n-3系脂肪散を強化した食事療法が有効と考えられた肺気腫の一例

An effective treatment for the advanced stages of chronic obstructive pulmonary disease (COPD) has not been established yet. We report our recent experience of one patient with pulmonary emphysema treated by dietary supplementation of n-3 fatty acid for two months. He presented improvements in clinical symptoms and pulmonary function, and suppression of leukotriene B(4) generation by peripheral leukocytes. We consequently suppose that dietary treatment with n-3 fatty acids (perilla seed oil) may offer benefits for the treatment of pulmonary emphysema by competitively inhiabiting the conversion of arachidonicacid to leukotrienes and prostanoids.今回我々は,肺気腫の症例に対してn-3系脂肪酸を強化した食事療法をおこない,臨床症状,呼吸機能検査所見ともに速やかに改善を認め,同時に白血球のロイコトリエンB4産生能が著明に減少した一例を経験したので報告する｡ 症例は67歳,男性｡主訴は労作時呼吸困難｡【第一回目入院】3カ月間入院し,薬物療法,温泉を用いた理学療法を行った｡自覚症状はやや改善が見られたが,呼吸機能検査所見の改善は得られなかった｡【第二回目入院】1年後に再入院｡n-3系脂肪酸強化食事療法も併用した｡自覚症状および,呼吸機能検査上,FVC,FEV1.0,PEFなどに改善を認めた｡n-3系脂肪酸はアラキドン酸代謝を通してロイコトリエン合成に関与すると推定されるが,経渦中に白血球のLTB4産生能の減少を認めた｡この症例は肺気腫に対するn-3系脂肪酸強化食 事療法の有用性が示唆され,病態を考える上でも興味深いと考えられた

気管支喘息症例における末梢血白血球のロイコトリエンC4産生能とロイコトリエン受容体括抗薬プランルカストの効果に関する検討

The correlation between the efficacy of 4-weeks administration with pranlukast, leukotriene receptor antagonist, and LTs generation by peripheral leukocytes were evaluated in 18 patients with mild-persistent asthma. The efficacy of pranlukast administration was assessed by symptom, morning PEF and pulmonary function. Pranlukast were effective in 12/18(67%) patients. In those patients, LTC4 generation before pranlukast administration was significantly high, compared with that in pranlukast-ineffective patients. LTC4 generation decreased after 4-weeks administration with pranlukast in effective patients. In ineffective patients, however, LTC4 generation increased after 4-weeks administration. LTB4 had shown no significant difference between effective and ineffective patients before administration, and LTB4 decreased after 4-weeks in both groups. Proport ion of peripheral eosinophi Is in effective patients were higher than that in ineffective patients, however not significant. After 4-weeks, proportion of eosinophi Is was decreased in effective patients and increased in ineffective patients. These findings suggest that pranlukast is effective for patients with high LTC4 generation and has the effect to suppress the accumulation of eosinophils in such patients.軽症気管支喘息18例にロイコトリエン受容体桔抗薬プランルカストを4週間投与し，その効果と末梢血白血球からのLTC4，LTB4産生能の関係を検討した．プランルカストの効果は臨床症状，起床時ピークフロー値，肺機能の変化によって判定し，効果群，非効果群の2群に分類した．18例中12例（67％）の症例がプランルカスト投与により，臨床症状の軽減，ピークフロー値の増加，肺機能の改善が認められた．効果群におけるプランルカスト投与前のLTC4値は，非効果群のLTC4値に比較して有意に高値であった．4週間の投与後には 効果群ではLTC4値は減少し，非効果群では増加した．両群のLTB4値はプランルカスト投与前で有意な差は認められず，投与後には両群で減少した．投与前の好酸球分画は，効果群において非効果群に比べ高値であったが，有意な差は認められなかった．4週間の投与後，効果群においては好酸球は減少し，非効果群においては増加した．以上の結果より，プランルカストは末梢血白血球のLTC4産生能が高い症例において効果的であり，好酸球集積を抑制する作用を有すると考えられる

高齢者気管支喘息における気道過敏性と温泉療法

Clinical effects of spa therapy were examined in 150 patients with asthma in relation tobronchial hyperresponsiveness and patient age. 1. The efficacy rate of spa therapy was larger as the patient age was higher: the rate was 73.3% in patients under age 49, 81.8% in those between the ages of 50 and 59, 86.4% in those between the ages of 60 and 69, and 90.6% in those over age 70. The mean of efficacy rates was 83.3% in all subjects. 2. The bronchial hyperresponsiveness (BH) was lower as patient age was higher: the BH in patients between the ages of 60 and 69 and in those over age 70 was significantly lower compared to the BH in those under age 49 (p < O.OOl). 3. Clinical effects of spa therapy tended to be lower in patients with increased bronchial hyperresponsiveness. The bronchial hyperresponsiveness showed a tendency to decrease after spa therapy in whom the therapy was effective, however, the BH did not change in patients with slight or no efficacy during spa therapy.1.温泉療法では,年齢が高くなるほどその有効率も高くなると言う傾向が見られ､49才以下の症例では73.3% ,50-59才の症例では81.8% , 60-69才の症例では86.4% ,70才以上では90.6% であり,全症例の平均有効率は73.3% であった｡　 2.気道過敏性は,年齢が高くなるほど低下する傾向が見られ,60-69才および70才以上の症例の気道過敏性は,49才以下の症例と比べ有 意に低い値を示した(P < 0.001)。　 3.温泉療法の臨床効果は,気道過敏性が強くなるにつれて低下する傾向が見られた｡また,温泉療法の著効例や有効例では,治療により 気道過敏性が低下してくるが､やや有効例や無効例では,気道過敏性はほとんど変化しないことが示された

Point-Focusing Electromagnetic-Acoustic Transducer for Crack Inspection

Stress corrosion cracking in stainless-steel pipes is a critical failure in atomic power plants and chemical plants. In ultrasonic testing, piezoelectric transducers are generally used, in which reproducibility of amplitude measurements is not necessarily high because of effects of coupling materials and contacting conditions between the transducers and specimens. Comparing to the transducers, an electromagnetic acoustic transducer (EMAT) requires no coupling materials and is less sensitive to the contacting conditions, making the reproducibility higher. However, lower signal to noise (S/N) ratio has been a disadvantage. For increasing the S/N ratio, we developed a point-focusing EMAT (PF-EMAT) [1]. It generated shear-vertical (SV) waves from concentric line sources on a top surface of a specimen. Coil configuration of the EMAT was designed so that the SV waves were accumulated in phase at a focal point on the bottom surface, which increased the S/N ratio and improved the spatial resolution. We have designed PF-EMATs operated at different frequencies, and applied to artificially fabricated defects on stainless steel specimens. In this presentation, we show the results, and discuss availability of the PF-EMAT to crack inspection

Glowing gold nanoparticle coating: restoring the lost property from bulk gold

ArticleNanoscale. 11(9): 3786-3793. (2019)journal articl

サーモグラフィーによる体表面温度の測定 3.体表面温度の回復率と末消血流量との相関

The body surface peripheral circulation in 12 cases,　including 9 patients with　diabetes mellitus who were suffering coldness, numbness or pain in their feet, and 3 healthy volunteers was examined using Laser-Doppler blood flowmetry. At the same time, the body surface temperature was estimated by thermography. Thermographic results were analyzed quantitatively by calculating a recovery ratio as : Recovery ratio = [Total counts of thermography(Pixels) over temperature (T) after cold loading] ÷ [Initial counts over T before cold loading] x 100(%). The recovery ratio and the blood flow were correlated, r=0.68, p<O.01. The peripheral circulation of 16 patients with diabetes mellitus was observed at three different conditions including, l)placed at room temperature at 20℃for 15 min, 2) submerged and warmed for 5 min in a hot bath at 36℃(i.e. hot loading), and 3) submerged and cooled for 5 min in a water bath at 20℃ (i.e. cold loading). Three different baseline temperatures, 26℃, 27℃ and 28 ℃, were used in processing the　thermographic results into pictures. The highest correlation (r=0.59, p=0.0002) was obtained under the condition of cold loading using a baseline temperature limitation of27℃.The difference ratio (%) of blood flow was calculated as the blood flow at cold loading divided by the blood flow at hot loading in these 16 patients. The difference　ratio of the blood flow and the recovery ratio of thermography were correlated, r=0.46, p<O.OOO1. We found a strong correlation between the results of Laser-Doppler blood flowmetry and one of thermographic methods used to monitor peripheral circulation in patients with diabetes mellitus. Cold loading using a baseline temperature limitation of 27℃ were recommended for further examinations. Patients with low blood flow as well as　with large differences in their peripheral circulation between cold loading and hot　loading had severe coldness in their body surface temperature. We showed the usefulness of the results of thermography, when quantified by picture processing using computer software, in relation with the results of Laser-Doppler blood flowmetry.末梢神経障害を有する糖尿病患者の末梢循環障害の程度を数量的に検討する目的で､下肢に冷感ならびにしびれ感または疼痛を訴える糖尿病患者9症例と健常ボランティア3例の計12例(平均年齢59歳)についてサーモグラフィーを用いて体表面温度を測定した｡更に,サーモグラフィーで得られた結果と末梢皮膚血流量をレーザードプラー血流計を用いて測定して得られた結果と比較した｡サーモグラフィーによる測定で得られた結果は回復率として数量化して表示された｡回復率の算出方法は回復率= [冷水負荷後の特定温度27℃以 上の体表面温度のサーモグラフィーのPixelの総数]÷ [冷水負荷前の特定温度27℃以上の体表面温度のサーモグラフィーのPixelの総数]×100%で求めた｡レーザードプラ-血流計を用いて測定して得られた末梢血流量は左右それぞれ5カ所,計10カ所の測定値の平均で表示した｡その結果,末梢皮膚温度の回復率と末梢皮膚の血流量との問には正の相関関係(r=0.68,p<0.01)が認められた｡次に,末梢皮膚血流量について,室温20℃安静15分後,温水36℃浸水負荷10分後,冷水20℃浸水負荷30分後の異なる3条件について､またサーモグラフィーで得られた結果を,画像処理の過程で用いられた,26℃,27℃,28℃の3つの異なる特定温度との関連について検討を行なった｡対象は,下肢に冷感ならびにしびれ感または疼痛を訴える糖尿病患者16症例(平均年齢69歳,平均HbAIC9.6%)について測定した｡その結果,末梢皮膚 血流量は冷水20℃浸水負荷30分後に測定して得られた結果と,回復率は特定温度27℃で画像処理して得られた結果とが最も相関が高い(r=0.59,p=0.0002)ことが示された｡`次に,相関が高い条件は,室温20℃安静15分後に血流量を測定した場合(r=0.483,p=0.0002)であった｡そして温 水36℃浸水負荷10分後に測定して得られた結果とが最も相関関係が低い結果となった｡更に,冷水20℃浸水負荷30分後に測定して得られた結果を温水36℃浸水負荷10分後に測定して得られた結果で割った比を%で表示したところ回復率とこの比との間には正の相関関係(r=0.46,p<0.0001)が認められた｡このことから,温水36℃負荷時と,冷水20℃負荷時との差が大きい患者 において末梢皮膚温度の低下が著しいことが示された｡これまで悲観血的に測定されてきたサーモグラフィーによる末梢循環の数量的評価の試みは,レーザー血流計による結果と組み合わせることで,両者の間に正の相関関係が示されたことにより,今後,数量化された客観的評価を可能にした

サーモグラフィーによる体表面温度の測定 2.温水負荷の効果

The body surface temperature of 41 patients suffering coldness, numbness or pain in their feet was examined using thermography. Thermographic results were analyzed quantitatively by calculating a recovery ratio as: Recovery ratio =[Total counts of thermography (Pixels) over temperature (T) after cold loading] ÷ [Initial counts over T before cold loading] x 100(%). Three different baseline temperatures, 26℃. 27℃ and 28℃, were used in processing the thermographic results into pictures. The recovery ratio was susceptible to temperature, and we recommend a baseline temperature limitation of 27℃ for clinical study. A bi-modal distribution of recovery ratio was observed in 18 patients with diabetes mellitus. One group (6 subjects) had high recovery ratio between 80%-100%, and another group (10 subjects) had a low recovery ratio between 0%-19%. The results of thermography were also influenced by weather. To reduce the effect of outside temperature, we used pre-loading with hot water at 36℃ for 5 min (hot loading).　A large difference in　recovery ratio between presence and absence of hot loading was observed in 6 of the 30 subjects. The difference was over-estimated in more than 20% of recovery ratio without hot loading as compared with hot loading in these 6 subjects. The effect of drugs on peripheral circulation, such as beraprost sodium and sarpogrelate hydrochloride, was clear and quantified using thermography under these conditions of hot loading.下肢に冷感ならびにしびれ感または疼痛を訴える患者41症例についてサーモグラフィーを用いて体表面温度を測定した｡測定で得られた結果は回復率として数量化して表示された｡回復率の算出方法は回復率=[冷水負荷後の特定温度T℃以上の体表面温度のサーモグラフィーのPixelの総数]÷[温水負荷前の特定温度T℃以上の体表面温度のサーモグラフィーのPixelの総数]× 100%で求めた｡サーモグラフィーで得られた結果と画像処理の過程で用いられた,26℃,27℃,28℃の3つの異なる特定温度T℃ との関連について検討を行なった｡その結果,回復率は特定温度T℃に影響を受けやすいことが明らかとなった｡下肢の体表面温度の低い臨床症例においては27℃の条件が適当と考えられた｡前述の41症例中の18症例の糖尿病患者について検討を行なった｡そのサーモグラフィーの結果は,比較的回復率の高い(80%～100%)群の6症例と比較的回復率の低い(0%～19%)群の10症例の2群に別れた｡わずかに残り2症例が20%から79%の間であった｡下肢の症状が気温の低い時期に出親しやすいためにサーモグラフィーの検査を冬期に行なう必要性が高まった｡しかし,天候の影響を受けやすいために冷水負荷前の測定領域の下肢が冷えすぎているために20℃の室温に15分間の安静時間では体表面温度が十分に暖まることが出来ず,27℃以上の領域として測定範囲全体を観察できない 問題に直面した｡この間温点を解決する手段として36℃の温水に5分間下肢を入れて暖める温水負荷を加えることにした｡そこで, 温水負荷を行なった症例30症例について,温水負荷を行なう前(室温)の回復率と温水負荷を行なった後の回復率について比較検討を行なったところ,20%にあたる6症例において温水負荷を行なわなかった場合に20%以上の回復率の過剰評価が認めら れた｡温水負荷を行なうことにより年間を通じて天候の影響を最小限にすることが可能となり,この結果,長期間の内服薬の末梢循環に及ぼす影響の測 定を行なった場合に,季節の影響を最小限にしてサーモグラフィーにより回復率を用いて数値化された測定結果を検討することが可能となった｡具体的に末梢循環の改善に薬効が有ると言われている薬剤であるベラプロストおよびサルポグレラートを3ヵ月間内服した場合の前後のサーモグラフィーで得られた回復率について検討を行なった｡その結果はベラプロストにおいては,6.9%から41.9%に上昇または回復率の6.1倍の上昇を認めた。サルポグレラートにおいては,1.9%から17.3%に上昇または回復率の9.1倍の上昇を認めた。以上より,温水負荷を加えたサーモグラフィーの測定結果の数値化は下肢に症状の有る患者の末梢循環の評価ならびに薬効の評価の比較に有用であることが表わされた

気管支喘息患者における白血球ロイコトリエン産生能に対する不飽和脂肪酸食の効果に影響する因子

Dietary supplementation with perilla seed oil, a vegetable oil rich in α -lin- olenic acid, inhibits the generation of leukotrienes(LTs) by leucocytes in patients with bronchial asthma. We examined the factors that affect the suppression of LT generation by leucocytes with perilla seed oil-rich supplementation in patients with asthma, by comparing the clinical features of patients with asthma, whose generation of leukotriene (LT) C4 was suppressed by dietary supplementation with perilla seed oil (n-3 fatty acids) (group A), with those of patients who showed no suppression of LTC4 generation (group B). Group A showed a significant increase in the generation of LTB4 and L TC4 by leucocytes after corn oil-rich supplementation (n-6 fatty acids), and a significant decrease in the generation of LTB4 and LTC4 after perilla seed oil-rich supplementation (n-3 fatty acid). However, this was not observed in group B. The level of serum IgE and peak expiratory flow (PEF) in group A were significantly higher than in group B. Furthermore, the serum levels of LDL-cholesterol, β-lipoprotein and　phospholipid were significantly lower in group A than in group B. These results suggest that the clinical features differ between these two asthmatic populations with respect to suppression of LTB4 and LTC4 generation by n-3 fatty acids in perilla seed oil-rich supplementation.a-リノレン酸の豊富なエゴマ油の食事は気管支喘息患者の白血球ロイコトリエン(LT)産生能を抑制する｡気管支喘息患者の内,エゴマ油食によりLTC4の産生が抑制された群(A群)と抑制されない群(B群)の臨床データを比較することにより,気管支喘息患者の白血球ロイコトリエン産生能に影響する因子を検討した｡A群はコーン油(n-6系脂肪酸)の豊富な食事後,白血LTB4,LTC4の産生能が増加し,エゴマ油(n-3系脂肪酸)の豊富な食事後LTB4,LTC4の産生能が減少した｡これらの変化はB群では認められなかった｡A群のIgE値,ピークフロー(PEF)値はB群に比し,有意に高値であった｡またLDL-コレステロール,β-リポ蛋白,リン脂質はA群ではB群に比し,有意に低値であった｡これらの結果はエゴマ油の豊富な食事のn-3系脂肪酸によるLTB4,LTC4の産生能の抑制に関して2群の気管支喘息患者群間に臨床データの相違があることを示唆している

Predicting the Route of Delivery in Women with Low-Lying Placenta Using Transvaginal Ultrasonography: Significance of Placental Migration and Marginal Sinus

Background/Aims: To examine the significance of placental migration and the presence of a placental marginal sinus to predict the eventual route of delivery in low-lying placenta. Methods: 49 women with a low-lying placenta after 30 weeks' gestation were studied. The distance between the internal os and leading edge of the placenta was measured weekly using transvaginal ultrasonography until 37 weeks' gestation. The relationship between the rate of placental migration, the presence of a placental marginal sinus and the eventual mode of delivery was investigated. Results: Although the cesarean section rate was 56.3% (9/16) in the 'slow' migration (0-2.0 mm/week) group, no patient (0/33) in the 'fast' (>2.0 mm/week) migration group underwent a cesarean section (p<0.01). The cesarean section rate was 71.4% (5/7) in patients with a placental marginal sinus, significantly greater than the rate of 9.5% (4/42) in patients without a marginal sinus (p<0.01). Conclusion:A decreased rate of placental migration until 37 weeks' gestation and the presence of a placental marginal sinus were associated with subsequent cesarean delivery because of antepartum vaginal bleeding. These parameters may be useful for predicting the route of delivery in women with a low-lying placenta.ArticleGYNECOLOGIC AND OBSTETRIC INVESTIGATION. 73(3):217-222 (2012)journal articl