3 0 0 0 OA 致死性不整脈を伴う急性冠症候群に関連する因子についての検討
- 著者
- 芥野 絵理 菊池 幹 百名 洋平 吉村 仁 折口 秀樹 林谷 俊児 毛利 正博 山本 英雄 瀬筒 康弘 山本 雲平 宮田 健二 野間 充 多治見 司
- 出版者
- 公益財団法人 日本心臓財団
- 雑誌
- 心臓 (ISSN:05864488)
- 巻号頁・発行日
- vol.44, no.SUPPL.2, pp.S2_93-S2_97, 2012 (Released:2013-09-18)
- 参考文献数
- 7
急性冠症候群において致死性不整脈が出現し得ることは広く知られており,一般的には虚血心筋の再灌流時に発生すると考えられている.電気生理学的機序により急性冠症候群時の致死性不整脈発生機序は理論づけられているが,臨床的にどのような因子が影響を及ぼしているかは明らかとなっていない.今回,われわれは,2010年1月から2011年6月までの18カ月間に,当院において急性冠症候群に対する緊急経皮的冠動脈形成術を行った208例において,致死性不整脈出現にどのような因子が関与しているかを検討した.208例中18例において,急性期に心室頻拍/心室細動(VT/VF)などの致死性不整脈が出現した.致死性不整脈出現例での責任冠動脈は左冠動脈主幹部(LMT)が1例,左前下行枝(LAD)が5例,左回旋枝(LCX)が2例,右冠動脈(RCA)が10例であった.基礎疾患でのリスクファクターを検討したところ糖尿病を有する症例に多く,左右の冠動脈では右冠動脈を責任病変とする症例で出現しやすいという結果であった.
- 著者
- 宮田 健
- 出版者
- 公益社団法人 日本薬学会
- 雑誌
- YAKUGAKU ZASSHI (ISSN:00316903)
- 巻号頁・発行日
- vol.123, no.12, pp.987-1006, 2003 (Released:2003-11-29)
- 参考文献数
- 48
- 被引用文献数
- 3 6
Disturbance of the normal mucociliary clearance due to hyperproduction of mucus and modification of its physicochemical characteristics is a common finding in airway diseases. Drugs that affect airway secretion have been developed and used to cleanse the respiratory tract for many centuries and in many countries. On the basis of the mechanism of their actions, the mucoactive drugs are classified into several groups. Some mucoactive drugs have direct effects on the production or composition of airway secretions, resulting in increased effectiveness of mucociliary clearance. Other mucoactive drugs do not have a specific action on mucus, but have beneficial effects on airway structure and function, which lead to correction of the pathophysiologic mechanisms that result in abnormal secretions. However, since many drugs have overlapping effects, it is difficult to classify these drugs into groups based on their major actions. Taken together with previous findings on mucoactive drugs, it appears that an antioxidant effect is a common property of mucoactive drugs and that it is a crucial action to exert their effects against airway diseases. In light of this idea, we must use specific experimental models to simulate pharmacologic events in airway inflammation. The development of new techniques has made it possible to identify and measure the mucus components, measure the rheologic parameters more accurately, and evaluate mucociliary clearance precisely in animals and humans. Therefore, with modifications of methods, we have investigated airway-cleansing drugs from various points of view to reflect actions in inflammatory states for more than two decades. Here, I introduce the methods we have used to study many of the parameters involved in airway clearance, including cough reflex, and describe some of the mucoactive-antitussive drugs that we have studied recently. There is an increasing usage of traditional Chinese herbal medicines in clinics and hospitals, because they tend to have moderate side effects and sometimes remarkable efficacy. To renormalize overall defects in airway disorders, Chinese medicines may be adequate, because they are composed of various herbs with weak but ubiquitous pharmacologic activities. We have been investigating Bakumondo-to. Bakumondo-to has been used for the treatment of bronchitis and pharyngitis accompanying severe dry cough. We found that unlike codeine Bakumondo-to had a notable antitussive activity against the cough associated with bronchitis and the cough increased by angiotensin-converting enzyme inhibitors. Recently, we have found that, in alveolar type II cells, Bakumondo-to attenuated phosphatidylcholine secretion increased by oxygen radicals from activated PMNLS. In addition, we found that Bakumondo-to itself stimulated phosphatidylcholine secretion and increased β-adrenoceptor gene expression in rat alveolar type II cells. We studied the mechanism of action and clarified that Bakumondo-to increased glucocorticoid-sensitive promotor activity. The effect may contribute to its ubiquitous effectiveness in the treatment of airway diseases. Various parameters (chemical properties, physical properties, mucus production, surfactant phospholipid production, and mucociliary clearance) are considered to be important for the dynamics and mobilization of airway secretions. Pharmacologic investigation, with appropriate techniques, of the ability of an agent to modify these parameters can provide useful information about its mechanism of action. However, since these parameters are interconnected, it is very complicated to elucidate the precise mechanisms of action of mucoactive drugs. This means that the goal of treatment cannot always be achieved by the modification of a single parameter, but should, more realistically, be aimed at a renormalization of several parameters. On the basis of this idea, glucocorticoids are ideal mucoactive drugs because they exert various…
2 0 0 0 OA 「麦門冬湯の慢性炎症性気道疾患治療薬としての病態薬効解析」
- 著者
- 宮田 健
- 出版者
- The Japan Society for Oriental Medicine
- 雑誌
- 日本東洋医学雑誌 (ISSN:02874857)
- 巻号頁・発行日
- vol.51, no.3, pp.375-397, 2000-11-20 (Released:2010-03-12)
- 被引用文献数
- 2 2
