JP4245476B2 - 光線療法装置 - Google Patents
光線療法装置 Download PDFInfo
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- JP4245476B2 JP4245476B2 JP2003518652A JP2003518652A JP4245476B2 JP 4245476 B2 JP4245476 B2 JP 4245476B2 JP 2003518652 A JP2003518652 A JP 2003518652A JP 2003518652 A JP2003518652 A JP 2003518652A JP 4245476 B2 JP4245476 B2 JP 4245476B2
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Description
アレルギー性鼻炎または枯草熱は、人口の10〜20%がかかる最も頻繁に起こるアレルギー性疾患である。特に工業が発達した国において、アレルギー性鼻炎にかかる患者の数がここ数年間に非常に急速に増大している。患者の数が多いために、治療のための直接および間接費は巨額なものになる。
血管運動神経性鼻炎は、異なる非特定病因により起こるまだ分かっていない病因による鼻の粘膜の炎症性疾患である。この臨床症状は、アレルギー性鼻炎に非常によく似ている。持続性の鼻詰まり、鼻のかゆみ、くしゃみ、鼻汁、およびまれな嗅覚の喪失を観察することができる。これらの症状は、肥満細胞を活性化する媒介物質が原因となっている。このような媒介物質は、刺激が与えられた場合、鼻の粘膜の神経端部から放出される。
この疾患の特徴は、鼻の分泌物内の多数の好酸球であり、アレルギー性の病因がないことである。この疾患は、多くの場合、鼻ポリープ、すなわち鼻の粘膜の異常増殖を併発する。臨床症状はアレルギー性鼻炎と同じである。
副鼻腔の炎症は、多くの場合、鼻の粘膜の炎症(副鼻腔炎)を併発するが、独立した副鼻腔の炎症も多発する(副鼻腔炎)。この疾患の病因は多くの場合アレルギー性のものであるが、その正確な病因は、多くの場合まだ分かっていない。治療法は発見されていないが、鼻炎に対する治療法と同じ治療法が通常使用される。
これらの光源は、いくつかの態様(動作原理、出力エネルギーまたはパワー、インパルス・モードまたは連続モードでの動作、単色または多色光等)に基づいて分類することができる。
本発明者の目的は、小さな腔を治療するための紫外線を放射する光線療法装置を開発することであり、特殊な紫外線源を構成することであり、さらに、本発明のテーマは、この光線療法装置の使用方法である。
図1は、紫外線光源1、外へ出ていく紫外線ビーム2、光学的結合装置3を示す。紫外線ビームは通過する際に焦点を結ぶ。光ビームは光伝達システム4に入り、次に紫外線照射接触ユニット5内に入る。接触ユニットは、患者の鼻腔6に挿入される。光は接触ユニットから鼻の粘膜上に照射される。
本発明の光線療法装置は、紫外線による体の疾患の治療および予防、とりわけ好適には、アレルギー性鼻炎(枯草熱)、血管運動神経性鼻炎、非アレルギー性好酸性鼻炎、慢性副鼻腔炎(副鼻腔の炎症)のような鼻の粘膜および副鼻腔の普通に見られる炎症の治療、または鼻ポリープ(鼻の粘膜の慢性炎症でよく起こる異常増殖性病巣)の治療用に使用される。
上記疾患の治療に使用する局所コルチコステロイドの効果と同様に、その免疫抑制効果に関連する紫外線は、処理したエリア上のビールス性および細菌性感染症の出現を容易にする場合がある。しかし、その可能性は現在使用している局部免疫抑制剤よりも低い。何故なら、紫外線はまた、直接的な微生物殺菌効果も持っているからであり(1998年発行のJ Endodontics 24号、781〜785ページ掲載のFolwaczny M、Liesenhoff T、Lehn N、Horch HHの「308nmエキシマ・レーザ照射の殺菌作用:インビトロ調査」(Bactericidal action of 308nm excimer−laser radiation:an in vitro investigation))、また紫外線は、上皮細胞の直接的な微生物殺菌活性を増大した(1987年発行のBr J Dermatol 116号469〜475ページ掲載のCsato M、Kenderessy SzA、Dobozy Aの「紫外線照射による分離した人間の表皮細胞の鵞口瘡カンジダ殺菌活性の強化」(Enhancement of Candida albicans killing activity of separated human epidermal cells by ultraviolet radiation))。
アレルギー性鼻炎(枯草熱)、血管運動神経性鼻炎、非アレルギー性好酸性鼻炎、慢性副鼻腔炎または鼻ポリープのような鼻の粘膜および副鼻洞の通常の疾患の薬物療法のために、世界中で数十億ドルが消費されている。利用できる治療の機会があるにも関わらず、患者の作業能力は多くの場合非常に低くなる。光線療法装置およびそれを使用すると、患者の臨床症状が迅速に効果的に軽減するので、この疾患の治療に関連する直接および間接費は大きく低減する。さらに、本発明の紫外線光源は周知の各紫外線に感応する疾患の治療のために使用することができる。
10年前からraqweedによる枯草熱にかかっている患者の症状は、使用した抗ヒスタミン剤および局所コルチコステロイド点鼻薬による治療では満足な治療結果が得られなかった。診察した際には、患者はひどい鼻詰まり、鼻のかゆみ、鼻汁、頻繁なくしゃみおよび鼻の口蓋のかゆみを訴えた。日光で照射されていない患者の背中の上で、308nm塩化キセノン・レーザ光源により最小紅斑線量(MED)を測定し、それが200mJ/cm2であることが分かった。次の日に、鼻の粘膜の光線療法をスタートした。この目的のために、紫外線光源(塩化キセノン・レーザ)からの308nmの波長の紫外線ビーム2を、光学的に焦点を結ばせることにより、石英からできている直径1.6mmの光ケーブル4内に向けた。上記ケーブルを、図4の紫外線照射接触ユニット5に接続した。直径4mmの平面平行透明プラスチック・ディスクで覆われているこのユニットの出力ウィンドウ26を鼻の粘膜に接続し、表面を100mJ/cm2の線量で照射した。この照射を周波数が1Hz、インパルスの長さが15ns、紫外線照射接触ユニット5の出力ウィンドウ26のところでのインパルスのエネルギーが1.79mJであるインパルスにより行った。4mmの出力ウィンドウ26の直径を考慮した場合、その表面の面積は0.1256cm2であり、そのため照射のエネルギー密度は14.25mJ/cm2である。線量を100mJ/cm2とするために、全部で7つのインパルスを照射した。各鼻孔16内で上記面積を照射した。
抗ヒスタミン剤および局所ステロイドによる治療効果がなかった、イエダニによる通年性アレルギー性鼻炎の患者に対して、308nm波長の塩化キセノン・レーザにより光線療法をスタートした。
抗ヒスタミン剤および局所コルチコステロイド鼻ドロップを使用しても、raqweedによる枯草熱にかかっている患者の重い症状は十分に改善しなかった。診察の時、患者の症状(鼻詰まり、鼻のかゆみ、鼻汁、頻繁なくしゃみおよび鼻の口蓋のかゆみ)が重かったので、光線化学療法をスタートすることにした。最小光毒性線量を、太陽光線で照射されなかった患者の前腕部の上で測定した。図2の紫外線光源1を照射のために使用したが、その際、310〜350nmの波長の2つの紫外線ビームが、光学フィルタを通った後で光伝達システム(光ケーブル)4内に導入されるようにした。MPDは500mJ/cm2であり、図4の紫外線照射接触ユニット5を使用して、2.0×MPD(=1000mJ/cm2)の線量で鼻の粘膜の治療をスタートした。8−メトキサラレン鼻スプレーを使用した後で、光線化学療法を行った。図4の紫外線照射接触ユニット5のヘッド25を鼻腔内に挿入し、1000mJ/cm2の線量で鼻の粘膜を照射した。紫外線のパワー密度は、紫外線照射接触ユニットの出力ウィンドウのところで43.2mW/cm2であった。走査光源27の可視光線ビームにより、紫外線保護眼鏡の保護の下で治療を視覚的に制御した。
左の鼻孔内に大きなポリープがあるというので患者を診察した。このポリープは調剤の局所コルチコステロイドの投与では改善せずに、慢性副鼻腔炎を起こしていたので、塩化キセノン・レーザにより光線療法をスタートした。最小紅斑線量(MED)を、患者の背中の上で測定したところ250mJ/cm2であった。光線療法を行うために、レーザからの308nmの波長の紫外線ビーム2を、図8の紫外線照射接触ユニット5に結合している、直径0.5mmの石英紫外線案内ケーブル4内に光学的に焦点を結ばせた後で導入した。上記照射ユニット5の透明なプラスチックからできている厚さ2mmの平面平行ディスク36をポリープの表面と接触させ、750mJ/cm2の線量で直径2mmの円形領域を照射した。照射は、5Hzの周波数で行った。インパルスの長さは15nsであり、インパルスのエネルギーは1.96mJであった。そのため、750mJ/cm2の照射を行うために12のインパルスを使用した。1回目の治療の後5日目には、鼻ポリープは傷跡もなく消失し、患者の苦痛も消失した。
原因が分かっていない慢性副鼻腔炎を起こしている患者の場合には、症状の治療のために最初いくつかの薬剤(抗ヒスタミン剤、コルチコステロイド、抗生物質)を投与したが効果がなかったので、光線療法を行った。図2の紫外線光源1を治療のために使用した。最小紅斑点線量(MED)を、最初に太陽光線で照射されなかった患者の前腕部の上で測定し、次に、140mJ/cm2の線量で、鼻の粘膜の治療をスタートした。図4の紫外線照射接触ユニット5の直径4mmの平面平行ディスク36を、炎症を起こしている粘膜と接触させ、治療のためにこの表面を照射した。治療は、走査光源27の可視光線により、紫外線保護眼鏡の保護の下で視覚的に制御された。炎症を起こしている全粘膜を照射するために、鼻孔当たり全部で8カ所に携帯用装置を使用した。週当たり数回この治療を反復して行った。6回目の治療の後で患者の症状はかなり軽減し、10回目の治療の後で患者の症状は消失した。
1カ月後に治療を中止したが、現在に至るまで患者の症状は再発していない。
2 紫外線ビーム
3 光学的結合装置
4 光伝達システム
5 紫外線照射接触ユニット
6 鼻孔
7 電力源ユニット
8 電線
9 凹面鏡
10 ハウジング
11 電極
12 石英電球
13 光学フィルタ
14 出力開口部
15 集光レンズ
16 ダイクロイック・ミラー
17 レンズ・システム
18 目標を照射する光源
19 観察光学システム
20 ハンドグリップ
21 拡大レンズ
22 光学チューブ
23 固定装置
24 テーパ状エンドピース
25 ヘッド
26 出力ウィンドウ
27 走査光源
28 鏡
29 レンズ
30 中央に孔のある凹面鏡
31 ペン状ハンドル
32 平面治療ヘッド
33 シリンダー状対称治療用ヘッド
34 紫外線に対して透明な側壁
35 点状治療用ヘッド
36 平面平行ディスクまたはレンズ
37 柔軟な内視鏡
38 画像処理用光ケーブル
39 画像処理装置
40 位置決めデバイス
41 走査光線レンズ
42 走査光線用光ケーブル
Claims (2)
- 鼻腔または副鼻腔の疾患を治療および予防するための光線療法装置であって、
紫外線ビーム(2)を放射する紫外線源(1)と、紫外線ビームに焦点を結ばせる光学的結合装置(3)と、光学フィルタ(13)と、直径1ミクロンから10mmの光ケーブルからなる光伝達システム(4)と、光伝達システムに接続している紫外線照射接触ユニット(5)とを備え、紫外線源(1)が、電極(11)を有しかつガスで満たされた石英電球(12)を有していて、その石英電球(12)と光学的結合装置(3)とが出力開口部(14)を有するハウジング(10)に装着されており、
前記石英電球(12)は数立方ミリメートルから0.1立方ミリメートルの数倍の範囲の放電量を有し、
前記光学的結合装置(3)は、前記石英電球(12)の一方の側で前記出力開口部(14)に隣接した位置にあって紫外線ビーム(2)に焦点を結ばせる集光レンズ(15)と、前記石英電球(12)の前記一方の側と反対側に位置する凹面鏡(9)とを備え、前記石英電球(12)で発生した紫外線ビーム(2)の一部が前記一方の側から直接集光レンズ(15)へ向かうとともに、前記石英電球(12)で発生して前記反対側へ向かう紫外線ビーム(2)が凹面鏡(9)で反射して集光レンズ(15)へ向かい、該集光レンズ(15)を通った紫外線ビーム(2)が出力開口部(14)を通りかつ光学フィルタ(13)を通って光伝達システム(4)に導かれるようになっており、
前記紫外線照射接触ユニット(5)は、光伝達システム(4)に連結されたハンドグリップ(20)と、ハンドグリップ(20)に連結された光学チューブ(22)と、光学チューブ(22)に連結されたテーパー状のエンドピース(24)と、前記エンドピース(24)に装着されて一端が固定装置(23)によって光学チューブ(22)に固定され他端に出力開口部(26)が形成されていて、該他端を鼻腔または副鼻腔に挿入するようになっているヘッド(25)とを有し、光伝達システム(4)から出た紫外線ビームが前記ヘッド(25)の出力開口部(26)を通って紫外線照射接触ユニット(5)を出て行くようになっている光線療法装置。 - 鼻腔または副鼻腔の疾患を治療および予防するための光線療法装置であって、
紫外線ビーム(2)を放射する紫外線源(1)と、紫外線ビームに焦点を結ばせる光学的結合装置(3)と、光学フィルタ(13)と、直径1ミクロンから10mmの光ケーブルからなる光伝達システム(4)と、光伝達システムに接続している紫外線照射接触ユニット(5)とを備え、紫外線源(1)が、電極(11)を有しかつガスで満たされた石英電球(12)を有していて、その石英電球(12)と光学的結合装置(3)とが出力開口部(14)を有するハウジング(10)に装着されており、
前記石英電球(12)は数立方ミリメートルから0.1立方ミリメートルの数倍の範囲の放電量を有し、
前記光学的結合装置(3)は、前記石英電球(12)の一方の側で前記出力開口部(14)に隣接した位置にあって紫外線ビーム(2)に焦点を結ばせる集光レンズ(15)と、前記石英電球(12)の前記一方の側の反対側に位置する凹面鏡(9)とを備え、前記石英電球(12)で発生した紫外線ビーム(2)の一部が前記一方の側から直接集光レンズ(15)へ向かうとともに、前記石英電球(12)で発生して前記反対側へ向かう紫外線ビーム(2)が凹面鏡(9)で反射して集光レンズ(15)へ向かい、該集光レンズ(15)を通った紫外線ビーム(2)が出力開口部(14)を通りかつ光学フィルタ(13)を通って光伝達システム(4)に導かれるようになっており、
前記紫外線照射接触ユニット(5)は、ペンの形をしているハンドル(31)を備えるとともに、前記ハンドル(31)に取り外し可能に装着された、平面治療ヘッド(32)、シリンダー状対称治療用ヘッド(33)または点状治療用ヘッド(35)を備えていることを特徴とする光線療法装置。
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2001
- 2001-08-10 HU HU0103279A patent/HU224941B1/hu not_active IP Right Cessation
- 2001-10-24 AT AT01982627T patent/ATE430598T1/de not_active IP Right Cessation
- 2001-10-24 CZ CZ2004177A patent/CZ2004177A3/cs unknown
- 2001-10-24 ES ES01982627T patent/ES2325058T3/es not_active Expired - Lifetime
- 2001-10-24 PL PL374004A patent/PL204588B1/pl not_active IP Right Cessation
- 2001-10-24 EP EP01982627A patent/EP1420857B1/en not_active Expired - Lifetime
- 2001-10-24 UA UA2004031506A patent/UA84257C2/ru unknown
- 2001-10-24 RU RU2004104624/14A patent/RU2290224C2/ru not_active IP Right Cessation
- 2001-10-24 JP JP2003518652A patent/JP4245476B2/ja not_active Expired - Fee Related
- 2001-10-24 DE DE60138656T patent/DE60138656D1/de not_active Expired - Lifetime
- 2001-10-24 SK SK87-2004A patent/SK287945B6/sk not_active IP Right Cessation
- 2001-10-24 AU AU2002214169A patent/AU2002214169B2/en not_active Ceased
- 2001-10-24 WO PCT/HU2001/000102 patent/WO2003013653A1/en active Application Filing
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- 2003-05-19 US US10/440,690 patent/US20040030368A1/en not_active Abandoned
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2005
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2006
- 2006-02-15 US US11/354,788 patent/US20060155349A1/en not_active Abandoned
- 2006-02-15 US US11/354,364 patent/US20060136019A1/en not_active Abandoned
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RU2004104624A (ru) | 2005-03-10 |
DE60138656D1 (en) | 2009-06-18 |
US20060155349A1 (en) | 2006-07-13 |
SK287945B6 (sk) | 2012-06-04 |
AU2002214169B2 (en) | 2007-07-12 |
PL374004A1 (en) | 2005-09-19 |
WO2003013653A1 (en) | 2003-02-20 |
ATE430598T1 (de) | 2009-05-15 |
US20040030368A1 (en) | 2004-02-12 |
HU0103279D0 (en) | 2001-10-28 |
US20060111760A1 (en) | 2006-05-25 |
JP2004537382A (ja) | 2004-12-16 |
UA84257C2 (ru) | 2008-10-10 |
EP1420857B1 (en) | 2009-05-06 |
ES2325058T3 (es) | 2009-08-25 |
PL204588B1 (pl) | 2010-01-29 |
US7226470B2 (en) | 2007-06-05 |
HU224941B1 (en) | 2006-04-28 |
SK872004A3 (en) | 2004-08-03 |
RU2290224C2 (ru) | 2006-12-27 |
EP1420857A1 (en) | 2004-05-26 |
US20060235492A1 (en) | 2006-10-19 |
US20060136019A1 (en) | 2006-06-22 |
CZ2004177A3 (cs) | 2004-05-12 |
HUP0103279A2 (hu) | 2003-04-28 |
US20040204747A1 (en) | 2004-10-14 |
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