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

Cutaneous sarcoidosis : Clinical features and management

1976年から1996年に岡山大学第2内科を受診したサルコイドーシス255例のうち,65例(71病変)の皮膚サルコイドーシス(皮膚サ症)について,臨床経過,臨床検査成績,胸部病変との関連,予後について検討した｡皮膚サ症患者の年齢は18歳から77歳で中央値は51歳であった｡女性例が42例(65%)と多 く,特に50歳代女性に43%と最も高率であった｡皮膚病型では結節型33例,皮下型16例,び慢浸潤型3例,局面型6例,結節性紅斑様皮疹3例,苔癬様型1例,瘢痕浸潤9例であった｡皮膚サ症では非皮膚サ症に比して気管支肺胞洗浄液中リンパ球の低率が見られたが,その他の臨床成績に差は認められなかった｡皮膚病型別に検討すると,局面型,び慢浸潤型では気管支肺胞洗浄液中リンパ球CD4/CD8比は高く,3年後の皮膚および肺病変の残存率は高かった｡一方皮下型ではCD4/CD8比は低く皮膚,肺病変の残存率も低かった｡Of 255 patients with clinical and histologic evidence of sarcoidosis, 65 (25percent) presented with various cutaneous manifestations of the disease. Cutaneous sarcoid patients were 42 women and 23 men ranging from 18 to 77 years in age. The skin lesions have included nodular infiltration in 33 patients, subcutaneous tumor in 16 patients, lupus pernio in 3, annual plaques in 6, erythema nodosum-like eruption in 3, lichinoid in 1, and scars in 9. There was no correlation between the presence of cutaneous lesions and chest radiolographic stages, abnormal pulmonary gallium uptake, cell differenciations of bronchoalveolar lavages and serum angiotensin converting enzyme activities. Forty-six patients followed for at least 3 years to determine the course of the disease. Subcutaneous tumors tended to heal within 3 years, while lupus pernio and plaque lesions were likely to have a protracted course

Application and validation of a new histologic staging and grading system for primary biliary cirrhosis

BACKGROUND: We proposed a new grading and staging system for primary biliary cirrhosis (PBC), which takes into account the degree of both chronic cholangitis activity (CA) and hepatitic activity (HA) for grading disease activity and that of fibrosis, bile duct loss, and chronic cholestasis for staging. In this study, we validated our new system. METHODS: Using liver biopsy specimens from 166 cases of PBC, chronic cholangitis with mild periductal lymphoplasmacytic infiltration, including chronic nonsuppurative destructive cholangitis, and the combined activity of interface hepatitis and lobular hepatitis were categorized into 4 grades on the basis of their degree and distribution (CA0-3 and HA0-3, respectively). For staging, because orcein staining was not available in this study, 2 criteria (fibrosis and bile duct loss) were independently scored from 0 to 3 on the basis of their degrees, and a final stage score was created from the sum. RESULTS: Although there was a relatively uniform distribution of CA0/1/2/3 cases, the cases of HA0/1/2/3 were distributed as 21%, 64%, 13%, and 3%, respectively, with a prominent number of cases categorized as having none or mild HA. The distribution of stages 1 to 4 using our system was considerably different from that using the classic system and, importantly, showed a correlation with patient outcome. CONCLUSIONS: Our system revealed that the activities of chronic cholangitis and hepatitis did not correlate with each other in terms of degree and that our staging system properly reflected the outcome of PBC patients. The present study could validate the effectiveness of this new system for characterizing the pathologic condition of PBC. Copyright © 2013 by Lippincott Williams &Wilkins

The role of fibronectin in bronchoalveolar lavage fluid of asthmatic patients.

Allergic and chronic inflammation of the airway is regarded as the main pathogenesis of bronchial asthma, in which adhesion of inflammatory cells requires the expression of adhesion molecules. Thus, to clarify the role of fibronectin (FN) in the airway inflammation of bronchial asthma, FN levels in plasma and bronchoalveolar lavage fluid (BALF) from bronchial asthmatics were determined. FN concentrations in plasma and BALF were measured by enzyme-linked immunosorvent assay (ELISA) in 17 asthmatic patients and 10 healthy controls to elucidate the role of FN in allergic inflammation. The mean FN/albumin (Alb) level in the BALF of asthmatic patients was 2.973 micrograms/mg, which was significantly higher than that of healthy controls (0.727 microgram/mg). Non-atopic asthmatics showed a significantly higher level of FN in their BALF in comparison with atopic asthmatics, although the ratio of FN to albumin showed no significant difference. FN levels in BALF correlated significantly with total cell density (r = 0.71, P &#60; 0.05) and alveolar macrophage density (r = 0.64, P &#60; 0.05). FN levels in plasma did not correlate with those in BALF. In conclusion, increased FN in BALF, which was produced locally in the airways of asthmatic patients, is actively involved in the regulation of allergic inflammation.</p

n-3系脂肪酸食の気管支喘息に対する臨床効果:n-6系脂肪酸との比較

N-3 fatty acids, such as fish oil, have been reported to have some beneficial effects in patients with bronchial asthma by suppressing leukocyte function, followed by reduction of the need for pharmacologic agents. To examine the effects of dietary supplementation with perilla seed oil rich in α-linolenic acid (ALA), 23 patients with　asthma took corn oil rich in linoleic acid (LA) for the former two weeks, perilla seed oil for the later two weeks. The asthmatic patients were classified into two groups by the changes of the generation of leukotrienes B4 (LTB4), C4 (LTC4), and B5 (LTB5) during the two courses of dietary modification: one was sensitive to dietary modification, and the other was insensitive to dietary supplementation. We compared the two groups in clinical characteristics. Significant differences were observed in peak flow (PEF), forced expiratory volume in one second (FEV1.0), IgE, sex, obesity index (OI), concentration of serum total cholesterol, albumin, low density lipoprotein {LDL)-cholesterol, β-lipoprotein and phospholipids between two groups. This study indicated that these factors influence the generation of LTB4, C4 and B5 of asthmatic patients in dietary supplementation.気道への炎症性白血球の集合が気管支喘息の病態に関わっている。魚油などのn-3系脂肪酸が白血球の機能を抑制することにより気管支喘息患者に良好な効果をもたらし,薬剤の必要性を減じたとの報告がなされている｡α-リレノン酸を豊富に含有するエゴマ油食の効果を調べるため,気管支喘息患者23名に2コースの食事-リノール酸の豊富なコーン油食を2週間摂取後,エゴマ油食を2週間-を摂取してもらった｡喘息患者は2コースの食事間のロイコトリエンB4(LTB4),CA(LTC4),B5(LTB5)の変化から2群-1群は食事に対し感受性のある群,もう1つは感受性の無い群-に分類した｡我々はこの2群を臨床的に検討したところ,ピークフロー(PEF),1秒量(FEV10),IgE,性別,肥満率(OⅠ),血清総コレステロール,アルブミン,低比重リポ蛋白(LDL)-コレステロール,β-リポ蛋白,リン脂質において2群間に有意差が認められた｡今回の研究から,これらの因子が,喘息患者において,LTB4,LTC4,LTB5の産生に対する食事療法の効果に影響を及ぼしていることが示唆された

Factors affecting prognosis of idiopathic interstitial pneumonia.

&#60;P&#62;Idiopathic interstitial pneumonia (IIP) is a progressive and often fatal pulmonary disorder, and evaluating the prognosis of patients with IIP has never been sufficient. Accordingly, factors including clinical features, laboratory data, cellular components in bronchoalveolar lavage (BAL) fluid and response to corticosteroid therapy were analyzed in 35 patients with IIP whose median age of respiratory onset was 60 years (range; 37-77 years). Nineteen patients (54.3%) were in the active stage of IIP and 16 of them were treated with corticosteroids. Significant prognostic factors were the neutrophil percentage in BAL fluid, interstitial shadows on chest radiograph, pulmonary function, blood oxygen level, grade of dyspnea, and disease activity at the initial examination. Patients in the active stage showed higher proportions of neutrophils and eosinophils in BAL fluid than those in the non-active stage. Despite corticosteroid therapy, the survival of patients in the active stage was significantly shorter than those in the non-active stage. Fifty percent of the patients treated with corticosteroids were regarded as responders at 1 month after the initiation of therapy; however, there was no significant difference between responders and non-responders in terms of survival time. In conclusion, disease activity and neutrophils in BAL fluid may be important predictors of the prognosis of IIP.&#60;/P&#62;</p

Comparison of T-Cell Interferon-γ Release Assays for Mycobacterium tuberculosis-Specific Antigens in Patients with Active and Latent Tuberculosis

Through the use of QuantiFERON-TB Gold, a commercial IFN-γ assay, we compared differences in quantitative T-cell responses to Mycobacterium tuberculosis (MTB)-specific antigens [QuantiFERON TB-2G (QFT-2G)] between patients with active tuberculosis (TB) disease and those with latent TB infection (LTBI). The patient group consisted of 180 patients with active TB disease (culture-positive for MTB) and 50 screening contacts with LTBI-positive response to the QFT-2G test. We prospectively performed a tuberculin skin test (TST) and a QFT-2G test for all subjects. The median IFN-γ levels upon the application of both antigens, ESAT-6 and CFP-10, were significantly higher in patients with active TB disease than in those with LTBI. A combined positive response to both antigens occurred at a higher rate in patients with active TB disease than in those with LTBI. There were no significant relationships between the quantitative responses of IFN-γ to both antigens and the maximum induration on TST in both patient groups. We demonstrated significant differences in the quantitative responses of IFN-γ to MTB between patients with active TB disease and those with LTBI in this study. However, there was an overlap in the IFN-γ levels between active TB disease and LTBI groups. Therefore, it would be difficult to use the QFT-2G test to completely discriminate active TB disease from LTBI

A study on health control for cadets in sea training 1. : body composition and blood circulation among cadets in sea training

東京水産大学海洋システム工学講座東京水産大学水産資源経営講座東京水産大学練習船海鷹丸東京水産大学練習船海鷹丸東京水産大学練習船海鷹丸東京水産大学練習船海鷹丸東京水産大学練習船海鷹丸東京水産大学練習船青鷹丸東京水産大学練習船青鷹丸東京水産大学名誉教