日本胸部疾患学会雑誌
Online ISSN : 1883-471X
Print ISSN : 0301-1542
ISSN-L : 0301-1542
21 巻, 10 号
選択された号の論文の12件中1~12を表示しています
  • 芳賀 敏彦
    1983 年 21 巻 10 号 p. 925-927
    発行日: 1983/10/25
    公開日: 2010/02/23
    ジャーナル フリー
  • 佐川 弥之助
    1983 年 21 巻 10 号 p. 928-934
    発行日: 1983/10/25
    公開日: 2010/02/23
    ジャーナル フリー
    In this paper, I would like to discuss 1. some measurement methods of pulmonary extravascular water volume related to lung edema and 2. abnormal respiration during sleeping from the viewpoint of acute and chronic respiratory failures, respectively.
    1. Measurement methods of pulmonary extravascular water volume.
    At present, chest X-ray photograph is regarded as the best clinical measurement method of pulmonary extravascular water volume. But, as this method has some undeniable disadvantages, establishment of other measurement methods desired. This is the reason why we tested some other methods experimentally.
    1) Static lung compliance and closing volume.
    Closing volume is far more sensitive than static lung compliance as the index of pulmonary extravascular water volume, and clinical application is possible. But, closing volume has its own disadvantage, because it does not express water volume quantitatively.
    2) Impedance plethysmography.
    Although impedance plethysmography has the disadvantage that it does not distinguish between intrapleural effusion and intrapulmonary water, and does not detect slight increase of pulmonary extravascular water volume, this method has a merit of facilitating continuous monitering.
    3) Double indicator dilution method.
    Double indicator dilution method is the most excellent method theoretically, but indicator has some problems to be solved. So, we investigated the heat-indocyanine green method, heat-heat method, heat-conductivity method, and came to the conclusion that heat-conductivity method was the best when instream catheter of our invention was used.
    2. Abnormal respiration during sleeping.
    1) We investigated apnea and hypopnea types of abnormal respiration during sleeping in patients with chronic respiratory failure, and confirmed the serious decrease of SaO2 during REM sleeping in both types.
    2) Usually, in normal cases, abdominal movement is greater than ribcage movement related to respiration during REM sleeping; but in cases of chronic respiratory failure caused by ribcage abnormality, abdominal movement did not become greater in REM sleeping, in spite of smaller ribcage movement. This phenomenon seems to be one of the causes of severe decrease of SaO2 during REM sleeping.
    3) In cases of chronic respiratory failure, maximal Ptc CO2 during nocturnal oxygen inhalation did not show significant difference from that during room air inhalation in non-REM sleep stage, but showed significant difference in REM sleep stage. This phenomenon shows the possibility that increased PaCO2 during REM sleep stage does not decrease during non-REM stage or while awake.
  • 大島 駿作
    1983 年 21 巻 10 号 p. 935-937
    発行日: 1983/10/25
    公開日: 2010/02/23
    ジャーナル フリー
    Macrophages were collected by bronchoalveolar lavage (BAL) from patients with various types of interstitial pnuemonitis (i.e., alveolitis) characterized by major lesions in the alveolar wall. These cells were then examined by light and electron microscopy. In addition, the effects of BAL macrophages were evaluated by various methods, such as PHA-stimulated proliferative T cell response, and PWM-induced immunoglobulin production of B cells. Macrophage function was also tested in terms of presence of antigens, phagocytosis and SRBC rosette formation mediated by IgG-Fc or C3 receptors, NBT reduction, and oxygen consumption. Furthermore, BAL-lymphocytes were examined in order to determine the percentages of activated T cells and activated B cells. These results all revealed that both macrophages and T cells were highly activated in granulomatous lung diseases including hypersensitivity pneumonitis, sarcoidosis, and chronic beryllisis, but not in idiopathic interstitial pneumonitis and interstitial pneumonitis with collagen disease, in which marcophages and B cells, rather, were highly activated.
    These findings suggest that interstitial pneumonitis might be classified into two groups, one being “T lymphocyte alveolitis” and the other, “B lymphocyte alveolitis”.
  • 螺良 英郎, 岡安 大仁
    1983 年 21 巻 10 号 p. 938-976
    発行日: 1983/10/25
    公開日: 2010/02/23
    ジャーナル フリー
  • 松本 保和, 久保 進, 田川 秀樹, 福井 純, 坂井 明紀, 今村 俊之, 古賀 秀隆, 原 耕平
    1983 年 21 巻 10 号 p. 977-983
    発行日: 1983/10/25
    公開日: 2010/02/23
    ジャーナル フリー
    We studied the N2 washout test in 6 young normal subjects, and 32 patients with chronic pulmonary disease, and performed multiple compartement analysis. Sequential distribution of ventilation fraction was shown, and very different patterns of distribution between normal subjects and patients were obtained. We consider that the mean of ventilation per volume (λi-mean) and its standard deviation (λi-SD) shows the overall ventilation fraction of the lungs, and the severity of unequal ventilation respectively. Especially, λi-SD was higher in patients and correlated well with parameters of pulmonary function. We concluded that our method is very significant for the clinical investigation of unequal ventilation.
  • 石原 陽子, 内田 裕子, 北村 諭, 高久 史麿
    1983 年 21 巻 10 号 p. 984-987
    発行日: 1983/10/25
    公開日: 2010/02/23
    ジャーナル フリー
    Leukotrienes, which are derived from arachidonic acid have similar chemical structures to prostaglandins, have recently been shown to possess most of the biological activity previously attributed to “slow reacting substance of anaphylaxis” (SRS-A). In the past two years, it has been established that the SRS-A activity is almost entirely attributable to leukotrienes C4, D4, and E4 (LTC4, LTD4, and LTE4). Lipoxygenese catalyzes the oxygenation of arachidonic acid and biosynthetizes leukotrienes.
    The present investigation was conducted to demonstrate the effect of AA-861 and T-22083, specific inhibitors of lipoxygenase activity, on the release of chemical mediators from passively sensitized quinea pig lung tissues.
    Male Hartley strain guinea pigs weighing about 200g were used as the experimental animals. The lung tissue was minced into fragments (10-20mg). The lung fragments were incubated in gamma globulin solution at 37°C for 3-4 hours bubbling with oxygen and carbon dioxde (95:5, v/v). Histamine and SRS-A released from the lung tissue by the antigen (ovalbumin) challenge were quantitated by bioassay methods.
    1) The amount of histamine released from sensitized lung tissue by the challenge of antigen showed marked decrease by preincubating with AA-861 or T-22083, and the percent inhibition by AA-861 was bigger than that by T-22083.
    2. The amount of SRS-A released from passively sensitized lung tissue by antigen challenge showed marked decrease by preincubation with AA-861 or T-22083, and the percent inhibition by AA-861 was bigger than that by T-22083.
    The above results suggest that AA-861 and T-22083, have not only an inhibiting action on the release of SRS-A from sensitized lung tissue but also have an inhibiting action on the release of histamine, and that these drugs might become useful therapeutic agents against various anaphylactic reactions including bronchial asthma.
  • 谷崎 勝朗, 周藤 真康, 小野波 津子, 田村 尚彦, 塩田 雄太郎, 松香 陽子, 多田 慎也, 高橋 清, 木村 郁郎
    1983 年 21 巻 10 号 p. 988-992
    発行日: 1983/10/25
    公開日: 2010/02/23
    ジャーナル フリー
    Forty-five asthmatic subjects were treated with aerosol and intravenous administration of heparin. Immediate effects (within 30 minutes) were obtained in 20 out of 45 cases (44.4%). Delayed efficacy which appears several hours after the administration was observed in 15 out of 23 cases (65.2%).
    The increased efficacy of heparin was demonstrated in the cases whose age or age of onset was over 40 years. The values of FEV1.0%, V50 and V25 were lower in the effective cases than in the non-effective cases. The cases in which heparin was effective showed a lower bronchial response to salbutamol inhalation.
    The metabolism of plasma heparin after the intravenous administration was increased in the attack stage of bronchial asthma compared to that in healthy subjects, although no significant difference in the metabolism of plasma heparin was shown between the effective and the non-effecive cases.
  • 堀江 孝至, 赤柴 恒人, 萩原 照久, 河村 宏一, 細川 芳文, 長尾 光修, 岡安 大仁
    1983 年 21 巻 10 号 p. 993-999
    発行日: 1983/10/25
    公開日: 2010/02/23
    ジャーナル フリー
    Small airway abnormalities have been pointed out in cases of interstitial lung diseases in several papers, however, others have reported that those may be due to the effect of smoking in such patients. In the present study, small airways were histologically and physiologically evaluated in 24 cases of various interstitial lung diseases. Biopsy specimens revealed peribronchiolar fibrosis in 18 cases and smooth muscle hypertrophy and thickening of basement membrane in 15 cases. However, existence and degree of airway narrowing could not be evaluated in our biopsy specimens. Pulmonary function data showed restrictive changes in most of the cases with normal FEV1.0% and RV/TLC. Comparing normal smokers and nonsmokers, V50 and V25 were decreased in 14 cases and 13 cases, respectively, and closing volume was elevated in 12 out of 19 cases in interstitial lung diseases. Relations of V50 and V25 to vital capacity were not significant, therefore, reduction of V50 and V25 could not be attributed to the decrease in lung volume.
    These results indicate that the small airway diseases are common in interstitial lung diseases.
  • 成田 亘啓, 上野 美智代, 宮崎 隆治, 佐田 和夫, 白井 史朗, 西川 潔, 春日 宏友, 三上 理一郎, 大野 良隆, 今井 俊介, ...
    1983 年 21 巻 10 号 p. 1000-1006
    発行日: 1983/10/25
    公開日: 2010/02/23
    ジャーナル フリー
    We reported an autopsy case of pulmonary asbestosis complicated with secondary bronchitis and rheumatoid arthritis. This case died due to respiratory failure, and differed from ordinary pulmonary asbestosis in the unusual early progression of clinical course. Autopsy revealed foci of rheumatoid type superimposed upon pulmonary asbestosis in the lung, and extensive bronchoectasis. We discussed 5 previously reported cases of pulmonary asbestosis complicated with rheumatoid arthritis.
  • 白木 るい子, 木下 美登里, 和頴 房代, 渡辺 晴雄, 北村 諭
    1983 年 21 巻 10 号 p. 1007-1010
    発行日: 1983/10/25
    公開日: 2010/02/23
    ジャーナル フリー
    A 47-year-old female with the limited form of Wegener's granulomatosis had been treated for seven years. She was admitted to our hospital with a chief complaint of exertional dyspnea. On admission her arterial blood PO2 was 58mmHg. Fiberoptic bronchoscopy revealed the marked stenosis of the subglottic region (about 70%). Oral administration of prednisolone did not improve her symptoms. After tracheotomy, the PO2 went up to 88mmHg and her exertional dyspnea disappeared.
    This type of lesion has become rather unusual these days after the introduction of immunosuppressant therapy. But in the future it may be seen more frequently as the patients with Wegener's granulomatosis survive longer.
  • 橋上 裕, 山本 正彦, 高田 勝利, 杉浦 孝彦, 森下 宗彦, 市村 貴美子, 鳥井 義夫, 吉川 公章, 鈴木 雅之, 野田 明孝
    1983 年 21 巻 10 号 p. 1011-1016
    発行日: 1983/10/25
    公開日: 2010/02/23
    ジャーナル フリー
    19歳の女性が, 検査の目的で入院をした. 問題点は, 不明熱, 皮下結節. 胸部X線像で, 右肺門影腫脹を認めた. 皮下結節の針生検にて, Weber-Christian 病と診断した. 入院経過中に, 胸部X線像は, 胸膜炎と無気肺を呈した. 動脈瘤も合併した. 胸部X線像の改善につれて, 皮下結節も消失した.
  • 1983 年 21 巻 10 号 p. 1017-1024
    発行日: 1983/10/25
    公開日: 2010/02/23
    ジャーナル フリー
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