気管支喘息患者の血清コーチゾール値について. 副腎皮質ホルモン投与および年齢との関連

Serum cortisol levels were examined in 94 patients with bronchial asthma in relation to dose of glucocorticoids and age. 1. The level of serum cortisol was significantly lower in group A patients, treated with glucocorticoids (prednisolone of 5mg/day or more) for more than 2 years, (2.4±1.2mcg/㎗) than in group B, treated with glucocorticoids (prednisolone of 5mg or less) for less than 2 years, (6.8±3.7mcg/㎗) (p<0.001) and in group C, treated without glucocorticoids, (12.6±3.9mcg/㎗) (p<0.001). The serum cortisol level was also significantly lower in group B than in group C (p<0.001). 2. The level of serum cortisol was significantly lower in patients over the age of 70 compared to that in those aged between 0 and 39 years (p<0.01) and those between 40 and 49 (p<0.05), and those between 50 and 59 (p<0.02). The level was also lower in patients between 60 and 69 compared to that in those between 0 and 39, however, this was not significant. These results demonstrate that the level of serum cortisol decreases by long-term glucocorticoid regimen and with aging.気管支喘息94例を対象に,副腎皮質ホルモン投与および年齢との関連のもとに,血清コーチゾール値の変動を観察した｡まず副腎皮質ホルモンの投与量および投与期間により以下の3群に分けて検討した｡グループA :副腎皮質ホルモン,プレドニソロンに換算して1日5mg以上を2年間以上にわたり使用している症例,グループB:プレドニソロン1日5mg以下で2年間以内の使用症例, グループC:副腎皮質ホルモンを全く使用していない症例｡その結果,グループAの血清コーチゾ-ル値(2.4±1.2mcg/㎗)は,グループB (6.8±3.7mcg/㎗)(p 0.01)やC(12.6±3.9mcg/㎗)(p 0.001)に比べ有意に低い値であった｡2､グループCでは,70才以上の症例の血清コーチゾ-ル値は,0-39才の症例(p 0.0l),40-49才の症例(p 0.05),そして,50-59才の症例(p 0.02)に比べ有意に低い値であった｡これらの結果は,血清コーチゾール値は,副腎 皮質ホルモンの投与量や投与期間以外にも､加齢による影響を受ける可能性を示唆している

Integrated monitoring and reviewing systems for the Rokkasho Spent Fuel Receipt and Storage Facility

The Rokkasho Spent Fuel Receipt and Storage (RSFS) Facility at the Rokkasho Reprocessing Plant (RRP) in Japan is expected to begin operations in 1998. Effective safeguarding by International Atomic Energy Agency (IAEA) and Japan Atomic Energy Bureau (JAEB) inspectors requires monitoring the time of transfer, direction of movement, and number of spent fuel assemblies transferred. At peak throughput, up to 1,000 spent fuel assemblies will be accepted by the facility in a 90-day period. In order for the safeguards inspector to efficiently review the resulting large amounts of inspection information, an unattended monitoring system was developed that integrates containment and surveillance (C/S) video with radiation monitors. This allows for an integrated review of the facility`s radiation data, C/S video, and operator declaration data. This paper presents an outline of the integrated unattended monitoring hardware and associated data reviewing software. The hardware consists of a multicamera optical surveillance (MOS) system radiation monitoring gamma-ray and neutron detector (GRAND) electronics, and an intelligent local operating network (ILON). The ILON was used for time synchronization and MOS video triggers. The new software consists of a suite of tools, each one specific to a single data type: radiation data, surveillance video, and operator declarations. Each tool can be used in a stand-alone mode as a separate ion application or configured to communicate and match time-synchronized data with any of the other tools. A data summary and comparison application (Integrated Review System [IRS]) coordinates the use of all of the data-specific review tools under a single-user interface. It therefore automates and simplifies the importation of data and the data-specific analyses

ステロイド依存性重症難治性気管支喘息患者の血清コルチゾールに対する温泉療法の影響

Serum cortisol levels before and after spa therapy were compared in 30 patients with steroid-dependent intractable asthma (SDIA) in relation to clinical asthma types. 1. The mean level of serum cortisol in patients with type la-1 asthma was 2.0±0.7mcg/dℓ before spa therapy, and significantly increased to 9.0±3.1mcg/dℓ　(p<0.001). The serum cortisol level of patients with type la-2 also significantly increased from 3.3±1.5mcg/dℓ before spa therapy to 5.9±3.1 mcg/dℓ after the therapy (p<0.05). 2. The level of serum cortisol in patients with type Ib increased from 4.0±1.6mcg/dℓ to 7.8±1.4mcg/ dℓ after spa therapy (p<0.001). In contrast, the serum cortisol levels in patients with type II were not significantly different before (2.7±1.3mcg/dℓ) and after spa therapy (3.5±3.0mcg/dℓ). The results showed that an increase in the levels of serum cortisol by spa therapy was more clearly observed in patients with type la-1 asthma compared to that in type la-2 or type Ib, and that, in contrast, the serum cortisol levels in patients with type II asthma did not significantly increase by spa therapy, since their asthma attacks were always severe and chronic in spite of long-term glucocorticoid regimen.ステロイド依存性重症難治性気管支喘息患者30名において温泉療法前後の血清コルチゾール値を,臨床病型に基づいて検討した｡1.Ia-1型の症例における血清コルチゾール値は温泉療法前の2.0±0.7μg/dℓから9.0±3.lμg/dℓに有意に増加していた(p<0.001)｡Ia-2型でも3.3±1.5μg/dℓから5.9±3.1g/dℓに有意に増加していた(pく0.05)｡ 2.Ib型では温泉療法前後で4.0±1.6μg/dℓから7.8±1.4μg/dℓに有意に増加した｡一方,Ⅱ型の症例では,温泉療法前2.7±1.3μg/dℓ,温泉療法後3.5±3.0μg/dℓで有意な変化は認められなかった｡以上のように,温泉療法の血清コルチゾールに対する効果は,Ia-2,Ib型に比較してIa-1型で明らかであった｡一方,Ⅱ型の気管支喘息症例の血清コルチゾ-ル値は,温泉療法によって有意な変化を認めなかった｡これは長期にわたる副腎皮質ホルモン投与にかかわらず,Ⅱ型の症例の喘息発作は常に慢性的で重篤であるからと考えられる

インドネシア林業公社による住民協働森林管理制度の「住民のための林業」実現への貢献可能性 : 「結果」と「プロセス」の視点から

学位の種別:論文博士University of Tokyo(東京大学

Oscillation Reduction of an Anode-Layer-Type Hall Thruster by Azimuthal Propellant onuniformity

Discharge current oscillation in the frequency range of 10-100 kHz causes serious problems in using anode layer type Hall thrusters in space. As a novel approach to stabilize the discharge, azimuthally nonuniform propellant flow was created in an acceleration channel. A plenum chamber and hollow anodes were azimuthally divided into two or four sections and xenon flow rates supplied to them were controlled. As a result, the oscillation amplitude significantly decreased and oscillation-free operation was achieved at all magnetic flux densities

気管支喘息患者の気管支肺胞細胞からのヒスタミンとロイコトリエンC4遊離 ―アトピー性喘息におけるヒスタミンの役割について―

To clarify the main humoral triggering factor (histamine and/or leukotriene) of the early stage of asthma attacks, the release of histamine and leukotriene C4 (LTC4) from bronchoalveolar lavage (BAL) cells stimulated with Ca ionophore A23187 was examined in 7 patients with atopic asthma, and the results were compared to those in 7 nonatopic asthma patients. 1. The proportion of BAL basophilic cells was significantly higher in atopic patients than in nonatopic patients (p<0.05). 2. The content of histamine in BAL fluid was significantly higher in atopic (2.3mcg/mℓ) comparted to that in nonatopic patients (0mcg/mℓ)(p<0.001). The content of LTC4 was high in nonatopic (2.4ng/mℓ) than in atopic patients (0.5ng/ mℓ), however, this was not significant. 3. The release of histamine from BAL cells was 32.6% in atopic and 0% in nonatopic patients, and this was significant (p<0.001). The release of LTC4 from BAL cells was significantly higher in nonatopic (11.3ng/10(6)cell) than in atopic (3.5ng/10(6)cell)(p<0.02). The results demonstrate that histamine play more important role in atopic patients as a main triggering factor of attacks than LTC4. In contrast, in nonatopic patients, LTC4 is more predominant than histamine during early stage of asthma attacks.気管支喘息発作初期に関与する液性因子(ヒスタミン,ロイコトリエン)の役割を明らかにするために,気管支肺胞洗浄(BAL)細胞からのカルシウムイオノフォアA23187によるヒスタミンとロイコトリエンC4 (LTC4)遊離の検討を行った｡対象はアトピー性喘息患者7名,非アトピー性喘息患者7名とした｡1.BAL液中の好塩基性細胞の比率は,アトピー性喘息患者において有意に高値を示した｡2.BAL液中ヒスタミン濃度は非アトピー性喘息患者(0mcg/mℓ)に比して,アトピー性喘息患者(2.3mcg/mℓ)において有意に高値を示した｡一方,BAL液中LTC4濃度は,アトピー性喘息患者(0.5ng/mℓ)に比し て非アトピー性喘息患者(2.4ng/mℓ)において,高値を示したが,有意差は見られなかった｡3.BAL細胞からのヒスタミン遊離は非アトピー性喘息患者(0%)に比して,アトピー性喘息患者(32.6%)において有意に高値を示した｡LTC4遊離はアトピー性瑞息患者(3.5ng/10(6)胞)に比して,非アトピー性喘息患者(ll.3ng/10(6)細胞)において有意に高値を示した｡以上より,喘息発作初期に関与する液性因子としては,アトピー性喘息患者においてはヒスタミンが重要であり,非アトピー性喘息患者においてはLTC4が,重要であることが,明らかになった

気管支喘息患者における努力肺活量(% FVC)の低下と気道炎症ならびに臨床病型との関連

Clinical features of asthmatics with a low % FVC (<80%) were studied in relation to airway inflammation and clinical asthma types. 1. Twenty four (75.0%) of the 32 subjects with a low % FVC had steroid-dependent intractable asthma. 2. A significant association between % FVC value and clinical asthma type was found. The value of % FVC was significantly lower in subjects with type II asthma (bronchiolar obstruction), in which significantly decreased proportion of lymphocytes,and significantly increased proportion of neutrophils in bronchoalveolar lavage (BAL) fluid were observed, than in those with type la-1 (simple bronchoconstriction) with (P<0.001) and without glucocorticoid therapy (P<0.02). 3. The % FVC value was significantly improved after treatment in type lb (hypersecretion) with BAL eosinophilia, but not in those with type II with BAL neutrophilia. These results demonstrate that marked decrease of % FVC in patients with asthma correlated with airway inflammation, and that airway reversibility by medication is very low in patients with type II asthma.努力肺活量(% FVC)低値を示す気管支喘息の臨床病態を明らかにするために気道炎症ならびに臨床病型との関連について検討を行った｡% FVCが80%未満の気管支喘息患者32名を対象として,スパイロメトリー,気管支肺胞洗浄(BAL)を施行し,臨床病態を解析し,治療効果の評価を行なった｡1.対象中24名(75%)の患者がステロイド依存性重症難治性喘息であった｡2.細気管支閉塞型喘息患者において,% FVC値の有意の低下が認められ,BAL液中のリンパ球の減少と好中球の増加が認められた｡3.FVC値,FEV1.0億の治療による改善は,BAL液中好酸球の増加を示す過分泌型喘息においては認められが,BAL液中好中球の増加を示す細気管支閉塞型喘息においては認められなかった｡ 以上より喘息患者における% FVC値の低下は気道炎症と関連しており,細気管支閉塞型喘息における治療による可逆性は著しく低下していることが示唆された

BAL液中好中球増加をともなわないⅡ型喘息について

Clinical features of asthma patients with bronchiolar obstruction (type Ⅱ asthma) were studied in relation to the proportion of neutrophils in bronchoalveolar lavage (BAL) fluid. Of 13 subjects studied, 7 were accompanied with BAL neutrophilia (53.5%) (BALn(+)) and 6 were without BAL neutrophilia (3.5%) (BALn(-)). 1. The mean age was higher in BALn(-) (66.0 years) than in BALn(+) patients (55.0 years). 2. Bronchial reactivity to methacholine was slightly higher in BALn(-) patients than in those with BALn(+). 3. The value of FEV1.0% was significantly lower in BALn(+) patints than in those with BALn(-) (p<0.01). 4. The proportion of BAL lymphocytes was signicantly more decreased in BALn(+) patients compared to the proportion in those with BALn(-) (p<0.001). 5. the values of serum IgG, IgA, and IgM were not significantly different between BALn(+) and BALn(-) patients, however, the value of IgG was more decreased in BALn(+) patients than in those with BALn(-). These results suggest that two kinds of type Ⅱ asthma ; one is with BAL neutrophilia related to suppressed immunity, and another is without BAL neutrophilia in part due to aging.細気管支閉塞型(Ⅱ型)喘息の臨床的特徴が,BAL液中の好中球頻度との関連のもとに検討された｡対象13例のうち,7例がBAL液中好中球増加(平均好中球頻度;53.5%)をともなう症例(BALn(+))で,残りの6例はBAL液中好中球増加 をともなわない(3.5%)症例(BALn(-))であった｡1.平均年齢は,BALn(+)症例(55.0才)に比べ,BALn(-)症例(66.0才)でより高い傾向が見られた｡2.メサコリンに対する気道過敏性は,BALn(+)症例に比べBALn(-)症例でやや高い傾向が見られたが,両者間に有意の差は見られなかった｡3.FEV1.0%値は,BALn(-)症例に比べBALn(+)症例で有意に低い値を示した(P<0.05)｡4.BAL液中リンパ球頻度はBALn(+)症例でBALn(-)症例に比べ有意に低い値を示した(P<0.001)｡5.血清IgG,IgAおよびIgM値には両者間に有意の差は見られなかったが,IgG値はBALn(+)症例でより低い傾向が見られた｡これらの結果より,Ⅱ型喘息にはBAL液中好中球増加を示す症例と示さない症例の2種類があること,そして前者は免疫能の低下と,そして後者は加齢とある程度の関連があることが示唆された

中高年発症型喘息患者におけるIgE系アレルギー反応の加令による変化

Age-related changes in IgE-mediated allergic reaction were examined in patients with late onset asthma, whose asthma occured over the age at onset of 40. 1. The number of patients with a high serum IgE level over 3001U/mℓ was larger in those between the ages at onset of 40 and 49 and over age at onset 60 than in those between the ages at onset 50 and 59. 2. A positive RAST score to Hdm and cockroach allergens was more frequently found in patients between 40 and 49 and over age 60 at onset compared to those between 50 and 59 at onset. In contrast, the number of patients with a positive RAST to Candida was larger in those between 50 and 59 at onset than in those of between 40 and 49 and over 60 at onset. 3. Severe asthma was more frequently and slight asthma was less frequently observed in patients between 50 and 59 at onset than in those of the other age at onset groups. These results suggest that IgE-mediated allergic reaction in patients between the ages at onset of 50 and 59 is different from that in those with early onset asthma, and that the reaction in patients between the ages at onset 40 and 49 and over 60 resembles to the reaction in those with early onset asthma.発症年令が40才以上の中高年発症型喘息患者におけるIgE系アレルギー反応の加令による変化について検討を加えた｡1.発症年令が40から49才と60才以上の患者では,50から59才の患者に比して血清IgE値が300IU/mℓ以上の高値を示す頻度が高い傾向が見られた。2.ダニ,ゴキブリに対するRAST陽性率は発症年令が50から59才の患者に比して,40から49才と60才以上の患者で高値を示した｡一方,カンジダに対するRAST陽性率は,発症年令が40から49才と60才以上の患者に比して,50から59才の患者で高値を示した｡3.発症年令が50から59才の患者では,他の発症年令の患者に比べて,重症例が多く,軽症例が少ない傾向が見られた｡以上の結果から,発症年令が50から59才の患者のIgE系アレルギー反応は若年発症型喘息患者と異なり,発症年令が40から49才と60才以上の患者のIgE系アレルギー反応は若年発症型喘息患者と 類似することが示唆された