日本胸部疾患学会雑誌
Online ISSN : 1883-471X
Print ISSN : 0301-1542
ISSN-L : 0301-1542
22 巻, 2 号
選択された号の論文の15件中1~15を表示しています
  • 仲田 祐
    1984 年 22 巻 2 号 p. 87-88
    発行日: 1984/02/25
    公開日: 2010/02/23
    ジャーナル フリー
  • 田中 満, 佐藤 勝, 小林 弘祐, 竹口 甲三
    1984 年 22 巻 2 号 p. 89-99
    発行日: 1984/02/25
    公開日: 2010/02/23
    ジャーナル フリー
    We developed a new type of bronchofiberscope and devised a method for photography. Also, for the first time, we observed and photographed lesions of 1mm or less in bronchioli.
    This new type of bronchofiberscope is 1.8mm in external diameter at the tip, with a visual field angle of a focal length of 2-30mm in range, 1150mm in effective length, and 1350mm in total length it has excellent observation and recording ability. We believe that endoscopic examination of the bronchioli will become popular and can serve as one method to solve problems of early diagnosis of lesions in the bronchioli which are known as the silent zone or quiet zone. It is also considered that as a method of morphological diagnosis of the lesion in the peripheral airway, endoscopic examination of the bronchioli and selective alveolo-bronchography should be performed at the same time, and a transbronchial lung biopsy specimen should be taken from the target area.
    Original morphological examinations of the peripheal airway has not yet been performed. However, we belive that finding a way to apply this endoscopic examination of the bronchioli to routine clinical work practice is an urgent topic.
  • モルモットを用いた実験的研究
    石原 陽子, 内田 裕子, 北村 諭, 高久 史麿
    1984 年 22 巻 2 号 p. 100-103
    発行日: 1984/02/25
    公開日: 2010/02/23
    ジャーナル フリー
    It has been postulated that interferon is a powerful therapeutic agent against viral infection, intracellular parasites and malignant tumor cell proliferation, although its precise mechanism is still unknown. Recently, several reports have shown that the effects of interferon are mediated or modulated by prostaglandins or other arachidonic acid metabolites.
    The important functions of the pulmonary circulation are to bring the blood in contact with alveolar gas, for the purpose of gas exchange, and to metabolize various vasoactive substances. Prostaglandins and related lipids are inactivated, synthetized and released from the lung by various stimuli.
    The present investigation was conducted to demonstrate the effects of interferon on the action of bronchoactive agents in guinea pig tracheal strips, and on the metabolism of vasoactive substances through isolated perfused guinea pig lung lobes.
    1) The tonus of guinea pig tracheal strips did not show any significant change with continuous infusion of interferon (1×103 to 1×106U).
    2) The contractile responses induced by acetylcholine, histamine, serotonin and prostaglandin D2 in guinea pig tracheal strips were not affected by continuous infusion of interferon (1×101-1×105U/ml).
    3) Percent inactivation of prostaglandin D2 and prostaglandin F showed a significant decrease with continuous infusion of interferon (1×104U/ml), while those of prostaglandin E2 and serotonin did not show any significant changes.
  • 岸本 広次, 下方 薫
    1984 年 22 巻 2 号 p. 104-110
    発行日: 1984/02/25
    公開日: 2010/02/23
    ジャーナル フリー
    We examined immune interferon production by peripheral blood lymphocytes as one of the parameters of cellular immunity in patients with lung cancer. Immune interferon production by cultured peripheral blood lymphocytes was measured in 50 untreated patients with lung cancer and 17 normal subjects by the use of mitogens (PPD, PHA, ConA, and PWM). In addition, PPD skin test, T-cell number, and lymphpcyte blastogenesis against ConA were investigated.
    The interferon titer in patients with lung cancer was significantly lower than that in normal subjects. The PPD skin test correlated well with the interferon titer. No correlation was found between the interferon titer and T-cell number or ConA-stimulated blastogenesis. The clinical course in patients with lung cancer correlated well with interferon production.
    In conclusion, we think that measurement of immune interferon production by peripheral blood lymphocytes in patients with lung cancer is useful for the assessment of cellular immunity and clinical prognosis.
  • 気管支肺胞洗浄液, 血清ACE値との対比
    市川 洋一郎, 林 俊治, 光武 良幸, 藤野 和馬, 田中 二三郎, 加地 正郎
    1984 年 22 巻 2 号 p. 111-117
    発行日: 1984/02/25
    公開日: 2010/02/23
    ジャーナル フリー
    The usefulness of Ga-67 scanning in the evaluation of disease activity was examined in a study including 32 patients with sarcoidosis; 20 untreated and 12 treated patients. The levels of serum angiotensin-converting enzyme (ACE) were measured in all 32 patients, and bronchoalveolar lavage was performed in 10 untreated patients and 7 treated patients.
    Ga-67 scanning was compared with the level of serum ACE and the numbers of lymphocytes and T-lymphocytes obtained from bronchoalveolar lavage fluid.
    Ga-67 scanning was useful in the detection and assessment of subclinical lesions that were not revealed by traditional methods of investigation.
    Ga-67 uptake sites not only correlated with levels of serum ACE, but also the number of T-lymphocytes of bronchoalveolar lavage fluid in both groups of patients.
    No correlation was seen between the intensity of the Ga-67 uptake in lungs and the level of serum ACE in untreated patients but a positive correlation was seen in treated patients.
    In the untreated group a strong correlation between the intensity of Ga-67 uptake in lungs and the number of lymphocytes and T-lymphocytes obtained from bronchoalveolar lavage fluid was noted (r=0.86, p<0.01).
    These data suggested that Ga-67 scanning reflects the intensity of T-lymphocyte-mediated alveolitis. Ga-67 scanning should prove useful to assess T-cell alveolitis and to determine the disease activity stage of sarcoidosis.
  • 桑平 一郎
    1984 年 22 巻 2 号 p. 118-124
    発行日: 1984/02/25
    公開日: 2010/02/23
    ジャーナル フリー
    A six-channel scanning impedance pneumograph (Nihon Kohden Kogyo Co., Ltd., OGR-5100S) was applied to the assessments of changes in regional flow ans volume in various lung fields. A co-axial electrode (NI-601V), which consists of a thin polyester disc and electroconductive gel, made it possible to obtain stable recordings of regional respiratory ΔZs on body exertion. Changes in regional respiratory ΔZs and the derivatives of the ΔZs during forced expiration from TLC to RV were recorded simultaneously on X-Y co-ordinates, which were considered to represent regional flow-volume relationships. Also, they were each recorded on a polygraph simultaneously with overall flow and volume for quantitative analysis of the time sequences. Measurements were performed on 8 healthy laboratory workers and patients with various pulmonary disorders.
    In healthy subjects it was observed that neither regional flow nor volume showed a significant difference between right and left lung fields, whereas those obtained in the upper lung fields differed significantly from those recorded in the lower zone. Regional differences in ventilatory functions in the diseased lungs, which were hardly recognized in overall flow-volume curves, were well reflected by the regional flow-volume curves.
    It was demonstrated that the present impedance method could be successfully used for evaluating regional ventilatory function in both normal and diseased lungs.
  • 塩谷 直久, 竹澤 祐一, 三上 理一郎, 工藤 翔二, 渋谷 惇夫
    1984 年 22 巻 2 号 p. 125-130
    発行日: 1984/02/25
    公開日: 2010/02/23
    ジャーナル フリー
    We measured the acoustic transmission of the respiratory system in five healthy subjects and low-pass filtering action of the normal thorax was evaluated. Sinusoidal sound waves of 100Hz to 1, 000Hz were introduced through the mouth and transmitted sounds were picked up with microphones at four locations; at the mouth, over the trachea at the anterior neck, and at the apical and basal position of the chest wall. The signal of ventilatory movement was simultaneously recorded.
    The sound intensity over the trachea and the chest was significantly influenced by the opening of the glottis accompanying respiration.
    The sound intensity in the chest, which was normalised by the intensity over the trachea, showed rapid attenuation with increasing frequency. The cut-off frequency was about 300Hz at the apex and 150Hz at the base, and the attenuation rate was 12dB/octave in both the apex and the base. Below the cut-off frequency, the sounds were evenly transmitted and were attenuated at about 15dB in both the apex and the base. There were no significant differences in acoustic transmission according to lung volumes.
    This method may be applied as a noninvasive examination in pulmonary diseases.
  • 永島 暉也, 梅田 博道
    1984 年 22 巻 2 号 p. 131-137
    発行日: 1984/02/25
    公開日: 2010/02/23
    ジャーナル フリー
    The acute effects of smoking one cigarette on lung function was studied in 26 healthy young smokers. There were no significant changes in FVC, FEV1.0, MMF, Vmax and thoracic gas volume at FRC. On the other hand, there were significant increases in airways resistance (p<0.01) and Visor (p<0.05), and a significant decrease in specific airway conductance (p<0.01). In addition, ΔV25 showed a tendency to decrease after smoking a cigarette (0.05<p<0.10). The effect of smoking a cigarette was almost immediate and the mean duration of the effect on airway resistance was 20 minutes and on Visor 30 minutes. These results seem to suggest some differences between the defense mechanisms in the central and peripheral airways.
    The effect of the amount of inspired cigarette smoke diluted (1:1.7) with air on the airways was studied in 7 smokers. After 10 inhalations of 60ml cigarette smoke, specific airway conductance was decreased in all subjects, but Visor was almost unchanged. Visor was increased in 4 of 7 subjects after 10 inhalations of 150ml cigarette smoke by which even the peripheral airways may have been exposed to cigarette smoke, and specific airway conductance was decreased to almost the same extent as after 10 inhalations of 60ml cigarette smoke. From the results obtained by this inhalation test of cigarette smoke, we infer that the increase in Visor after smoking a cigarette may reflect the impairment of peripheral airways.
  • 山縣 一仁, 北村 諭, 杉山 幸比古, 山口 和克, 京野 洋子
    1984 年 22 巻 2 号 p. 138-143
    発行日: 1984/02/25
    公開日: 2010/02/23
    ジャーナル フリー
    Pulmonary alveolar microlithiasis of unknown cause is characterized by familial occurrence and the deposition of laminated calcium stones within alveoli. The most specific diagnostic technique available is radiologic examination of chest by means of xerotomography. Symptoms are often absent even when involvement is massive, but since the disorder seems to be progressive and to be caused by some abnormality of calcium metabolism, it will eventually lead to symptoms of pulmonary insufficiency, perhaps with pulmonary heart disease.
    The patient was a 32 year-old male in whom an abnormal lung shadow was noticed by routine roentgenographic examination almost 8 years ago. He had no symptoms except marked clubbing of fingers. Chest X-ray film showed fine sand-like particles spread uniformly through both lungs. Transbronchial lung biopsy was carried out and revealed the alveoli to contain concentrically laminated calcospherites which are completely devoid of all nuclear structure.
    We believe that this is the first case of pulmonary alveolar microlithiasis diagnosed by transbronchial lung biopsy.
  • 長尾 啓一, 秋元 敏佑, 角坂 育英, 瀧澤 弘隆, 富岡 玖夫, 渡辺 昌平, 熊谷 朗
    1984 年 22 巻 2 号 p. 144-149
    発行日: 1984/02/25
    公開日: 2010/02/23
    ジャーナル フリー
    Two cases, one acute and one chronic (or subacute) type, of pigeon breeder's disease were reported. The precipitating antibody possibly against X-PGG was demonstrated in both cases. Positive inhalation test to sterilized pigeon dropping extract (500μg/5ml for 15 minutes) was shown in the acute type, and excerbation of clinical signs upon exposure to the pigeon breeding conditions was noted in the chronic type case. The development of cell-mediated immunity to pigeon dropping extracts was also demonstrated in the acute case. Immunological examinations of pigeon fanciers and their families might be necessary in the preclinical stage.
  • 林 俊治, 徳永 尚登, 光武 良幸, 田中 二三郎, 市川 洋一郎, 加地 正郎
    1984 年 22 巻 2 号 p. 150-153
    発行日: 1984/02/25
    公開日: 2010/02/23
    ジャーナル フリー
    A 74 year-old female was admitted on December, 1981 with bronchopneumonia. Chest roentgenogram showed bilateral lower lobe pneumonia and prominent dilatation of the trachea and main bronchi. Breast CT scan showed that the largest widths of the trachea, right and left bronchi were 48, 32 and 23mm in diameter. Bronchoscopic examination showed an irregular lumen and sacullar dilatation of the trachea and main bronchi. In the cartilaginous portion of the trachea atrophy of the longitudinal elastic fibers and the lamina elastica interna of arteriola was soon.
  • M蛋白, 多発ニューロパチーおよび膣癌の合併例について
    興梠 博次, 安藤 正幸, 高野 卓二, 杉本 峯晴, 菅 守隆, 島津 和泰, 堀尾 直, 荒木 淑郎
    1984 年 22 巻 2 号 p. 154-159
    発行日: 1984/02/25
    公開日: 2010/02/23
    ジャーナル フリー
    A 56 year-old female was admitted because of exertional dyspnea and general fatigue. Five years before admission, her chest roentgenogram showed linear, micronodular and reticular shadows in the both lower lung fields. Corticosteroid and antibiotics were given with slight remission. Two months before entry, she complained of exertional dyspnea.
    On physical examination, dullness and diminished breath sounds were present over the lower area of the right lung. The liver, spleen and peripheral lymphnode were not palpable. The glove and stocking type of paresthesia and hypesthesia were present and deep tendon reflexes were diminished or absent. The hemoglobin was 11.2g/ml, the white-cell count was 11600, with 2% basophils, 1% eosinophils, 2% neutrophils, 5% monocytes, 66% lymphocytes and 2% abnormal lymphocytes with indented or segmented nuclei (ATL cells). The bone marrow examination showed 13.2% plasma cells with no myeloma cells and 1% abnormal lymphocytes. IgG was 4426mg/dl with M-protein of IgG-κ type. The other immunoglobulins were not suppressed. Anti-ATLA (ATL associated antigen) antibody was detected. Chest roentgenogram on admission showed increased linear, micronodular and reticular shadows in the same area as five years previously and a mass shadow in the right lower lung.
    A transbronchial lung biopsy of the right lower lung revealed infiltration of ATL cells in the alveolar septa. The ATL cells were also detected in the bone marrow. A biopsy of the eczematous skin eruption showed Pautrier's microabscess in the epidermis and infiltration of ATL cells in the dermis.
    One month after the beginning of treatment with vincristine, cyclophophamide and prednisolone, the symptoms, laboratory data and chest roentgenogram were moderately improved.
    During the hospital course, vaginal cancer was detected. Two years after admission, she died because of vaginal cancer without exacerbation of ATL. Autopsy was not possible.
    The causative agent of ATL is thought to be type C retrovirus and that of vaginal cancer is suspected to be herpes virus type 2. Therefore, she might have susceptibility to viral infections.
    In summary, there are three intersting points in this report. (1) Pulmonary involvement of ATL cells may be over seven years, but luekemic change in peripheral blood was mild. (2) The pathogenic agents of ATL and vaginal cancer may be both viral infections. (3) This is the second case of the M-protein associated with ATL, and M-protein induced polyneuropathy.
  • 山本 朝子, 菊地 弘毅, 平賀 洋明
    1984 年 22 巻 2 号 p. 160-164
    発行日: 1984/02/25
    公開日: 2010/02/23
    ジャーナル フリー
    58歳, 男性, 慢性肝炎で内科通院中のところ咳嗽出現し, 胸部X線写真上左中肺野に異常影を認めた. しかし当日呼吸器科に転科し再撮したがこの時の胸部X線写真では, 異常影は消失していた.
    我々はこのような症例を数例続けて経験したため原因を調べた. その結果, これはフイルム装填中に生じる減感クニック現象による人工的異常影であることが分った. 本例はその1例である.
  • 1984 年 22 巻 2 号 p. 165-168
    発行日: 1984/02/25
    公開日: 2010/02/23
    ジャーナル フリー
  • 1984 年 22 巻 2 号 p. 168-173
    発行日: 1984/02/25
    公開日: 2010/02/23
    ジャーナル フリー
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