the adenoids and the palatine tonsils play an important role in regulating mucosal immune responses and the colonization of NTHi in the nasopharynx.
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Takaaki Kimura, Jun'ichi Yoda, Tadahito Saito, Michiaki Yokoyama, Kiyo ...
1997 Volume 48 Issue 2 Pages
81-83
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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The term apoptosis stands for a mechanism of controlled cell deletion which maintains the homeostasis of living bodies. In palatine tonsil, apoptosis seems to be mainly observed in lymphocytes which have accomplished their immunological role. In this study, we demonstrate the presence of apoptotic cells in palatine tonsil using a histochemical technique, and we compare the number of apoptotic cells in inflammatory and non-inflammatory conditions using an image analyzing system. In the mantle zone, fewer apoptotic cells were observed than in the germinal center. Under inflammatory conditions, apoptotic cells were increased in the interfollicular space. Apoptosis may play an important role in the immunological equilibrium of tonsils by eliminating hyperreactive clones.
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Yuji Tohda, Hirokazu Kubo, Rie Urakami, Hiroshi Nakahara, Masato Murak ...
1997 Volume 48 Issue 2 Pages
84-90
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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We studied respiratory mucosa immune responses in bronchial asthma using guinea pigs and human respiratory epithelial cells. In asthma models (guinea pigs), CD4
+ T cells enhanced LAR, and CD8
+ T cells inhibited LAR after antigen inhalation. Regulatory effects of IL-5 and ICAM-1 on LAR were detected. PAF enhanced the adhesion of human respiratory epithelial cells and eosinophils. TNF-α stimulated the production of GM-CSF in human respiratory epithelial cells, while TGF-β
1 depressed human eosinophil survival.
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Takashi Kanda
1997 Volume 48 Issue 2 Pages
91-93
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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The clinical symptoms of allergic laryngitis are persistent paroxymal cough, itching, pain and irritation of the throat. The etiology of this disease might be an allergic reaction and hypersensitivity of the sensory nerve system in the mucosa of the pharynx, larynx and trachea. 76% of our patients with Japanese cedar pollinosis had some kind of laryngeal symptoms. The lower respiratory tract in these patients showed a methacoline hypersensitivity of approximately 70%.
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Hiroshi Nagura, Noriaki Andoh, Hironobu Sasano
1997 Volume 48 Issue 2 Pages
94-99
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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The esophageal mucosa forms an active immunological microenvironment different from other mucosal surfaces. In contrast to the intestinal mucosa, its mucous coat is scant, and it has few immuno-inflammatory infiltrates and glandular structures. It is covered by a thick stratified squamous epithelial cell layer, which expresses neither class II MHC antigens nor cell adhesion molecules, but is distributed by class II MHC-positive intraepithelial Langerhans cells as a unique population of antigen-presenting cells. The submucosal vascular unit, however, consists of venule-like blood vessels which constitutively express various cell adhesion molecules, regardless of the presence or absence of inflammation.
In response to certain specific and nonspecific inflammatory stimuli, esophageal squamous cells synthesize and secrete a wide variety of cytokines, which may upregulate the activation of the submucosal vascular endothelial cells and promote infiltration by memory T-cells and neutrophils in inflammatory lesions. In addition, continuous stimuli from the mucosal surface induce cell degeneration and proliferation, and cause progressive genetic changes in the exposed esophageal mucosa.
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T. Unno, M. Kono
1997 Volume 48 Issue 2 Pages
100-101
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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Satoshi Tatsuno, Miyoko Yamashita, Shimpei Tada
1997 Volume 48 Issue 2 Pages
102-106
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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Magnetic resonance imaging (MRI) has become firmly established as a useful diagnostic tool for the evaluation of T-staging in head and neck cancer, including laryngopharyngeal squamous cell carcinoma. However, there is often an inadequate contrast between normal tissue and the carcinoma even in MRI. It is especially difficult to assess the presence or absence of neoplastic invasion of the laryngeal cartilage on conventional T1- and T2-weighted images. Fat-suppressed MRI may settle this matter. Frequently, MRI for patients with laryngopharyngeal cancer may be incomplete because their involuntary motion may severely degrade the quality of the obtained images. We can expect that the latest advances in fast scan techniques will overcome this problem. This essay describes recent progress in MRI techniques aimed at improving the imaging cancer arising from laryngopharynx.
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Fumitoshi Mimura, Michio Kono
1997 Volume 48 Issue 2 Pages
107-110
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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Spiral CT is a new technique that couples continuous X-ray tube rotation with a continuous table feed. It enables us to acquire a wide range of data during a single breath hold. With an uninterrupted volume of data, spiral CT provides high quality three dimensional (3D) images or Multiplanar Reconstruction (MPR) images. 3D images are useful for evaluating central airway diseases. The advantages include the following: (1) 3D images provide information on the poststenotic bronchus, which cannot be observed by bronchoscopy. (2) 3D images can assess the effect of chemotherapy or radiation therapy. (3) 3D images are useful in planning for stenting or resection. (4) 3D images can demonstrate tracheobronchial mucosal irregularity. However, intramural invasion cannot be evaluated by 3D image.
In terms of spatial resolution, MRI is slightly inferior to CT. However, contrast resolutionis higher with MRI than with CT.
In this paper, we will discuss the value of spiral CT and MRI in evaluating lung cancer, along with their specific advantages and disadvantages.
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Ikuo Kawahara, Kiminori Fujimoto, Jun Uozumi, Osamu Edamitsu, Masafumi ...
1997 Volume 48 Issue 2 Pages
111-118
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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One hundred twelve patients with esophageal carcinoma who had undergone CT and MRI before surgery were studied retrospectively. The longest transverse diameter (LTD) and shortest transverse diameter (STD) of 4, 018 resected lymph nodes were measured. Only 29 (1%) of the STD were 10mm or longer among 3, 685 non-metastatic lymph nodes, while 128 (38%) were shorter than 5mm among the 333 metastatic lymph nodes.
To differentiate metastatic lymph nodes from non-metastatic nodes based on size, the regional maximum standards of the LTD and STD of non-metastatic nodes were calculated.
The STD showed a smaller variation and more useful parameter than the LTD. A standard maximum size for normal STD of nodes in each region was proposed as follows: 12mm for nodes in # 106tb-R; 10mm for nodes in # 107, # 109-L, # 5, and # 9; and 8mm for nodes in other regions.
A guideline based on an STD of 10mm for the diagnosis of metastatic nodes was considered appropriate. The accuracy of the CT diagnosis of lymph node metastasis was 75%, sensitivity 55% and specificity 85%, according to this criterion. Even using STD/LTD ratio criteria in addition to the STD size criterion, there was no remarkable change in the accuracy of detection of lymph node metastasis.
Helical CT was used in the other 12 patients with esophageal carcinoma. Helical CT can detect smaller lymph nodes compared to conventional CT. Therefore, the accuracy rate was increased from 43% by conventional CT to 51% by helical CT.
The accuracy of a MRI diagnosis of lymph node metastasis was 69%, sensitivity 59% and specificity 74%, using similar CT size criteria. In addition to these criteria, with heterogeneous pattern criteria for the lymph nodes the results were 71%, 43% and 86%, respectively.
Other new criteria and techniques should be considered to improve the evaluation of lymph node metastasis from esophageal carcinoma.
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Yasumasa Niwa, Hidemi Goto, Tetsuo Hayakawa
1997 Volume 48 Issue 2 Pages
119-122
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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Ultrasound probes and three dimensional images are technologies on the cutting-edge of endoscopic ultrasonography. Ultrasound probes are easier to use and more accurate than standard EUS in the evaluation of the depth of the invasion in superficial esophageal carcinoma. However, the high frequency of the probe limits the depth of penetration, making the assessment of large tumors and extramural lesions difficult.
3D images were produced by the reconstruction of ultrasonographic images using a computer workstation. The probe was withdrawn via the biopsy channel of a conventional endoscope at a constant speed. The images were recorded on video, and, following the examination, 3D displays of the lesion were produced. Our system provides surface image (by the Phong shading method) and section images. We can visualize any section and determine the position of the probe image in relation to the surface image. These new diagnostic methods will become clinically available in the near future.
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T. Shirakusa, A. Kureya
1997 Volume 48 Issue 2 Pages
123
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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T. Ogoshi, K. Kawano
1997 Volume 48 Issue 2 Pages
124
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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T. Kubota, N. Otani, Y. Kadokura
1997 Volume 48 Issue 2 Pages
125
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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M. Mitsui, K. Ochi, H. Nakashima, H. Kaneko, T. Kinoshita, T. Ohashi, ...
1997 Volume 48 Issue 2 Pages
126
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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M. Kawaida, H. Fukuda, N. Kono
1997 Volume 48 Issue 2 Pages
127
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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Video-assisted Thoracic and Mediastinal Surgery
H. Okabayashi, T. Shirakusa
1997 Volume 48 Issue 2 Pages
128
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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E. Tamura, M. Ogura, T. Tabe, M. Nakanobo, K. Karaho, T. Furukawa, T. ...
1997 Volume 48 Issue 2 Pages
129
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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M. Endo, T. Tanaka
1997 Volume 48 Issue 2 Pages
130-131
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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H. Makuuchi
1997 Volume 48 Issue 2 Pages
132
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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M. Yohihda, K. Momma
1997 Volume 48 Issue 2 Pages
133
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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H. Inoue, K. Nagai, T. Kawano, K. Yoshino, K. Takeshita, M. Endo
1997 Volume 48 Issue 2 Pages
134
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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T. Kozu, H. Yamada, M. Arima, N. Harada, E. Hishikawa, K. Isono
1997 Volume 48 Issue 2 Pages
135
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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T. Akaishi
1997 Volume 48 Issue 2 Pages
136
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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K. Kawahara, T. Maekawa, Y. Yamashita, T. Shirakusa
1997 Volume 48 Issue 2 Pages
137
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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M. Ohyama
1997 Volume 48 Issue 2 Pages
138-139
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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Y. Sakakura
1997 Volume 48 Issue 2 Pages
140-141
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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S. Kudo
1997 Volume 48 Issue 2 Pages
142-144
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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Takashi Horie
1997 Volume 48 Issue 2 Pages
145-146
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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The purpose of this lecture is to interpret the complaint of dyspnea for otolaryngologists. Dyspnea is an important subjective symptom, but its mechanisms have not been completely established. In addition, dyspnea is a difficult symptom to evaluate quantitatively. Recently, a visual analog scale and the Borg scale have been widely employed to express degree of dyspnea. For the clinical evaluation of patients complaining of dyspnea, precise analysis is important. Hypoxemia is not proportional to the degree of dyspnea, but blood gas analysis is important for the determination of the severity of dyspnea, its causes and the necessity of emergency care.
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Y. Nagasaka
1997 Volume 48 Issue 2 Pages
147-148
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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Takemoto Shin
1997 Volume 48 Issue 2 Pages
149-150
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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Various abnormalities, involving dysfunction of the muscles and the peripheral or central nervous system, can cause swallowing disorders. An accurate determination of the location and degree of lesions, as well as detailed observation of the swallowing functions, are necessary in the management of dysphagia. Dysphagia caused by disorders of central nervous system can be divided into two groups: lesions of the corticobulbar tract and those of the brainstem involving the central pattern generator. Pathophysiology and treatment are different in each group. Indications for the surgical treatment of dysphagia are discussed.
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1997 Volume 48 Issue 2 Pages
151-167
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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1997 Volume 48 Issue 2 Pages
168-189
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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1997 Volume 48 Issue 2 Pages
190-205
Published: April 10, 1997
Released on J-STAGE: February 22, 2010
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