記述言語：英語   掲載種別：研究論文（学術雑誌）  

Basophils were reported to be associated with allergy pathogenesis and the efficacy of allergen immunotherapy. Using a purified cedar allergen, we recently studied the effectiveness of sublingual immunotherapy for patients with Japanese cedar pollinosis. Patients were classified as high responders (HR) and nonresponders (NR), and comprehensive microarray analysis was used to examine peripheral basophils in both groups. A total of 153 genes were differentially expressed in HR and NR patients. Most of these differentially expressed genes encoded intracellular molecules, and expression levels were higher in HR patients than in NR patients. mRNA expression of the gene encoding D4, zinc, and double plant homeodomain (PHD) fingers family 2 (DPF2) was significantly correlated with copy number variation (CNV). Genetic variation in the DPF2 gene and its expression in basophils might be associated with the efficacy of sublingual immunotherapy.

DOI： 10.1272/jnms.JNMS.2020_87-104

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: We conducted a randomized, placebo-controlled, double-blind clinical trial to investigate the optimal dose and long-term efficacy and safety of Japanese cedar (JC) pollen tablets for SLIT (JapicCTI-142579). Here, we report details of the effects of the JC pollen SLIT tablet on rhinitis and conjunctivitis symptoms over three pollen dispersal seasons. METHODS: A total of 1042 JC pollinosis patients (aged 5-64 years) were randomized to receive tablets containing placebo (P), 2000, 5000, or 10,000 Japanese allergy units (JAU) of JC pollen for 15 months to identify an optimal dose. Patients receiving P (n = 240) and the optimal dose (5000 JAU; A, n = 236) were then randomized to receive P or A for an additional 18 months (AA, AP, PA, and PP groups, allocation ratio 2:1:1:2). Nasal and ocular symptoms, rescue medication use, and quality of life (QOL) were assessed on quantitative scales. RESULTS: In the second and third seasons, the AA, AP, and PA groups exhibited significantly better improvements in nasal, ocular, and medication scores compared with the PP group in the order AA > AP > PA > PP during the second season and AA > PA > AP > PP during the third season. Rescue medication use and QOL scores were also significantly better in the AA, AP, and PA groups compared with the PP group. CONCLUSIONS: The JC pollen SLIT tablet relieved nasal and ocular symptoms and medication use and improved QOL in a treatment duration-dependent manner. Continuous dosing regimens appear to enhance the efficacy of the drug.

DOI： 10.1016/j.alit.2019.05.002

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DOI： 10.1016/j.alit.2019.07.007

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：OXFORD UNIV PRESS  

Sublingual immunotherapy (SLIT) is effective against allergic rhinitis, although a substantial proportion of individuals is refractory. Herein, we describe a predictive modality to reliably identify SLIT non-responders (NRs). We conducted a 2-year clinical study in 193 adult patients with Japanese cedar pollinosis, with biweekly administration of 2000 Japanese allergy units of cedar pollen extract as the maintenance dose. After identifying high-responder (HR) patients with improved severity scores and NR patients with unchanged or exacerbated symptoms, differences in 33 HR and 34 NR patients were evaluated in terms of peripheral blood cellular profiles by flow cytometry and serum factors by ELISA and cytokine bead array, both pre-and post-SLIT. Improved clinical responses were seen in 72% of the treated patients. Pre-therapy IL-12p70 and post-therapy IgG1 serum levels were significantly different between HR and NR patients, although these parameters alone failed to distinguish NR from HR patients. However, the analysis of serum parameters in the pre-therapy samples with the Adaptive Boosting (AdaBoost) algorithm distinguished NR patients with high probability within the training data set. Cluster analysis revealed a positive correlation between serum T(h)1/T(h)2 cytokines and other cytokines/chemokines in HR patients after SLIT. Thus, processing of pre-therapy serum parameters with AdaBoost and cluster analysis can be reliably used to develop a prediction method for HR/NR patients.

DOI： 10.1093/intimm/dxx034

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCI LTD  

Objective: Bilastine is a novel second-generation antihistamine. This open-label, single-arm, phase III study evaluated the safety and efficacy of long-term treatment with bilastine in Japanese patients with seasonal (SAR) or perennial allergic rhinitis (PAR).
Methods: Patients with SAR or PAR who met the registration criteria and did not violate the exclusion criteria received bilastine (20 mg, once daily) for 12 weeks (treatment period). Patients with PAR who met the transition criteria could elect to continue the bilastine treatment for an additional 40 weeks (continuous treatment period: a total of 52 weeks). Safety and tolerability were the primary outcomes, and the main secondary endpoint was to evaluate changes in efficacy variables from baseline measurements.
Results: Fifty-eight patients with SAR and 64 patients with PAR received bilastine (20 mg/day) for 12 weeks. Fifty-five patients with PAR transitioned to the continuous treatment period. Adverse events (AEs) were reported by 17.2% of patients with SAR and by 31.3% of patients with PAR, and adverse drug reactions (ADRs) were reported by 6.3% of patients with PAR but by no patients with SAR during the 12 -week treatment period. All of the ADRs were mild in severity. During the 52 -week treatment period, AEs and ADRs were reported by 73.4% and 6.3% of patients with PAR, respectively. All of the ADRs occurred during the 12 -week treatment period, and none during the continuous treatment period. The AEs were categorized using the System Organ Class of nervous system disorders; 4.7% of patients reported headache, but none reported somnolence. One serious AE was reported, but it was considered to be unrelated to the bilastine treatment. There were no deaths, and no patients withdrew from the study because of AEs. In patients with SAR, bilastine significantly decreased the total nasal symptom score (TNSS), total ocular symptom score (TOSS), and total symptom score (TSS) relative to baseline. Prolonged treatment with bilastine resulted in the maintenance of a significant reduction in TNSS, TOSS, and TSS from the baseline in patients with PAR. Improvement of quality of life was also observed in patients with SAR and PAR.
Conclusion: Bilastine was safe, well tolerated, and effective for patients with SAR and PAR. The observed improvement was maintained for the duration of the study, with no loss of drug efficacy. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.anl.2016.07.021

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記述言語：英語   出版者・発行元：JAPANESE SOCIETY ALLERGOLOGY  

Like asthma and atopic dermatitis, allergic rhinitis is an allergic disease, but of the three, it is the only type I allergic disease. Allergic rhinitis includes pollinosis, which is intractable and reduces quality of life (QOL) when it becomes severe. A guideline is needed to understand allergic rhinitis and to use this knowledge to develop a treatment plan. In Japan, the first guideline was prepared after a symposium held by the Japanese Society of Allergology in 1993. The current 8th edition was published in 2016, and is widely used today.
To incorporate evidence based medicine (EBM) introduced from abroad, the most recent collection of evidence/literature was supplemented to the Practical Guideline for the Management of Allergic Rhinitis in Japan 2016. The revised guideline includes assessment of diagnosis/treatment and prescriptions for children and pregnant women, for broad clinical applications. An evidence-based step-by-step strategy for treatment is also described. In addition, the QOL concept and cost benefit analyses are also addressed. Along with Allergic Rhinitis and its Impact of Asthma (ARIA), this guideline is widely used for various clinical purposes, such as measures for patients with sinusitis, childhood allergic rhinitis, oral allergy syndrome, and anaphylaxis and for pregnant women. A Q&A section regarding allergic rhinitis in Japan was added to the end of this guideline. Copyright (C) 2016, Japanese Society of Allergology. Production and hosting by Elsevier B.V.

DOI： 10.1016/j.alit.2016.11.001

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記述言語：日本語   出版者・発行元：(NPO)日本頭頸部外科学会  

頭頸部手術において、顔面神経下顎辺縁枝の機能温存は、術後QOLを保つために大切である。また、その結果のフィードバックは手技向上のためにも重要である。本研究では、術後の口唇運動麻痺の多様性とその評価について検討した。2013年以降に手術を行った耳下腺良性疾患100例を対象に、口角下制時、口唇突き出し時の口唇運動の左右差を評価した。口唇下制の左右差は36例で確認された。その中でオトガイ筋収縮スコア0は22例、1は9例、2は5例であった。術後1ヵ月ではそれぞれ31%、77%、100%、3ヵ月では5%、56%、100%で口角下制左右差が残存した。術後口唇運動麻痺は、オトガイ筋収縮の程度により群分けができ、治癒予測の根拠となると考えられた。(著者抄録)

DOI： 10.5106/jjshns.26.363

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：JAPANESE SOCIETY ALLERGOLOGY  

Background: Bilastine, a novel non-sedating second-generation H-1 antihistamine, has been approved in most European countries since 2010. This study aimed to evaluate the superiority of bilastine over placebo in Japanese patients with perennial allergic rhinitis (PAR).
Methods: This randomized, double-blind, placebo-controlled, parallel-group, phase III study (trial registration number JapicCTI-142600) evaluated the effect of a 2-week treatment period with bilastine (20 mg once daily), fexofenadine (60 mg twice daily), or a matched placebo (double dummy) in patients with PAR. All patients were instructed to record individual nasal and ocular symptoms in diaries daily. The primary endpoint was the mean change in total nasal symptom scores (TNSS) from baseline to Week 2 (Days 10-13).
Results: A total of 765 patients were randomly allocated to receive bilastine, fexofenadine, or placebo (256, 254, and 255 patients, respectively). The mean change in TNSS from baseline at Week 2 was significantly decreased by bilastine (-0.98) compared to placebo (-0.63, P = 0.023). Bilastine and fexofenadine showed no significant difference in the primary endpoint. However, the mean change in TNSS from baseline on Day 1 was more significantly decreased by bilastine (-0.99) than by placebo (-0.28, P < 0.001) or fexofenadine (-0.62, P = 0.032). The active drugs also improved instantaneous TNSS 1 h after the first and before the second drug administration on Day 1 (P < 0.05). The study drugs were well tolerated.
Conclusions: After 2-week treatment period, bilastine 20 mg once daily was effective and tolerable in Japanese patients with PAR, and exhibited a rapid onset of action. Copyright (C) 2016, Japanese Society of Allergology. Production and hosting by Elsevier B.V.

DOI： 10.1016/j.alit.2016.05.014

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：KARGER  

The molecular mechanisms underlying age-related hearing loss are unknown, and currently, there is no treatment for this condition. Recent studies have shown that microRNAs (miRNAs) and age-related diseases are intimately linked, suggesting that some miRNAs may present attractive therapeutic targets. In this study, we obtained 8 human temporal bones from 8 elderly subjects at brain autopsy in order to investigate the expression profile of miRNAs in the inner ear with miRNA arrays. A mean of 478 different miRNAs were expressed in the samples, of which 348 were commonly expressed in all 8 samples. Of these, levels of 16 miRNAs significantly differed between young elderly and old elderly subjects. miRNAs, which play important roles in inner ear development, were detected in all samples, i.e., in both young and old elderly subjects, whether with or without hearing loss. Our results suggest that these miRNAs play important roles not only in development, but also in the maintenance of inner ear homeostasis. (C) 2017 S. Karger AG, Basel

DOI： 10.1159/000479724

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記述言語：英語   出版者・発行元：BIOMED CENTRAL LTD  

The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma and rhinitis and (3) to develop guidelines with all stakeholders that could be used globally for all countries and populations. ARIA-disseminated and implemented in over 70 countries globally-is now focusing on the implementation of emerging technologies for individualized and predictive medicine. MASK [MACVIA (Contre les Maladies Chroniques pour un Vieillissement Actif)-ARIA Sentinel NetworK] uses mobile technology to develop care pathways for the management of rhinitis and asthma by a multi-disciplinary group and by patients themselves. An app (Android and iOS) is available in 20 countries and 15 languages. It uses a visual analogue scale to assess symptom control and work productivity as well as a clinical decision support system. It is associated with an inter-operable tablet for physicians and other health care professionals. The scaling up strategy uses the recommendations of the European Innovation Partnership on Active and Healthy Ageing. The aim of the novel ARIA approach is to provide an active and healthy life to rhinitis sufferers, whatever their age, sex or socio-economic status, in order to reduce health and social inequalities incurred by the disease.

DOI： 10.1186/s13601-016-0137-4

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

In this study, we investigated the effect of aging on biochemical markers in serum obtained from Thoroughbred horses (n = 30) and ponies (n = 15). Aging was observed to have an effect on albumin, total bilirubin, thyroxine, and iron levels. The triglyceride concentration in ponies was found to be significantly higher than in Thoroughbreds. Furthermore, an age-related increase in triglycerides was only observed in ponies. There was no aging effect on diacron-reactive oxygen metabolites and biological antioxidant potential concentration. A significant negative correlation between age and bilirubin, known as a strong antioxidative substance, was obtained in both the Thoroughbred and pony groups. However, the distribution area of data was different due to higher bilirubin concentrations in Thoroughbreds. The serum iron levels were correlated with serum triglyceride levels in ponies. We propose that the metabolism of ponies differs from that of Thoroughbreds and that careful breeding and appropriate exercise are required for aging ponies. (C) 2016 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.jevs.2016.03.011

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記述言語：日本語   出版者・発行元：(NPO)日本頭頸部外科学会  

舌下腺全摘出術を施行したガマ腫17例に対して、前治療の有無、手術時間、術後在院日数、再発の有無を検討し、その有用性を考察した。性別は男8例、女9例、年齢は8〜51歳(中央値26歳)であった。手術時間は44〜109分(中央値70分)、術後在院日数は3〜7日(中央値5日)であった。5例に前治療歴があり、前治療の有無による術中・術後経過の差異は認めなかった。経過期間が6ヵ月以上の症例は15例で、経過を確認し得た14例全例で再発を認めなかった。本術式は、進展範囲の大小や、新鮮・再発例に関わらず1度の画一的な手術療法で完治が得られる可能性が高く、有用な治療法と考えられた。(著者抄録)

DOI： 10.5106/jjshns.25.409

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その他リンク： http://search.jamas.or.jp/link/ui/2016208071

記述言語：日本語   出版者・発行元：(NPO)日本頭頸部外科学会  

非脂腺型リンパ腺腫は2005年の唾液腺腫瘍のWHO分類でlymphadenomaから独立した腫瘍である。われわれは2例の耳下腺非脂腺型リンパ腺腫を経験した。症例は54歳男性と61歳女性で、いずれも腫瘤は耳下腺の下方に存在し、境界明瞭でやや硬く、顔面神経麻痺や疼痛を認めなかった。画像検査や穿刺吸引細胞診からワルチン腫瘍を強く疑ったが、2例とも悪性リンパ腫も否定できなかったため、耳下腺浅葉切除術を施行し、非脂腺型リンパ腺腫と診断した。この2例と過去の報告を検討し、非脂腺型リンパ腺腫の臨床像を明らかにすることで、術前の鑑別診断の一助となると思われた。(著者抄録)

DOI： 10.5106/jjshns.25.415

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その他リンク： http://search.jamas.or.jp/link/ui/2016208072

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY  

Several unmet needs have been identified in allergic rhinitis: identification of the time of onset of the pollen season, optimal control of rhinitis and comorbidities, patient stratification, multidisciplinary team for integrated care pathways, innovation in clinical trials and, above all, patient empowerment. MASK-rhinitis (MACVIA-ARIA Sentinel NetworK for allergic rhinitis) is a simple system centred around the patient which was devised to fill many of these gaps using Information and Communications Technology (ICT) tools and a clinical decision support system (CDSS) based on the most widely used guideline in allergic rhinitis and its asthma comorbidity (ARIA 2015 revision). It is one of the implementation systems of Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA). Three tools are used for the electronic monitoring of allergic diseases: a cell phone-based daily visual analogue scale (VAS) assessment of disease control, CARAT (Control of Allergic Rhinitis and Asthma Test) and e-Allergy screening (premedical system of early diagnosis of allergy and asthma based on online tools). These tools are combined with a clinical decision support system (CDSS) and are available in many languages. An e-CRF and an e-learning tool complete MASK. MASK is flexible and other tools can be added. It appears to be an advanced, global and integrated ICT answer for many unmet needs in allergic diseases which will improve policies and standards.

DOI： 10.1111/all.12686

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCI LTD  

For the treatment of nasal and nostril stenosis caused by facial burn, it is necessary to perform rhinoplasty and nasal vestibuloplasty using various flaps, perform cicatrectomy of the nostrils with a rhinosurgical procedure, and prevent restenosis of the nostrils and nasal cavity for a certain period by methods such as placement of a nasal retainer or transnasal airway and gauze packing of the nasal cavity. With all methods, postoperative placement of a retainer or nasal treatment is necessary for the prevention of postoperative restenosis, and the patient's cooperation is essential.
In a patient who did not cooperate in postoperative treatments due to autism and had recurrences of nasal and nostril stenosis after conventional surgical treatments, adequate patency of the nasal cavity and nostrils could be maintained with minimal postoperative treatment by placing a self-expandable metallic esophageal stent. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.anl.2015.02.013

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：KARGER  

Background: Two major distinct subsets of dendritic cells (DCs) are arranged to regulate immune responses: DEC-205+ DCs drive Th1 polarization and 33D1+ DCs establish Th2 dominancy. Th1 polarization can be achieved either by depletion of 33D1+ DCs with a 33D1-specific monoclonal antibody (mAb) or by activation of DEC-205+ DCs via intraperitoneal injection of alpha-galactosylceramide (alpha-GalCer). We studied the effect of 33D1+ DC depletion or DEC-205+ DC activation in vivo using an established mouse model of allergic rhinitis (AR). Methods: Mice were injected intraperitoneally with OVA plus alum and challenged 4 times with daily intranasal administration of OVA. Immediately after the last challenge, allergic symptoms such as sneezing and nasal rubbing as well as the number of cells in the bronchoalveolar lavage fluid (BALF) and nasal lavage fluid (NALF) were counted. The levels of serum OVA-specific IgG1, IgG2a, and IgE were also determined by ELISA. Results: The allergic symptom scores were significantly decreased in 33D1+ DC-depleted or DEC-205+ DC-activated AR mice. The levels of OVA-specific IgG1, IgG2a, and IgE, and the number of NALF cells, but not BALF cells, were reduced in 33D1+ DC-depleted but not in DEC-205+ DC-activated AR mice. Moreover, the activated DEC-205+ DCs suppressed histamine release from IgE-sensitized mast cells, probably through IL-12 secretion. Conclusions: The manipulation of innate DC subsets may provide a new therapeutic strategy for controlling various allergic diseases by reducing histamine release from IgE-sensitized mast cells by driving the immune response towards Th1 dominancy via activation of DEC-205+ DCs in vivo. (C) 2016 The Author(s) Published by S. Karger AG, Basel

DOI： 10.1159/000443237

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1159/000381059

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記述言語：英語   出版者・発行元：JAPANESE SOCIETY ALLERGOLOGY  

Like asthma and atopic dermatitis, allergic rhinitis is an allergic disease, but of the three, it is the only type I allergic disease. Allergic rhinitis includes pollinosis, which is intractable and reduces quality of life (QOL) when it becomes severe. A guideline is needed to understand allergic rhinitis and to use this knowledge to develop a treatment plan. In Japan, the first guideline was prepared after a symposium held by the Japanese Society of Allergology in 1993. The current 7th edition was published in 2013, and is widely used today.
To incorporate evidence based medicine (EBM) introduced from abroad, the most recent collection of evidence/literature was supplemented to the Practical Guideline for the Management of Allergic Rhinitis in Japan 2013. The revised guideline includes assessment of diagnosis/treatment and prescriptions for children and pregnant women, for broad clinical applications. An evidence-based step-by-step strategy for treatment is also described. In addition, the QOL concept and cost benefit analyses are also addressed. Along with Allergic Rhinitis and its Impact of Asthma (ARIA), this guideline is widely used for various clinical purposes, such as measures for patients with sinusitis, childhood allergic rhinitis, oral allergy syndrome, and anaphylaxis and for pregnant women. A Q&A section regarding allergic rhinitis in Japan was added to the end of this guideline.

DOI： 10.2332/allergolint.14-RAI-0768

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.3109/21556660.2014.960969

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Strenuous exercise reduces immune cell function and increases the risk of respiratory and gastrointestinal infections. In addition, it affects mood state and causes physical fatigue. Athletes require both mental and physical conditioning to execute good performance. In this study, we conducted a randomized, double-blind, placebo-controlled clinical trial to evaluate the immunopotentiation and fatigue-alleviation effects of Lactobacillus gasseri OLL2809 (LG2809) and α-lactalbumin (αLA) in university-student athletes after strenuous exercise. A total of 44 university students who performed strenuous exercise daily were separated into 3 groups to receive a 4-week course of placebo, 100 mg LG2809, or 100 mg LG2809 in combination with 900 mg αLA, respectively. Before and after each dietary treatment, the subjects performed strenuous cycle ergometer exercise for 1 h. Before and after each exercise session, blood samples and visual analogue scale scores for fatigue were obtained. In addition, the mood of each subject before and after the dietary treatment was evaluated using the Profile of Mood States (POMS) questionnaire. LG2809 ingestion was effective in preventing reduced natural killer cell activity due to strenuous exercise and elevating mood from a depressed state. In addition, LG2809 + αLA was found to alleviate minor resting fatigue, which was supported objectively by the significant reduction in the serum reactive oxygen metabolites and transforming growth factor β1 levels. These effects could be helpful for athletes to maintain mental and physical condition.

DOI： 10.1139/apnm-2012-0490

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Society of Allergology  

DOI： 10.2332/allergolint.13-OA-0570

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(株)医薬ジャーナル社  

プランルカスト水和物は花粉症の初期療法に有用な薬剤であり、ガイドラインにも記載されている。しかしながら、花粉大量飛散時には追加の処方が必要になる場合がある。プランルカスト水和物と鼻噴霧用ステロイド薬を併用した初期療法を設定し、スギ花粉症患者を対象に3シーズンにおける症状とQOLについて検討した。2剤を併用した初期療法では飛散開始後に治療を開始した症例と比較して、症状やQOLスコアが有意に抑制されていた。また2011年のような大量飛散年においても症状は抑制されていた。眠気などの副作用を訴えるものは少なく、満足度も高い治療方法であると考えた。(著者抄録)

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記述言語：日本語   出版者・発行元：(NPO)日本頭頸部外科学会  

頸部気管の腺様嚢胞癌(ACC)では、根治性と喉頭を含めた臓器機能温存のバランスが治療の課題となる。われわれは頸部気管ACCに対し、気管切除と二期的再建術、術後放射線治療により、喉頭温存治療を行った。症例は39歳女性、主訴は呼吸困難であった。頸部気管後壁から右側壁にかけて内腔に突出する腫瘍を認め、気管切開と同時に生検を行いACCと診断した。手術では輪状軟骨から第6気管輪の右側後壁を切除し、頸部皮弁を挿入して気管皮膚瘻を造設した。瘻孔は二期的に閉鎖した。病理学的に切除断端陽性であり、放射線療法を追加した。現在、治療後7年が経過し、再発を認めていない。本法は気管ACC治療の選択肢のひとつになると考える。(著者抄録)

DOI： 10.5106/jjshns.23.255

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その他リンク： http://search.jamas.or.jp/link/ui/2014086087

記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: In practical guidelines for management of allergic rhinitis in Japan, pranlukast is a leukotriene receptor antagonist recommended for the treatment of pollinosis. However, the effect of pranlukast on nasal symptoms for cedar pollinosis has not been thoroughly investigated. The aim of this study is to examine this effect in a double-blind controlled crossover study using a pollen challenge chamber (the OHIO Chamber) developed in Japan. RESEARCH DESIGN AND METHODS: A total of 39 patients with cedar pollinosis were targeted. The subjects were exposed to a specific amount of cedar pollen (8000/m(3)) in the OHIO Chamber during the non-cedar pollen season. Efficacy of pranlukast for the treatment of artificially induced nasal symptoms was compared with that of a placebo using the crossover method. Pranlukast was administered orally for 3 days, after dinner on the day before cedar pollen exposure, after breakfast and after dinner on the day of cedar pollen exposure, and after breakfast on the following day. Pollen testing was carried out twice, with a 1-week wash-out interval. CLINICAL TRIAL REGISTRATION: The University Hospital Medical Information Network in Japan (UMIN), number UMIN000001282. MAIN OUTCOME MEASURES: The effect of pranlukast was evaluated using self-rating of nasal symptoms by the subjects. RESULTS: All 39 subjects demonstrated a positive skin reaction to cedar pollen by a positive CAP-RAST score (class 2 or higher) within the last 3 years, and experienced aggravated congestion during the cedar pollen season for more than 2 years. Nasal congestion was inhibited significantly in the pranlukast group compared to the placebo group during cedar pollen exposure. Furthermore, pranlukast significantly inhibited nasal congestion compared to the placebo on the day after exposure and on the following day. CONCLUSIONS: The effect of pranlukast on cedar pollinosis indicates immediate action, and such an effect could take place continuously after cedar pollen exposure. These results demonstrate that pranlukast is effective for the relief of congestion due to pollinosis.

DOI： 10.3109/21556660.2012.703630

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.2500/aap.2012.33.3615

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記述言語：英語   出版者・発行元：Japanese Society of Allergology  

Background: Leukotriene receptor antagonists (LTRAs) are effective for prophylactic treatment of pollinosis based on studies showing that administration of LTRAs prior to or at the start of the pollen season reduces symptoms and QOL disturbance at the peak of pollen dispersal. Two goals of prophylactic treatment of pollinosis are use of fewer types of drugs and delay of onset of symptoms and impairement of QOL. Therefore, this study was performed to determine if pranlukast, a LTRA, met these goals in treatment of pollinosis.<br> Methods: Pranlukast or placebo was administered to patients who visited our hospital immediately before the start of Japanese cedar pollen dispersal. The study was performed for 4 weeks as a double blind randomized trial. Subsequently, all patients were given pranlukast for a further 4 weeks from the peak until the end of pollen dispersal. The incidence of symptoms and use of concomitant drugs were investigated from daily nasal allergy records kept by patients. QOL was evaluated using the JRQLQ questionnaire.<br> Results: In the double blind period of the study, the percentage of patients who used concomitant drugs for nasal symptoms was significantly lower in the pranlukast group compared to the placebo group. Development of nasal symptoms (sneezing, runny nose and nasal congestion) and disturbance of daily activities were significantly delayed in the pranlukast group. No serious adverse reactions occurred in the pranlukast group and no patient withdrew from treatment with pranlukast.<br> Conclusions: Pranlukast is effective for prophylactic treatment of pollinosis.<br>

DOI： 10.2332/allergolint.10-OA-0285

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: Self-care with ten-cha is the most common complementary alternative medicine for allergic rhinitis in Japan, but evidence for an actual therapeutic effect is lacking. The purpose of the study was to investigate the effect of ten-cha (Rubus suavissimus) on house dust mite allergic rhinitis. METHODS: The study was performed in the otolaryngology departments of 5 facilities (Chiba University, Kagoshima University, Fukui University, Okayama University, and Nippon Medical School) from July to December 2009. A randomized double-blind study was performed with central enrollment and allocation. The subjects ingested 400mg of ten-cha extract or placebo (3 capsules/day) daily for 4 weeks as a food intervention. The number of subjects was chosen with anticipation of an effect equivalent to that of mast cell-stabilizing drugs. A nasal allergy diary-based symptom score and a QOL score were used for evaluation. RESULTS: The ten-cha and placebo groups included 47 and 42 subjects, respectively. The improvement rates for sneeze, nasal discharge, nasal obstruction, and symptom scores were greater in the ten-cha group than in the placebo group throughout the intervention period, and the effect tended to increase with time in the ten-cha group. However, the differences between the groups were not significant. QOL was not significantly improved in either group. CONCLUSION: Ingestion of ten-cha had an effect on allergic rhinitis, but the effect of Ten-Cha was limited and did not differ significantly from placebo. These results suggest that ten-cha does not exhibit an effect equivalent to mast cell-stabilizing drugs at the dose used in this study.

DOI： 10.1016/j.anl.2010.11.017

Web of Science

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) are the 2 forms of desensitization for allergic diseases which are used internationally. Despite the lack of sufficient evidence of the mechanism, SCIT has been used in Japan. When SCIT is performed appropriately, it is effective for allergic rhinitis, as supported by high-level evidence, including the results of meta-analysis. However, its use in Japan has not become widespread due to various problems, including the risk of anaphylaxis. Therefore, attention is being focused on SLIT because it is easier to perform but may be similarly effective and has been extensively discussed and evaluated internationally. Comparison of SCIT and SLIT can only be done with some allergen, which has also been discussed extenesively. Many patients and physicians would welcome the use of SLIT in Japan, and its first use against pollinosis due to Japanese cedar pollen is planned for 2014.

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記述言語：英語   出版者・発行元：Japan Society for Bioscience, Biotechnology, and Agrochemistry  

A randomized, double-blind, placebo-controlled clinical trial was conducted to determine whether oral administration of heat-killed Lactobacillus gasseri OLL2809 would affect the immune response and reduce the symptoms of Japanese cedar pollinosis (JCP) in subjects with JCP. Following a 1-week pre-observation period, the subjects were randomly divided into two groups and were orally administered a placebo or tablets containing 100 mg of L. gasseri OLL2809 per d for 8 weeks during the pollen season in 2007. The results showed no obvious differences between the groups. Supplementary subgroup analysis revealed that the OLL2809 subgroups with CAP-RAST scores of 4 or 5 exhibited improvement in nasal symptoms scores and serum allergy-related items, including Japanese cedar pollen-specific IgE levels. L. gasseri OLL2809 was found to be effective in reducing symptoms in subjects with a high predisposition to allergies by modulating systemic immune systems.

DOI： 10.1271/bbb.90144

PubMed

CiNii Books

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その他リンク： https://jlc.jst.go.jp/DN/JALC/00337018679?from=CiNii

DOI： 10.1517/14656560902758368

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

IL-33, an IL-1-like cytokine, is a ligand for IL1RL1, which is an important effector molecule of type 2 T helper responses. Although IL-33/IL1RL1 interaction has been suggested to be important in induction of allergic airway inflammation, serum levels of IL-33 and the genetic influences of the polymorphisms of IL-33 in human allergic diseases are unclear.
The aim of this study was to examine whether the serum IL-33 level and polymorphisms in IL-33 are associated with Japanese cedar (JC) pollinosis, the most common form of allergic rhinitis, and a major public health problem, in Japan.
We performed linkage disequilibrium (LD) mapping of the gene using the HapMap database, and two selected tag single nucleotide polymorphisms were genotyped. We conducted an association study of IL-33 (JC pollinosis, n=170; normal controls, n=100) and measured the IL-33 levels in sera of the 270 subjects by ELISA.
Serum levels of IL-33 were significantly higher in patients with JC pollinosis (P=0.0018) than in controls. In genetic association analysis, we found a positive association between the polymorphism and JC pollinosis (P=0.048).
Our results support a role for IL-33 in the pathogenesis of JC pollinosis.
Cite this as: M. Sakashita, T. Yoshimoto, T. Hirota, M. Harada, K. Okubo, Y. Osawa, S. Fujieda, Y. Nakamura, K. Yasuda, K. Nakanishi and M. Tamari, Clinical and Experimental Allergy, 2008 (38) 1875-1881.

DOI： 10.1111/j.1365-2222.2008.03114.x

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記述言語：英語   出版者・発行元：Japanese Society of Allergology  

Background: Seasonal allergic rhinitis (SAR) induced by Japanese cedar pollen is a substantial problem in Japan. Sublingual immuno-therapy (SLIT) is safer than conventional antigen-specific immunotherapy, the only treatment modality by which complete cure of the disease can be expected. We investigated the safety and efficacy of SLIT in the treatment of cedar pollinosis patients compared to placebo.<br> Methods: A randomized, placebo-controlled, double-blind study was conducted in 61 cedar pollinosis patients. Increasing doses of standardized Japanese cedar extract or placebo were administered sublingually in intervals ranging from daily to once a week after six weeks. The primary efficacy variable was the mean of the daily total symptom scores (TSS) during the pollen dispersing period. Secondary efficacy variables included the QOL scores and related variables.<br> Results: Primary efficacy variable scores were significantly lower for some days in the SLIT group than in the placebo group (P <.01 or P <.05). Secondary efficacy for the QOL score in SLIT group was almost of half of placebo group. There was no significant difference in the overall incidence of side effects between the SLIT group and the placebo group.<br> Conclusions: SLIT was effective and safe in the treatment of cedar pollinosis.<br>

DOI： 10.2332/allergolint.O-07-514

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DOI： 10.1159/000083322

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：American Thoracic Society  

Allergic rhinitis is an IgE mediated atopic disease characterized by elevated levels of allergen specific IgE antibodies that play a central role in mediating allergic reactions. Interleukin 13 (IL-13) is a novel T-cell- derived cytokine that shares several functional properties with IL-4 and has been demonstrated to be capable of inducing IgE synthesis. The present study was designed to investigate the expression of IL-13 gene in the epithelial compartment of the nasal mucosa of patients with perennial allergic rhinitis (PAR) to house dust mite, comparing it with that in the nasal epithelial compartment of chronic infectious rhinitis (CIR) patients and normal volunteers (NV). We also investigated the IL-13 gene expression in the peripheral blood of PAR patients. Nasal scrapings were collected from the inferior turbinate of patients undergoing conchotomy surgery and from outpatients, and the mRNA expression of IL-13 was analyzed by the RT-PCR method. Peripheral blood mononuclear cells were isolated by density-gradient centrifugation and the expression of IL-13 gene was examined by the RT-PCR method. IL-13 expression at protein level and its cell source were analyzed by immunohistochemistry of inferior turbinate biopsies. The levels of total serum IgE and allergen-specific IgE antibodies in the serum were estimated by the PRIST and CAP RAST method, respectively. IL-13 gene expression was detected in the epithelial compartment of the nasal mucosa of 18/19 PAR patients but was undetected in normal volunteers and CIR patients. The level of IL-13 gene expression in PAR patients correlated strongly with the levels of total serum IgE (r = 0.80, p &lt
0.0001) and serum specific IgE (r = 0.74, p &lt
0.0005). Furthermore, IL-13 gene expression was not detected in the peripheral blood of PAR patients. IL-13 expression at protein level was localized to lymphocytes and mast cells. The selective expression of IL-13 gene in the epithelial compartment of the nasal mucosa of PAR patients and its strong correlation with the levels of serum IgE suggest its important role in the pathogenesis of PAR, probably by enhancement of IgE synthesis. The absence of IL-13 gene expression in the peripheral blood of PAR patients in contrast to its expression in the epithelial compartment of their nasal mucosa suggest that IL-13 may play a more important role locally within the microenvironment of the nasal mucosa.

DOI： 10.1164/ajrccm.152.6.8520776

Scopus

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: In children with obstructive sleep apnea (OSA) who underwent adenotonsillectomy (AT), we measured body height and weight using standard deviation (SD) scores, insulin-like growth factor 1 (IGF-1), and skeletal age using carpal radiography. We then compared these values before and after surgery with the aim of investigating postoperative improvements in growth hormone (GH) deficiency. METHODS: Subjects comprised 35 children between 2 and 9 years of age (21 boys, 14 girls; mean age, 5.85 ± 1.75 years). Respiratory event index (REI), 3 % oxygen desaturation index (3 % ODI), height SD score, body mass index (BMI) percentile, blood IGF-1 level, and skeletal age from carpal radiographs were measured before surgery and both 3 and 12 months after surgery, and compared. RESULTS: Height SD score improved significantly from preoperatively (-0.44 ± 1.13) to both 3 months postoperatively (-0.22 ± 1.14) and 12 months postoperatively (-0.13 ± 0.94). However, no significant improvement in height SD score was seen from 3 months to 12 months after AT. BMI percentile improved significantly from preoperatively (35.6 ± 26.7) to both 3 months postoperatively (44.7 ± 26.5) and 12 months postoperatively (49.1 ± 22.15), with significant improvement also seen from 3 months to 12 months after AT. SD score for IGF-1 showed significant improvement from before (-0.57 ± 1.00) to 12 months after surgery (-0.12 ± 0.89). No significant improvement in the difference between skeletal and chronological ages was seen from before to after surgery, but the number of patients for whom skeletal age normalized from before to after surgery increased significantly (74.3 % vs. 94.3 %), and the number with advanced or delayed skeletal age decreased significantly (25.7 % vs. 5.7 %) CONCLUSION: Early improvements can be obtained with surgical treatment in children with OSA who have short height and poor weight gain due to GH deficiency.

DOI： 10.1016/j.anl.2023.09.002

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: The odor recognition thresholds in T&T olfactometry are measured by either the examiner's judgment of the patients' odor expression for each standard odor or by the patient's choice of the correct response from an olfactory term table. This study aimed to clarify the correct odor expressions and use of the olfactory term table. METHODS: A questionnaire was administered to otolaryngologists or medical staff in charge of testing at facilities where T&T olfactometry is performed. The questionnaire consisted of the facility's background, environment and procedures of T&T olfactometry, choice of the correct answer with five different standard odors, and use of the olfactory term table. For the choices, the expressions used were those considered correct at Nippon Medical School Tama Nagayama Hospital and the Kyoto Nose and Allergy Clinic. RESULTS: A total of 81 valid responses were obtained. Most respondents belonged to medical and educational institutions (59.3%, 48/81). The laboratories in the respondents' institutions were completely ventilated using various methods. Clinical laboratory technicians inspected 51.7% (45/81) of the facilities. The order of standard odors in the odor recognition threshold test differs depending on the facility. When the examiner was unsure about the answer given by the patient in the odor recognition threshold test, 16.1% (9/56) of the respondents chose "present the olfactory term table," 33.9% (19/56) chose "increase the concentration," and 37.5% (21/56) chose "present the olfactory term table" or "increase the concentration," depending on the situation. A total of 96.4% (54/56) of the facilities treated odor expressions other than those in the olfactory term table as correct, and the odor expressions that were considered correct differed from facility to facility. Of the respondents, 80.2% (65/81) answered "I know the olfactory term table," and the mean value of satisfaction with the current olfactory term table was 4.4 ± 3.0. Of the respondents, 81.5% (53/65) answered that "the timing of presenting the olfactory term table should be standardized in all facilities." CONCLUSION: In the odor recognition threshold test by T&T olfactometry, this study revealed that the odor expressions considered as correct answers for the standard odors and the use of the olfactory term table differed among facilities.

DOI： 10.1016/j.anl.2023.07.009

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: After Endoscopic Sinus Surgery (ESS), packing plays an important role in wound healing and hemostasis. However, the effect of the packing removal procedure on physician stress has not been evaluated. The purpose of this study was to evaluate physician stress during packing removal for patients treated with AQUACEL® Ag Advantage versus KALTOSTAT®. METHODS: This retrospective study included 15 patients who underwent packing with ESS for chronic rhinosinusitis performed at two centers; 9 were treated with AQUACEL® Ag Advantage and 6 were treated with KALTOSTAT®. Physician stress during packing removal was evaluated with the National Aeronautics and Space Administration-Task Load Index (NASA-TLX). The time required to remove the packing and the number of instruments used in the procedure were recorded. Postoperative bleeding (Boezaart bleeding score) and wound healing were graded. Patient symptoms on the day after surgery and pain during packing removal were assessed using a visual analog scale. RESULTS: Computed tomography scores, asthma complications, and blood eosinophil counts were significantly higher in the AQUACEL® Ag Advantage group. Patient symptoms on the day after surgery were not significantly different between the two groups. Physician stress during the task of packing removal was significantly lower in the AQUACEL® Ag Advantage group than in the KALTOSTAT® group (35.5 vs. 81.0, p=0.016) according to the NASA-TLX scores. The number of instruments used in the procedure was significantly lower in the AQUACEL® Ag Advantage group than in the KALTOSTAT® group (3.0 vs. 6.0, p=0.015). There were no significant differences in procedure time for packing removal, postoperative bleeding, wound healing, or patient pain at the time of packing removal between the groups. CONCLUSION: Physicians feel stressed about packing removal. In addition, AQUACEL® Ag Advantage is useful for packing after ESS, requiring fewer instruments for the procedure than KALTOSTAT® and reducing physician stress about the procedure. LEVEL OF EVIDENCE: Level 3.

DOI： 10.1016/j.bjorl.2023.101292

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The house dust mite (HDM) sublingual immunotherapy (SLIT)-tablet is a treatment option for allergic rhinitis with/without conjunctivitis (AR/C) approved in adults worldwide and in adolescents in some countries. OBJECTIVE: To supplement existing adolescent HDM SLIT-tablet safety data by conducting the MT-18 trial in adolescents. METHODS: MT-18 (EudraCT:2020-000446-34) was a phase 3, open-label, single-arm, 28-day safety trial of daily HDM SLIT-tablet (12 SQ-HDM dose) in European adolescents (12-17 years) with HDM AR/C, with or without asthma. The primary end point was at least 1 treatment-emergent adverse event (TEAE). MT-18 results were compared with 12 SQ-HDM adolescent subpopulation data from previously described 1-year phase 3 trials conducted in North America (P001; clinicaltrials.gov:NCT01700192) or Japan (TO-203-3-2; JapicCTI:121848). RESULTS: No treatment-related anaphylaxis, epinephrine administrations, severe local swellings, severe mouth or throat edema, or eosinophilic esophagitis occurred in the trials. For MT-18 (N = 253), P001 (N adolescents = 189), and TO-203-3-2 (N adolescents = 206), the percentage of adolescents treated with 12 SQ-HDM reporting any TEAE was 88%, 95%, and 93%, respectively, and the percentage reporting any treatment-related AE (TRAE) was 86%, 93%, and 66%, respectively. The most common TRAEs were local application site reactions. Most TRAEs were mild in intensity and were typically experienced the first 1 to 2 days of treatment. There were no asthma-related TEAEs with the HDM SLIT-tablet. The safety profile appears similar between adolescents with or without asthma at baseline. CONCLUSION: The HDM SLIT-tablet was well tolerated in European, North American, and Japanese adolescents with HDM AR/C, indicating safety of the HDM SLIT-tablet is insensitive to age or geographic region. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: (P001: NCT01700192); EudraCT: (MT-18; 2020-000446-34); JapicCTI: (TO-203-3-2; 121848).

DOI： 10.1016/j.anai.2023.03.006

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

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記述言語：日本語   出版者・発行元：日本職業・環境アレルギー学会  

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記述言語：日本語   出版者・発行元：日本耳鼻咽喉科免疫アレルギー感染症学会  

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記述言語：日本語   出版者・発行元：日本耳鼻咽喉科免疫アレルギー感染症学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J07551&link_issn=&doc_id=20230405410013&doc_link_id=10.3950%2Fjibiinkotokeibu.126.3_248&url=https%3A%2F%2Fdoi.org%2F10.3950%2Fjibiinkotokeibu.126.3_248&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

The Practical Guideline for the Management of Allergic Rhinitis, the fist guideline for allergic rhinitis in Japan, was prepared after a symposium held by the Japanese Society of Allergology in 1993. The current 9th edition was published in 2020 and is widely used today. The most recent collection of evidence from the literature was supplemented to the revised guideline to incorporate evidence-based medicine. The revised guideline includes updated epidemiology of allergic rhinitis in Japan, a figure representing the mechanisms of allergic rhinitis in both the onset and sensitization phases with the introduction of regulatory T cells and type 2 innate lymphoid cells, practical assessment for diagnosis, new pharmacotherapy agents such as anti-IgE mAb and a new drug delivery system for antihistamines, sublingual immunotherapy for children, dual sublingual immunotherapy for house dust mites and Japanese cedar pollen extract, new classification for surgery for allergic rhinitis, and treatment and prescriptions for older adults. An evidence-based step-by-step strategy for treatment is also described.

DOI： 10.1016/j.alit.2022.11.003

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: The status of dupilumab self-injection at home is not well understood. We therefore aimed to identify the barriers to adherence to dupilumab self-injection. PATIENTS AND METHODS: This non-interventional open-label study was conducted between March 2021 and July 2021. Patients with atopic dermatitis, bronchial asthma, and chronic rhinosinusitis with nasal polyps receiving dupilumab, from 15 sites, were requested to complete a self-administered questionnaire regarding the frequency and effectiveness of dosing as well as their use and satisfaction with dupilumab. Barriers to adherence were assessed using the Adherence Starts with Knowledge-12. RESULTS: We included 331 patients who used dupilumab for atopic dermatitis (n = 164), chronic rhinosinusitis with nasal polyps (n = 102), and bronchial asthma (n = 65). The median efficacy of dupilumab scored 9.3 on the visual analog scale. Overall, 85.5% of the patients self-injected dupilumab, and 70.7% perfectly complied with the established injection dates. The pre-filled pen was significantly superior to the conventional syringe in terms of usability, operability, ease of pushing the plunger, and patient satisfaction. However, the pre-filled pen caused more pain during self-injection than did the syringe. Multivariate logistic regression analysis showed that adherence decreased with longer dupilumab treatment duration (p = 0.017) and was not associated with age, sex, underlying disease, or device type. There was a difference in responses related to "inconvenience/forgetfulness" between the good and poor adherence groups. CONCLUSION: The pre-filled dupilumab pen was superior to the syringe in terms of usability, operability, ease of pushing the plunger, and satisfaction. Repetitive instructions are recommended for preventing poor adherence to dupilumab self-injection.

DOI： 10.2147/PPA.S389865

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1016/j.jacig.2022.10.006

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記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：日本語   出版者・発行元：日本耳鼻咽喉科免疫アレルギー感染症学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Der p 23 has recently been recognized as a new house dust mite (HDM) major allergen that may be linked to the development of asthma in HDM allergic patients. This study aimed to investigate the frequency of sensitization to HDM major allergen components including Der p 23 and to examine the correlation between HDM-sensitization and AR symptom score in Japanese HDM allergic rhinitis (AR) patients without allergic asthma. Serum samples (n = 120) collected from Japanese HDM AR patients (12 to 64 years) without asthma were assessed for allergen-specific IgE (s-IgE) by ImmunoCAP (Dermatophagoides pteronyssinus (D. pteronyssinus; Der p) extract, Der p 23) or immunosolid-phase allergen chip (Der p 1, Der p 2). Japanese HDM AR patients without asthma showed a high prevalence of allergic sensitization to the HDM major allergens Der p 1 (94.2%), Der p 2 (97.5%) and Der p 23 (71.7%). No difference in the prevalence was detected for Der p 1 and Der p 2 s-IgE among three age groups. However, the prevalence of Der p 23 s-IgE was significantly higher in the younger group compared to the elderly group. No significant correlation was found between AR symptom scores and concentration of s-IgE towards Der p extract and any of the three HDM major allergens. Although the prevalence of sensitization towards D. pteronyssinus major allergens is high in Japanese AR patients without asthma, there was no correlation between allergen specific IgE including IgE towards Der p 23 and AR symptom in this population.

DOI： 10.1016/j.intimp.2022.108640

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：日本語   出版者・発行元：日本耳鼻咽喉科免疫アレルギー感染症学会  

70歳代、男性。5年前にCOPD合併喘息と診断され、経口ステロイドを含む治療を受けるも、治療抵抗性を示したため、mepolizumabが投与された。投与により一定の効果は認められたものの喘息発作は消失せず、投与開始2年4ヵ月後には鼻症状および鼻茸を伴う慢性副鼻腔炎が出現し、近医より当科へ紹介となった。JESRECスコアは15点で、喘息の合併や鼻茸の生検結果から重症好酸球性副鼻腔炎と診断された。副鼻腔炎と喘息の改善を期待してdupilumabに薬剤を変更した結果、変更から7ヵ月で嗅覚障害以外の鼻症状、副鼻腔炎、鼻茸は改善した。だが、肺機能や喘息症状の改善はみられなかった。

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J07545&link_issn=&doc_id=20220720460005&doc_link_id=%2Ffm9areka%2F2022%2F000202%2F005%2F0059-0064%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Ffm9areka%2F2022%2F000202%2F005%2F0059-0064%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

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記述言語：日本語   出版者・発行元：日本耳鼻咽喉科免疫アレルギー感染症学会  

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記述言語：日本語   出版者・発行元：日本耳鼻咽喉科免疫アレルギー感染症学会  

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記述言語：日本語   出版者・発行元：日本耳鼻咽喉科免疫アレルギー感染症学会  

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記述言語：日本語   出版者・発行元：日本耳鼻咽喉科免疫アレルギー感染症学会  

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記述言語：日本語   出版者・発行元：日本耳鼻咽喉科免疫アレルギー感染症学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Der p 23 has recently been recognized as a new house dust mite (HDM) major allergen that may be linked to the development of asthma in HDM allergic patients. This study aimed to investigate the frequency of sensitization to HDM major allergen components including Der p 23 and to examine the correlation between HDM-sensitization and AR symptom score in Japanese HDM allergic rhinitis (AR) patients without allergic asthma. Serum samples (n = 120) collected from Japanese HDM AR patients (12 to 64 years) without asthma were assessed for allergen-specific IgE (s-IgE) by ImmunoCAP (Dermatophagoides pteronyssinus (D. pteronyssinus; Der p) extract, Der p 23) or immunosolid-phase allergen chip (Der p 1, Der p 2). Japanese HDM AR patients without asthma showed a high prevalence of allergic sensitization to the HDM major allergens Der p 1 (94.2%), Der p 2 (97.5%) and Der p 23 (71.7%). No difference in the prevalence was detected for Der p 1 and Der p 2 s-IgE among three age groups. However, the prevalence of Der p 23 s-IgE was significantly higher in the younger group compared to the elderly group. No significant correlation was found between AR symptom scores and concentration of s-IgE towards Der p extract and any of the three HDM major allergens. Although the prevalence of sensitization towards D. pteronyssinus major allergens is high in Japanese AR patients without asthma, there was no correlation between allergen specific IgE including IgE towards Der p 23 and AR symptom in this population.

DOI： 10.1016/j.intimp.2022.108640

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Many people with aphasia demonstrate problems of oral production at the discourse level. The Main Concept Analysis (MCA) for oral discourse production is a published evidence-based battery for quantifying the degree of presence, accuracy, completeness, and efficiency of targeted main concepts in oral discourse. In Japan, such a standardized tool specialized for assessing spoken discourse is currently lacking. The purpose of this study was to adapt the Japanese version of MCA for oral discourse production (the Japanese-MCA) and examine its validity and reliability. Stage 1 of the study involved the establishment of linguistically-specific main concepts (MCs) of the Japanese-MCA. Ten speech-language-hearing therapists and 60 healthy participants who were native monolingual Japanese speakers were recruited to determine MCs. Stage 2 examined the criterion validity and reliability of the Japanese-MCA. Language samples of 20 participants with aphasia, as verified by Standard Language Test of Aphasia (SLTA), and 20 healthy older participants were used. Results of Stage 1 of the study yielded normative data with a set of target MCs that were geographically and linguistically specific for use in Japan. The results also revealed the comparability of the Japanese-MCA and previously reported versions of other languages. Stage 2 findings indicated not only a high correlation of criterion validity, but also good reliability of the test. With established norms and specific scoring criteria of the Japanese-MCA, it is believed that this new tool will become a useful addition to clinical management and research of aphasia in Japan.

DOI： 10.1080/02699206.2021.1915385

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記述言語：英語  

DOI： 10.1016/j.alit.2021.08.012

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記述言語：英語  

DOI： 10.1016/j.alit.2021.08.012

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Georg Thieme Verlag KG  

Abstract

Anatomy education is a crucial part of the curriculum for medical students, and it is essential for surgeons to perform safe surgery. The anatomy of the sinus cavity is complicated and cannot be easily understood through cadaver dissection practice and reading of surgical anatomy textbooks. Therefore, the development of methods to effectively teach the anatomy of such complex structures is essential for performing safe medical procedures. This study aimed to investigate whether the use of virtual reality (VR) in an educational course on paranasal sinus anatomy could contribute to the understanding and learning efficiency of dissection of the complex sinus anatomy. We devised a system to observe the paranasal sinuses in the VR space by polygonizing the shape of the sinus cavity using computed tomography images of the sinuses. Medical students moved around the VR space and viewed the sinuses from different angles using the VR system; notably, this is impossible in a conventional anatomy laboratory. A questionnaire was administered to 27 medical students (15 men and 12 women; mean age, 24.9 years) to evaluate their understanding of the sinus anatomy and the number of times they had experienced VR and used VR systems. We found that more than 70% of the students had never used VR before, but they could easily use it even if they were unfamiliar with the operation of the VR system, and the learning process was enjoyable and efficient. Thus, the VR application could be a useful tool for educating medical students.

DOI： 10.1055/s-0042-1759820

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Japan Rhinologic Society  

DOI： 10.7248/jjrhi.61.607

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Japanese cedar (JC) pollinosis is a common allergic rhinitis in Japan. JC pollen sublingual immunotherapy (SLIT) tablets are licensed for the treatment of JC pollinosis. OBJECTIVE: To assess the disease-modifying effects of JC pollen SLIT tablets over 5 years (2014-2019), comprising a 3-year treatment period and 2-year follow-up. METHODS: A total of 1042 patients with JC pollinosis (aged 5-64 years) were included in the study. An optimal dose-finding study was performed in the first 15 months, after which 240 patients in the placebo (P) group and 236 patients in the optimal active dose (A) group (5000 Japanese allergy units) were re-randomized to receive P or A for an additional 18 months (designated AA, AP, PA, and PP groups). Clinical efficacy was evaluated by the total nasal symptom and medication score (TNSMS) during the peak symptom period of each JC pollen season over 3 years of treatment and 2 years of observation after treatment cessation. RESULTS: The AA, AP, and PA groups exhibited significantly reduced TNSMS; however, the largest relative reduction was seen in the AA group both during the treatment period (third season, 46.3% vs PP, P < .001) and during the 2-year follow-up period (fourth and fifth seasons, 45.3% and 34.0% vs PP, respectively; P < .001). The most common adverse drug reactions were mild reactions at the administration site. CONCLUSIONS: JC pollen SLIT tablets show sustained clinical efficacy during 3 years of treatment and sustained disease-modifying effects for at least 2 years after treatment cessation.

DOI： 10.1016/j.jaip.2021.06.060

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記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The spinal accessory nerve (SAN) has several anatomical variations, which may be a pitfall in neck dissection (ND). These include the trapezius muscle branch (TB), which stems from the common trunk before entering the sternocleidomastoid muscle (SCM). AIMS/OBJECTIVES: To investigate the prevalence of this variation and suggest a protocol for preventing unexpected injury of the TB in ND. MATERIALS AND METHODS: We conducted a retrospective cohort study for 93 patients who had undergone neck dissection (117 sides) without resection of the SCM nor SAN. We recorded the division of the TB after and before penetration of the SCM by the common trunk (penetrating type TB [PTB]) and non-penetrating type TB [NPTB], respectively). RESULTS: Among NDs, PTB and NPTB were observed in 61 (52%) and 56 (48%) sides, respectively. In the subgroup of 24 cases with bilateral ND, PTB/PTB, NPTB/NPTB, and NPTB/PTB were observed in eight (33%), nine (38%), and seven (29%) cases, respectively. The prevalence of PTB/NPTB did not differ according to age, sex, or laterality. CONCLUSIONS AND SIGNIFICANCE: NPTB is a common anatomical variation. The presence or absence of a branch from the common trunk must be initially checked to avoid unexpected damage to the TB.

DOI： 10.1080/00016489.2021.1954688

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background Despite the abundant experience of tonsillectomy with steroid pulse therapy (TSP) for patients with immunoglobulin A (IgA) nephropathy, the therapeutic efficacy of TSP on renal prognosis remains controversial. The purpose of this study was to evaluate the efficacy of whether TSP effectively prevents chronic kidney disease (CKD) progression. Methods This was a single-center, retrospective observational study. A total of 149 patients were enrolled in the current study who were confirmed with IgA nephropathy by renal biopsy between February 2011 and August 2019. The impact of TSP on CKD progression was compared with conservative treatment during a follow-up period of 3 years. Results In total, 110 patients received TSP and 39 patients received conservative treatment. There were no differences between the two groups in the initial CKD stages: 65.1% of patients had CKD G1-2, 32.2% had CKD G3, and 2.7% had CKD G4-5. The initial urine protein was 0.7 g/gCr, which was not different between the two groups. Kaplan-Meier analysis showed that patients with TSP had a significantly better renal prognosis than those in the conservative treatment group after one and a half years (p = 0.007). Multivariable analysis revealed that TSP had a significant impact on the prevention of CKD progression, with an adjusted odds ratio of 0.07 (95% confidence interval, 0.01-0.87; p=0.039). However, we could not confirm the predictive value of the Oxford Classification on TSP efficacy. Additionally, the initial urinary protein level was a risk factor for CKD progression. Conclusions TSP was associated with a lower risk of CKD progression. In this regard, our study supports that TSP may be a reasonable treatment option for patients with IgA nephropathy. In the featured study, it needs to be elucidated which histopathological classifications benefit from TSP treatment.

DOI： 10.7759/cureus.15736

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記述言語：日本語   出版者・発行元：(一社)日本腎臓学会  

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記述言語：日本語   出版者・発行元：(一社)日本アレルギー学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Proton pump inhibitors (PPIs) are widely used medicines worldwide. However, a rare etiology of syndrome of inappropriate secretion of antidiuretic hormone (SIADH) related to PPI was recently reported. Therefore, the putative role of PPIs in SIADH cannot be underestimated. A 78-year-old Japanese woman was admitted to our hospital for treatment of left Bell's palsy. On admission, the patient was oriented with normal laboratory data, including a serum Na level of 135 mEq/L. Oral glucocorticoids and a proton pump inhibitor were initiated in combination with oral valaciclovir. Six days later, the patient's consciousness became impaired. Laboratory data showed a serum Na level of 103 mEq/L, a urine Na level of 64.8 mEq/L, a urine K level of 43.6 mEq/L, and a urine osmolality of 450 mOsm/kg H2O. The patient met the criteria for SIADH. The initial treatment included water restriction and 3% hypertonic saline administration. The cessation of PPI significantly improved the urine diluting capacity and concomitantly increased serum Na, which indicated that the use of PPI had been responsible for the etiology of SIADH. The present case illustrates that physicians need to be aware of the uncommon adverse effects of PPI, such as SIADH.

DOI： 10.2302/kjm.2020-0008-CR

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES/HYPOTHESIS: The aim of the study was to develop a test for the assessment of retronasal olfaction in healthy participants and patients with olfactory disorders using "tasteless" powders. STUDY DESIGN: Prospective case-control series. METHODS: A total of 150 participants (110 women, 40 men, mean age = 40 ± 16 years) were recruited for this study; 100 were healthy controls and 50 were patients with olfactory loss due to infections of the upper respiratory tract (n = 25), idiopathic causes (n = 12), sinonasal disease (n = 7), and head trauma (n = 6). Orthonasal olfactory function was evaluated using the Sniffin' Sticks test battery, and retronasal olfaction was evaluated using powders lacking distinctive tastes administered to the oral cavity. To establish test-retest reliability, healthy participants had their orthonasal and retronasal function tested twice. RESULTS: The validity analyses revealed that the selected 16 stimuli differentiated between normosmic participants and patients with olfactory loss, and that retronasal and orthonasal olfaction were highly correlated. CONCLUSIONS: The results of the present study indicate that patients with olfactory loss and controls can be clearly separated using a reliable test of retronasal olfaction based on 16 retronasal stimuli. LEVEL OF EVIDENCE: 2b Laryngoscope, 131:E324-E330, 2021.

DOI： 10.1002/lary.28698

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: There have been no reports of treatment effect persistence after long-term sublingual immunotherapy (SLIT) in patients with Japanese cedar (JC) pollinosis. Therefore, we conducted a post-marketing clinical trial to investigate the efficacy, safety, and effect persistence of JC pollen SLIT drops after approximately 3 years of treatment. METHODS: This was an open-label trial of 233 patients with JC pollinosis who were treated with JC pollen SLIT drops for approximately 3 years (2015-2017) and followed-up for an additional 2 years (2018-2019). Efficacy and effect persistence were evaluated using nasal and ocular symptom scores, daily use of rescue medication, and Japanese Rhinoconjunctivitis Quality of Life Questionnaire scores recorded during the JC pollen dispersal season of each year. Safety was evaluated by monitoring adverse events and adverse drug reactions. RESULTS: The mean combined total nasal symptom and medication score (range 0-18) during the peak symptom periods of 2015 through 2019 were 5.47 ± 3.38, 4.52 ± 3.13, 3.58 ± 2.63, 5.28 ± 4.01, and 6.83 ± 4.65, respectively. The percentage of patients who used no rescue medications during the same periods was 64.8%, 75.2%, 80.3%, 63.7%, and 50.3%, respectively. A total of 138 adverse drug reaction incidents were recorded in 73 of the 233 patients (31.3%), of which 134 incidents (97.1%) were mild in severity. CONCLUSIONS: JC pollen SLIT drops demonstrated treatment duration-dependent efficacy with effects that persisted for 2 years after cessation of treatment. The drug had a favorable safety profile over the 5-year study period.

DOI： 10.1016/j.alit.2020.05.008

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

DOI： 10.15036/arerugi.70.948

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: As part of the planning for a future multicenter study, this preliminary clinical trial used serum samples from patients to identify biomarkers for predicting the therapeutic effects of sublingual immunotherapy (SLIT) for Japanese cedar pollinosis (JCP). METHODS: This prospective study included patients undergoing SLIT for JCP at our hospital. All enrolled patients (N = 17) started SLIT between June and November of 2015. With informed consent from the patients, blood samples were obtained in January, March, and June of 2016, and patients completed the Japan rhino-conjunctivitis quality of life questionnaire (JRQLQ). On the basis of the JRQLQ results, the 6 patients with the best outcomes were included in the high-response group (HRG), and the 5 patients with the worst outcomes were included in the poor-response group (PRG). We then compared serum data between the two groups, to identify useful biomarkers. RESULTS: IL-12p70 and VEGF levels tended to be higher in the HRG than in the PRG in January, March, and June (0.10 > p > 0.05). In addition, the June IL-17 level was significantly higher (p < 0.05) in the HRG than in the PRG. CONCLUSIONS: IL-12p70 and VEGF may be useful biomarkers for predicting the effects of SLIT. In addition, although IL-17 does not appear to be useful as a biomarker for evaluating treatment response at the start of SLIT, it may be useful as a biomarker after the beginning phase of SLIT.

DOI： 10.1272/jnms.JNMS.2020_87-506

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: As part of the planning for a future multicenter study, this preliminary clinical trial used serum samples from patients to identify biomarkers for predicting the therapeutic effects of sublingual immunotherapy (SLIT) for Japanese cedar pollinosis (JCP). METHODS: This prospective study included patients undergoing SLIT for JCP at our hospital. All enrolled patients (N = 17) started SLIT between June and November of 2015. With informed consent from the patients, blood samples were obtained in January, March, and June of 2016, and patients completed the Japan rhino-conjunctivitis quality of life questionnaire (JRQLQ). On the basis of the JRQLQ results, the 6 patients with the best outcomes were included in the high-response group (HRG), and the 5 patients with the worst outcomes were included in the poor-response group (PRG). We then compared serum data between the two groups, to identify useful biomarkers. RESULTS: IL-12p70 and VEGF levels tended to be higher in the HRG than in the PRG in January, March, and June (0.10 > p > 0.05). In addition, the June IL-17 level was significantly higher (p < 0.05) in the HRG than in the PRG. CONCLUSIONS: IL-12p70 and VEGF may be useful biomarkers for predicting the effects of SLIT. In addition, although IL-17 does not appear to be useful as a biomarker for evaluating treatment response at the start of SLIT, it may be useful as a biomarker after the beginning phase of SLIT.

DOI： 10.1272/jnms.JNMS.2020_87-506

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記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Allergen immunotherapy (AIT) reduces symptoms and medication use associated with allergic rhinitis with or without conjunctivitis and allergic asthma. Although several AIT guidelines exist, there remain unanswered questions about AIT that are relevant to everyday practice. Our objective was to prepare an evidence-based overview addressing the practical aspects of AIT in clinical practice based on published evidence and the experience of international experts in the field. Topics covered include interpretation and translation of clinical trial data into everyday clinical practice (eg, allergen doses and treatment duration), assessment of risk and treatment of local and systemic allergic reactions, recommendations for improvement of AIT guidelines, and identification of appropriate data for seeking regulatory approval, to name a few. Many informational gaps in AIT practice need further evaluation as products and practices evolve.

DOI： 10.1016/j.jaip.2020.04.071

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Cedar pollinosis (CP), a common form of seasonal allergic rhinitis (AR), is a substantial medical problem in Japan due to its high prevalence and severe symptoms. Omalizumab (anti-IgE therapy) has previously proven to be effective in CP/AR, but no studies for inadequately controlled severe CP/AR despite standard-of-care (SoC) have been conducted. OBJECTIVE: To determine the efficacy of omalizumab added to SoC in patients with inadequately controlled severe CP in a randomized, double-blinded, placebo-controlled, phase III study. METHODS: Adult/adolescent patients with severe CP whose symptoms were inadequately controlled despite nasal corticosteroids plus 1 or more oral medications in the previous 2 seasons were randomized to receive omalizumab (n = 162) or placebo (n = 175). All patients received concomitant antihistamines and nasal corticosteroids as SoC. The primary endpoint was the mean nasal symptom score during the severe symptom period. Secondary endpoints included mean ocular symptom score, quality of life (QoL), and safety. RESULTS: The SoC + omalizumab treatment had statistically significantly and clinically important lower nasal (least squares mean difference, -1.03, P < .001) and ocular (-0.87, P < .001) symptom scores compared with SoC + placebo, respectively. Differences in scores for individual components of nasal and ocular symptoms were also statistically and clinically significant. SoC + omalizumab also improved QoL scores as overall and in all domains. No unexpected safety signals were observed. CONCLUSIONS: In patients with severe CP, omalizumab added to SoC demonstrated consistent efficacy in improving symptoms and QoL, and was well tolerated. These results indicate that omalizumab could be a promising therapeutic option for severe CP/AR.

DOI： 10.1016/j.jaip.2020.04.068

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND AND OBJECTIVE: Nasal symptoms of allergic rhinitis can be reduced with allergen-specific subcutaneous immunotherapy (SCIT). However, the mechanisms underlying the effectiveness of SCIT for Japanese cedar pollinosis are not well understood. We studied changes in the numbers of metachromatic cells, eosinophils and neutrophils in nasal swabs following SCIT for Japanese cedar pollinosis. METHODS: Subjects were either untreated or given SCIT for 0.5 to 13 years duration. For the 2019 seasons, nasal swabs were taken in the pollinosis preseason (immunotherapy n = 36; untreated control, n = 62) and in the pollinosis season (immunotherapy n = 45; untreated control n = 46) and the numbers of mast cells, eosinophils and neutrophils assessed by microscopy. RESULTS: There were significant improvements in symptom severities following SCIT in comparison to untreated subjects (P < .0003, the Mann-Whitney U test) in preseason, and (P < .00001) in season. Metachromatic cell counts from nasal swabs of SCIT subjects in preseason and in the season were lower than those of untreated subjects (P = .0029 and P = .031, respectively). Eosinophil numbers in nasal swabs of subjects given SCIT were lower than in untreated subjects (P = .0031) in season, but not in preseason. There were no significant differences in degrees of neutrophilia between untreated and SCIT subjects in preseason and in season. CONCLUSION: One mechanism underlying the effectiveness of SCIT for Japanese cedar pollinosis involves a reduction in the number of metachromatic cells in nasal swabs in the preseason and an inhibition of increases in the number of metachromatic cells and eosinophils in season.

DOI： 10.1002/iid3.301

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND AND OBJECTIVE: Nasal symptoms were reduced following allergen-specific sublingual immunotherapy (SLIT) for allergic rhinitis. The mechanisms underlying the effectiveness of SLIT for Japanese cedar pollinosis are poorly understood. We studied changes in the numbers of metachromatic cells, eosinophils, and neutrophils following SLIT for Japanese cedar pollinosis. METHODS: Nasal swabs were taken in the preseason (n = 32) and in pollinosis season (n = 49) from subjects given sublingual drop immunotherapy for an average duration of 1.5 years. The numbers of metachromatic cells (mast cells and basophils), eosinophils and neutrophils were determined and compared with those from untreated subjects in preseason (n = 65) and in season (n = 54). RESULTS: SLIT subjects had a significantly reduced frequency of moderate to most severe symptoms in comparison to untreated subjects in preseason (P < .001, the Mann-Whitney U test), and (P < .00001) in season. Metachromatic cell counts in nasal swabs of SLIT subjects in preseason and in season were lower than those of untreated subjects (P = .014, the Mann-Whitney U test) and (P = .00001) respectively. Eosinophil numbers in SLIT subjects were not significantly different than in untreated subjects in both preseason (P = .29) and in season (P = .09). However, when SLIT subjects in season were divided into those with greater than or equal to 1.5 years, or <1.5 years of SLIT duration, the degree of eosinophilia in those with SLIT greater than or equal to 1.5 years was significantly lower (P = .011) than in untreated patients, but not in those with SLIT less than 1.5 years (P = .9). There were no significant differences in neutrophil numbers in nasal swabs between untreated and SLIT subjects in preseason and in season. CONCLUSION: One of mechanisms underlying the effectiveness of sublingual drop immunotherapy for Japanese cedar pollinosis is a reduction of the number of metachromatic cells in preseason and in season. Eosinophilia was also reduced in season in those given SLIT for greater than or equal to 1.5 years.

DOI： 10.1002/iid3.314

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記述言語：日本語   出版者・発行元：日本口腔・咽頭科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Like asthma and atopic dermatitis, allergic rhinitis is an allergic disease, but of the three, it is the only type I allergic disease. Allergic rhinitis includes pollinosis, which is intractable and reduces quality of life (QOL) when it becomes severe. A guideline is needed to understand allergic rhinitis and to use this knowledge to develop a treatment plan. In Japan, the first guideline was prepared after a symposium held by the Japanese Society of Allergology in 1993. The current 8th edition was published in 2016, and is widely used today. To incorporate evidence based medicine (EBM) introduced from abroad, the most recent collection of evidence/literature was supplemented to the Practical Guideline for the Management of Allergic Rhinitis in Japan 2016. The revised guideline includes assessment of diagnosis/treatment and prescriptions for children and pregnant women, for broad clinical applications. An evidence-based step-by-step strategy for treatment is also described. In addition, the QOL concept and cost benefit analyses are also addressed. Along with Allergic Rhinitis and its Impact of Asthma (ARIA), this guideline is widely used for various clinical purposes, such as measures for patients with sinusitis, childhood allergic rhinitis, oral allergy syndrome, and anaphylaxis and for pregnant women. A Q&A section regarding allergic rhinitis in Japan was added to the end of this guideline.

DOI： 10.1016/j.alit.2020.04.001

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

近年になり、スギ花粉症などのアレルギー性鼻炎の増加が指摘されている。馬場らが中心となって1998年と2008年に全国の耳鼻咽喉科医師ならびにその家族を対象としたアンケートによる鼻アレルギー疫学調査が行われ、有病率の推移が詳細に報告されている。今回われわれは、前回の調査から11年後の2019年に同様の調査を行い、スギ花粉症、通年性アレルギー性鼻炎ならびにスギ以外の花粉症の有病率を同定した。アレルギー性鼻炎全体の有病率は49.2%、スギ花粉症単独の有病率は38.8%と前回調査に比べ大きく増加していた。さらに10歳代でスギ花粉症が著明に増加していることも明らかとなった。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J01099&link_issn=&doc_id=20200630280011&doc_link_id=%2Fdz0jibik%2F2020%2F012306%2F011%2F0485-0490%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdz0jibik%2F2020%2F012306%2F011%2F0485-0490%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Diacron-reactive oxygen metabolite (d-ROM) and biological antioxidant potential (BAP) levels in the serum of horses were measured (ponies, n = 15; thoroughbred, n = 31; other full-sized horses, n = 7). The mean d-ROM levels in horses were significantly higher (p < 0.001) than those in dairy cattle (n = 25) and dogs (n = 31). However, d-ROM levels in horses were lower than the standard levels reported in humans. When d-ROM and BAP levels were plotted graphically, the points for horses with a disease (ringbone in 1 Japanese sports horse, cellulitis in 1 thoroughbred, melanoma in 1 Lipizzaner) fell outside the group of points for other (non-diseased) horses. A similar separation was seen (using data from other authors) for a horse with Rhodococcus equi, a horse following castration surgery, and a mare following delivery. These results, comparing horses, other animals, and humans, are interesting from the standpoint of comparative medicine, and they contribute to the sparse literature available on d-ROM and BAP levels in animals. Because the level of d-ROM and BAP levels were changed depending on the situation of health, those indexes are promising as indices of health in horses.

DOI： 10.3390/ani10040617

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

IgE and mast cells play a pivotal role in various allergic diseases, including asthma, allergic rhinitis, and urticaria. Treatment with omalizumab, a monoclonal anti-IgE antibody, has significantly improved control of these allergic diseases and introduced a new era for the management of severe allergic conditions. About 10 years of experience with omalizumab treatment for severe allergic asthma confirmed its effectiveness and safety, reducing symptoms, frequency of reliever use, and severe exacerbations in patients with intractable conditions. Omalizumab is particularly useful in childhood asthma, where atopic conditions often determine clinical courses of asthma. Recently, omalizumab is approved for the treatment of chronic spontaneous urticaria (CSU) with the fixed dose of 300 mg. Although the mechanisms underlying the actions of omalizumab in CSU are not fully clarified, nearly 90% of patients with CSU showed a complete or a partial response to omalizumab treatment. Furthermore, omalizumab is just approved for the treatment of severe Japanese cedar pollinosis (JC) based on the successful results of an add-on study of omalizumab for inadequately controlled severe pollinosis despite antihistamines and nasal corticosteroids. For proper use of omalizumab to treat severe JC, co-administration of antihistamines is necessary, while patients should meet the criteria including strong sensitization to Japanese cedar pollen (≥class 3) and poor control under standard treatment. In the management of severe allergic diseases using omalizumab, issues including cost and concerns about relapse after its discontinuation should be overcome. At the same time, possibilities for application to other intractable allergic diseases should be considered.

DOI： 10.1016/j.alit.2020.01.004

PubMed

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記述言語：日本語   出版者・発行元：日本鼻科学会  

<p>日本鼻科学会では，2014年より学会主導による『鼻科基礎研究ハンズオンセミナー』を開催している。これは，耳鼻咽喉科臨床医の基礎研究に対するモチベーションや研究技術の向上，ひいては各大学間の研究を通じた横断的連携を図る目的で企画された。今回で6回目となる本セミナーを第58回日本鼻科学会総会・学術講演会（東京）において企画した。今回は，①マウスの取り扱い・疾患マウスモデルの作製法，②バイオインフォマティシャンによる次世代シーケンサーを用いたビッグデータの解析，③マルチプレックスアッセイの基礎と手技および④組織切片の作製方法の4つのテーマをそれぞれのブースで実演し，セミナー終了後に参加者にアンケート調査を実施した。参加者の93％からセミナーについて高い評価を得た。参加者の79％から「今後の継続を望む」という意見や参加者の約半数は「横のつながりを作れた」と回答した。本邦から発信する基礎鼻科学の新知見に直結する有意義なセミナーと考えられた。</p>

DOI： 10.7248/jjrhi.59.172

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記述言語：日本語   出版者・発行元：(株)ライフ・サイエンス  

花粉曝露室OHIO Chamberを用いて、1日目スギ花粉、2日目ヒノキ科花粉の連続曝露で誘発される鼻アレルギー症状に対するルパタジンフマル酸塩(以下ルパタジン)の効果を盲検下で検討した。スギ・ヒノキ科花粉症の被験者45例をルパタジンの用量維持群(1日目10mg、2日目10mg)、用量変更群(1日目10mg、2日目20mg)およびプラセボ群の3群(各群15例)に割りつけ、各花粉曝露1〜1.5時間前に研究薬を経口投与した。その結果、用量変更群の2日目ヒノキ科花粉曝露180分後の鼻3症状(くしゃみ、鼻汁、鼻閉)合計スコア変化量は、プラセボ群に比べて有意に抑制された。また、1日目スギ花粉曝露時の鼻3症状合計スコア変化量は、プラセボ群に比べてルパタジン群で抑制する傾向を示した。なお、後観察期間を含め、ルパタジン群に副作用は認められなかった。新規抗ヒスタミン薬のルパタジンは、スギ花粉飛散に続くヒノキ科花粉飛散による鼻アレルギー症状に対し、20mgへの増量処方を含めて、有効かつ安全な薬剤であることが示された。(著者抄録)

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記述言語：日本語   出版者・発行元：(一社)日本小児アレルギー学会  

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記述言語：日本語   出版者・発行元：(一社)日本小児アレルギー学会  

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記述言語：日本語   出版者・発行元：(一社)日本小児アレルギー学会  

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記述言語：日本語   出版者・発行元：(一社)日本小児アレルギー学会  

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記述言語：日本語   出版者・発行元：(有)科学評論社  

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記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

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記述言語：日本語   出版者・発行元：日本味と匂学会  

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DOI： 10.1016/j.alit.2019.03.007

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記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

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記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1177/1945892419831924

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記述言語：日本語   出版者・発行元：(公社)日本薬理学会  

アレルゲン免疫療法は、1960年代より行われてきた皮下免疫療法(subcutaneous immunotherapy:SCIT)の時代から、その高い有効性と、各種アレルギー疾患治療法の中でほぼ唯一「根治」が見込める治療法として、その評価が確立されてきた。さらに近年、SCITにおける煩雑な抗原投与法を大幅に改良した舌下免疫療法(sublingual immunotherapy:SLIT)薬が登場したことによって、2014年のシダトレンを皮切りに毎年のように新薬が上市される等、アレルギー性鼻炎の治療はまさにパラダイムシフトの時代を迎えている。一方その長い歴史の中で、アレルゲン免疫療法がどのようにして根治も目指せる高い有効性を発揮できるのか、その作用メカニズムの解析も進められてきたが、現在に至るまでその全容は解明されていない。今のところ、アレルゲンのIgE結合を阻害する抑制性抗体の産生や、Th1/Th2バランスの正常化、制御性T細胞の誘導等が、主たるメカニズムとして有力とされるが、それらを否定する報告も多い。われわれも最近、スギ花粉症を対象としたSLITの臨床研究を実施した中で、そのメカニズムの解明に挑戦した。特に、通常行われるプラセボとの比較ではなく、実薬を投与されていながら高い有効性を示した著効患者と、全く効果のみられなかった無効患者間での比較を行うことによって、さらに単一のパラメータ間ではなく、多くのパラメータを統合的に比較解析することによって、これまで知られていなかった、SLITの作用メカニズムに結びつく生体応答カスケードを含めた作用点が浮かび上がってきた。本稿では、アレルゲン免疫療法が有効性を発揮する作用メカニズムについて、われわれの最近の解析結果を紹介しながら論じてみたい。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J01200&link_issn=&doc_id=20190709430004&doc_link_id=130007678408&url=http%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F130007678408&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

記述言語：日本語   出版者・発行元：日本耳鼻咽喉科免疫アレルギー学会  

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記述言語：日本語   出版者・発行元：(一社)日本アレルギー学会  

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記述言語：日本語   出版者・発行元：(一社)日本アレルギー学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Rupatadine is a novel non-sedating second-generation H1-antihistamine with antiplatelet-activating factor activity, first marketed in Spain in 2003. It is used for treating allergic rhinitis in more than 80 countries. This study investigated its efficacy and safety in Japanese patients with seasonal allergic rhinitis (SAR). METHODS: This was a randomized, placebo-controlled, double-blind study conducted at 4 medical institutions in Japan (JapicCTI-152785). Adolescent and adult SAR outpatients aged 12-64 years entered a 1-week placebo run-in period. After eligibility was confirmed, patients orally received placebo, rupatadine 10 mg, or 20 mg once daily for 2 weeks. The primary endpoint was a change from baseline to second week of treatment in total 4 nasal symptom score (T4NSS). RESULTS: Nine hundred patients were randomly assigned to placebo, rupatadine 10 mg, or rupatadine 20 mg (302, 298, and 300 patients, respectively). The least squares mean difference in the primary endpoint between rupatadine and placebo was -1.085 for 10 mg, and -1.415 for 20 mg (analysis of covariance, both P < 0.001). The rates of adverse events were 6.6%, 14.1%, and 15.0% for placebo, rupatadine 10 mg, and rupatadine 20 mg, respectively. Somnolence was most frequently reported: 7.0% for rupatadine 10 mg and 7.3% for rupatadine 20 mg. No serious adverse drug reactions were observed, and no adverse events resulted in premature discontinuation. CONCLUSIONS: Rupatadine 10 and 20 mg were significantly superior to placebo in improving nasal and ocular symptoms of SAR, and were well tolerated.

DOI： 10.1016/j.alit.2018.08.011

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Crystalloid granuloma (CG) of salivary gland is an extremely rare inflammatory disease, and only 6 cases have been reported in the English literature. CG is histologically characterized by a granulomatous reaction to amylase crystalloid deposition. A 73-year-old woman presented with a painful left neck mass. Computed tomography depicted a mass located in the lower pole of the left parotid gland, suspicious for a tumoral lesion. Preoperative fine needle aspiration cytology found amylase crystalloid deposition with a few inflammatory cells. Surgical sections of the mass revealed formation of a granuloma containing abundant eosinophilic but glassy and transparent amorphous crystalloids, suggestive of α-amylase crystalloid. No neoplastic elements were detected. The case was eventually diagnosed with CG in the parotid gland. Our findings suggest that when we identify amylase crystalloids in fine needle aspiration cytology smears from the salivary gland, CG should be considered even if neoplasm is clinically or radiographically suspected.

DOI： 10.1177/1066896918791031

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DOI： 10.1016/j.jaip.2018.11.044

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Antihistamines targeting the histamine H₁ receptor play an important role in improving and maintaining the quality of life of patients with allergic rhinitis. For more effective and safer use of second-generation drugs, which are recommended by various guidelines, a classification based on their detailed characteristics is necessary. Antihistamines for first-line therapy should not have central depressant/sedative activities. Sedative properties (drowsiness and impaired performance) are associated with the inhibition of central histamine neurons. Brain H₁ receptor occupancy (H₁RO) is a useful index shown to be correlated with indices based on clinical findings. Antihistamines are classified into non-sedating (<20%), less-sedating (20⁻50%), and sedating (≥50%) groups based on H₁RO. Among the non-sedating group, fexofenadine and bilastine are classified into "non-brain-penetrating antihistamines" based on the H₁RO. These two drugs have many common chemical properties. However, bilastine has more potent binding affinity to the H₁ receptor, and its action tends to last longer. In well-controlled studies using objective indices, bilastine does not affect psychomotor or driving performance even at twice the usual dose (20 mg). Upon selecting antihistamines for allergic rhinitis, various situations should be taken into our consideration. This review summarizes that the non-brain-penetrating antihistamines should be chosen for the first-line therapy of mild allergic rhinitis.

DOI： 10.3390/ijms20010213

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.2196/10450

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Objective: Long-term safety and efficacy of 10- and 20-mg rupatadine in Japanese patients with perennial allergic rhinitis (PAR) were investigated in a 52-week open-label study (JapicCTI-152952, clinicaltrials.jp). Methods: The rupatadine dose was fixed to 10 mg once daily for the first 2 weeks. Thereafter, the study investigator was allowed to increase the dosage to 20 mg if the response was insufficient. Safety was evaluated on the basis of treatment-emergent adverse events, laboratory findings, and vital sign measurements. The primary efficacy endpoint was changed from baseline to Week 2 in the total 4 nasal symptom score. Secondary efficacy endpoints included changes over time in ocular symptoms, patient and physician clinical overall impression, and patient quality-of-life. Results: Seventy-two immunoglobulin E positive patients (mean age = 32.1 years), consisting of 58 adults (age ≥ 18 years) and 14 adolescents (12-17 years), were enrolled. Ninety-four treatment-emergent adverse events were reported in 48 patients (66.7%), including nine adverse drug reactions in nine patients (12.5%). The most frequently reported adverse drug reaction was somnolence (9.7%). The primary and secondary efficacy endpoints demonstrated a statistically significant clinical benefit with rupatadine. The rupatadine dose was increased from 10 to 20 mg in 36 patients (50.0%), which resulted in better symptom management. Conclusions: Rupatadine 10- and 20-mg once-daily doses were well tolerated in long-term use. Updosing to 20 mg is a reasonable option in PAR patients whose symptoms cannot be controlled effectively by the 10-mg dose.

DOI： 10.1080/21556660.2019.1614005

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

From the era of subcutaneous immunotherapy (SCIT) in 1960s, allergen immunotherapy (AIT) has been established as a highly effective and curable treatment for allergic diseases. Furthermore, the recent appearance of sublingual immunotherapy (SLIT) in which the complicated administration procedure in SCIT was improved has been causing paradigm shifts in the treatment of allergic rhinitis. During the long history of AIT, the mechanisms by which this therapy leads its strong efficacy have been investigated but not fully clarified yet. The production of blocking antibodies that interrupt allergen-IgE binding, normalization of Th1/Th2 balance, and introduction of regulatory T cells are the major candidate mechanisms, though there are several conflicting reports. In our recent clinical study of SLIT against Japanese cedar pollinosis, we also tried to elucidate its mechanisms. Especially by comparing high-responder and non-responder patients using integrated analysis with multiple data, not by comparing with a placebo control group using individual data, we have successfully identified several target molecules and cascades of SLIT. Herein, we would like to describe the potential mechanisms by which AIT exhibits its strong efficacy with referring our recent novel findings.

DOI： 10.1254/fpj.154.23

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Different clinical trials showed the superior efficacy of rupatadine compared to placebo at improving seasonal allergic rhinitis (SAR) symptoms, but no study has assessed if the response promoted is clinically meaningful. METHODS: This study is a pooled analysis of data of seven randomized, double-blind, placebo-controlled SAR studies comparing responder proportions upon treatment with rupatadine (10 or 20 mg) or placebo. We evaluated the following symptom scores at baseline (Visit 1) and over 14 days of treatment: Total 4 Nasal Symptom Score (T4NSS), Total 2 Ocular Symptom Score (T2OSS) and Total 6 Symptom Score (T6SS). The proportion of responders (50% and 75% response) and the time to response were compared between groups on days 7 (Visit 2) and 14 (Visit 3). Responder rates were compared between groups on days 7 and 14 for the complete/near-to-complete response for T4NSS (TN4SS score ≤ 2 and each symptom score ≤ 1) and T6SS (T6SS score ≤ 3 and each symptom score ≤ 1). RESULTS: Data from 1470 patients were analyzed: 332 treated with placebo, 662 with rupatadine 10 mg and 476 with rupatadine 20 mg. The reduction in T4NSS, T2OSS and T6SS over 14 days of treatment relative to baseline was statistically higher in rupatadine groups vs the placebo group, with greater improvements in the 20 mg group. A statistically higher proportion of patients reached the 50% and 75% response for T4NSS, T2OSS and T6SS in rupatadine groups compared to the placebo group across the visits. Among rupatadine-treated patients, those receiving 20 mg compared favourably for both cut-off responses. The time to achieve a proportion of responders was shorter in the rupatadine 20 mg group than in the rupatadine 10 mg and placebo groups for all the symptom scores. The number of patients who achieved a complete/near-to-complete response for both symptom scores was higher in rupatadine groups than in the placebo group, with higher proportions in the 20 mg group. CONCLUSIONS: This responder analysis confirms the superior efficacy of rupatadine vs placebo to treat SAR. Rupatadine promoted higher proportions of responders according to stringent response criteria and in a dose-dependent manner, with faster and higher response rates in the 20 mg group.

DOI： 10.1186/s13601-019-0293-4

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The SQ house dust mite (HDM) sublingual immunotherapy (SLIT)-tablet (TO-203, Torii, Japan/ALK, Denmark) treatment has been effective against respiratory allergic diseases in patients aged ≥12 years during European, Japanese, and North American trials. This trial was conducted to investigate the efficacy and safety of this treatment in Japanese children (5-17 years) with moderate-to-severe HDM allergic rhinitis (AR). METHODS: In this randomized, double-blind, placebo-controlled trial, 458 Japanese children were randomly assigned to a daily SQ HDM SLIT-tablet [10 000 Japanese Allergy Unit (JAU), equivalent to 6 SQ-HDM in Europe and the US] or placebo (1:1) treatment for 1 year. Inclusion required an AR symptom score of ≥7 on at least 7 days during a 14-day run-in period while symptomatic treatment was withdrawn. The primary endpoint was the total combined rhinitis score (TCRS) comprising AR symptom and medication scores during the last 8 weeks of the treatment period. RESULTS: The analysis of primary endpoint demonstrated statistically significant absolute reduction in TCRS of 1.22 with a relative difference of 23% (95% confidence interval, 14% to 31%) in the 10 000 JAU compared with placebo. Predefined stratified analyses revealed the same degree of efficacy of 1.11 (P = 0.002), 21% (8% to 32%) and 1.36 (P = 0.001), 26% (11% to 38%), respectively, in pediatric (5-11 years) and adolescent subjects (12-17 years). The treatment was well tolerated by both pediatric and adolescent subjects. CONCLUSION: This trial, for the first time, demonstrated the efficacy and safety of the HDM SLIT-tablet in pediatric patients with moderate-to-severe HDM AR (JapicCTI-152953).

DOI： 10.1111/all.13544

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記述言語：日本語   出版者・発行元：(公財)東京都福祉保健財団人材養成部職員研修室  

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記述言語：英語  

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記述言語：日本語   出版者・発行元：(一社)日本めまい平衡医学会  

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DOI： 10.1183/13993003.congress-2018.PA964

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記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

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DOI： 10.4168/aair.2018.10.5.562

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記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

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記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

This study investigates bromine (Br) concentration and its relationship with iodine concentration in serum samples of 86 horses. The mean serum Br concentration in horses pastured on green grass near the seashore was significantly higher (P<0.001) than that in horses pastured in a sand paddock. A significantly negative correlation (r=-0.479, P<0.01) between the serum Br and iodine concentrations was evident in the horses that pastured on green grass. The concentrations of several elements such as sodium and potassium were virtually constant in the serum. In addition, there were elements present below the detection limit of the analytical instruments used. In contrast, it was suggested that geological differences have a marked influence on serum Br concentrations in animals. Thus, we hypothesized that serum Br concentration in horses is a possible indicator reflecting geological differences.

DOI： 10.1292/jvms.17-0457

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記述言語：日本語   出版者・発行元：日本口腔・咽頭科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.alit.2018.06.001

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The emedastine patch was developed in Japan as the first transdermal drug delivery system of emedastine difumarate for allergic rhinitis. METHODS: A multicenter, randomized, double-blind, placebo-controlled, parallel-group comparison was conducted in patients with seasonal allergic rhinitis. Patients were administered Emedastine patches (4 or 8 mg), placebo, or levocetirizine hydrochloride (5 mg tablet) once daily for 2 weeks (double-dummy technique). The primary objective was superiority to placebo by the change of the total nasal symptom score (sneezing, rhinorrhea, and nasal congestion) in Week 2. Levocetirizine was a reference drug and not a comparator in this study. RESULTS: A total of 1276 patients were randomized to receive the 4 mg emedastine patch (n = 384), 8 mg emedastine patch (n = 382), placebo (n = 384), or levocetirizine (n = 126). The least squares mean (LSM) of the change from baseline of the total nasal symptom score (TNSS) in Week 2 was significantly larger in both emedastine patch groups than in the placebo group (adjusted p < 0.0001). In secondary analysis, LSM of the change in the TNSS was -1.20, -1.49, -0.44, and -1.32 in the 4 mg emedastine patch, 8 mg patch, placebo, and levocetirizine, respectively. Reductions in the number of episodes and scores of individual nasal symptoms were all significantly larger throughout the day in the emedastine patch groups than the placebo group (all p < 0.05). No clinically significant safety problems occurred. CONCLUSIONS: The emedastine patch (4 and 8 mg) effectively and safely controlled symptoms of seasonal allergic rhinitis with sustained action throughout the day. STUDY REGISTRATION: JapicCTI-153092.

DOI： 10.1016/j.alit.2017.12.005

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DOI： 10.1016/j.alit.2018.02.003

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記述言語：英語  

BACKGROUND: To evaluate the long-term safety of subcutaneous immunotherapy with TO-204, a standardized house dust mite (HDM) allergen extracts, we conducted a multicenter, open label clinical trial. METHODS: Japanese patients aged 5-65 years were eligible for the study, if they had HDM-induced allergic rhinitis (AR), allergic bronchial asthma (BA), or both. TO-204 was administered in a dose titration scheme, and the maintenance dose was determined according to the predefined criteria. The treatment period was 52 weeks, and patients who were willing to continue the treatment received TO-204 beyond 52 weeks. This clinical trial is registered at the Japan Pharmaceutical Information Center (Japic CTI-121900). RESULTS: Between July 2012 and May 2015, 44 patients (28 with AR and 16 with allergic BA) were enrolled into the study. All patients were included in the analysis. The duration of treatment ranged from 23 to 142 weeks and the median maintenance dose was 200 Japanese allergy units (JAU). Adverse events occurred in 22 patients (50%). The most common adverse event was local reactions related to the injection sites. Four patients experienced anaphylactic reactions when they were treated with the dose of 500 JAU. Two patients experienced anaphylactic shock with the doses of 1000 JAU at onset. These 6 patients could continue the study with dose reduction. CONCLUSIONS: Safety profile of TO-204 was acceptable in Japanese patients with HDM-induced AR or allergic BA. Higher doses should be administered carefully, because the risk of anaphylaxis increased at doses of 500 or 1000 JAU.

DOI： 10.1016/j.alit.2017.11.004

PubMed

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掲載種別：研究論文（学術雑誌）  

© 2017 Elsevier B.V. Objective: Clarification of the association between the swallowing function and respiratory and phonatory functions. Methods: The subjects were 30 patients with a chief complaint of swallowing disorder with clear consciousness capable of retaining a sitting position. Patients with organic and functional diseases of the larynx were excluded. Twenty-two and eight patients were male and female, respectively, and the mean age was 77.0 ± 14.6 years old. The chest expansion score was measured as an index of the respiratory function, and the maximum phonation time (MPT) was measured as an index of the phonatory function. The presence or absence of aspiration was judged using videoendoscopic swallowing study (VESS) and videofluoroscopic swallow studies (VFSS). The patients were divided into those with and without aspiration, and the chest expansion score and MPT were compared. In addition, the distance of laryngeal elevation was measured in the lateral view of VFSS, and its correlations with the chest expansion score and MPT were closely analyzed. To evaluate reliability of the test, the distance of laryngeal elevation and videoendoscopic score were compared between the presence and absence of aspiration. Results: The distance of laryngeal elevation was significantly shortened and the videoendoscopic score was significantly higher in the group with aspiration, as previously reported. On comparison of the chest expansion score between the groups with and without aspiration, no significant difference was noted at the axillary or xiphoid process level, and shortening was significant only at the 10th rib level in the group with aspiration. On comparison of MPT, it was significantly shortened in the group with aspiration. In addition, a significant positive correlation with the distance of laryngeal elevation was noted in both chest expansion score and MPT. Conclusion: It was suggested that declines of the respiratory and phonatory functions are risk factors of aspiration through limiting laryngeal elevation, and the chest expansion score at the 10th rib level and MPT are useful for screening of aspiration.

DOI： 10.1016/j.anl.2017.08.009

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記述言語：日本語   出版者・発行元：耳鼻咽喉科臨床学会  

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記述言語：日本語   出版者・発行元：(一社)日本アレルギー学会  

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記述言語：英語  

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記述言語：日本語  

DOI： 10.11406/rinketsu.59.1988

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.anl.2017.05.009

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：OceanSide Publications Inc.  

Background: It is difficult to identify the onset of allergic rhinitis in infants because making a conclusive diagnosis can be challenging. Objective: We used a combination of cell differentials in nasal swabs and immunoglobulin E (sIgE) antibody values to food and inhalant allergens to make the diagnosis and identify relevant allergens for investigation of the onset of allergic rhinitis. Methods: We studied 302 children, 2 to 120 months old, who visited our clinic for rhinorrhea. Nasal swabs were taken from all children, and neutrophils (N), eosinophils (Eo), and mast cells (Mc) were identified by nasal cytology and their numbers were estimated. Levels of sIgE antibodies to various food and inhalant allergens were determined in patients with nasal Eo and Mc. Results: Percentages of participants with Eo-Mc and Eo-Mc-N at 2-14 (n &lt
84), 15-24 (n &lt
57), 25-60 (n &lt
73), and 61-120 months of age (n &lt
88) were 20, 23, 58, and 65%, respectively. There were no significant differences between the 2-14 and 15-24, and 25-60 and 61-120 months age groups, but there was a significant difference between the 15-24 and 25-60 months age groups (p &lt
0.00013). The percentages of participants with sIgE antibodies to food and inhalant allergens as solitary or main allergen were 12%/0% at 2-14 months old, 10.5%/7% at 15-24 months old, 1.3%/42.4% at 25-60 months old, and 0%/56.8% at 61-120 months old, respectively with a significant difference between 15-24 and 25-60 months old groups (p &lt
0.00025) for inhalant allergens. Conclusion: Allergic rhinitis associated with inhalant allergens in infants 15 months of age is rare, but it is tempting to postulate that symptoms of rhinitis in these infants may be associated with sIgE antibodies to food allergens. Transition of sIgE responses from food to inhalant allergens occurred after 15 months of age, and sIgE antibodies to inhalant allergens were predominant after 25 months.

DOI： 10.2500/ajra.2018.32.4503

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Medical Association of Nippon Medical School  

Carcinosarcoma (CS) is a rare tumor, consisting of both carcinomatous and sarcomatous components. In this paper, we present a case of CS arising from a pleomorphic adenoma (PA) of the submandibular gland. A 64-year-old Japanese man presented with a left submandibular mass that had developed for 20 years with complaints of pain for the last 3 months. Magnetic resonance imaging showed a lesion involving the left submandibular gland. The patient underwent total dissection of the left submandibular gland and left cervical lymph nodes. Upon gross examination, the mass appeared completely covered by fibroadipose tissue measuring 46×42×45 mm
sectioning revealed a solid-white nodule with central bleeding and necrosis, invading into the surrounding adipose tissue. Microscopically, the presence of carcinomatous and sarcomatous components in the fibro-myxomatous stroma was detected, suggestive of pre-existing PA. The carcinoma component was diagnostic of salivary adenocarcinoma, not otherwise specified, whereas the sarcomatous component exhibited features of osteosarcoma characterized by formation of osteoid. As the border between the carcinomatous and sarcomatous components was not evident, CS may have occurred via transformation of the carcinoma into sarcoma. Tumor metastasis was detected in the cervical lymph nodes. Immunohistochemically, AE1/AE3 expression was noted in the carcinomatous component, but not in the osteosarcoma component. Both components were diffusely positive for vimentin. Four months after the operation, the patient developed a metastatic CS lesion in the lung, suggesting tumor aggression.

DOI： 10.1272/jnms.2018_85-8

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: Macrolide therapy is an important conservative therapy for chronic rhinosinusitis, especially in Japan. The mechanism underlying this therapy involves anti-inflammatory and not antimicrobial activity. However, the administration of long-term low-dose macrolides (LTLMs) causes an increase in the number of antibiotic-resistant bacteria. EM900 is a derivative of erythromycin (EM), with anti-inflammatory but not antibacterial effects. It does not induce macrolide-resistant bacteria as shown by LTLM. In the present study, we analyzed the inhibitory effects of EM900 in comparison with those of clarithromycin (CAM) on inflammatory cytokine production in human nasal epithelial cells (HNEpCs). METHODS: After HNEpCs were cultured for 4 days, CAM or EM900 was added into the culture, followed by stimulation with tumor necrosis factor (TNF)-α. Interleukin (IL)-8 and vascular endothelial growth factor (VEGF) levels were measured using real-time polymerase chain reaction (RT-PCR) and an enzyme-linked immunosorbent assay (ELISA). RESULTS: Both the ELISA and RT-PCR showed that EM900 and CAM significantly inhibited IL-8 production in HNEpCs. In contrast, EM900 and CAM did not suppress the increased VEGF production when HNEpCs were stimulated with TNF-α. CONCLUSION: EM900 showed an anti-inflammatory effect, such as that of CAM, due to the inhibitory effect on IL-8 production in HNEpCs.

DOI： 10.1272/jnms.JNMS.2018_85-42

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The influence of S-carboxymethylcystein (S-CMC) on the proliferation ability of goblet cells in nasal polyp epithelium in response to inflammatory stimulation was examined. METHODS: The subjects were patients with chronic paranasal sinusitis. An epithelial cell culture system was established using nasal polyp mucosa excised during endoscopic paranasal sinus surgery. The samples were divided into 4 groups (group a: control group, group b: 10 ng/mL tumor necrosis factor-α (TNF-α) treatment group, group c: 10-7 M S-CMC and 10 ng/mL TNF-α treatment group, group d: 10-5 M S-CMC and 10 ng/mL TNF-α treatment group). The total number of epithelial cells and number of goblet cells were measured under a microscope, and the ratio of goblet cells to the total number of epithelial cells was calculated. RESULTS: In group b, 10 ng/mL of TNF-α significantly increased the number of goblet cells compared with group a, suggesting involvement of TNF-α in goblet cell proliferation. In addition, the number of goblet cells significantly decreased in group d compared with that in group b, and it also decreased in group c compared with that in group b, although the difference was not significant, and the decrease was smaller than that in group d, suggesting that S-CMC inhibited goblet cell proliferation in a concentration-dependent manner. CONCLUSION: TNF-α promoted goblet cell proliferation in nasal polyps, suggesting its influence on nasal polyp formation. As S-CMC inhibited inflammatory stimulation-induced goblet cell proliferation in nasal polyp epithelium, it may be useful for the treatment of sinusitis.

DOI： 10.1272/jnms.JNMS.2018_85-33

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

DOI： 10.15036/arerugi.67.938

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We presented a case with non-Traumatic superficial temporal artery (STA) aneurysm which was diagnosed appropriately both clinically and pathologically. A 76-year-old female patient complained of a mass in the right pre-Auricular region. We diagnosed STA aneurysm without history of head trauma After resection, pathological diagnosis was true aneurysm, which was related to arteriosclerosis, but not to trauma. This patient had been observed for the comorbid abdominal aortic aneurysm, which was due to arteriosclerosis. We can conclude that this patient was with multi-Aneurysms caused by arteriosclerosis.

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記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

内視鏡下副鼻腔手術は多くの耳鼻咽喉科医が経験する手術の1つである。副鼻腔は複雑な構造と、その部位から、手術により合併症が少なからず発生し得る。また、海外では合併症の訴訟が多数あると報告されており、術前にインフォームド・コンセントを得ることは必須である。しかし、どのように手術説明が行われているかの検討はなされていない。本調査では、手術説明内容の現状を把握することで、その問題点を抽出した。平成24年11月から平成27年10月で10施設の内視鏡下副鼻腔手術の年間平均手術件数、執刀医の人数、手術説明の担当者、合併症に関する説明内容および合併症数を調査した。平均年間症例数は232例、平均執刀医数は3.3人、執刀医の90%が手術説明を行っていた。すべての施設で髄液漏、眼窩損傷について説明が行われていた。3年間の手術総件数7000件のうち、0.3%(21症例)に合併症を認めた。内訳は中等度以上の眼窩損傷が0.18%(13症例)、髄液漏が0.07%(5症例)、出血による再手術が0.04%(3症例)であった。過去3年間で眼窩損傷を生じたことのある施設とそうでない施設では、手術説明内容に差異は認められなかった。これは、どの施設においても眼窩損傷のリスクが十分に説明されていることによるものと考えた。0.1%程度の頻度で生じる合併症である眼窩損傷、髄液漏の説明は必須と考える。(著者抄録)

DOI： 10.7248/jjrhi.56.557

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J01675&link_issn=&doc_id=20180122310002&doc_link_id=10.7248%2Fjjrhi.56.557&url=https%3A%2F%2Fdoi.org%2F10.7248%2Fjjrhi.56.557&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：日本語   出版者・発行元：(株)医学書院  

76歳女。2年前に腹部大動脈瘤を指摘され経過観察中であった。初診3ヵ月前に右耳前部腫瘤を自覚し、頸部CTでは軸位断で右耳前部に浅側頭動脈の走行に一致した腫瘤を認め、動脈と同等で、均一に造影された。冠状断では輸入血管を確認できた。以上の所見と局所所見を合わせて右浅側頭動脈瘤と診断し、初診5ヵ月後に全身麻酔下に摘出術を施行した。術中所見では瘤は暗赤色で、心拍と一致した拍動を認めた。近・遠位側の浅側頭動脈を同定した上で瘤の周囲を切離し、動脈を近位側と遠位側で結紮・切断して瘤を摘出した。病理組織学的所見では血管内膜には不規則な線維性の肥厚を著明に認め、肥厚部の中膜弾性板には断裂・変性等を認め、一部では中膜弾性板が消失していた。以上より、動脈硬化性変化による真性動脈瘤と診断した。併存疾患から全身の動脈硬化が示唆されたことも含めて、非外傷性動脈硬化性浅側頭動脈瘤と診断した。

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記述言語：日本語   出版者・発行元：(一社)日本耳科学会  

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記述言語：日本語   出版者・発行元：日本口腔・咽頭科学会  

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記述言語：英語   出版者・発行元：一般社団法人日本アレルギー学会  

Background: Complementary and alternative medicine (CAM) is extensively used in patients with allergic diseases worldwide. The purpose of this study was to investigate the actual situation of CAM practice in the treatment of allergic rhinitis. Methods: We distributed questionnaires to otolaryngologists at 114 facilities in Japan. The subjects who participated in this study included children <16 years of age and adults 16 years of age diagnosed with allergic rhinitis by otolaryngologists. The survey was performed in the period from September 2007 to August 2009. Furthermore

DOI： 10.1016/j.alit.2016.10.006

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MOSBY-ELSEVIER  

Background: The SQ house dust mite (HDM) sublingual immunotherapy (SLIT) tablet has been approved in 11 European countries and Japan for patients with HDM-induced respiratory allergic disease.
Objective: This trial was conducted to confirm the efficacy and safety of the SQ HDM SLIT tablet in Japanese patients with moderate-to-severe HDM-induced allergic rhinitis (AR).
Methods: The trial was a randomized, double-blind, placebo-controlled trial including 946 Japanese adults and adolescents (12-64 years). Subjects were randomly assigned to daily treatment with the SQ HDM SLIT tablet at a dose of 10,000 Japanese allergy units (JAU) or 20,000 JAU or to placebo (1: 1: 1). The primary end point was the total combined rhinitis score (TCRS), which is composed of AR symptom and medication scores during the efficacy evaluation period. Symptom and medication scores of AR and conjunctivitis, rhinitis quality of life, and symptom-free and symptom-severe days were evaluated as secondary end points.
Results: Analysis of the primary end point demonstrated statistically significant reductions in TCRSs of 1.15 (22%, P &lt; .001) in the 10,000-JAU group and 0.99 (19%, P &lt;. 001) in the 20,000-JAU group compared with the placebo group. The statistically significant treatment effect was evident from 12 weeks of treatment onward. All secondary end points, except AR medication score, were statistically significant in favor of active treatment compared with placebo. Post hoc analysis of TCRSs in adolescents showed the same efficacy as in adults (P&lt;.05). The treatment was well tolerated by both adults and adolescents.
Conclusion: The trial confirmed the efficacy and safety profile of the SQ HDM SLIT tablet in Japanese adult and adolescent patients with moderate-to-severe HDM-induced AR. These data support the robust efficacy and safety profile of previously reported European data.

DOI： 10.1016/j.jaci.2016.09.043

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：JAPANESE SOCIETY ALLERGOLOGY  

Background: Environmental exposure chambers have been used to expose subjects to aeroallergens to investigate the efficacy of prophylactic treatment with symptomatic agents in Japan. We first examined the therapeutic effect of bilastine (BIL), a novel non-sedative second-generation Hi-antihistamine, in subjects with Japanese cedar pollinosis using an artificial exposure chamber (OHIO Chamber).
Methods: This was a randomized, double-blind, four-way crossover, placebo- and active-controlled phase II study (trial registration number JapicCTI-132213). Subjects were exposed to cedar pollen (8000 grains/m(3)) for 2 h on Day 1 and 4 h each on Day 1 and 2. BIL 10 or 20 mg, placebo, or fexofenadine hydrochloride (FEX) 60 mg was administered orally 1 h after the start of pollen exposure on Day 1. Placebo or FEX was administered 12 h after the first dosing. The primary efficacy endpoint was the sum of total nasal symptom score (TNSS) from 0 to 3 h after the Day 1 dosing.
Results: We enrolled 136 subjects and the sum of TNSS on Day 1 of the three active treatments was significantly lower than that of placebo and was maintained up to 26 h after the first dosing (Day 2). The sum of TNSS or sneezing score on Day 1 after BIL 20 mg was more significantly decreased than after FEX. Moreover, BIL showed a faster onset of action than FEX.
Conclusions: We demonstrated the efficacy, rapid onset, and long duration of action of BIL in subjects with Japanese cedar pollinosis exposed to cedar pollen using the OHIO Chamber. Copyright (C) 2016, Japanese Society of Allergology. Production and hosting by Elsevier B.V.

DOI： 10.1016/j.alit.2016.06.009

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記述言語：日本語   出版者・発行元：一般社団法人 日本耳鼻咽喉科学会  

DOI： 10.3950/jibiinkoka.120.1381

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   出版者・発行元：日本動物看護学会  

J-GLOBAL

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

In this study, iodine and thyroxin (T4) concentrations in the serum of 69 horses were investigated. Higher iodine concentrations were obtained from the horses housed in Chiba Prefecture. In contrast, T4 concentrations of horses at Shizuoka Prefecture were higher than those of horses at Chiba Prefecture. There was a significant correlation (r = 0.643, P < 0.001) between the iodine and T4 concentrations of horses at Saitama and Shizuoka prefectures. Although a significant correlation (r = 0.794, P < 0.001) was also observed in the investigation of all horses at Chiba Prefecture, the distribution area of the data was separated from the data of horses housed in Saitama and Shizuoka prefectures. A higher iodine concentration in the environment is expected in the sampling area at Chiba Prefecture. Thus, it was suggested that the concentrations of iodine in the serum of horses are influenced by geological differences. It was thought that equine serum is a useful sample for monitoring.

DOI： 10.1007/s10661-016-5221-7

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Respiratory virus infections are involved in asthma exacerbations. However, there are no reports of the relationship between respiratory virus infections and Japanese cedar pollinosis. OBJECTIVE: We studied the relationship between respiratory viral infection and the appearance of preseasonal symptoms and the severity of seasonal symptoms in Japanese cedar pollinosis. METHODS: In 36 patients with asthma and with no symptoms (PreAsyP) and 54 patients with asthma and with symptoms (PreSyP) before the cedar pollen shedding commenced (preseason), and 37 patients with mild-to-moderate severity (InMild/Mod) and 45 patients with severe to extreme severity (InSev/Ext) after cedar shedding commenced (in season), the occurrence of respiratory viruses and nasal smear cytology were examined. RESULTS: In total, seven infections with respiratory viruses were detected among the subjects. Human rhinovirus (HRV) C infection was detected in one subject in each of the PreAsyP and PreSyP groups, and one HRVA infection occurred in the InMild/Mod group. In the InSev/Ext group, one HRVA, one HRVC, one respiratory syncytial virus, and one human metapneumovirus were detected. There was no significant difference in the rate of detection of viral infections between the PreAsyP and the PreSyP groups (p = 0.077), and between the InMild/Mod group and the InSev/Ext group (p = 0.24, Wilcoxon rank sum test). When cells types in nasal smears were identified and their abundance examined, the rate of neutrophilia in the subjects in the PreSyP group was 54%, which was statistically higher (p < 0.01) than the subjects in the PreAsyP group (25%). Interestingly, in the subjects in the InSev/Ext group, the proportion of eosinophils (40%) was larger (p < 0.05) than in the subjects in the InMild/Mod group (19%). CONCLUSION: These results provided no evidence that respiratory virus infections contributed to preseasonal symptoms and severity in season of Japanese cedar pollinosis. Nasal neutrophilia was related to preseasonal symptoms, whereas nasal eosinophilia was related to severity of symptoms during the pollen season.

DOI： 10.2500/ar.2016.7.0157

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: Epigenetics is now considered to be crucially involved in normal genetics and differentiation and in pathological conditions, such as cancer, aging, and inflammation. Epigenetic mechanisms involve DNA methylation and histone modifications. The purpose of this study was to investigate the effects of inflammation on epigenetics in young subjects and the effect of aging. MATERIALS AND METHODS: The palatine tonsils were extracted from child and adult patients with chronic tonsillitis. Hematoxylin-eosin staining was performed to examine the morphology of the palatine tonsils. A fluorescence immunological examination was also performed to detect acetyl-histone H3 or dimethyl-histone H3. Confocal scanning microscopy was used for observations. RESULTS: Acetylated histone H3 was detected in tonsils from child patients but not from adult patients. Dimethylated histone H3 was not detected in tonsils from either group of patients. Degeneration of the tonsillar structures was apparent in tonsils from adult patients. DISCUSSION: The differential expression of acetylated histone H3 Lys9 may reflect immunological differences between young and aged tonsils. The decrease observed in the activity of histone methyltransferase induced the down-regulated expression of methylated histone H3. CONCLUSION: Our results suggest that epigenetic changes participate in chronic inflammation and aging in the palatine tonsils. Although the results do not lead to a direct treatment, the epigenetic pathogenesis of chronic inflammation, such as immunoglobulin A nephropathy, by focal infections will be described in greater detail in future studies, which will lead to new treatments being developed.

DOI： 10.1272/jnms.83.54

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Objective: To determine the efficacy of the antihistamine bepotastine on treating nasal symptoms in patients with Japanese cedar and cypress pollinosis, based on two previous studies that looked at bepotastine OD's inhibitory effect on symptom onset after exposure. Design and methods: Randomized double-blind placebo controlled, parallel study. Twenty-eight volunteers with Japanese cedar and cypress pollinosis were randomly assigned into two experimental groups: a bepotastine-treated or a placebo control group. Subjects received either 10 mg bepotastine tablets or placebo tablets 1 day before entering an artificial exposure pollen chamber (OHIO Chamber) and also for three or more consecutive days. They were exposed to Japanese cedar and cypress pollen for 3 h per day for 2 days. Nasal and ocular symptoms were self-rated by each patient at regular intervals in addition to being objectively measured. Possible cognitive impairment was assessed by using the digit cancellation test (D-CAT). Results: In Study 1, under controlled conditions, there were no significant differences (p > .05) between subjects exposed to Japanese cedar pollen and those exposed to cypress pollen in terms of total nasal symptom score (TNSS). In Study 2, in the placebo group, the amount of nasal discharge and the number of sneezes did not diminish before cypress pollen exposure on the second day (p < .05). This suggests that an antihistamine can suppress the symptoms of hang over. No deterioration of work performance was observed in the bepotastine group after pollen exposure for 2 days, as measured by D-CAT (p > .05). Conclusion: We conclude that bepotastine can suppress allergy-related symptoms without impairing work performance in subjects with seasonal allergic rhinitis caused by Japanese cedar pollen or cypress pollen.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background: This study was conducted to evaluate the safety and tolerability, and population pharmacokinetics (PPK) of montelukast as well as efficacy in the treatment of perennial allergic rhinitis (PAR) in paediatric Japanese patients aged between 1 and 15 years. Methods: In this multi-centre, open-label trial, 87 paediatric Japanese patients with PAR received montelukast 4 mg oral granules (OG) for 4 weeks (1-5-year-olds, N = 15), 4 mg OG for 12 weeks (1-5-year-olds, N = 36), 5 mg chewable tablets (CT) for 12 weeks (6-9-year-olds, N = 18), or 5 mg CT for12 weeks (10-15-year-olds, N = 18). Clinical exams and laboratory assessments were conducted at study visits, and adverse events (AE) were monitored throughout the study up to 14 days after the last visit. Population pharmacokinetic approach was used to estimate AUC0-∞, Cmax, Tmax and apparent elimination half-life in each age group. Efficacy was assessed based on global evaluations by the subject's caregiver. Results: There were no serious AEs and one discontinuation due to an AE. The most common AEs in any of the treatment groups were nasopharyngitis, pharyngitis, and acute sinusitis. Montelukast exposure (AUC0-∞) was similar in the 1-5-year-old group and the 6-9-year-old group, but 19% lower in the 10-15-year-old group. Among all patients, the total proportion of patients whose global evaluation was "very much better" was 5.7% (week 2), 11.5% (week 4), and 16.9% (week 12) reflecting improvement in symptoms over time. Conclusion: Montelukast was generally well tolerated in Japanese children with PAR. AUC0-∞was similar in 1-5 and 6-9-year-olds, while a lower exposure was observed in the 10-15-year-old group likely due to differences in bodyweight. The exposure in Japanese paediatric patients was generally consistent with that in non-Japanese paediatric and adult patients. As assessed by the patients' caregivers, montelukast also demonstrated symptomatic improvement based on global evaluations of PAR.

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: In the 1990s, the Japanese Society of Allergology (JSA) standardized Japanese cedar pollen allergen vaccines. In the present study, the task force for house dust mite (HDM) allergen standardization of the Committee for Allergens and Immunotherapy of JSA reports the standardization of HDM allergen vaccines in Japan. METHODS: In vivo allergenic potency was determined by intradermal testing of 51 Japanese adults with positive serum specific IgE to HDM allergens. In vitro total IgE binding potency was analyzed by competition ELISA using a pooled serum, with sera obtained from 10 allergic patients. The amounts of HDM group 1 (Der 1) and group 2 major allergens in eight HDM allergen extracts were measured by sandwich ELISAs. Correlation between the in vitro total IgE binding potency and major allergen levels was analyzed. RESULTS: We selected a JSA reference HDM extract and determined its in vivo allergenic potency. The in vitro total IgE binding potency significantly correlated with Der 1 content, group 2 allergen content, and their combined amount, indicating that measurement of major allergen contents can be used as a surrogate in vitro assay. CONCLUSIONS: The task force determined the in vivo allergenic potency (100,000 JAU/ml) and Der 1 content (38.5 μg/ml) of the JSA reference HDM extract, selected the measurement of Der 1 content as the surrogate in vitro assay, and decided that manufacturers can label a HDM allergen extract as having a titer of 100,000 JAU/ml if it contains 22.2-66.7 μg/ml of Der 1.

DOI： 10.1016/j.alit.2015.01.005

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：JAPANESE SOCIETY ALLERGOLOGY  

Background: Fluticasone furoate nasal spray (FFNS) is a glucocorticoid developed for the treatment of allergic rhinitis (AR). This study aimed to assess the safety, efficacy, and systemic exposure of FFNS in Japanese children with perennial AR (PAR).
Methods: In this multicentre, open-label, phase 3 study, 61 children aged 2 to &lt;15 years were treated with FFNS 55 mu g, once daily for 12 weeks. Nasal and ocular symptoms were scored by parents/guardians/patients and recorded in a patient's daily diary. In addition, rhinoscopy findings, including mucosal swelling, were scored by the investigators as an efficacy measure. As a safety measure, adverse events and clinical laboratory data were evaluated.
Results: An adverse event was reported by 67% of patients during the treatment and follow-up period, all of which were mild in intensity. The most commonly reported adverse events were nasopharyngitis and acute sinusitis (acute rhinosinusitis). There were no serious adverse events. FFNS 55 mu g improved nasal symptom scores and rhinoscopy findings compared with the baseline. Ocular symptom scores were also improved compared with the baseline in FFNS 55 mu g in a sub-group of patients with any ocular symptoms at baseline. FFNS 55 mu g was shown to be well tolerated over the 12-week treatment period. Majority of patients receiving FFNS 55 mu g had unquantifiable plasma levels of fluticasone furoate (FF).
Conclusions: Twelve-week treatment with FFNS 55 mu g, once daily, is well tolerated and effective with low systemic exposure in Japanese children aged 2 to &lt;15 years with PAR. Copyright (C) 2014, Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

DOI： 10.1016/j.alit.2014.07.002

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記述言語：日本語   出版者・発行元：The Oto-Rhino-Laryngological Society of Japan, Inc.  

DOI： 10.3950/jibiinkoka.118.541

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Although second-generation antihistamines, such as bepotastine besilate, are recommended as a first-line treatment option for adult perennial allergic rhinitis (PAR), few non-sedating second-generation antihistamines are safe for children. OBJECTIVE: A double-blind, placebo-controlled, comparative study of 473 pediatric PAR patients (7 - 15 years old) to determine the superiority and safety of bepotastine besilate (10 mg twice daily) relative to placebo for improved total and individual nasal symptom scores compared with baseline. RESEARCH DESIGN AND METHODS: Subjects were randomized to placebo (n = 233) or bepotastine besilate (n = 240, 10 mg orally twice daily for 2 weeks). Interference of daily life by PAR was assessed by measuring change in individual nasal symptom scores from baseline. RESULTS: Bepotastine besilate was superior to placebo in terms of total nasal symptom scores, with improved overall nasal symptoms of PAR compared with baseline values. Subgroup analyses demonstrated bepotastine besilate was effective irrespective of age, sex or body weight. No clinically significant adverse drug reactions often observed with first-generation antihistamines were reported and no difference in adverse events between groups was observed. CONCLUSIONS: Bepotastine besilate is effective and safe for pediatric PAR patients aged 7 - 15 years, and has a significant clinical impact on PAR. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01861522 ( https://clinicaltrials.gov/ct2/show/NCT01861522 ).

DOI： 10.1517/14656566.2015.1085511

PubMed

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記述言語：英語   出版者・発行元：The Society of Practical Otolaryngology  

To predict the histological type of parotid salivary gland tumors, dynamic-enhanced MRI could be useful. Eight patients with parotid salivary gland tumors were examined preoperatively using gadolinium-enhanced dynamic MRI. The time of peak enhancement (T peak) and washout ratio (WR) were determined from time-signal intensity curves (TSI-curves). According to previous reports, we categorized our 8 patients into four main patterns based on the T peak and WR. Type A (T peak>120 sec) was the pleomorphic type, type B (T peak≦120 sec, WR≧30%) was the Warthin tumor type, type C (T peak≦120 sec, WR<30%) was the malignant tumor type, and type D (flat) was not enhanced. According to the pathological diagnosis, the tumors of patients study comprised four cases of pleomorphic adenomas, two cases of Warthin tumors, one case of sebaceous lymphadenoma and one case of salivary duct cysts. While all four cases of pleomorphic adenoma were categorized into type A, one sebaceous lymphadenoma case, a rare benign salivary gland tumor, was categorized into type B (pattern of Warthin tumors). We obtained basically the same result as previous reports on categorization. On that basis, we were able to examine the histological type of sebaceous lymphadenomas using dynamic contrast-enhanced MRI.

DOI： 10.5631/jibirinsuppl.141.68

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その他リンク： http://search.jamas.or.jp/link/ui/2015308169

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：JAPANESE SOCIETY ALLERGOLOGY  

Background: Fluticasone furoate nasal spray (FFNS) is a glucocorticoid developed for the treatment of allergic rhinitis (AR). This is the first randomized clinical trial to assess the efficacy and safety of FFNS in Japanese children with perennial AR (PAR).
Methods: In this multicentre, randomized, double-blind, placebo-controlled, parallel-group, phase III study, 261 children aged 6 to &lt;15 years were treated with FFNS 55 mu g, once daily or placebo for two weeks. Nasal and ocular symptoms were rated by parents/guardians/patients in the patient daily diary. The primary endpoint was the mean change from baseline in the three total nasal symptom score (3TNSS). In addition, rhinoscopic findings were rated by the investigators as an efficacy measure. As a safety measure, adverse events and clinical chemistry and hematology were evaluated.
Results: Mean change from baseline over the entire treatment period in 3TNSS was greater in the FFNS 55 pg group compared with placebo, and the difference was statistically significant (p &lt; 0.001). Significant improvements in rhinoscopic findings of swelling of inferior turbinate mucosa and quantity of nasal discharge were also observed. The total ocular symptom score (TOSS) was reduced significantly in the FFNS 55 pg group, compared with placebo, in the second week in a subgroup of patients with baseline TOSS &gt; 0. The incidence of adverse events was similar between FFNS 55 mu g (18%) and placebo (19%).
Conclusions: Two-week treatment with FFNS 55 mu g, once daily is effective and tolerable in Japanese children aged 6 to &lt;15 years with PAR.

DOI： 10.2332/allergolint.14-OA-0688

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: In the 1990s, the Japanese Society of Allergology (JSA) standardized Japanese cedar pollen allergen vaccines. In the present study, the task force for house dust mite (HDM) allergen standardization of the Committee for Allergens and Immunotherapy of JSA reports the standardization of HDM allergen vaccines in Japan. METHODS: In vivo allergenic potency was determined by intradermal testing of 51 Japanese adults with positive serum specific IgE to HDM allergens. In vitro total IgE binding potency was analyzed by the competitive ELISA using a pooled serum, with sera obtained from 10 allergic patients. Concentrations of HDM group 1 (Der 1) and group 2 major allergens in eight HDM allergen extracts were measured by sandwich ELISAs. Correlation between the in vitro total IgE binding potency and major allergen levels was analyzed. RESULTS: We selected a JSA reference HDM extract and determined its in vivo allergenic potency. The in vitro total IgE binding potency significantly correlated with Der 1 content, group 2 allergen content, and their combined amount, indicating that measurement of major allergen contents can be used as a surrogate in vitro assay. CONCLUSIONS: The task force determined the in vivo allergenic potency (100000 JAU/ml) and Der 1 content (38.5 μg/ml) of the JSA reference HDM extract, selected the measurement of Der 1 content as the surrogate in vitro assay, and decided that manufacturers can label a HDM allergen extract as having a titer of 100000 JAU/ml if it contains 22.2-66.7 μg/ml of Der 1.

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Periostin is a 90-kDa member of the fasciclin-containing family; it functions as part of matricellular proteins, and its production by airway epithelial cells is induced by IL-4 and IL-13. Periostin is secreted by fibroblasts and upregulated in the airway epithelia of patients with bronchial asthma; it is considered to contribute to remodeling under this pathological condition. However, despite many studies in diverse research areas, our overall understanding of this intriguing molecule is still inadequate. Here, we integrate the available evidence on periostin expression and its roles in otolaryngological diseases, including allergic rhinitis, chronic rhinosinusitis with nasal polyps, aspirin-induced asthma, organized hematoma, eosinophilic otitis media, and IgG4-related disease. Periostin might be involved as an important structural mediator in pathological processes such as insult and injury, Th2-driven inflammation, extracellular matrix restructuring, fibrosclerosis, tumor angiogenesis, and tissue remodeling.

DOI： 10.2332/allergolint.13-RAI-0673

PubMed

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

アレルギー性鼻炎では鼻粘膜の神経原性炎症が生じている.その主役はサブスタンスP(SP)をはじめとする神経ペプチドであるが,分解酵素である中性エンドペプチデース(NEP)はその活性を低下させる.神経ペプチドはブラディキニン(BK)により神経より放出され, BKでの反応が増加する花粉飛散期では両者の血管への作用が増強すると考えられる.しかし,アレルギー性鼻炎の症状をSPやBKの受容体拮抗薬を用いても制御することは現段階では不可能であり,今後の検討が必要である.一方,アレルギー性鼻炎は免疫疾患が基本にある典型的I型アレルギー疾患で,抗原特異性が発症の条件となる.このため抗原特性を持つ根治的治療と認識されているのはアレルゲン免疫療法のみで,アレルギーの感作にかかわる誘導相に治療効果が作用する.皮下免疫療法(subcutaneous immunotherapy ; SCIT)は1911年に初めてNoon LがLancetにイネ科花粉症に対し施行し,現在まで続いている.しかし残念ながらわが国では,アナフィラキシーなどの副作用の面からかアレルギー性鼻炎に対しSCITは限られた施設だけで行われているのが現状であり,欧米よりも普及していない.一般的にこの免疫療法を広めるために,現在,より安全な新しい舌下免疫療法が注目を集めている.

DOI： 10.15036/arerugi.63.1317

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その他リンク： http://search.jamas.or.jp/link/ui/2015092555

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Like asthma and atopic dermatitis, allergic rhinitis is an allergic disease, but of the three, it is the only type I allergic disease. Allergic rhinitis includes pollinosis, which is intractable and reduces quality of life (QOL) when it becomes severe. A guideline is needed to understand allergic rhinitis and to use this knowledge to develop a treatment plan. In Japan, the first guideline was prepared after a symposium held by the Japanese Society of Allergology in 1993. The current 7th edition was published in 2013, and is widely used today. To incorporate evidence based medicine (EBM) introduced from abroad, the most recent collection of evidence/literature was supplemented to the Practical Guideline for the Management of Allergic Rhinitis in Japan 2013. The revised guideline includes assessment of diagnosis/treatment and prescriptions for children and pregnant women, for broad clinical applications. An evidence-based step-by-step strategy for treatment is also described. In addition, the QOL concept and cost benefit analyses are also addressed. Along with Allergic Rhinitis and its Impact of Asthma (ARIA), this guideline is widely used for various clinical purposes, such as measures for patients with sinusitis, childhood allergic rhinitis, oral allergy syndrome, and anaphylaxis and for pregnant women. A Q&A section regarding allergic rhinitis in Japan was added to the end of this guideline.

DOI： 10.2332/allergolint.14-RAI-0768

PubMed

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.63.476_2

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

We introduce evidence for the efficacy of allergen immunotherapy, including sub-cutaneous immunotherapy (SCIT) and sub-lingual immunotherapy (SLIT), which are used internationally now. There is not the exact methodology established methodology, but a lot of succesful case reports, so SCIT is still used in Japan. The effect is large enough by the proper SCIT method form its evidence including the meta-analysis data. However, judging from the care setting in Japan, various problems still need to be resolved. Therefore, the SLIT approach, which appears to be the more easy-to-adopt approach, has received much attention inotherco-untries. Comparison of these two currently used routes for immunotherapy is still much debated. There are a large number of patients and doctors that are willing to the safer SLIT in Japan. Practical use of SLIT for pollinosis caused by Japanese cedar pollen is expected to be introduced in 2014.

DOI： 10.5631/jibirin.106.769

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DOI： 10.1016/j.oooo.2013.01.002

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DOI： 10.2332/allergolint.12-OA-0498

PubMed

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記述言語：日本語   出版者・発行元：耳鼻と臨床会  

過去2年間に当科アレルギー外来にてアレルゲン免疫療法を開始した134例を対象とし、年齢性別、治療抗原、治療内容、注射回数、副作用、治療効果につき報告した。患者の年齢は30歳から50歳に多く、人数に男女差はみられなかった。治療抗原はスギ単独が54例(40.3%)、スギ+ハウスダストが36例(26.9%)と多かった。各抗原とも2段階、3段階のステップアップを行ったが、開始量、維持量には個人差がみられた。合計3,481回の注射で5回(0.14%)、134例中5例(3.7%)に副作用がみられた。脱落症例は22例(16.4%)であり、うち11例が抗原増量中の脱落であった。スギのアレルゲン免疫療法を行った患者のうち約27.7%が2012年スギシーズン中の薬物療法を必要としなかった。(著者抄録)

DOI： 10.11334/jibi.59.93

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記述言語：日本語   出版者・発行元：(NPO)日本気管食道科学会  

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記述言語：日本語   出版者・発行元：日本嚥下医学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Since the discovery of button battery, it has been widely applied in various electric devices. However, the button battery has a potential risk as a foreign body in the nasopharyngeal field. Thus, there is a need for early diagnosis and removal of these batteries. METHODS: We experienced a case of foreign body in the nasal cavity. A battery was lost around a 2-year-old patient. He visited a local pediatric clinic. X-ray examination of the neck, chest. and abdomen showed no sign of a foreign body. He subsequently exhibited left cheek swelling and came to our clinic. RESULTS: X-ray examination of head revealed a metallic foreign body in the left nasal cavity. The foreign body was approached using an endoscope under general anesthesia. The nasal cavity was filled with necrotic tissue. We removed the foreign body using forceps. After surgery, perforation of nasal cavity was identified. CONCLUSIONS: The button battery was a potential risk because it contained toxic substances, could release an electrical current, and exerted direct pressure on the surrounding tissues. Surgical removal of button battery is the treatment of first choice. As for late complications, saddle nose is reported. Our patient would receive nasoplastic surgery around the age of 18 years. In summary, our patient's nose was not initially examined using x-ray study. It is very important to keep in mind the possibility of a nasal foreign body, not only for ear, nose, and throat doctors but also for pediatricians.

DOI： 10.1097/PEC.0b013e318280d535

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

A solitary nasal schwannoma in a 31-year-old woman is described. The patient had a 10-year history of left nasal obstruction and presented with worsening symptoms. Computed tomography revealed a mass in the left nasal cavity extending into the ethmoidal and sphenoidal sinuses. A large, white polypoidal mass with a smooth surface was removed endoscopically piece by piece. Microscopic examination showed the tumor to be a benign spindle-cell neoplasm with predominantly mixed cellular pattern and with an indistinct focal mixture of hypercellular and hypocellular areas, likely representing Antoni A and B areas, respectively. Differential diagnoses included schwannoma, neurofibroma, solitary fibrous tumor, and meningioma. On immunohistochemical examination, the neoplastic cells showed diffuse and strong positivity for S-100. CD34 was positive primarily in the hypocellular area (Antoni B) but weak or negative in the hypercellular area (Antoni A). Staining for calretinin was focal and strong, and that for glial fibrillary acidic protein was diffuse and weak; however, stainings for estrogen receptor, epithelial membrane antigen, and α-smooth muscle actin were negative. This immunohistochemical profile confirmed the diagnosis of schwannoma. The combined use of immunostains (CD34, calretinin) could be useful for differentiating sinonasal schwannoma from its histological mimics when the typical features are weak or absent.

PubMed

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.62.1458

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2014139685

記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

【背景と目的】我々はこれまでに,スギ花粉症における本格的花粉飛散前の症状発現,すなわち季節前発症にブドウ球菌などの細菌が関与する可能性を報告した.そこで今回は,本格的飛散前後の保菌率や鼻粘液上皮細胞診を詳細に解析し,スギ花粉症の季節前発症における細菌の関与について検討した.【方法】2011年,スギ単独感作例で飛散前無症状群(PreAs)53名,発症群(PreSy)60名,飛散中発症群(InSy)72名の鼻腔を綿棒で採取した粘液上皮成分をハンセル染色,細胞増多判定を行った.又細菌培養検査を行った(InSy群70名).【結果】黄色ブドウ球菌はPreAs 79%, PreSy 75%で検出され両群間に有意の差はなかった.InSyでは53%であった.表皮ブドウ菌の検出率はPreAs 15%, PreSy 10%, InSy 16%.モラキセラ・カタラーリスはPreAs 9%に対し,PreSy 25%で有意に高かった.細胞診は好酸球のみではPreAs 6%, PreSy 2%と両群低値でありInSy 51%であった.好中球のみはPreAs 45%に対し,PreSy 65で有意に高く,2+以上ではPreAs 20%に対しPreSyは47%でさらに有意に高かった.浸潤細胞なしはPreAs 43%に対し,PreSyは22%で有意に低かった.以上のことからスギ花粉季節前発症は好中球増多による鼻炎によるものであり,ブドウ球菌やモラキセラ・カタラーリスなどが関与しているものと思われた.

DOI： 10.15036/arerugi.62.689

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その他リンク： http://search.jamas.or.jp/link/ui/2013286360

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：JAPANESE SOCIETY ALLERGOLOGY  

Background: Pendrin and periostin are newly identified mediators of the inflammatory process. The expression of these proteins in human sinonasal tissue and their roles in allergic rhinitis and chronic rhinosinusitis remain to be elucidated. This study investigated the expression of pendrin and periostin in sinonasal tissue of patients with allergic rhinitis, chronic rhinosinusitis, and aspirin-induced asthma. Prospective control study conducted at Yamagata University, Japan.
Methods: Surgical samples were investigated by means of real-time reverse transcription-polymerase chain reaction to evaluate the expression of pendrin and periostin mRNA. The presence and location of pendrin and periostin were determined by immunohistochemistry and Western blotting.
Results: Pendrin and periostin production was significantly higher in patients with nasal disorders than in controls. Further significant increases in periostin expression were noted in patients with chronic rhinosinusitis with nasal polyps and in those with aspirin-induced asthma. Immunohistochemistry revealed positive staining for pendrin in epithelial cells and submucosal glands and for periostin in the basement membrane in all three disorders, and additionally for periostin in nasal polyp tissue in chronic rhinosinusitis and aspirin-induced asthma.
Conclusions: Production of pendrin and periostin is upregulated in allergic rhinitis, chronic rhinosinusitis with nasal polyps, and aspirin-induced asthma. These findings suggest that pendrin can induce mucus production and that periostin can induce tissue fibrosis and remodeling in the nasal mucosa. Therefore, these mediators may be therapeutic target candidates for allergic rhinitis, chronic rhinosinusitis with nasal polyps, and aspirin-induced asthma.

DOI： 10.2332/allergolint.11-OA-0370

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Many countries throughout the world have experienced an increase in the prevalence of allergic rhinitis (AR), which has come to be a major cause of morbidity in developed countries. The pathology underlying AR is regarded as IgE-mediated type I allergy characterized by mucosal inflammation that occurs in response to allergen exposure. In Japan, AR caused by Japanese cedar pollen, the most common allergic disease, has become a salient public health challenge. Almost all primary care physicians and otorhinolaryngologists have been consulted by AR patients between February and April. Although most such patients have received treatment, numerous patients with AR have not received proper examinations for AR. Clinical guidelines are systematically developed statements that are designed to help practitioners make decisions about appropriate and effective health care. Guidelines in many countries including Japan have been published for AR. Unfortunately, those guidelines have remained untested. Moreover, they might be difficult for non-specialists to use. In this review, we specifically examine the present standard examination for diagnosis of AR and optimal classification for AR in Japan. We hope that this review would be used not only for the support of daily practice but also for selection of AR patients for clinical trials.

DOI： 10.1016/j.anl.2011.12.006

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Allergic rhinitis (AR) and asthma represent global health problems for all age groups. Asthma and rhinitis frequently coexist in the same subjects. Allergic Rhinitis and its Impact on Asthma (ARIA) was initiated during a World Health Organization workshop in 1999 (published in 2001). ARIA has reclassified AR as mild/moderate-severe and intermittent/persistent. This classification closely reflects patients' needs and underlines the close relationship between rhinitis and asthma. Patients, clinicians, and other health care professionals are confronted with various treatment choices for the management of AR. This contributes to considerable variation in clinical practice, and worldwide, patients, clinicians, and other health care professionals are faced with uncertainty about the relative merits and downsides of the various treatment options. In its 2010 Revision, ARIA developed clinical practice guidelines for the management of AR and asthma comorbidities based on the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) system. ARIA is disseminated and implemented in more than 50 countries of the world. Ten years after the publication of the ARIA World Health Organization workshop report, it is important to make a summary of its achievements and identify the still unmet clinical, research, and implementation needs to strengthen the 2011 European Union Priority on allergy and asthma in children. © 2012 American Academy of Allergy, Asthma &amp
Immunology.

DOI： 10.1016/j.jaci.2012.07.053

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：INFORMA HEALTHCARE  

Conclusions: The changes in the cochlin isoforms in the perilymph may provide important insights to the understanding of cochlin function and the pathogenesis of related inner ear diseases. Objectives: Cochlin is involved in various pathologies of the inner ear. Altered levels of cochlin isoforms in developing inner ear tissue were reported previously. The purpose of this study was to elucidate the cochlin isoform expression in the perilymph of rats during postnatal development in relation to Coch gene mRNA expression. Methods: We studied the cochlin isoforms in the rat perilymph during postnatal development by Western blot analysis. Real-time PCR was also performed to elucidate the expression level of Coch mRNA in the developing inner ear of rats. Results: Western blot analysis showed that the expression of p63s in the perilymph was highest on the 12th day after birth (DAB12), the earliest age at which we could identify the perilymphatic space microscopically, and it decreased gradually as the cochlea developed. On the other hand, the expression of Cochlin-tomoprotein (CTP) was lowest on DAB12 and increased gradually up to DAB24. COCH mRNA was detected from DAB3 and gradually increased to DAB15, and then gradually decreased to DAB70.

DOI： 10.3109/00016489.2012.687456

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MEDICAL ASSOC NIPPON MEDICAL SCH  

Solitary fibrous tumor is a rare neoplasm, which was first described as a primary spindle-cell tumor of the pleura, is a type of mesenchymal tumor. Although the majority of these tumors originate in the pleura, they can also derive from extrapleural sites, such as the liver. lung, abdomen, and extremities. We report a rare case of a nasal solitary fibrous tumor that originated from the nasal superior turbinate. The tumor. measuring 45 x 25 x 10 mm, was in the right nasal cavity. We successfully removed the tumor in one piece through endonasal endoscopic surgery. The tumor had spindle-shaped cells within a collagenous stroma and was positive for CD34. There has been no evidence of tumor recurrence in the 14 months following surgery. (J Nippon Med Sch 2012: 79: 373-376)

DOI： 10.1272/jnms.79.373

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCI LTD  

There are ethical dilemmas in managing head and neck cancers during pregnancy. Diagnostic and treatment modalities need to be carefully determined. We herein describe 3 cases of tongue cancer during pregnancy. The details of the management would contribute to the daily practices for head and neck cancers.
All three patients were Japanese female patients, two of them were 29 years old and one was 26 years old. All patients were admitted to the Nippon Medical School Hospital during pregnancy, complaining of oral pain and/or discomfort. Case 1 was diagnosed as tongue cancer stage T3N0M0, however, the tumor was superficial and controllable by partial glossectomy. Case 2 was stage T2N0M0 with deep invasion with ulcer, and the hemi-glossectomy with neck dissection and the reconstruction was thought to be the standard modality. However, she underwent partial glossectomy in order to reduce the stress of the fetus. Case 3 could not be diagnosed on admission by biopsy and she underwent partial glossectomy after delivery. In case 3, the pathological diagnosis was pT1 tongue cancer. In case 1 and case 3, the patient and baby were healthy. In case 2, however, the patient died of recurrence at the primary site.
In decision making of the strategy, the most important factors are not only oncological evaluation but also ethical and emotional factors. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.anl.2011.08.003

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：KOREAN ACAD ASTHMA ALLERGY & CLINICAL IMMUNOLOGY  

Purpose: Allergic rhinitis (AR) and asthma share many characteristics, but structural changes are observed far less often in AR. Matrix metalloproteinases (MMPs) constitute a family of Zn-dependent endopeptidases that can decompose the extracellular matrix and basement membrane, and regulate cell infiltration. We analyzed the expression of MMPs and their inhibitors, tissue inhibitors of metalloproteinases (TIMPs), in allergic nasal mucosa after nasal allergen challenge (NAC) and determined their relationship to inflammatory cells. Methods: Nasal mucosa specimens were obtained at surgery performed for hypertrophied turbinates. We performed NAC with house dust mite (HDM) allergen disks and control disks, and took biopsies at 30 minutes, 6 hours, and 12 hours after NAC. Cells expressing MMP-2, MMP-9, MMP-13, TIMP-1, and TIMP-2, as well as eosinophils and mast cells, were analyzed immunohistochemically. The MMPs and TIMPs in allergic nasal mucosa were quantified using enzyme-linked immunosorbent assays. Results: At 30 minutes post-NAC, HDM-exposed nasal mucosa exhibited significantly more MMP-2+, MMP-9+, MMP-13+, TIMP-1+, and TIMP-2+ cells compared with control mucosa, and the numbers of MMP-9+ and TIMP-1+ cells correlated strongly with the number of mast cells. At 6 hours post-NAC, the numbers of MMP+ and TIMP+ cells did not differ significantly between HDM-exposed mucosa and control mucosa, but the ratios of MMP+ cells to TIMP+ cells were higher in HDM-exposed mucosa. At 12 hours post-NAC, the number of MMP-13+ cells tended to be higher in HDM-exposed mucosa and was strongly correlated with the number of eosinophils. Quantitatively, the levels of MMP-2 and MMP-13 were significantly higher than the MMP-9 level, and the TIMP-2 level was significantly higher than the TIMP-1 level in allergic nasal mucosa. Conclusions: We demonstrated increased expression of MMP-2, MMP-9, and MMP-13 in allergic nasal mucosa, high MMPs-to-TIMP-1 ratios, and a strong correlation between MMP-9 and mast cells and between MMP-13 and eosinophils. The imbalance between MMPs and TIMPs may contribute to the migration of inflammatory cells such as eosinophils and mast cells to the nasal mucosa of AR patients, suggesting a possible active role of MMPs in AR.

DOI： 10.4168/aair.2012.4.4.231

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MEDICAL ASSOC NIPPON MEDICAL SCH  

Background: Recent studies have examined the effects of intranasal corticosteroids (INSs) in relieving the ocular symptoms of seasonal allergic rhinoconjunctivitis (SAR) and perennial allergic rhinitis. However, because most of these studies were based on subjective assessments by patients, the associated factors and mechanism of action are unknown.
Methods: A single-center, randomized, double-blind, parallel-group study was carried out in which patients with SAR were randomly assigned to an INS mometasone furoate nasal spray (MFNS) group or to a placebo group and treated once daily for 4 weeks. Substance P concentrations in tears were measured, ocular and nasal symptoms were recorded by patients in an allergy diary, and findings were recorded by an ophthalmologist.
Results: There was no significant difference between treatment groups in the mean change from baseline of substance P concentration in tears after 4 weeks of treatment, but the mean change tended to increase in the placebo group and tended to decrease in the MFNS group (P = 0.089). All ocular and nasal symptom scores, except eye tearing, were significantly lower in the MFNS group than in the placebo group. Furthermore. substance P concentrations were strongly correlated with ocular and nasal symptom scores.
Conclusions: In patients with SAR. INSs tend to decrease the substance P concentration in tears, which is correlated with the severity of ocular and nasal symptoms. (J Nippon Med Sch 2012; 79: 182-189)

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記述言語：日本語   出版者・発行元：日本耳鼻咽喉科免疫アレルギー学会  

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記述言語：日本語   出版者・発行元：(NPO)日本気管食道科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本気管食道科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本気管食道科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/j.1472-9733.2011.01155.x

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記述言語：日本語   出版者・発行元：日本嚥下医学会  

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記述言語：日本語   出版者・発行元：日本嚥下医学会  

3年前、84歳女性が誤嚥のエピソードもなしにARDSに至るほどの重篤な誤嚥性肺炎を患った。肺炎の治癒後、彼女は3年もの間毎月嚥下内視鏡検査のみで嚥下不能と診断されていた。われわれは、彼女の状態は後期ダンピング症候群に起因する慢性的な低血糖によるものと判断した。そこで、われわれは、糖の含有率の高い栄養剤から脂肪の含有率が高く、糖の含有率の低い栄養剤へ変更し、そして、歩行訓練といった理学的治療を施した。すると、その後、再度経口摂取可能となった。(著者抄録)

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2012&ichushi_jid=J05944&link_issn=&doc_id=20120330030026&doc_link_id=%2Feg1engei%2F2012%2F000101%2F029%2F0191-0196%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Feg1engei%2F2012%2F000101%2F029%2F0191-0196%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：日本音声言語医学会  

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.61.1395_1

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.2500/aap.2012.33.3517

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: The study objective was to investigate the prophylactic efficacy of montelukast (MLK) 10 mg in suppressing seasonal allergic rhinitis (SAR) symptoms induced by Japanese cedar (JC) pollen and to determine how many days before exposure to JC in the artificial exposure chamber (OHIO chamber) would be optimal to start administration. METHODS: This was a single-institution, double-blind, randomized placebo-controlled four-group parallel inter-group comparison study. Adult volunteers with JC pollinosis were divided into four groups: an MLK 7-day administration group (n = 27), an MLK 3-day administration group (n = 27), an MLK 1-day administration group (n = 26), and a placebo group (n = 26). The mean change in total nasal symptom scores (nasal obstruction, nasal discharge and sneezing) (TNSS) and each of the nasal symptom scores during exposure of JC pollen in the OHIO chamber were investigated. RESULTS: The mean change in TNSS was significantly lower in the MLK treatment group, regardless of the number of days of administration, than in the placebo group (p = 0.0192). The results for the individual nasal symptoms showed that nasal obstruction was significantly suppressed in the 1-day administration group as compared with placebo (p = 0.0076), but no differences were found in sneezing score between any of the groups. For nasal discharge, we found a trend towards the effect clearing up after 3 days of administration. No serious adverse events were observed during the study. CONCLUSION: Although this study was acute and this artificial exposure model was conducted out of the pollen season, nasal symptoms that developed in the pollen exposure chamber, especially nasal obstruction, were significantly suppressed by starting oral administration of MLK 10 mg at least 1 day before exposure. These results suggest that prophylactic administration of MLK is effective and safe in the treatment of SAR.

DOI： 10.3109/21556660.2012.728547

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Medical Association of Nippon Medical School  

Inducible nitric oxide synthase (iNOS/NOS II) mediates cytotoxicity under pathological stimulation. The purpose of this study was to examine whether the blockade of NOS activity leads to a decrease in cochlear damage after intense acoustic stimulation. Guinea pigs were divided into 4 groups: (1) a noise group, (2) a NOS inhibitor (NG-nitro-L-arginine methyl ester [LNAME]) + noise group (L-NAME/noise group), (3) an L-NAME group, and (4) a control group. Stimuli involved a pure tone at a frequency of 2 kHz for 5 hours. The sound pressure level was 120 dBSPL. In the L-NAME/noise group, 50 mg/kg body weight of L-NAME was injected 1 hour before acoustic stimulation. In the control group and the L-NAME group, acoustic stimulation was not performed. In the L-NAME group, the same dose of L-NAME was injected intraperitoneally. In the control group, only physiological saline was injected. Auditory brainstem responses (ABRs) were recorded before and immediately, 1 day, and 7 days after acoustic stimulation. The ABR threshold was significantly higher immediately after acoustic stimulation in both the noise group and the L-NAME/noise group. One day after acoustic stimulation, the threshold shift was decreased in the noise group. The threshold shift was still present 7 days after acoustic stimulation but was significantly lower in the L-NAME/noise group than in the noise group. In the L-NAME group and the control group, threshold shifts were not apparent. The lateral wall, the organ of Corti, and the spiral ganglion cells of the cochlea in both the L-NAME group and the control group did not display immunoreactivity for iNOS at any time. Immunoreactivity for iNOS was found in the lateral wall, the supporting cells (Hensen's cells, Deiters' cells, and pillar cells), and the spiral ganglion cells in both the noise group and the L-NAME/noise group. These immunoreactivities for iNOS were detected immediately, 1 day, and 7 days after acoustic stimulation. Immunoreactivity decreased over time in the stria vascularis, the organ of Corti, and the spiral ganglion cells in the noise group. The same phenomenon was observed in the L-NAME/noise group. In conclusion, iNOS was detected in cochlea damaged by acoustic stimulation. A NOS inhibitor (L-NAME) reduced the elevation of hearing thresholds. Our results suggest that the expression of iNOS participates in the pathogenesis of cochlear damage caused by acoustic trauma.

DOI： 10.1272/jnms.79.121

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

Background: In Japanese cedar pollinosis (JCP), some patients attacked nasal symptoms similar to pollinosis before season. Nobody knows the reason. We analyzed the nasal cytology from patients before and in season in 2010. Methods: Cytology of nasal smear by taking with nasal swab and Hansel's staining was performed. Degree of infiltrating cells are graded, and five types are divided
neutrophil only (N), neutrophil pre-dominant (N&gt
Eo/Mc), Eo/Mc outnumber or equal neutrophil (Eo/Mc≥N), either Eosinophil or mast cell (Eo/Mc), and no infiltrating cells Cell -). Bacterial culture was enforced symptomatic patients of JCP with neutrophil predominant before season. Chi-square test was used for statistic analysis between before and in season, and among symptomatic JCP (SyJP), combined JCP with HD or other allergy (SyCJP), and asymptomatic JCP and CJCP (AsJP/CJP). Results: Before season, 58% of SyJP (n = 83) was N with significantly higher (p&lt
0.005) compared to 21% of SyCJP (n = 42) and 10% of AsJP/CJP (n = 19). And before season, 45% of SyCJP was Eo/Mc with significantly higher (p&lt
0.005) than 9.6% of SyJP (n = 83) and 10% of AsJP/CJP (n = 19). In season (March), percentage of Eo/Mc in SyJP (n = 42) and SyCJP (n = 64) was of 58%, 56% respectively with statistically higher than before season in both groups. Fifty seven percentage of AsJP/CJP (n = 19) was Cell - with much higher (p&lt
0.005) than SyJP and SyCJP (0∼7%) before and in season. Staphylococcus aureus in 25 and Staphylococcus epidermis in 12 patients were detected from 39 patients. Conclusion: These results mean Staphylococcus species might involve symptom appearance of SyJP before season. ©2012 Japanese Society of Allergology.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Apoptosis can be described as programmed cell death. Apoptosis regulates cell turnover and is involved in various pathological conditions. The characteristic features of apoptosis are shrinkage of the cell body, chromatin condensation, and nucleic acid fragmentation. During apoptosis, double-stranded DNA is broken down into single-stranded DNA (ssDNA) by proteases. Acoustic trauma is commonly encountered in otorhinolaryngology clinics. Intense noise can cause inner ear damage, such as hearing disturbance, tinnitus, ear fullness, and decreased speech discrimination. In this study, we used immunohistochemical and electrophysiological methods to examine the fragmentation of DNA in the cochleas of guinea pigs that had been exposed to intense noise. Twenty-four guinea pigs weighing 250 to 350 g were used. The animals were divided into 4 groups: (I) a control group (n=6), (II) a group that was exposed to noise for 2 hours (n=6), (III) a group that was exposed to noise for 5 hours (n= 6), and (IV) a group that was exposed to noise for 20 hours. The stimulus was a pure tone delivered at a frequency of 2 kHz. The sound pressure level was 120 dBSPL. No threshold shifts were apparent in group I. Group II showed a significant elevation of the hearing threshold (ANOVA, p&lt
0.05*). The ABR threshold level was also significantly elevated immediately after the acoustic stimulation in groups III and IV (ANOVA, p&lt
0.01 * *). In groups I, II, and IV, the lateral wall of the ear did not show immunoreactivity to ssDNA but did in group III. No immunoreactivity was apparent in the organ of Corti in group I or II. However, the supporting cells and outer hair cells in groups III and IV showed reactions for ssDNA. The fine structure of the organ of Corti had been destroyed in group IV. The lateral wall showed immunoreactivity for ssDNA only in group III, whereas the organ of Corti showed reactions for ssDNA in groups III and IV. Our study suggests that apoptotic changes occur in patients that suffer acoustic trauma. Once the apoptotic pathway has started, it is irreversible. Thus, early diagnosis and treatment are necessary. Earplugs should also be worn at rock concerts.

DOI： 10.1272/jnms.79.349

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記述言語：日本語   出版者・発行元：JAPAN SOCIETY OF IMMUNOLOGY AND ALLERGOLOGY IN OTOLARYNGOLOGY  

日本のアレルギー性鼻炎治療における抗ヒスタミン薬のエビデンスレベルは高くなかった。それは開発治験しかランダム化された試験がほとんどなく，またプラセボを使用しない，さらに英文での公表がなかったからである。このため近年では市販された後に多くのエビデンスが収集され，また開発治験でもその結果を英文で公表し，レベルが向上してきた。実際の臨床現場ではアレルギー性鼻炎の治療方針はガイドラインに述べられているようにくしゃみ・鼻汁型をその適応とし，効果の高く副作用の少ない抗ヒスタミン薬を基本治療薬とする。一方，鼻閉型では抗ロイコトリエン薬や鼻噴霧用ステロイド薬を主として処方すべきである。種々の抗ヒスタミン薬の効果がフィールド試験，暴露試験などで検討されているが，効果には個人的なバラつきが存在し，ただ単に強い弱いと比較する事だけでは抗ヒスタミン薬を選択できないことを知る必要がある。<br>

DOI： 10.5648/jjiao.29.1

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その他リンク： http://search.jamas.or.jp/link/ui/2012014140

記述言語：日本語   出版者・発行元：(NPO)日本気管食道科学会  

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記述言語：日本語   出版者・発行元：(株)医薬情報研究所  

OHIO Chamberにおけるスギ・ヒノキ科花粉連続曝露に対するベポタスチンベシル酸塩OD錠の効果について検討した。成人のスギ・ヒノキ科花粉を原因抗原とする季節性アレルギー性鼻炎の患者を対象とした。無作為化、単盲検、群間比較試験で、スギ・ヒノキ科花粉の非飛散期である7月に実施した。無作為に2群に分け、ベポタスチン群14例、プラセボ群14例とした。OHIO Chamberを用い、スギ・ヒノキ科花粉を連日で曝露し、ベポタスチンベシル酸塩を曝露前日から継続的に服用することによって症状発現の抑制と作業効率の維持ができた。実際の臨床状況においてもベポタスチンベシル酸塩の有効性、安全性を高く評価できるものと推察できることから、ベポタスチンベシル酸塩がスギ花粉症シーズンだけでなくヒノキ科花粉症シーズンにおいても連続的に有用な薬剤であることが示唆された。

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記述言語：日本語   出版者・発行元：(一社)日本鼻科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：INFORMA HEALTHCARE  

Conclusions: The cochlin-tomoprotein (CTP) detection test can be used to make a definite, objective diagnosis of traumatic perilymphatic fistula (PLF), and therefore offers valuable information on patient selection for surgical treatment. Objectives: Penetrating middle ear injury can cause traumatic PLF, which is a surgically treatable otologic emergency. Recently, we have reported on CTP, a novel perilymph-specific protein. The purpose of this study was to determine if the CTP detection test is useful for the diagnosis of traumatic PLF. Methods: This was a prospective study of CTP detection in penetrating middle ear injury cases with tympanic membrane perforation and hearing loss. Results: A total of seven individuals were included in this study. CTP was detected in three of four cases with posterosuperior quadrant perforation of the tympanic membrane. In one of these three cases, even though the high resolution CT scan was not suggestive of PLF and the perilymph leakage could not be visualized intraoperatively, the CTP detection test was able to detect PLF. In two cases, the preoperative positive test results enabled us to make a diagnosis of PLF and a decision for surgical treatment. CTP was not detected in the cases with anterior or inferior tympanic membrane perforation.

DOI： 10.3109/00016489.2011.575795

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MEDICAL ASSOC NIPPON MEDICAL SCH  

We describe 3 cases of metachronous hypopharyngeal cancer developing after laryngeal cancer had been treated with both radiotherapy and total laryngectomy.
All 3 patients were men, 2 were 89 years old, and 1 was 65 years old. All patients had undergone total laryngectomy and radiotherapy for cancer for the glottis more than 20 years earlier. All patients underwent total hypopharyngectomy with jejunal free flap reconstruction. Surgery was complicated by scars from previous cancer treatment, and highly sophisticated surgical skills are needed, especially for preparing the recipient vessels. The postoperative period was largely uneventful and without fatal complications, however, 2 of the 3 patients died of distant metastasis 22 months and 31 months after surgery. (J Nippon Med Sch 2011; 78: 261-266)

DOI： 10.1272/jnms.78.261

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：KOREAN ACAD ASTHMA ALLERGY & CLINICAL IMMUNOLOGY  

Purpose: Nasal polyposis is a chronic inflammatory disease of the upper airways often associated with asthma and characterized by markedly increased numbers of eosinophils, Th2 type lymphocytes, fibroblasts, goblet cells and mast cells. Previous studies have shown elevated levels of thymic stromal lymphopoietin (TSLP) in atopic diseases like asthma, atopic dermatitis and mainly in animal models of allergic rhinitis (AR). Here, we investigated the expression of TSLP in nasal polyps from atopics and non-atopics in comparison with the nasal mucosa and its potential role in nasal polyposis. Methods: Messenger RNA expression for TSLP, thymus and activation-regulated chemokine (TARC) and macrophage derived chemokine (MDC) in nasal polyps and nasal mucosa of atopics and non-atopics was analyzed by real time PCR. Immunoreactivity for TSLP in nasal polyps and in the nasal mucosa of patients with AR and non-allergic rhinitis (NAR) was analyzed by immunohistochemistry. Eosinophil counts was analyzed by Wright-Giemsa staining and nasal polyp tissue IgE, by ELISA. Results: Messenger RNA expression for TSLP,TARC and MDC was markedly higher in nasal polyps as compared to the allergic nasal mucosa. Immunoreactivity for TSLP was detected in epithelial cells, endothelial cells, fibroblasts and inflammatory cells of the nasal mucosa and nasal polyps. The number of TSLP(+) cells was significantly greater in the nasal mucosa of AR than NAR patients. The number of TSLP(+) cells in nasal polyps from atopics was significantly greater than that of non-atopics and that in the allergic nasal mucosa. The number of TSLP(+) cells correlated well with the number of eosinophils and the levels of IgE in nasal polyps. Conclusions: The high expression of TSLP in nasal polyps and its strong correlation to eosinophils and IgE suggest a potential role for TSLP in the pathogenesis of nasal polyps by regulating the Th2 type and eosinophilic inflammation.

DOI： 10.4168/aair.2011.3.3.186

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記述言語：日本語   出版者・発行元：(株)篠原出版新社  

頭頸部癌診療におけるセカンドオピニオンの現状と課題について検討した。頭頸部癌患者で、セカンドオピニオンを求め紹介した57例と紹介された43例を対象とした。紹介先はがん専門病院が31例、他大学病院が10例、総合病院が10例であった。また、ホスピスへの紹介が6例であった。ホスピスへ紹介した症例を除いた51例の中で、治療方針が決定できた症例は50例であった。紹介元はがん専門病院が18例、他大学病院が14例、総合病院が11例であった。41例はセカンドオピニオン後に治療方針を決定することができた。相談内容別は、癌診断の正確性についての相談が5例、治療方法の妥当性を他の治療法と比較した相談が85例、治療の可否についての相談が10例であった。癌治療後のQOL低下についての相談が多くを占めた。

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記述言語：日本語   出版者・発行元：(NPO)日本気管食道科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本気管食道科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

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記述言語：日本語   出版者・発行元：The Society of Practical Otolaryngology  

In a pollen-season study of the clinical prophylactic effect in those with Japanese cedar allergy, we found that symptoms were less severe and quality of life (QOL) higher in those treated before rather than after pollen season started.<br> These results indicate that prophylacsis is effective in treating Japanese cedar pollinosis.<br>

DOI： 10.5631/jibirinsuppl.130.44

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その他リンク： https://jlc.jst.go.jp/DN/JALC/00367915955?from=CiNii

記述言語：英語   出版者・発行元：Japanese Society of Allergology  

Background: Among the gramineae species, orchard grass is a typical causative pollen that provokes seasonal rhinitis. The purpose of this study was to examine the protective efficacy of epinastine hydrochloride for signs and symptoms caused by repeated nasal provocation with discs containing orchard grass pollen.<br> Methods: A single-dose, placebo-controlled, double-blind, crossover clinical study was conducted in subjects with orchard grass pollinosis. The pollen challenge was conducted with the use of provocation discs containing orchard grass pollen.<br> Results: Epinastine hydrochloride suppressed nasal symptoms caused by nasal provocation tests using orchard grass pollen discs. Among the nasal symptoms, the number of sneezing was significantly inhibited 30 minutes and 60 minutes after the administration of epinastine hydrochloride, as compared with placebo. There were no adverse reactions to the study drugs.<br> Conclusions: Our results suggest that nasal provocation tests with discs containing orchard grass pollen is a useful method for evaluating the onset of action of antiallergic drugs. As compared with placebo, epinastine hydrochloride decreased early-phase sneezing and the total nasal symptom score after repeated nasal provocations with orchard grass pollen discs.<br>

DOI： 10.2332/allergolint.10-OA-0219

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CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2012012890

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

Adrenomedullin (AM) is a potent hypotensive and vasodilatory peptide. AM may exert protective actions against the development of many diseases by modulating the blood circulation and body fluid balance. In addition to these functions, it has recently been reported to play important roles in the development of allergy and infections. The purpose of the present study was to demonstrate the existence of AM in the human nasal mucosa and to discuss whether AM might contribute to the pathogenesis of nasal congestion. We measured the total AM concentrations in the nasal discharge. The total AM concentration in the nasal discharge was significantly higher in the non-allergy group (72.1 +/- 55.5 fmol/ml) than in the allergy group (37.1 +/- 44.2 fmol/ml). By immunohistochemical examination, we identified AM-containing cells in the nasal mucosa from both subjects with and without nasal allergy, and also in nasal polyps. Moreover, those cells were positive for anti-tryptase antibody which recognizes mast cells. In nasal allergy, vasodilatation and increase in vascular permeability are characteristic features of the immediate phase response. Reduced AM levels in the nasal discharge may be associated with attenuation of both of these factors. On the other hand, immunohistochemical analysis demonstrated AM-immunoreactive cells in the chronic phase of rhinosinusitis. In the late and inflammatory phase, mast cells produce AM, which possibly acts as an inhibitor of inflammatory cell migration. In conclusion, AM may be actively secreted into the nasal discharge. AM in the nasal discharge may have protective and anti-inflammatory effects in the nasal mucosa. (C) 2010 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.peptides.2010.10.028

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記述言語：日本語   出版者・発行元：日本音声言語医学会  

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.60.1398_1

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Society of Allergology  

Background: Allergen-specific immunotherapy (SIT) is currently used for several allergic disorders and IL-10-producing regulatory T cells (Tr1) induced by SIT suppress allergic reactions. We investigated the relation between IL-10 production and acquiring allergy. Methods: A prospective study was undertaken to evaluate the effect of SIT on IL-10 production in T cells and other cell fractions in children with pollinosis. In addition, blood samples were collected from non-allergic healthy controls and patients with pollinosis to compare the levels of IL-10 production. PBMC were cultured with pollen peptides or control allergens, and the IL-10 production from monocyte and CD4 T cell was analyzed. Results: Monocytes and CD4 T cells from SIT group of patients produced high levels of IL-10, suggesting that the induction of IL-10 is essential for inducing T cell tolerance. IL-10 production from monocytes and T cells was significantly increased in non-allergic controls compared to patients with pollinosis. This high IL-10 production was observed even when PBMC were stimulated with antigens other than pollen peptides. Conclusions: IL-10 is critical for induction of specific T cell tolerance, and increased production of IL-10 by monocytes and T cells during inflammatory responses or after SIT may influence effector cells in allergy. Present data implicates that the low productivity of IL-10 by monocytes and T cells is closely related with sensitivity to multiple allergens, and resistance to allergic diseases. Augmentation of constitutive IL-10 production from immune system is a potential therapeutic approach for allergic disorders. © 2011 Japanese Society of Allergology.

DOI： 10.2332/allergolint.10-OA-0198

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.60.1299_2

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background: Allergic rhinitis is a global health problem that causes major illnesses and disability worldwide. Allergen-specific immunotherapy (SIT) is the only available treatment that can alter the natural course of allergic disease. However, the precise mechanism underlying allergen-SIT is not well understood. Objective: The aim of the current study was to identify protein expression signatures reflective of allergen-SIT - more specifically, sublingual immunotherapy (SLIT). Methods: Serum was taken twice from patients with seasonal allergic rhinitis caused by Japanese cedar: once before the pollen season and once during the season. A total of 25 patients was randomly categorized into a placebo-treated group and an active-treatment group. Their serum protein profiles were analyzed by 2-dimensional electrophoresis. Results: Sixteen proteins were found to be differentially expressed during the pollen season. Among the differentially expressed proteins, the serum levels of complement C4A, apolipoprotein A-IV (apoA-IV), and transthyretin were significantly increased in SLIT-treated patients but not in placebo-treated patients. Among these proteins, the serum levels of apoA-IV correlated with the clinical symptom-medication scores (r = -0.635
P &lt
.05) and with quality of life scores (r = -0.516
P &lt
.05) in the case of SLIT-treated patients. The amount of histamine released from the basophils in vitro was greatly reduced after the addition of recombinant apoA-IV in the medium (P &lt
.01). Conclusion: Our data will increase the understanding of the mechanism of SLIT and may provide novel insights into the treatment of allergic rhinitis. © 2010 American Academy of Allergy, Asthma &amp
Immunology.

DOI： 10.1016/j.jaci.2010.06.031

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記述言語：日本語   出版者・発行元：日本医科大学医学会  

DOI： 10.1272/manms.6.167

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その他リンク： http://search.jamas.or.jp/link/ui/2011046680

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Society of Practical Otolaryngology  

The evidence of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) is introduced. SCIT and SLIT is an allergen immunotherapy used internationally now. In Japan, SCIT is still the only immunotherapy. There are no evidence-based protocols for SCIT but the effect is reliable with high level evidences including the meta-analysis. Although the effect of SCIT is large, the social problems around the medical system in Japan prevent SCIT from general usage. SLIT is another immunotherapy that is internationally evaluated as an effective therapy. SLIT is handier to perform and is gathering attention. Some double-dummy tests reported that SLIT was as effective as SCIT, but the effectiveness of SLIT compared to that of SCIT is still controversial. Many doctors and patients are longing for SLIT to be available in Japan. We are aiming to put SLIT to pollinosis caused by Japanese cedar pollen in practical use at 2014.

DOI： 10.5631/jibirin.103.695

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/j.1472-9733.2010.01147.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIBRAPHARM/INFORMA HEALTHCARE  

Objective:
The efficacy of antihistamines in perennial allergic rhinitis in children has been evaluated in studies using active comparators, whereas placebo-controlled studies are very few. A randomized, multicenter, double-blind, parallel-group clinical study was carried out to evaluate the dose-response relationship and superiority of olopatadine hydrochloride over placebo in children aged 7 to 16 years with perennial allergic rhinitis.
Methods:
Subjects received twice daily treatment for two weeks with either olopatadine 2.5 mg, 5 mg or placebo after a one-week observation period. Efficacy was assessed based on the diary card score the subject (or guardian) recorded.
Results:
Of the 302 subjects randomized, two were excluded from analysis: one did not receive treatment; the other was not monitored for efficacy parameters. The remaining 300 subjects (97 in the placebo group, 103 in the olopatadine 2.5-mg group and 100 in the olopatadine 5-mg group) constituted the full analysis set (FAS) for the efficacy analysis. As a primary endpoint, the total three nasal symptom score (for sneezing, rhinorrhea and nasal congestion) at final assessment was compared with baseline or the score obtained in the observation period. The change from baseline was then tested using analysis of covariance (ANCOVA) with the baseline score as covariate. Williams&apos; test was applied to the least squares means estimated from this ANCOVA model for each treatment group, resulting in showing the monotonicity Williams&apos; test assumed. The total three nasal symptom score significantly improved in the 5-mg group compared with the placebo group (p = 0.019). In contrast, the 2.5-mg group did not differ statistically from the placebo group. Adverse events occurred in 33.7% (33/98 subjects) in the placebo group, 35.9% (37/103 subjects) in the 2.5-mg group and 35.0% (35/100 subjects) in the 5-mg group. There were no serious or severe adverse events.
Conclusions:
Olopatadine hydrochloride 5 mg twice daily is an effective and safe treatment for perennial allergic rhinitis in children.

DOI： 10.1185/03007995.2010.485413

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記述言語：日本語   出版者・発行元：(NPO)日本気管食道科学会  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(株)医薬ジャーナル社  

最近、スギ花粉症における睡眠障害が注目されている。スギ花粉症は鼻症状が急速に出現・増悪するために睡眠障害が出現しやすい。本研究ではスギ花粉症における睡眠障害に対するベポタスチンベシル酸塩の効果について検討した。対象は2009年のシーズンに初受診したスギ花粉症患者46例である。初診時に、質問票を用いて鼻症状、QOL、睡眠障害について評価した。ベポタスチンベシル酸塩を内服開始し、2週間後、4週間後に同じアンケートで評価を行った。結果は、内服開始によって鼻症状、QOL、睡眠障害のすべてにおいてスコアが有意に改善した。鼻症状では鼻閉の改善度が最も大きかったが、これまでも鼻閉が睡眠障害に深く関係しているとされており、今回の検討でも鼻閉が改善したことで睡眠障害が改善したと考えた。(著者抄録)

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.59.1315

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.59.1289_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.59.420_3

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.59.320_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.59.360

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Society of Practical Otolaryngology  

A 2-week randomized double-blind parallel-group comparison study of dexamethasone cipecilate (NS126C) was conducted to verify efficacy at 400 μg/day QD in these with perennial allergic rhinitis versus fluticasone propionate (FP) nasal solution at 200 μg/day BID and NS-126C placebo. Of the 406 subjects included in the FAS (NS-126C: 162
FP: 161
placebo: 83), changes in total nasal symptom scores for sneezing, rhinorrhea, and nasal congestion as the primary endpoints, were -2.03±1. 95 in the NS-126C group and -2.10±1.77 in the FP group, yielding a group difference in change (95% confidence interval) of 0.07 (-0.32 to 0.46). The maximum 95% confidence interval of 0.46 was lower than the predetermined noninferiority margin (Δ=0.6), demonstrating NS-126C noninferiority to FP. Both comparison drugs were superior to placebo (p&lt
0.001). Patient population safety showed no significant difference between the two drug groups in the incidences of adverse events or adverse drug reactions. The incidence of nasal discomfort as an adverse drug reaction was 0. 6% (1/162) in the NS-126C group and 3.1% (5/161) in the FP group, indicating that the NS-126C powder preparation elcited fewer adverse nasal cavity drug reactions. These findings verified noninferior NS-126C efficacy administered at 400 ug once daily compared to fluticasone propionate nasal solution administered twice daily. NS-126C is thus effective and safe in treating allergic rhinitis.

DOI： 10.5631/jibirinsuppl.127.1

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Myoepithelioma is a rare neoplasm that can occur in either the major or minor salivary gland and accounts for less than 1% of salivary gland neoplasms. We report a rare case of a nasal myoepithelioma that originated from the nasal inferior turbinate. The tumor, measuring 50 x 30 x 20 mm, was in the right nasal cavity and had a necrotic surface. We removed the tumor through endonasal endoscopic surgery. The tumor had spindle-shaped cells and was positive for cytokeratin, (AE1/AE3), vimentin, S-100β, and MIB-1 but was negative for CD34, desmin, neuron-specific enolase, and synaptophysin. Slight immunoreactivity for smooth muscle actin was noted in some tumor cells. There has been no evidence of tumor recurrence in the 18 months following surgery.

DOI： 10.1272/jnms.77.273

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

Background: Although sublingual immunotherapy (SLIT) is hopeful therapy for seasonal allergic rhinitis by Japanese cedar pollen, there are many issues to study. We studied the adding effects on clinical efficacy by the treated years and sustained efficacy 1 year after a 3-year period of SLIT. Methods: Clinical efficacy of SLIT in patients with Japanese cedar pollinosis treated for different years of 1 year (n = 7), 2 years (n = 18) or 4 years (n = 5) were compared in 2009. Patients, who finished SLIT after a 3-year period and did not received SLIT at the fourth year (n = 12), was also compared with those who received SLIT at the fourth year (n = 5). Results: By adding treated year, clinical efficacy of sneezing, rhinorrhea and congestion became better, and symptom-medication score (SMS) was significantly better in the fourth year of SLIT. Patients with the fourth year of SLIT showed better SMS compared with those who finished at the third year. Conclusion: Consecutive treatment of SLIT showed better efficacy. Although it was recommended to continue SLIT therapy at least four years, it needed further study because of small number of patients. ©2010 Japanese Society of Allergology.

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

Purpose: According to the 2008 survey conducted by Baba et al, the average prevalence of Japanese cedar-pollen allergy is 26.5% in Japan, although there are great regional differences in the prevalence of this disease. In this study, we investigated the causes of its regional differences. Methods: Regional differences in the 2008 prevalence of cedar-pollen allergy in 47 prefectures, obtained by Baba et al, were examined in terms of the correlations with the following factors: mean cedar pollen count in each region, the pollen dispersal period, relative humidity in February and March, and the concentrations of SPM, NOx and Ox. The pollen counts of cedar and cypress and the sum of these pollen counts were also measured Results: The prevalence of cedar-pollen allergy had the highest correlation with the pollen dispersal period, followed by the correlation with the pollen count and relative humidity in the order. There was no statistically significant correlation between the prevalence of cedar-pollen allergy and air pollutants such as SPM. © 2010 Japanese Society of Allergology.

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.59.1459_4

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.59.1460_2

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/j.1472-9733.2009.01140.x

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記述言語：英語   出版者・発行元：Japanese Society of Allergology  

The prevalence of pollinosis caused by cedar pollen has increased by 10% these ten years of 26.5% in the investigation of 2008 in Japan. The pharmacotherapy is a main treatment tool for pollinosis, and the surgical treatment is not acknowledged to the treatment of pollinosis internationally. Moreover, allergen immunotherapy enters a special treatment method, and is an important therapeutic procedure. The allergen immunotherapy is unique for having possibility of curing allergen specific allergic diseases. However the side effect of allergen subcutaneous immunotherapy (SCIT), such as anaphylaxis is kept at a distance in a medical situation in Japan. Then, a sublingual immunotherapy (SLIT) that was safer than it, developed in Europe for pollinosis induced by grass or ragweed, but not in Japan. As a result, the effect of SLIT was proven in the cedar pollinosis in Japan as high level evidence. A whole body immunity induction is thought in the appearance of the effect, and, in addition, it is necessary to be going to be cleared the accurate mechanism of the effect in the future. Moreover, the development of a special SLIT and the import of an overseas product are needed in Japan.<br>

DOI： 10.2332/allergolint.08-RAI-0072

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記述言語：日本語   出版者・発行元：(株)医学書院  

患者は67歳,男性.4歳と65歳時に2回の気管切開歴がある.2回目の気管孔閉鎖後,吸気性喘鳴,呼吸困難,乾性咳嗽,咽喉頭異常感が出現,徐々に増悪した.過去の気管切開部に一致した声門下と頸部気管の狭窄と,咽喉頭まで及ぶ胃食道逆流症に特徴的な披裂部粘膜の発赤・腫脹およびinter-arytenoid barを認めたため,気道狭窄に対する手術とともに術前からプロトンポンプ阻害剤であるランソプラゾール30mg/日の投与を行った.術後,吸気性喘鳴と呼吸困難は消失したが,1年経過後も咳嗽と咽喉頭異常感は不変であった.CYP2C19の遺伝子型を調査したところ,代謝活性の強いhomozygous EMであったため,CYP2C19に依存しない代謝経路を有するプロトンポンプ阻害剤であるラベプラゾール20mg/日に変更したところ,咳嗽,咽喉頭異常感は消失した.(著者抄録)

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2009&ichushi_jid=J00435&link_issn=&doc_id=20090507150014&doc_link_id=10.11477%2Fmf.1404101267&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1404101267&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

記述言語：日本語   掲載種別：研究論文（その他学術会議資料等）   出版者・発行元：(株)医薬ジャーナル社  

鼻閉症状が残存する治療中のスギ・ヒノキ花粉症患者に対して、プランルカストの追加投与の効果について検討した。対象は平成20年3月18日から5月18日の研究期間内に山口県内の研究協力施設において治療された花粉症患者で、鼻閉症状が残存している患者116例である。それまでの治療を変えることなく、プランルカスト1日450mgを追加投与した。投与開始時、3日後、7日後に、鼻症状とQOLを評価するため、調査票を配布した。調査票は、最近24時間の自覚症状(くしゃみ回数、鼻をかんだ回数、鼻づまりの状況)、QOLの障害(仕事・勉強への影響、行楽への影響、生活行動への影響、睡眠への影響)を評価するよう作成した。追加投与の3日後、7日後には追加投与前と比べて有意に症状スコア、QOLスコアの改善を認めた。スギ花粉の飛散が多かった時期に限定して検討しても、同様の結果であった。以上の結果は、プランルカストの追加投与が、比較的短時間に症状やQOLの改善に効果を示す可能性を示唆している。(著者抄録)

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.58.1222_2

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：KARGER  

Background: Seasonal allergic rhinitis (SAR) induced by Japanese cedar pollens is a serious problem in Japan. Omalizumab, a humanized monoclonal anti-IgE antibody, improves symptoms associated with SAR, but a study comprehensively investigating the clinical efficacy, safety and pharmacological effects of omalizumab re-treatment has not yet been conducted. Methods: The open-label, 12-week study was carried out in 34 patients who had been treated with omalizumab in the core study conducted in the previous Japanese cedar pollen season. The study plan including study period, efficacy and safety endpoints, as well as dose regimen, was designed to be the same as in the core study. Omalizumab was administered subcutaneously every 2 or 4 weeks based on the serum IgE level and body weight of each patient. Results: Time course changes in daily nasal symptom medication scores as well as in daily ocular symptom medication scores throughout the pollen period were comparable with those in the omalizumab group in the core study. Serum free IgE levels decreased to below the target level in all patients and were equal to those in the omalizumab group in the core study. The adverse reaction profiles were similar to those in the core study. In addition, the overall incidence of drug-related adverse events and injection site reactions in the re-treatment study did not increase compared with those in the omalizumab group in the core study. There were no serious adverse events, and no anti-omalizumab antibodies were detected. Conclusion: Omalizumab was effective and safe when consecutively readministered in the second Japanese cedar pollen season. Copyright (c) 2009 S. Karger AG, Basel

DOI： 10.1159/000199719

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

Background: Sublingual immunotherapy (SLIT) for allergic rhinitis is commonly used in Europe, but not in Japan. Although some studies of SLIT for Japanese cedar pollinosis (JCP) were reported, all the subjects were adults. SLIT is an ideal treatment for children rather than for adults, because it overcomes subcutaneous immunotherapy in the complication of painful injections and habitual visits of a hospital. We tried an open pilot study of SLIT for pediatric JCP. Methods: Ten pediatric patients with JCP (4 boys and 6 girls, mean ages
8.5 ± 2.2 years old) were treated according to a scheduled doses of SLIT with a therapeutic standardized Japanese cedar pollen extract. They were maintained at the doses of 2000JAU of allergen once a week during pollen scattering. Clinical efficacies during the pollen scattering in the first season were evaluated from their diary of symptoms and medications, visual analog scale (VAS) of symptoms, and a questionnaire for SLIT. Results: The mean severity scores of nasal and ocular symptoms were low. VAS was also very short. Three of 10 patients had no symptoms without any drugs during the pollen season. Two patients were medicated within 5 days. Conclusions: SLIT was effective for pediatric Japanese cedar pollinosis. © 2009 Japanese Society of Allergology.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background: In recent years, many countries have experienced an increase in the prevalence of allergic rhinitis. No effective approach is currently available to prevent the onset of symptoms in allergic individuals. Pranlukast, a leukotriene receptor antagonist with a good safety and efficacy record for the management of allergic inflammation, may be appropriate for early intervention in the management of pollinosis. Objective: To investigate the efficacy of pranlukast as an early intervention in the control of cedar pollinosis. Methods: In a double-blind comparative study, pranlukast (n=102) or placebo (n=91) was administered to cedar pollinosis patients immediately before the start of the dispersion season and continued for 4 weeks. Subsequently, pranlukast was administered to all patients for 2 weeks until the end of the cedar pollen dispersion season (mid-March). All patients were carefully monitored for severity of nasal symptoms, symptom scores, medication scores, symptom-medication scores, and quality of life (QOL). Results: Compared with placebo, therapy with pranlukast before and during the dispersion of cedar pollen in these patients significantly improved nasal symptoms (paroxysmal sneezing, rhinorrhea, and nasal congestion), symptom scores, and symptom-medication scores. The drug also significantly reduced deterioration of QOL, and improved nasal symptoms and QOL throughout the dispersion period. Conclusion: Administering pranlukast immediately before the beginning of cedar pollen dispersion is effective in reducing symptoms of allergic rhinitis throughout the dispersion period. © 2009 Esmon Publicidad.

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.58.1320_4

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.58.1317_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.58.1196

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.58.1150_1

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background: B7/CD28 family co-signalling molecules play a key role in regulating T cell activation and tolerance. Allergen-specific immunotherapy (SIT) alters allergen-specific T cell responses. However, the effect of SIT on the expression of various co-signalling molecules has not been clarified. Objective: We sought to determine whether SIT might affect the expression of three co-inhibitory molecules, programmed death (PD)-1, B7-H1 and B and T lymphocyte attenuator (BTLA), in Japanese cedar pollinosis (JCP). Methods: Peripheral blood mononuclear cells (PBMCs) were isolated from JCP patients who had or had not received SIT. PBMC were cultured in the presence or absence of Cry j 1, after which the cell surface expression of PD-1, B7-H1 and BTLA, as well as IL-5 production, were determined. In addition, the effect of BTLA cross-linking on IL-5 production was examined. Results: After Cry j 1 stimulation, no significant differences in PD-1 and B7-H1 expression were observed between SIT-treated and SIT-untreated patients. BTLA expression was down-regulated in untreated patients after Cry j 1 stimulation and up-regulated in SIT-treated patients. Up-regulation of BTLA in SIT-treated patients was particularly apparent in a CD4+ T cell subset. IL-5 production was clearly reduced among SIT-treated patients, and the observed changes in BTLA expression correlated negatively with IL-5 production. Moreover, immobilization of BTLA suppressed IL-5 production in JCP patients. Conclusion: These results suggest that both IL-5 production and down-regulation of BTLA in response to allergen are inhibited in SIT-treated patients with JCP. BTLA-mediated co-inhibition of IL-5 production may contribute to the regulation of allergen-specific T cell responses in patients receiving immunotherapy. © 2008 The Authors.

DOI： 10.1111/j.1365-2222.2008.03116.x

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.57.361_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.57.1247

CiNii Books

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.57.73

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その他リンク： http://search.jamas.or.jp/link/ui/2008166175

記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.57.1528_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.57.1529_4

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記述言語：日本語   出版者・発行元：The Japan Broncho-esophagological Society  

近年，本邦においても，慢性閉塞性肺疾患（COPD）の増加が懸念されている。COPDの薬物療法には，吸入抗コリン薬が，単独でも十分な効果があり，全身的副作用が少ないことから多く使用されている。われわれは，最近開発された長時間作用型の吸入抗コリン薬（チオトロピウム）の使用により，喉頭内腔が湿潤性を失い嗄声をきたした症例（"喉頭乾燥症"と仮称した）を経験したので報告する。<br>症例は，60歳の男性。2カ月前から，声の出し難さと，嗄声が出現し，改善しないため，当科を受診した。喉頭内視鏡で観察を行ったところ，披裂間部および声帯後方に痂皮を伴う粘膜の湿潤性低下を認めた。詳しく問診を行ったところ，2カ月半前から，COPDに対して長時間作用型の吸入抗コリン薬（チオトロピウム）が投与されていたことが判明した。そこで，同薬を中止したところ，約1カ月で，喉頭内視鏡所見と嗄声は完全回復した。

DOI： 10.2468/jbes.58.533

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その他リンク： https://jlc.jst.go.jp/DN/JALC/00304111259?from=CiNii

記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）  

DOI： 10.1111/j.1365-2222.2007.00116.x

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.56.1090_3

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.56.1144_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.56.1144_3

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出版者・発行元：日本鼻科学会  

Japanese cedar pollinosis (JCP) is a relatively common disease in Japan and is a serious problem between February and April each year. H1 antagonists (antihistamines, including second-generation antihistamines) are used as first-line treatment in most patients. It has recently been recommended that patients who develop severe symptoms of pollinosis every year begin treatment immediately after the start of pollen release or the onset of symptoms. A physician should choose the drug regimen for each patient by selecting from among many second-generation antihistamines according to the amount of pollen release expected during the season and the type and severity of symptoms usually experienced by the patient during the peak season. However, there is wide variation in pollen release among the regions of Japan and from year to year. If constant effectiveness of an antihistamine for patients with JCP were demonstrated by a large-scale multicenter study for several years, it would please both patients with JPC and their physicians.<br>In this study we investigated the efficacy of the second-generation anti-histamine olopatadine in 1611 patients with JCP attending the clinics of 83 hospitals, for 3 consecutive years. Prophylactic olopatadine was effective against JCP, especially in the season pollen level was low (under 2000/season). In the season when there was a high pollen level, prophylactic olopatadine was effective until the peak pollen release. After one day of therapy olopatadine also significantly improved the nasal symptom scores of patients with moderate to severe symptoms of JCP. These results suggest that olopatadine is a very effective drug for the treatment of JCP.

DOI： 10.7248/jjrhi1982.46.1_18

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.56.310_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.56.373_4

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.56.373_3

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.56.1043_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.56.1125_3

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.56.1090_4

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.56.1042_1

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記述言語：日本語   出版者・発行元：The Society of Practical Otolaryngology  

DOI： 10.5631/jibirin.99.706

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その他リンク： http://search.jamas.or.jp/link/ui/2006318422

記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）  

DOI： 10.1111/j.1365-2222.2006.00112.x

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.55.417_3

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.55.474_3

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記述言語：英語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.55.345_1

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記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）  

DOI： 10.1111/j.1365-2222.2005.0091.x

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

【目的】スギ花粉症患者は季節前20〜60%の高率に発症すると報告されているが, 発症の判定は自覚症状に頼り, 他覚的証明に欠けている.そこで, 我々の開発した鼻内洗浄法で, 真偽を確かめた.【方法】1997年から2005年1月, 当科外来患者を発症後短時日に洗浄し, 洗浄液中の花粉数を測定し, 季節前, 中, 後の花粉数と比較した.【結果】季節前花粉数は1箇以下が67.8%, 季節中が12.5%で, 両者に有意差があった.季節前発症に十分な花粉数をもつものは少なかった.スギ花粉以外の花粉も検出された.季節前花粉数は翌年の季節中飛散花粉総数と相関した.【考察, 結論】季節前発症には空中花粉数の測定法, 他の花粉の吸入, 個人の花粉感受性, 他の鼻疾患などの要因が関与している.しかし今回の研究結果からみて, 従来の季節前発症率の報告は高きにすぎ, 診断の正確性が問題である.

DOI： 10.15036/arerugi.54.636

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その他リンク： http://search.jamas.or.jp/link/ui/2005231377

記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

【目的】スギ花粉時然曝露による花粉の身体への付着を花粉症発症予防のために明らかにする. 【方法】非スギ花粉症男性高校生10名を洗顔後, 非花粉汚染木綿Tシャツ, 運動帽を着用, 運動場および教室内で2003年3月16日それぞれ2時間自由行動させ, 粘着テープでシャツ, 帽子, 顔面皮膚から付着花粉を採取カウントした. 不織木綿, 綿ポリエステル混紡, 羊毛布地を水洗, 運動場10カ所で5時間放置乾燥後, 付着スギ花粉を同様に採取カウントした. 実験運動場, 教室の浮遊, 落下花粉数もカウントした. 【結果】Tシャツ, 帽子, 皮膚付着花粉は運動場で教室内より多かった. 教室内外では単位面積当り付着数は有意差がなく, 教室内ではTシャツが皮膚より多い傾向にあった. 水洗布地への付着数は混紡で, 綿, 羊毛より少なかったが傾向差であった. 浮遊花粉数は教室内で少なかった. 【考察】結論:外出には混紡のコート, 帽子を着用し, 帰宅後は洗顔をする. コート, 帽子は玄関のコート掛けにかけておくが良い.

DOI： 10.15036/arerugi.54.555

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その他リンク： http://search.jamas.or.jp/link/ui/2005200676

記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

【目的】くしゃみ, 水性鼻漏, 鼻閉はアレルギー性鼻炎非アレルギー性鼻炎だけでなく正常人にもみられる. 正常鼻の症状の定義は鼻炎の診断, 重症度分類, 治療効果の判定に必要である. 【方法】鼻症状がなく, 鼻の治療歴もなく, 現在かぜをひいていない235人を登録リストから抽出し, 自記式鼻症状調査票を用いて郵送法で調査した(抽出群). 別に4耳鼻科診療所を鼻以外の疾患のため訪れた患者で, 検査により鼻正常と診断された54人を同じ調査票を用いて調査した(対照群). 【結果】回答率は49.8%, 回答者117人であった. 対照群の鼻症状は抽出群のそれより少なかった. 正常人の鼻症状はないか, 一時的の鼻閉, 1日5回以下のくしゃみ, 省鼻があるが, 鼻かゆみ, 後鼻漏は少なかった. 症状があっても週4日以内であった. 【結語】広く用いられている重症度分類においてgrade(-)は症状なし(0)と定義されている. 今回の研究によれば, 症状はないか, "くしゃみや省鼻は1日1〜5回未満がたまにある, 鼻閉はあっても苦痛でない"という程度の有症を正常としてgrade(-)に含めてよいと結論できる. 従って治療による正常化もこれに従ってgrade(-)を定義してよい.

DOI： 10.15036/arerugi.54.551

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その他リンク： http://search.jamas.or.jp/link/ui/2005200675

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記述言語：日本語   出版者・発行元：Society of Oto-rhino-laryngology Tokyo  

東京都において, 観測史上最多のスギ花粉飛散を記録した20o5年に, 多施設共同でスギ花粉症に対するラマトロバンおよび抗ヒスタミン薬との併用療法を, 鼻症状およびQOLについて花粉症日記と日本アレルギー性鼻炎標準調査票 (JRQLQ No.1およびNo.2鼻眼以外の症状用) を用いて検討した。比較に際しては, 初期治療群と飛散後治療群に群別した。初期治療群では飛散後治療群に比較して, 鼻症状およびQOLともにスギ飛散ピーク時のスコアの抑制がみられ, 副作用は認められなかつた。作用機序の異なるラマトロバンと抗ヒスタミン薬との併用は, シーズン10,000個/cm2を超えるような大量飛散年においても, 飛散ピーク時の鼻症状ならびに患者QOLを改善することから有用な治療法であることが示唆された。

DOI： 10.11453/orltokyo1958.48.427

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Blackwell Publishing  

Background: Although subcutaneous immunotherapy may cure allergic diseases, it is not commonly used in Japan because of the pain and risk of anaphylactic shock. Sublingual immunotherapy(SLIT)overcomes these limitations and although it is the most advanced form of local immunotherapy for clinical application, it is not used in Japan nor has it been extensively studied. Methods: After obtaining approval from the Ethics Committee of Nippon Medical School and informed consent from five patients with cedar pollinosis(one man, four women
age range, 38-66 years), administration of a therapeutic extract was started in July 2001 or later(mean treatment period, 13.4 months). The clinical efficacy of SLIT and its influence on the quality of life, as measured by the Japanese Allergic Rhinitis QOL Standard Questionnaire, and the incidence of side effects were evaluated in 2003. Results: Between February and April the mean severity score was 1.44 in the patients undergoing SLIT and 1.86 in the patients undergoing pharmacotherapy, and the respective mean QOL total scores during the season were 3.82 and 10.0. Neither systemic nor local side effects occurred during SLIT. Conclusions: SLIT is safe and effective for Japanese cedar pollinosis. ©2005 Japanese Society of Allergology.

DOI： 10.2332/allergolint.54.167

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.54.994_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.54.271_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.54.269_1

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記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）  

The prevalence of childhood allergic rhinitis is increasing steadily in Japan. Affected children are sensitized mainly by house dust mites
however, the prevalence of Japanese cedar pollinosis (JCP) in children is also on the rise. To ascertain the prevalence and current status of JCP in Japanese children, a retrospective analysis of a nationwide cross-sectional random sampling study was conducted. The survey, conducted shortly after the peak pollen season, was performed by self-evaluation questionnaire in 2001. Data from children aged under 15 years were collected and analysed. In these subjects, the response rate was 75.1%. The prevalence of JCP was 10.2% in children. Rhinorrhoea was the severest symptom reported
19.5% had severe or moderate interference with daily activities and consulted physicians. Few children used prescribed drugs and some took measures to avoid contact with allergens.

DOI： 10.1111/j.1472-9725.2004.00026.x

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.53.263_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.53.980_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.53.876_1

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