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7 座長 司会の方へ 1) 各セッションの開始 15 分前までに各会場の 次座長席 にご着席下さい 2) 発表 討論の進行は座長 司会に一任いたします ただし 時間は厳守下さい ポスター掲示についてポスター掲示は口演を行う日に限ります 9 月 30 日 ( 金 ) 10 月 1 日 ( 土 ) ともに 9:00 11:00 の間に ホテル阪神 2F ポスター掲示会場 ( レストラン NeN) の所定の演題番号パネルに貼り出して下さい 原則として口演当日の 18:00 18:30 の間に撤去して下さい この時間内に撤去されなかったポスターに関しては 学会事務局にて処分させて頂きますのでご留意下さい ( 例 )9 月 30 日 ( 金 ) に発表される場合 :9 月 30 日 ( 金 ) の 9:00 11:00 の間に張り出し 18:00 18:30 の間に撤去する ポスターの掲示用のボードの大きさは縦 横 cm のものを用意しております ポスターサイズの目安は タイトル 所属 演者名 : 縦 横 cm 発表内容用: 縦 横 cm 以内でお願いします 連絡先 学会期間中 : 学会本部 ( ホテル阪神 12F サロンパール) 大阪市福島区福島 5 丁目 6 番 16 号 TEL: FAX: 学会期間前後 : 第 44 回日本鼻科学会事務局大阪医科大学耳鼻咽喉科学教室 大阪府高槻市大学町 2-7 TEL FAX 事務局連絡先 : 幹事寺田哲也 (oto056@poh.osaka-med.ac.jp) 秘書井上雅美 (bika44@art.osaka-med.ac.jp)
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18 :0014: IgE 4 B 34 15:0016:
19 4 5 17:0018: :1011:
20 2 10:1011: :2013:20 13:2513:55 14:0015:00
21 3 15:0016: Acoustic Rhinometry 3 -X CT :0016: :008:45
22 5 9:0010: ESS 3 ESS :3012:00 1 Guidelines For Diagnosis and Treatment of Sinusitis in Foreign Countries Cornell University, USA Vijay K Anand 2 Current European guidelines for diagnosis and treatment of rhinosinusitis Huddinge University, Sweden Lars Pontus Stierna 3 Bacteriology and Antibiotic Susceptibility in Chronic Sinusitis with Polyp in Korea Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea Joo-Heon Yoon 4 International Consensus on Rhinosinusitis Nippon Medical School,Japan Ruby Pawankar
23 2 12:1013: :1013: :1514: :1514:15 1 NK/T
24 2 NK/T 3 NK/T 2 15:5017: YAMIK
25 1 9:0010: ESS
26 2 I 16:1017: Quantitative analysis of glucocorticoid receptor in nasal polyps 10 LPSPGN NF-B 11 glucocorticoid receptor- 12 MMP 3 II 17:0017:50 13 Aspartate Protease from Alternaria Activate and Degranulate Human Eosinophils through PAR-2 14 E2
27 15 D2 16 Eotaxin I 16:1017:00 18 Flt3 ligand 19 IL Toll like receptor (TLR) IL-4 TARC 21 enhanced pause(penh)
28 22 plasminogen activator inhibitor-1(pai-1) 4 5 I 17:0017: Functional MRI 25 NIH image :1017:10 28
29 / 17:1018:
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31 6 9 17:1018: T promiscuous T helper epitope CpG DNA 7 10 I 16:1016:50 50 Haller's cell (infraorbital ethmoid cell) 51
32 II 16:5017: HPC :3018:10 58 Nasal Cycle
33 59 nasal cycle IgE 8 13 I 16:1017:
34 8 14 I 17:0017: Sino-Orbital Aspergillosis /17:4018:
35 9 16 II 16:1017: CDDPTS II 17:0017: Gustatory rhinorrea 81
36 :4018: II 14:2015:00 86 SCC 87 IL-6
37 II 15:0015:
38 21 III 14:2015:00 95 Th1,Th2,Tc1,Tc IgE - 98 IgE - IgE+ IgE 22 III 15:0015:
39 QOL III 14:2015: NK/T Heat Shock Protein NK/T NK/T 108 EGFRKi-67 HPV
40 24 15:1015: paraganglioma FGF III 14:2015:
41 CT 26 II 15:0015: Musashi1
42 27 / 14:2015: Virtual endoscopy CT III 15:1015:
43 29 III 14:2015: :1015: Nasal-BiPAP
44 IV 14:2015:
45 32 / 15:1015:
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65 Engineering Inhibitory-Signaling Molecules to Regulate Allergic Disease Andrew Saxon Division of Clinical Immunology/Allergy, Department of Medicine UCLA School of Medicine, USA
66 Engineering Inhibitory-Signaling Molecules to Regulate Allergic Disease Division of Clinical Immunology/Allergy, Department of MedicineUCLA School of Medicine, USA Andrew Saxon We have undertaken to develop new therapies for allergic diseases by taking advantage of negative signaling via immunoreceptor tyrosine-based inhibition motif (ITIM)-containing receptors. We constructed bi-functional molecules that either directly or indirectly crosslink Fcε receptors to the FcγII receptors on targeted cells. The first approach directly co-aggregates Fcε and FcγII receptors utilizing a human fusion protein comprised of the human IgG1 γ hinge-chγ2-chγ3 region linked to the human IgE CHε2-CHε3-CHε4 region (GE2). The GE2 protein was shown to be able to inhibit the release of histamine in a dose-dependent fashion from purified human basophils that were experimentally or naturally sensitized. GE2 also inhibited release of IL-4 from human basophils and release of histamine and TNFα from human mast cells. These effects of GE2 were primarily mediated to effects on Syk phosphorylation and function. Passive cutaneous anaphylaxis (PCA) in transgenic mice expressing the human FcεRIα chain showed that GE2 was able to block PCA reactivity in vivo. Skin test reactivity to dust mite in Rhesus monkeys naturally allergic to dust mites was also blocked by GE2. Furthermore GE2 was also effective at inhibiting IL-4 plus CD40-driven class switch recombination and IgE production from human B cells via crosslinking low affinity receptor for IgE (CD23) and FcγRII. This inhibition of IgE class switch recombination was mediated via suppression of IL-4-induced STAT6-phosphorylation. The second approach employed coaggregation of FcεRI and FcγRII using an antigen-specific chimeric fusion protein (GFD) that was composed of the human Fcγ and the major cat allergen, Fel d1. GFD was designed to block mediator release by directly attaching to Fcγ receptors and at the same time indirectly binding to FcεRI via Fel d1 antigen specific IgE already bound to FcεRIs. GFD was expected to function as a safer form of antigen specific form of immunotherapy with GFD blocking acute reactivity to cat, e.g. not functioning as an allergen while still functioning as an immunogen. Indeed, GFD inhibited release of mediators from basophils of cat-allergic individuals while failing to induce release from these persons basophils. These effects of GFD were mediated via inhibition of Syk-Erk phosphorylation. GFD also inhibited PCA reactivity to Fel d1 in transgenic mice but did not induce skin reactivity itself at sensitized sites. In mouse models where animals were sensitized to Fel d1, GFD showed that it could block skin, pulmonary, and systemic reactivity to Fel d1. Simultaneously, GFD failed to induce systemic or local allergic reactivity in sensitized mice. This chimeric gamma-allergen protein platform may provide allergen-specific therapy with safety profile that may be critical in situations such as food allergy. Overall, we developed two new therapeutic strategies, one antigen-non-specific and one antigen-specific that provide novel yet distinctive approaches for the potential therapy of human allergic disease.
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79 1 Guidelines For Diagnosis and Treatment of Sinusitis in Foreign Countries Cornell University, USA Vijay K Anand 2 Current European guidelines for diagnosis and treatment of rhinosinusitis Huddinge University, Sweden Lars Pontus Stierna 3 Bacteriology and Antibiotic Susceptibility in Chronic Sinusitis with Polyp in Korea Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea Joo-Heon Yoon 4 International Consensus on Rhinosinusitis Nippon Medical School,Japan Ruby Pawankar
80 3 Cornell Vijay K Anand Sweden Huddinge Lars Pontus Stierna Yonsei Joo-Heon Yoon Ruby Pawankar GUIDELINES FOR DIAGNOSIS AND TREATMENT OF SINUSITIS IN FOREIGN COUNTRIES. Vijay K Anand Cornell University, USA The diagnosis and treatment of sinusitis has been streamlined reasonably well in the USA in the last ten years. Developing a model and applying that in day to day in an otolaryngological practice could be helpful in the successful management of sinusitis in foreign countries. This would help in organizing the diagnostic procedures and documentation. This would also allow physicians an opportunity to discuss the treatment options with patients clearly and demonstrate the indications for medical and surgical treatment options. In this presentation every effort will be made to describe the different types of sinusitis, identify the useful staging that is currently used and the effective tool to assess the outcome of the disease. The clear indications for maximal medical therapy and the indications for surgery that has been published by the Sinus Allergy partnership in association with the American Rhinologic Society will be presented. The presentation will also include the adjunctive medical treatments that are currently popular and demonstrate the applicability in other countries.
81 Current European guidelines for diagnosis and treatment of rhinosinusitis. Bacteriology and Antibiotic Susceptibility in Chronic Sinusitis with Polyp in Korea Pontus Stierna,MD,PhD,Prof. Karolinska University Hospital,14186 Stockholm,Sweden Rhinosinusitis is one of the most commonly made diagnoses by primary care physicians and specialists within the field of ENT and the disease is the result of complex interactions between microbial and host defence mechanisms. Rhinosinusitis may precipitate from a viral common cold probably in a subgroup of patients with a co-morbid mucosal disease but is still relatively rare at least presenting as a purulent infectious sinusitis. For acute sinusitis the bacteriology and their role in induction is established. Bacteria, respiratory viruses of fungi may also influence individual immune responses by either causing infection or by colonization and thereby through individual immune responses perpetuate the events of sinusitis. The persistence of the inflammatory response in sinusitis is not only dependent on individual differences in host immune responses, but also on specific influence of these responses by local microbes. Understanding and differentiating infectious and non-infectious inflammatory stimuli are critical to understanding sinusitis.the bacteria complicate the chronic sinusitis process by being opportunistic or colonizing and as may be seen from latest years of research on fungus and S. aureus colonization.emerging data speaks towards aberrant immune responses and locally reduced host defence, as major factors in the pathogenesis of chronic tissue pathology in long-standing sinusitis.epidemiological and clinical data analysing predisposing factors together with a basic understanding of the pathophysiology have been reviewed and resulted in the published European position paper on rhinosinusitis (EPOS).The role of the presented paper for the practical management of rhinosinusitis will be discussed. Joo-Heon Yoon, MD Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea The first-line therapy for chronic sinusitis with nasal polyps is medical treatment including antibiotics, however, difficulty in treatment has been confronted with the increase of antibiotics-resistant bacteria, which was promoted by improper and long-term use of antibiotics. Microbiology data of patients with chronic sinusitis with nasal polyps can be used as a guideline for the empirical use of antibiotics, resulting in reduction of treatment duration, medical costs, and complications. Accordingly, the Korean Rhinologic Society investigated the causative bacteria and antimicrobial susceptibility in children and adults with chronic sinusitis with nasal polyps in Korea. We studied the bacteriology of maxillary sinus aspirates from 81 patients with chronic sinusitis with nasal polyps and examined the sensitivity of the cultured microorganisms to the antibiotics. Aerobes were isolated in 58.0% of the cultures from the middle meatus and in 48.1% of those from the maxillary sinus. Staphylococcus aureus, Haemophilus influenzae, and Streptococcus pneumoniae were the most prevalent aerobic pathogens. Anaerobes were isolated in 8.6% of the cultures from the middle meatus and in 18.5% of the cultures from the maxillary sinus. The predominant anaerobic organisms were Prevotella and Peptostreptococcus in adults but none of them were cultured in children. A high rate of concordance of the middle meatus and maxillary sinus was noted. Monomicrobial infection was most commonly observed. Ampicillin-resistant H. influenzae isolates were cultured in 46% of the cases and the penicillin resistance rates were 93% for S. aureus, 25% were intermediate and 25% were resistant.for S. pneumoniae, and all isolates were interpreted resistant to penicillin G. for M. catarrhalis. Twenty five percent of S. pneumoniae were resistant to cefdinir, and 75% were resistant to clarithromycin, azithromycin, and clindamycin. In summary, the interesting findings in this study are that the isolation rate of S. pneumoniae is low and that the resistance rate of S. pneumoniae is quite variable among different kinds of cephalosporins. In Korea, we do not recommend penicillin as the first-line drug because of its high resistance rate. We recommend amoxacillin/clavulanate, cephalosposins and macrolide as the first-line medical treatment. In cases where there is no improvement of symptoms, cultures should be taken from the middle meatus, followed by appropriate selection of second-line antibiotics according to the sensitivity test results.
82 International Consensus on Rhinosinusitis Ruby Pawankar Nippon Medical School,Japan Rhinosinusitis is one of the most common disorders and a major health problem world wide. It is a multifactorial disease and its complex nature and the limited understanding of the relationship of this disease with associated factors, has made it difficult to precisely define and classify it. Broadly speaking, rhinosinusitis may be clinically defined as the condition manifested by an inflammatory response involving the mucous membranes of the nasal cavity and paranasal sinuses, fluids within these cavities, and/or underlying bone. Although conventionally called sinusitis, it is often preceded by rhinitis and rarely occurs without concurrent rhinitis, therefore the term rhinosinusitis is now more widely used. In order to develop safer and more effective treatment options, a better understanding of the pathophysiology of these diseases is needed. This should be followed by careful consideration of study designs for the evaluation of potential therapeutic modalities for rhinosinusitis, as well as appropriate outcome studies. Recognizing the need for evidence-based rhinosinusitis guidelines, an international consensus on rhinosinusitis was developed. Various etiologic factors play a role in rhinosinusitis, including microorganisms, allergic and nonallergic immunologic inflammation and noninfectious, nonimmunologic causes. Basically, rhinosinusitis can be classified into acute rhinosinusitis and chronic rhinosinusitis (CRS). CRS is further classified into CRS without nasal polyps (CRSsNP) or CRS with nasal polyps (CRSwNP). Allergic fungal rhinosinusitis (AFRS) is considered a distinct clinical subset of CRS in which patients have positive evidence of fungal allergy to the fungus colonizing their allergic mucin in the majority of cases. However, not all rhinosinusitis is inflammatory. Over- or under-activity of autonomic nerve pathways, abnormalities in leukotriene production or responsiveness, nociceptive dysfunction, or local irritation due to gastroesophageal reflux are demonstrable in select subsets of rhinosinusitis patients and likely predispose to the pathogenesis of CRS. Anatomic abnormalities, defects in mucociliary clearance and antibody deficiency syndromes may also predispose to rhinosinusitis. Aspirin-associated respiratory disease also predisposes to rhinosinusitis..the classification, objective and subjective assessment measures, diagnostic criteria and management of rhinosinusitis will be discussed. Also characteristic geographical differences in rhinosinusitis disease entities and patterns will be discussed.
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1) i) Barber, M. et al.: Brit. Med J, 2, 565, 19'49. ii) Barber, M.F.G. J. Hayhoe and J. E. M. Whithead: Lancet, 1120 `1125, 1949.-2) Bergey: Bergey's Manual of Determinative Bacteriology 7 th Ed: (1958).-3)
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* Department of Health Science Health Sociology Section, Juntendo University School of Health and Sports Science, Chiba, Japan (WHO: Ottawa Charter for Health promotion, 1986.) (WHO: Bangkok Charter
CHEMOTHERAPY JUNE 1993 Table 1. Background of patients in pharmacokinetic study
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Title 泌尿器科領域に於ける17-Ketosteroidの研究 17-Ketosteroidの臨床的研究 第 III 篇 : 尿 Author(s) 卜部, 敏入 Citation 泌尿器科紀要 (1958), 4(1): 3-31 Issue Date URL
Title 泌尿器科領域に於ける17-Ketosteroidの研究 17-Ketosteroidの臨床的研究 第 III 篇 : 尿 Author(s) 卜部, 敏入 Citation 泌尿器科紀要 (1958), 4(1): 3-31 Issue Date 1958-01 URL http://hdl.handle.net/2433/111559 Right Type Departmental Bulletin
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