Tamotsu Kaneko

Effects of Ozone Exposure on Experimental Asthma in Guinea Pigs Sensitized with Ovalbumin through the Airway

As ozone (O3) is known to cause airway inflammation and hyperresponsiveness, we examined the effects of O3 exposure (1, 3, or 5 ppm, 2 h) on sensitization and provocation in guinea pigs sensitized with ovalbumin (OA) through the airway. In groups exposed to O3 before sensitization, 5 ppm increased the production of IgG1 antibodies and decreased the OA sensitization threshold from 0.01 to 0.002%. In those exposed before provocation, 1, 3, or 5 ppm of O3 decreased the OA provocation threshold from 0.5 to 0.02%, and this enhancement appeared to depend on airway hyperresponsiveness. We conclude that O3 exposure may play an important role in causing asthmatic attacks rather than enhancing allergic sensitization.

NEPHROTIC SYNDROME ASSOCIATED WITH MALIGNANT MESOTHELIOMA

Sumi Tanaka, MD, 2nd Department of Internal Medicine, Urafune Hospital, 3-46 Urafune-cho, Minami-ku, Yokohama 232 (Japan) Discharge Admission Total protein ‘Albumin November 1991 Dear Sir, The association between nephrotic syndrome and malignancy has been well documented [1-3]. Several types of glomerular injury have been noted in patients with cancer [2], and the neoplasms that have been implicated include a variety of histological types from different primary sites [3]. We present a case with nephrotic syndrome associated with malignant mesothelioma. A 77-year-old man was admitted to our hospital with systemic edema, generalized weakness, and fatigue. Two years previously he had a pneumonia, at which time urinalysis showed no protein. He had not been receiving any medications. He had been working as an engineer on a ship and had been exposed to asbestos approximately 40 years prior to admission. Physical examination: On auscultation of his lungs, there were decreased breath sounds and some moist rales on the left. Heart sounds and abdomen were normal, and there was no lymphadenopathy. There was pitting edema of the whole body. Laboratory values included the following: total serum protein 5.4 g/dl, serum albumin 1.3 g/dl, total serum bilirubin 0.2 mg/ dl, serum glutamic-oxaloacetic transaminase 32 IU/1, serum glutamic-pyruvic transaminase 22, alkaline phosphatase 556IU/1, blood urea nitrogen 14 mg/dl, serum creatinine 0.8 mg/dl, Na 130 mEq/1, K 3.7 mEq/1, Ca 6.4 mg/dl, P 2.8, serum glucose 141, total cholesterol 184, triglycerides 107 mg/dl, eryth-rocyte sedimentation rate 50 mm/h, hemoglobin 8.9 g/dl, hematocrit 27.4%, white blood cell count 11.1 × lOVμl (with an increase in

Effects of pneumococcal vaccine in patients with chronic respiratory disease

In developed countries, it is very difficult to demonstrate the effectiveness of pneumococcal vaccines because the incidence of pneumococcal pneumonia is very low. Vaccination against pneumococci infection was advised for 1378 outpatients, over 60 years of age, with chronic respiratory disease for more than one year. Of these patients, those who responded affirmatively to the advice were vaccinated against pneumococci between August and November 2002. The effectiveness of vaccination was evaluated by means of a 2-year cohort-study, comparing the vaccinated group (647) with the non-vaccinated group (731). The variables analyzed were the frequency of onset of bacterial respiratory infection, hospitalization due to bacterial respiratory infection and onset of pneumococcal respiratory infection. The incidence of bacterial respiratory infection and the incidence of pneumococcal respiratory infection to have decreased in the following 2 years (17.4%, 0.9%), as compared to the previous year (25.9%, 3.1%), in the vaccinated group. Conversely, the frequency was higher in the following 2 years (14.4%, 0.9%) as compared to the previous year (14.2%, 0.4%) in the non-vaccinated group. This inter-group difference was statistically significant. Simultaneous vaccination against pneumococci and influenza virus also resulted in a significant reduction in the incidence of bacterial respiratory infection. No decrease was observed in the frequency of hospitalization. These results indicate that pneumococcal vaccine is useful for elderly patients with chronic respiratory disease and that its efficacy may be enhanced by simultaneous vaccination against influenza.