日本気管食道科学会会報

Mechanisms of Allergic Airway Disease

Stephen T. Holgate

1997 年 48 巻 2 号 p. 51-66
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.51

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気道管理の最新情報

古賀義久

1997 年 48 巻 2 号 p. 67-68
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.67

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気管支喘息と私

中島重徳

1997 年 48 巻 2 号 p. 69-73
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.69

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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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シンポジウム1 気管, 食道周辺領域の粘膜免疫反応司会者のまとめ

石川哮, 茂木五郎

1997 年 48 巻 2 号 p. 74-75
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.74

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咽頭・扁桃の感染に対する粘膜免疫応答

黒野祐一, 坂本菜穂子, 螻川内英臣, 茂木五郎

1997 年 48 巻 2 号 p. 76-80
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.76

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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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扁桃リンパ球の apoptosis による免疫応答制御

木村貴昭, 與田順一, 斉藤匡人, 横山道明, 九鬼清典, 山中昇

1997 年 48 巻 2 号 p. 81-83
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.81

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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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気管支喘息と気道粘膜免疫応答

東田有智, 久保裕一, 浦上理恵, 中原弘, 村木正人, 福岡正博, 中島重徳

1997 年 48 巻 2 号 p. 84-90
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.84

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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-β₁ depressed human eosinophil survival.

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喉頭アレルギーとスギ花粉症

神田敬

1997 年 48 巻 2 号 p. 91-93
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.91

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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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食道の粘膜免疫応答

名倉宏, 安藤紀昭, 笹野公伸

1997 年 48 巻 2 号 p. 94-99
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.94

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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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シンポジウム2 気管食道科領域における最新画像診断 (helical CT なども含む) 司会者のまとめ

海野徳二, 河野通雄

1997 年 48 巻 2 号 p. 100-101
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.100

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下咽頭のMRIを中心として

辰野聡, 山下三代子, 多田信平

1997 年 48 巻 2 号 p. 102-106
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.102

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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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気管・気管支・肺: とくに3DCT, MRI

三村文利, 河野通雄

1997 年 48 巻 2 号 p. 107-110
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.107

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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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食道癌リンパ節転移のCT, MRI診断

河原郁夫, 藤本公則, 魚住淳, 枝光理, 内田政史, 西村浩, 早渕尚文, 藤田博正

1997 年 48 巻 2 号 p. 111-118
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.111

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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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食道-特に超音波内視鏡

丹羽康正, 後藤秀実, 早川哲夫

1997 年 48 巻 2 号 p. 119-122
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.119

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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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ビデオシンポジウム気管食道科領域における鏡視下手術'96 1. 気道系司会者のまとめ

白日高歩, 呉屋朝幸

1997 年 48 巻 2 号 p. 123
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.123

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ラリンジャルマスクを使用した小児気管支ファイバースコープ検査の経験

大越俊夫, 川野和弘

1997 年 48 巻 2 号 p. 124
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.124

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甲状腺癌の気道浸潤例に対するコラーゲン人工気管の再建

窪田哲昭, 大谷尚志, 門倉義幸

1997 年 48 巻 2 号 p. 125
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.125

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甲状腺手術時の反回神経および上喉頭神経の保存について

三井雅夫, 越智健太郎, 中島博昭, 金子卓爾, 木下裕継, 大橋徹, 加藤功

1997 年 48 巻 2 号 p. 126
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.126

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直達喉頭鏡下傍内視鏡的喉頭手術

川井田政弘, 福田宏之, 甲能直幸

1997 年 48 巻 2 号 p. 127
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.127

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気管・縦隔領域における鏡視下手術

胸腔鏡および縦隔鏡を中心に

岡林寛, 白日高歩

1997 年 48 巻 2 号 p. 128
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.128

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喉頭内腔に対する超音波検査の応用

田村悦代, 小倉雅實, 田部哲也, 中之坊学, 唐帆健浩, 古川太一, 松永毅, 盛川宏, 村瀬優子, 北原哲, 井上 ...

1997 年 48 巻 2 号 p. 129
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.129

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ビデオシンポジウム気管食道科領域における鏡視下手術'96 2. 食道系司会者のまとめ

遠藤光夫, 田中隆

1997 年 48 巻 2 号 p. 130-131
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.130

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食道癌の内視鏡的手術 (EMR)

幕内博康

1997 年 48 巻 2 号 p. 132
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.132

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食道粘膜癌に対する内視鏡的粘膜切除術

吉田操, 門馬久美子

1997 年 48 巻 2 号 p. 133
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.133

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食道アカラシア, 食道平滑筋腫に対する内視鏡的手術

井上晴洋, 永井鑑, 河野辰幸, 吉野邦英, 竹下公矢, 遠藤光夫

1997 年 48 巻 2 号 p. 134
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.134

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胸腔鏡による食道筋腫摘出術

神津照雄, 山田英夫, 有馬美和子, 原田昇, 菱川悦男, 磯野可一

1997 年 48 巻 2 号 p. 135
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.135

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胸部食道癌に対する胸腔鏡による縦隔郭清

赤石隆

1997 年 48 巻 2 号 p. 136
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.136

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胸部食道癌の胸腔鏡下切除術

川原克信, 前川隆文, 山下裕一, 白日高歩

1997 年 48 巻 2 号 p. 137
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.137

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ランチヨンレクチャー副鼻腔気管支炎の病因・病態と治療の最新の考え方病因・病態

大山勝

1997 年 48 巻 2 号 p. 138-139
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.138

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ランチョンレクチャー副鼻腔気管支炎の病因・病態と治療の最新の考え方治療-耳鼻科の立場から

坂倉康夫

1997 年 48 巻 2 号 p. 140-141
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.140

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ランチョンレクチャー副鼻腔気管支炎の病因・病態と治療の最新の考え方治療-内科の立場から

工藤翔二

1997 年 48 巻 2 号 p. 142-144
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.142

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ランチョンレクチャー耳鼻科医に伝えたい内科の知識, 内科医に伝えたい耳鼻科の知識内科より-呼吸困難を中心に

堀江孝至

1997 年 48 巻 2 号 p. 145-146
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.145

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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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ランチョンレクチャー耳鼻科医に伝えたい内科の知識, 内科医に伝えたい耳鼻科の知識内科より-アスピリン喘息を中心に

長坂行雄

1997 年 48 巻 2 号 p. 147-148
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.147

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ランチョンレクチャー耳鼻科医に伝えたい内科の知識, 内科医に伝えたい耳鼻科の知識耳鼻科より-嚥下障害: 咽頭期嚥下について

進武幹

1997 年 48 巻 2 号 p. 149-150
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.149

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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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一般演題・ビデオ演題、記録

1997 年 48 巻 2 号 p. 151-167
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.151

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一般演題・ビデオ演題、記録 (2)

1997 年 48 巻 2 号 p. 168-189
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.168

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一般演題・ビデオ演題、記録 (3)

1997 年 48 巻 2 号 p. 190-205
発行日: 1997/04/10
公開日: 2010/02/22

DOIhttps://doi.org/10.2468/jbes.48.190

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