日本胸部疾患学会雑誌
Online ISSN : 1883-471X
Print ISSN : 0301-1542
ISSN-L : 0301-1542
17 巻, 11 号
選択された号の論文の9件中1~9を表示しています
  • 杉江 三郎
    1979 年 17 巻 11 号 p. 701-702
    発行日: 1979/11/25
    公開日: 2010/02/23
    ジャーナル フリー
  • 香川 順, 津留 喜恵子
    1979 年 17 巻 11 号 p. 703-709
    発行日: 1979/11/25
    公開日: 2010/02/23
    ジャーナル フリー
    We studied the bronchial reactivity of 6 healthy human subjects (3 nonsmokers and 3 smokers) to inhaled acetylcholine after 2-hour exposure to 0.3ppm ozone (O3), smoking cigarettes alone, 0.3ppm O3 with smoking, and 0.5ppm O3. Most subjects showed significant decrease of specific airway conductance (Gaw/Vtg) after these exposures in comparison with control measurements. The decrease of Gaw/Vtg after smoking was similar to O3 exposure and not enhanced by addition of O3. The decrease of Gaw/Vtg after 0.5ppm O3 seemed to be greater than 0.3ppm O3 in nonsmokers.
    Five of 6 subjects showed a tendency for Gaw/Vtg to decrease with each concentration of acetylcholine in comparison with controls, which indicated increased bronchial reactivity, but these 5 did not show the enhanced effect by a combination of O3 and smoking together.
    Although the mechanism of the increased reactivity after exposure to O3 at concentrations observed in the urban atmosphere is not clear, this problem should be investigated in particular in association with the pathogenesis of asthma.
  • 後藤 真暎, 細川 芳文, 石田 順治, 長屋 光修, 堀江 孝至
    1979 年 17 巻 11 号 p. 710-717
    発行日: 1979/11/25
    公開日: 2010/02/23
    ジャーナル フリー
    The terminal rise of N2 concentration in the single breath nitrogen washout curve (SBNWC) has been interpreted to be due to airway closure, flow limitation, or changes of sequential emptying from each lung area. In our present study, we examined the effect of uneven pulmonary compliance in excised dog lungs on the pattern of SBNWC especially on phase IV. Uneven distribution of pulmonary compliance was made by connecting the normal lung lobe and the ventilated lung lobe which produces significantly elevated elastic recoil to the Y tube (connected to the lung). After excision of each lung, one lobe was used as control and another one lobe was ventilated for one hour with large tidal volume (50% TLC). Ten dog lungs were used for SBNWC study and three lungs were for multiple (M) BNWC study. All control lungs showed one compartment in MBNWC and demonstrated flat phase III and no phase IV in SBNWC. On the other hand, ventilated lungs showed the existence of fast and slow compartments in MBNWC. SBNWC revealed a steep phase III without phase IV in three cases and a flat phase III with remarkable phase IV in seven cases. In connected lungs MBNWC clearly demonstrated two compartments, and steep phase III without phase IV was observed in six cases and relatively flat phase III with apparent phase IV was noted in four cases in SBNWC. In the present study, we employed slow flow rate (20ml/sec) for SBNWC and the deflation pressure-volume curve showed no inflection point which has been regarded as the beginning of airway closure in all cases. Our results suggest that phase IV could be caused by the uneven distribution of pulmonary compliance.
  • 三品 陸人, 斎藤 芳晃, 小野里 融, 斎藤 健一, 千代谷 慶三, 中村 雅夫, 佐々木 孝夫, 大久保 隆男, 滝島 任
    1979 年 17 巻 11 号 p. 718-723
    発行日: 1979/11/25
    公開日: 2010/02/23
    ジャーナル フリー
    The authors statistically studied the respiratory function in 138 cases of silicotics by means of principal component analysis. The respiratory function tests were spirography (%VC, FEV1%), measurement of the lung volumes (%TLC, %FRC, %RV, RV%), CO diffusing capacity by single breath method, (%DLCO, DLCO/VA), flow volume curve(%V50, %V25, V50/V25), the analysis of arterial blood gas(%PaO2, PaCO2, pH, %A-DO2) and mechanical properties (%Pel at TLC, Cst(1), Cdyn/Cst(1), RL, RT).
    According to the factor loading with values higher than 0.4 in each principal component, the significance of each principal component can be determined. The first principal component, Z1, included FEV1%, %V50, %V25, RL, RT, and RV% as the factor loading with higher value and may be considered as the obstructive impairment factor. Because %TLC, %FRC, %RV, Cst(1), %Pel at TLC and %DLCO showed higher values, Z2 was suggested to be the factor of restrictive impairment or over-inflation, Z3, the disturbance of diffusing capitacity with hypoxemia, and Z4 the impairment of small airway. In other words, the disturbance of respiratory function in silicosis may be constructed by the above described principal components.
    The principal component scores (PCS) are weighed by the various respiratory functions. If we compare two PCS with each other on the graph, the characteritics of the functional disturbance may be easily demonstrated. Lastly, we investigated the relationships between the grading of the findings on chest X-P and the PCS.
    The relation between the profusion of the small opacities and Z1, the obstructive impairment, and Z2, the restrictive impairment, and between the extent of the large opacities and Z1, obstructive impairment, was statistically significant.
  • 金沢 実
    1979 年 17 巻 11 号 p. 724-730
    発行日: 1979/11/25
    公開日: 2010/02/23
    ジャーナル フリー
    Fourty-nine patients with pulmonary emphysema and diffuse fibrotic change in the lungs (pulmonary fibrosis) were repeatedly studied in terms of changes in lung volumes and blood gas for more than two years. The lung volumes were measured according to the helium dilution method during the stable stage of illness. The annual change was estimated by applying the least-squares regression of obtained values against time. It was also estimated in fifty-one healthy control subjects, and was compared with that in the patients. Blood gas was measured during both the stable and exacerbated stages of illness under normal conditions. The annual change in blood gas was calculated only from the data in the stable stage.
    The mean annual changes in patients with pulmonary emphysema were decreases of 0.071l/yr for IRV, 0.040 for ERV, 0.055 for IC, and 0.092 for VC; and increases of 0.243 for RV, 0.174 for FRC, 0.118 for TLC, and 2.98%/yr for RV/TLC. The changes in these parameters were greater than those observed in the healthy subjects (p<0.05). Patients with pulmonary fibrosis showed greater decreases in ERV, VC, and TLC than did the healthy subjects; their mean annual changes were decreases of 0.061, 0.058, and 0.067, respectively. Although arterial blood gas in these patients changed little during the stable stage, a decrease in PaO2 and an increase in AaDO2 in patients with pulmonary fibrosis were statistically significant. (p<0.05) During the exacerbated stage, decreases in PaO2 and increases in AaDO2 in both groups of patients were marked. A number of patients with pulmonary emphysema showed hypercapnia, especially those whose PaO2 was below 50 torr. On the other hand, no patients with pulmonary fibrosis showed hypercapnia even during the stage of exacerbation. Changes observed during exacerbation were greater than those observed during the stable stage.
  • 末次 勧, 本間 れい子, 榊原 博樹, 石川 平八, 内藤 龍雄, 三木 知子, 梅田 博道
    1979 年 17 巻 11 号 p. 731-736
    発行日: 1979/11/25
    公開日: 2010/02/23
    ジャーナル フリー
    A 37-year-old woman was admitted with remittent fever of one month duration. The temperature rose as high as 40°C with shaking chills. There were needle tracks along veins of her bilateral cubital fossae. A blood culture on admission had grown a penicillin-resistant Staphylococcus aureus. X-ray films of the chest revealed small scattered areas of consolidation simulating bronchopneumonia in both lung fields. Thin-walled cavities were also found in some parts of the shadows. Because of her intractable bronchial asthma, initiated of the age of eighteen, she had used to perform intra-venous injections of ‘NEOPHYLLIN’ (2.5% aminophyllin, 10ml Amp.) by herself since thirty years old until quite recently. She also used ‘CODELSOL’ (prednisolone phosphoric acid ester 20mg/ml, 2ml Amp.) for about two years till six months before the admission. Those drugs were gotten from a certain drug store at the suggestion of a friend. As the method of injection was not completely clean, it is easy to suppose that the staphylococcall infection occured through the injection site. The use of corticosteroid also had to be an important factor in the development to endocarditis and a pneumonia secondary to hematogenous spread of the bacteria. She was treated with intensive chemotherapy and almost completely recovered about eight weeks after admission, except the remaining complication of valvular damage (without insufficiency). The use of oxacillin and gentamicin seemed to be most effective, as is indicated by previous reports.
  • 塙 充弘, 藤沢 弘芳
    1979 年 17 巻 11 号 p. 737-741
    発行日: 1979/11/25
    公開日: 2010/02/23
    ジャーナル フリー
    47才女, 髄液中に悪性リンパ腫細胞出現したため, 週1~2回 methotrexate 10mg髄注した. 初回髄注後より好酸球が増加し, 6回直後より高熱を発し, 胸部X線写真で全肺野にびまん性粒状散布影を認めた. methotrexate を中止して prednisolone を投与し, 翌日には解熱し, 約10日で異常陰影は消失した.
  • 1979 年 17 巻 11 号 p. 743-749
    発行日: 1979/11/25
    公開日: 2010/02/23
    ジャーナル フリー
  • 1979 年 17 巻 11 号 p. 750-754
    発行日: 1979/11/25
    公開日: 2010/02/23
    ジャーナル フリー
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