Author Mitsunobu, Fumihiro| Ashida, Kozo| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Okamoto, Makoto| Nishida, Norikazu| Nagata, Takuya| Takata, Shingo| Yokoi, Tadashi| Nakai, Mutsuo| Tanizaki, Yoshiro| Tanimoto, Mitsune|
Published Date 2003-02-01
Publication Title 岡大三朝医療センター研究報告
Volume volume73
Content Type Departmental Bulletin Paper
Author Nishida, Norikazu| Ashida, Kozo| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Okamoto, Makoto| Nagata, Takuya| Yokoi, Tadashi| Nakai, Mutsuo| Makino, Hirofumi| Tanizaki, Yoshiro|
Published Date 2003-02-01
Publication Title 岡大三朝医療センター研究報告
Volume volume73
Content Type Departmental Bulletin Paper
JaLCDOI 10.18926/11705
Title Alternative Clinical study on polypoid lesions of the colon
FullText URL 061_036_040.pdf
Author Ochi, Koji| Harada, Hideo| Matsumoto, Shuji| Seno, Toshinobu| Tanaka, Juntaro| Tachibana, Hideo| Akiyama, Tsuneo| Nakai, Mutsuo|
Abstract 1986年4月から1990年2月末までの間に岡山大学医学部附属病院三朝分院で経験した早期大腸癌を含む大腸ポリープ90例(107病変)を対象に,年齢,臨床症状,便潜血反応,病変存在部位について検討を行い,以下の成績を得た。(1)大腸検査総数の22.4%にポリープが発見された。ポリープの77%は腺腫,5%は腺癌(早期癌)であった。(2)便潜血反応はポリープ例の75.9%に陽性であり,右側大腸ポリープでの陽性率は高かったが,S状結腸および直腸ポリープでは70%程度であった。(3)若年者では右側結腸にポリープが発見されることは稀であるが,50才以上では18%程度に認められた。高齢者では右側結腸も内視鏡で検査することが重要である。(4)免疫学的便潜血検査法の導入により大腸ポリープの発見効率が改善するものと考え られた。
Abstract Alternative This report is concerned with clinical study on 90 patients with polypoid lesions (107 lesions) which we have encountered in Misasa Hospital, Okayama University in the past 4 years. Following results were obtained : (1) Polypoid lesions were detected in 90 (22.4%) and advanced adenocarcinoma (mostly resectable) in 22 (5.5%) of 402 patients who were examined by sigmoidoscopy and barium enema ; (2) Histological examination of the polypoid lesions showed adenoma in 77.2%, hyperplastic polyp in 8.7%, inflammatory polyp in 7.6%, neurinoma in 0.3% and early cancer (adenocarcinoma) in 5.4% ; (3) It was impossible to differentiate benign and malignant polypoid lesions on the basis of endoscopic and X-ray findings alone ; (4) Forty-two percent of the polypoid lesions was detected in the sigmoid colon, 30% in the rectum, 16.8% in the descending colon, 9.3% in the ascending colon, 0.9% in the caecum ; (4) Patients younger than 50 years of age showed only one polypoid lesion in the right hemicolon, whereas elder patients showed as many as 17 polypoid lesions ; (5) Among the 90 patients with polypoid lesions, 40 presented with abdominal pain, 20 with no symptoms (annual health check-up), 17 with irregular bowel habits, and 10 with melena ; (6) Among the 90 patients, occult blood in stool was positive in 75.8% with a lower positive rate in the lesions of the sigmoid and rectum ; (7) Among 5 asymptomatic patients with lesions and with a negative hemoccult test, 3 patients with a polypoid lesion were examined because of the patients' request, 1 patient with a polypoid lesion because of a positive family history, and the remaining 1 patient in a search for the primary lesion of the metastatic liver cancer ; (8) Among patients with a positive hemoccult test, the detection rate of polypoid lesions was 41.9% with use of an immunological method, whereas it was 19.7% with use of a chemical method. In conclusion, (1) detection of colonic polypoid lesions can lead to the detection of early cancer, although only histological examination can confirm the accurate diagnosis ; (2) a hemoccult test in stool with an immunological method is an effective method for screening asymptomatic colonic polypoid lesions, although it must be admitted that negative results may occasionally occur ; (3) macroscopic observation of the stool mass is important before sampling, because lesions of the sigmoid colon or the rectum may show scanty blood only on the limited area of the surface of the stool ; (4) patients elder than 50 years of age should be examined more carefully for the whole colon preferably with an endoscope, because they show a high incidence of small polypoid lesions in the right hemicolon.
Keywords 大腸ポリープ (Polyp of the colon) 大腸早期癌 (Early cancer of the colon)
Publication Title 環境病態研報告
Published Date 1990-09
Volume volume61
Start Page 36
End Page 40
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002313590
JaLCDOI 10.18926/15317
Title Alternative Diagonosis of pancreatic cyst using post-ERCP CT examination.
FullText URL 064_065_070.pdf
Author Ochi, Koji| Harada, Hideo| Matsumoto, Shuji| Seno, Tosinobu| Tanaka, Juntaro| Riaz Chowdhury| Mizushima, Takaaki| Sugimoto, Keisuke| Mitsunobu, Fumihiro| Tanizaki, Yoshiro| Nakai, Mutsuo| Akiyama, Tsuneo| Hasuoka, Hideaki|
Abstract ERCP直後にCTを撮影するERCP後CTはERCPの際に膵内に注入された造影剤をCTで検出するため,ERCPでは得られない情報が得られる利点がある。われわれはERCP後CTが診断や治療方針の決定に有用であった膵嚢胞の4例を経験した。膵嚢胞では主膵管との連絡,嚢胞の部位,性状診断にERCP後CTは有用な検査法であり,文献的考察を含めて報告した。
Abstract Alternative Post-ERCP CT (computed tomography (CT) examination performed immediately after endoscopic retrograde cholangiopancreatography) detects the contrast medium injected into the pancreatic duct and cystic lesions at the time of ERCP and, therefore, has the advantage of obtaining information which cannot be obtained by ERCP alone. We have experienced four cases of pancreatic cysts in which post-ERCP CT was useful for diagnosis and in deciding on treatment plans. The post-ERCP CT was proved to be a useful method for examining the site and characteristics of the cysts which communicated with the main pancreatic duct.
Keywords ERCP (Endoscopic retrograde cholangiopancreatography) CT (Computed tomography) 膵嚢胞 (pancreatic cyst)
Publication Title 岡大三朝分院研究報告
Published Date 1993-06
Volume volume64
Start Page 65
End Page 70
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307547
JaLCDOI 10.18926/15328
Title Alternative Relationship between bone mineral densities of second metacarpal bone and lumber spine
FullText URL 063_099_105.pdf
Author Nakai, Mutsuo| Okuda, Hiroyuki| Akiyama, Tsuneo| Takatori, Akimasa| Tanizaki, Yoshiro|
Abstract QCTおよびDIP法による測定値の相関性について検討し,DIP法による腰椎骨塩量の推定および,スクリーニングへの適用について考察した。QCT値とΣGS/DやMClとの相関関係の検討では.対象のQCT値が低値か高値かによって相関関係がかなり異なることが明らかになった。すなわち,QCT値が低い領域は,QCT値と,ΣGS/DやMCIに明らかな正の相関関係が認められたが,一方, QCT値が高い領域では,相関関係は認められなかった。また,ΣGS/D=2.8mmAI以上,またはMCI=0.48以上の症例においては腰椎圧迫骨折の危険は小さく,ΣGS/D=1.8mmAI以下,またはMCI=0.24以下の症例においては腰椎圧迫骨折の危険が大きい可能性が示唆された。
Abstract Alternative To compare bone mineral density between second metacarpal bone and lumber spine, two measuring methods, digital image processing method (DIP) for second metacarpal bone and quantitative computed tomography (QCT) for lumber spine were employed in this study. The bone mineral density was evaluated in 89 females and the results were compared between the two methods. A correlation between the bone mineral densities by QCT and ΣGS/D was found in subjects showing low mineral density by QCT, but not in those with high mineral density. These results reveal that DIP is useful to observe bone mineral density and if ΣGS/D and MCI are enough high, almost he hasn't risk of fracture of lumber spine.
Keywords 骨粗鬆症 (osteoporosis) 骨塩量 (bone mineral density) QCT (quantitative computed tomography) DIP法 (digital image processing method)
Publication Title 岡大三朝分院研究報告
Published Date 1992-06
Volume volume63
Start Page 99
End Page 105
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002307484
JaLCDOI 10.18926/19693
Title Alternative Angiography system combined with Toshiba BV type X-TV equipment. 1. Whole limb serial aort-arteriography
FullText URL 057_056_060.pdf
Author Nakai, Mutsuo| Akiyama, Tsuneo| Matsushima, Kishio|
Abstract 消化管診断用X線TV装置の天板機能を改良し,種々のフィルムチェンジャー,X線管球を組み合わせることにより,中規模病院において,スペース,経費などの点で有利な,血管造影システムを組むことができた。第1報では,このうち,下肢連続撮影システムについて紹介する。1.透視から造影まで,迅速に移行できるシステムとなった。2.スペース,経費の点で有利である。3.濃度補償については,LS-Ⅱ増感紙と,1.0cmエッジフィルターにより,体型によらず,全下肢にわたり,十分な補償効果が得られる。4.さらに長い長尺カセッテの開発が望まれる。
Abstract Alternative A whole-limb serial aort-arteriography system constituted of BV-type X-TV and extralarge film changer was developed and used clinically. The results were as foll-ows. 1. By improving functions of the board of TV table, changes from fluoroscopy to radiography became easier in whole limb serial aort-arteriography. 2. By using LS-Ⅱ screen and 1.0cm edge filter, we could get well compensated X-ray photographs.
Keywords 全下肢連続動脈造影 (whole-limb serial aort-arteriography) 長尺フィルムチェンジャー (extra-large-film changer) X-TV台天板 (the board of TV table)  濃度補償 (compensation of density)
Publication Title 環境病態研報告
Published Date 1986-07
Volume volume57
Start Page 56
End Page 60
ISSN 09133771
Related Url http://eprints.lib.okayama-u.ac.jp/19952
language 日本語
File Version publisher
NAID 120002308997
JaLCDOI 10.18926/19697
Title Alternative Angiography system combined with Toshiba BV-type X-TV Equipment. 2. Stereo-magnification system.
FullText URL 057_061_066.pdf
Author Akiyama, Tsuneo| Nakai, Mutsuo| Matsushima, Kishio|
Abstract 我々は,既設の消化管診断用X線TV装置(東芝BV型)を使用した立体拡大撮影システムを検討した。1.消化管診断用X線TV装置の透視天板の高さが一定であるため,従来のフィルムチェンジャー(AOT)では不可能であったが,上下動可能なフィルムチェンジャー(福放FC-10L特)を改良試作したことで最大2倍までの立体拡大撮影が可能となった。2.透視観察から撮影へ,コンタクト撮影から拡大連続撮影,立体撮影から立体拡大連続撮影へと併用して行うことが非常に簡単にできて被検者の負担軽減と多目的使用が可能となった。3.観察条件と立体感については,拡大率を変化させて,その立体感について検討した結果は、観察距離については,各拡大率における立体視しやすい距離は存在し,拡大率が2倍の場合には,観察距離を大きくするほど立体感も増加し,立体視し易い傾向が示された。
Abstract Alternative Angiography of the head and abdominal region gives a good deal of peculiar information for the diagnosis of nature of pathological lesions. When angiography could be performed by stereo-magnification radiography, the radiography gives better information for physicians. In this article, we tried angiography by the stereomagnifying radiography system utilizing X-TV equipment for examination of digestive system. 1. To magnify film image, the film changer was modified to move up and down, because the board of TV table did not change vertically. The board of TV table was also modified to slide more widely. The modifications could make it possible to magnify the film image by two times. 2. To use the X-TV equipment brought some advantages as follows it became very easy for us to convert the X-TV system from fluoroscopy to radiography, and contact seriography was easily changed to stereo-magnification seriography.
Keywords 立体拡大撮影 (Stereo-magnification radiography) フィルム連続撮影装置 (Fiim changer) 立体感 (Stereoscopic image)
Publication Title 環境病態研報告
Published Date 1986-07
Volume volume57
Start Page 61
End Page 66
ISSN 09133771
language 日本語
File Version publisher
NAID 120002309165
JaLCDOI 10.18926/19772
Title Alternative Changes in X-ray examinations.
FullText URL 059_093_096.pdf
Author Akiyama, Tsuneo| Nakai, Mutsuo|
Publication Title 環境病態研報告
Published Date 1988-08
Volume volume59
Start Page 93
End Page 96
ISSN 09133771
language 日本語
File Version publisher
NAID 120002309032
JaLCDOI 10.18926/19773
Title Alternative Application of personal computer in X-ray room business.
FullText URL 059_097_101.pdf
Author Nakai, Mutsuo| Akiyama, Tsuneo|
Publication Title 環境病態研報告
Published Date 1988-08
Volume volume59
Start Page 97
End Page 101
ISSN 09133771
language 日本語
File Version publisher
NAID 120002308983
JaLCDOI 10.18926/19832
Title Alternative Analytic study on colon examination for the past three years.
FullText URL 060_100_102.pdf
Author Akiyama, Tsuneo| Nakai, Mutsuo| Ochi, Koji|
Publication Title 環境病態研報告
Published Date 1989-07
Volume volume60
Start Page 100
End Page 102
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002309110
JaLCDOI 10.18926/19834
Title Alternative Application of personal computer system in nursing division. -(1) Programming for a roster-
Author Nakai, Mutsuo| Yoshida, Junko| Inagaki, Kikuko|
Publication Title 環境病態研報告
Published Date 1989-07
Volume volume60
Start Page 103
End Page 107
ISSN 09133771
language 日本語
File Version publisher
JaLCDOI 10.18926/14834
Title Alternative HRCT上の肺のLow Attenuation Areaおよび肺機能により評価された高齢者善喘息の特徴
FullText URL 72_009_015.pdf
Author Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Nishida, Norikazu| Takata, Shingo| Yokoi, Tadashi| Nakai, Mutsuo| Tanizaki, Yoshiro|
Abstract The clinical significance of low attenuation area <-950 HU of the lungs on high - resolution computed tomography (HRCT) was evaluated in 80 patients with asthma in relation to patient age, CT number, pulmonary function including % residusal volume (% RV) and % DLco, and generation of leukotrienes B4 and C4 by leucocytes. 1. The % LAA (<- 950 HU) of the lungs showed a tendency to increase significantly with aging; the % LAA was significantly larger in elderly patients over the age of 60 years than in those under the age of 49 years. The CT number was also significantlyincreased with aging. 2. The values of % FVC, % FEV1.0, and FEV1.0% were significantly decreased in elderly patients over age 70 compared with the values in those under age 49. 3. The value of % residual volume (% RV) tended to increase significantly with aging; the value in patients over the age of 70 years was significantly larger in those between the ages of 50 and 59 (p<O.OOl). and under the age of 49 years (p<O.OOl). 4. The % DLco value significantly decreased with aging; the value in patients over age 70 was significantly lower than the value in those between the ages of 50 and 59 (p<O.Ol) and under age 49 (p<O.OOl). 5. A significant correlation was observed between % LAA of the lungs and % RV (r=O. 67, p<0.001), however. any significant correlations were not observed between % LAA and the values of % FVC, % FEV1.0, and FEV1.0% . 6. The generation of LTB4 and LTC4 by leucocytes was not significantly related with patient age. The results suggested that % LAA of the lungs on HRCT tended to increse with aging, accompanied with a significant increase in % RV.
Abstract Alternative 気管支喘息80例(全例非喫煙者)を対象に,high resolution computedt omography (HRCT)上の肺の-950HU以下のLow attenuation area (LAA)の臨床的意義について, 患者年齢, CT number,残気率(% RV),拡散能(% DLco)を含む肺機能検査,白血球のコイコトリエンB4,C4の産生能などとの関連のもとに検討を加えた。 1.% LAAは,年齢が高くなるにつれて増加する傾向を示し,60才以上の症例の% LAAは,49歳以下の症例に比べ有意に高い値を示した。また,CT numberも,年齢が高くなるにつれて有意の増加を示した。 2.% FVC,% FEV1.0およびFEV1.0%値は,いずれも70才以上の症例で49歳以下の症例に比べ有意に低い値を示した。 3.残気率(% RV)は,年齢が高くなるにつれて増加する傾向を示し,70才以上の症例の% RVは,50-59才および49才以下の症例の% RVに比べ有意に高い値を示した。 4.一方,拡散能(% DLco)は,年齢が高くなるにつれて有意に低下する傾向を示し,70才以上の症例の% DLcoは,50-59才および49才以下の症例のDLcoに比べ有意に低い値を示した。 5.% LAAと% RVとの間には有意の相関が見られたが,% LAAと% DLco,および% LAAと換気機能(% FVC,% FEV1.0,FEV1.0%)との間には関連は見られなかった。 6.白血球のLTB4およびLTC4の産生能においては年齢による差は見られなかった。これらの結果は,% LAAが年齢とともに増加すること,そして% LAAは% RVと密接な関連を有していることを示している。
Keywords low attenuation area of the lung CT number residual volume DLco aging
Publication Title 岡大三朝分院研究報告
Published Date 2002-02-01
Volume volume72
Start Page 9
End Page 15
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308131
JaLCDOI 10.18926/14840
Title Alternative Multidetector-CT findings of dissecting aortic aneurysum and coronary artery disease. Based on the case of dissecting aortic aneurysum and coronary artery disease.
FullText URL 72_055_061.pdf
Author Ashida, Kozo| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Okamoto, Makoto| Takata, Shingo| Yokoi, Tadashi| Nakai, Mutsuo| Makino, Hirofumi| Tanizaki, Yoshiro|
Abstract 2000年になり多列検出器高速CT (Multi-detector CT,以下MDCT)が出現し,大動脈疾患や心電図同期での冠動脈狭窄病変診断への臨床応用が開始された.当院でも2001年7月からMDCTが稼動し,日常臨床診療に貢献している. 今回,解離性上行大動脈瘤(DeBakeyII)(以下DAA)と冠動脈疾患(LAD# 7の閉塞)を合併した患者を診療した.MDCTによるCT - Angiography (以下CTA)が両者の診断に非常に有用であった.患者の負担は100mlの末梢静脈内への造影剤の投与と約数十秒間の呼吸停止だけで,解離性大動脈瘤並びに冠動脈狭窄病変の診断にそれぞれ非常に有用であった.三次元診断の鮮明な画像が得られ,かつ低侵襲度のMDCT並びにCTAは,今後益々臨床の場で血管造影検査の強力なファーストチョイスの診療手段になると考える.
Abstract Alternative Multidetector-CT (MDCT) and CT-Angio hase proven to be extremely useful in diagnosis of dissecting aortic aneurysum (DM) and coronary artery disease (CAD) . We report a case of DM complicated with CAD which was diagnosed by new MDCT.
Keywords 解敵性大動脈瘤 (disecting aortic aneurysum) 冠動脈 (coronary artery) 狭心症 (anglna Pectoris) 多列検出器CT(マルチスライスCT) (MDCT) CT血管造影 (CT-Angiography)
Publication Title 岡大三朝分院研究報告
Published Date 2002-02-01
Volume volume72
Start Page 55
End Page 61
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308046
JaLCDOI 10.18926/14841
Title Alternative Two male steroid-dependent asthmatics treated with etidronate
FullText URL 72_062_065.pdf
Author Tsugeno, Hirofumi| Okamoto, Makoto| Takata, Singo| Yokoi, Tadashi| Nishida, Kazunori| Ashida, Kozo| Hosaki, Yasuhiro| Mitsunobu, Fumihiro| Tanizaki, Yoshiro| Nakai, Mutsuo| Akiyama, Tsuneo| Hasegawa, Hisakazu| Tsuji, Takao|
Abstract 男性のステロイド依存性気管支喘息患者にエチドロネートを4年間の長期間にわたり投与した経験を得たので報告する。症例は,男性のステロイド依存性気管支喘息で,エチドロネート200mg/日・14日間投与を4ケ月おきに4年間にわたり反復投与し,活性型ビタミンD製剤 (VD)投与と併用した2例と,活性型VD製剤を単独授与した2例。椎体圧迫骨折数,境骨耗骨密度,海綿骨骨密度,皮質骨骨密度について,椎体X線像,PQCT(Stratec XCT960)を用いて4ケ月毎に測定し,48ケ月後の効果を検討した。エチドロネートを投与した症例1では,総骨密度と海綿骨はやや増加を認め皮質骨密度は減少していた。エチドロネートを授与した症例2では,総骨密度,海綿骨,皮質骨密度はいずれも減少を認めたが,VD単独投与した2例よりもやや減少が抑制されていたようであった。VD単独投与した2例ではいずれの項目も減少を認めた。これらの症例からは,エチドロネートは男性のステロイドによる骨傷害にも有効と考えられたが,現在投与継続途中であり,今後さらに検討を続ける必要がある。
Abstract Alternative We report an experience about administration of etidronate to male steroid-dependent asthmatics for a long time. For 4 years, two men with steroid-dependent asthma were treated with etidronate (200 mg / day, for 14 days) every 4 months and 25-hydroxyvitamin D3 (VD) together, and two patients were treated with VD alone. Vertebral fractures were evaluated by the lateral spinal X-ray films, and radial total bone mineral density (BMD) , trabecular BMD and the cortical BMD were measured by pQCT (Stratec XCT960) every four months. Trabecular and total BMD increased but cortical BMD decreased in the case 1 who was treated with both etidronate and VD. In the case 2 with etidronate and VD treatments, total and trabecular BMD decreased, but reduction of these indices seemed to be more suppressed than that in two patients with VD alone. According to these experiences, etidronate may be effective against the steroid-induced bone injury in men. Since periods treatment are not en-ough long to evaluate therapeutic effect of etid-ronate, we will have to continue the examination of these cases further more from now on.
Keywords エチドロネート 男性 ステロイド 気管支喘息
Publication Title 岡大三朝分院研究報告
Published Date 2002-02-01
Volume volume72
Start Page 62
End Page 65
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308188
JaLCDOI 10.18926/14905
Title Alternative 胸部高分解能CT(HRCT)による肺野low attenuation area(LAA)の定量的評価 ―気管支喘息および肺気腫症例の比較検討―
FullText URL 071_019_028.pdf
Author Mitsunobu, Fumihiro| Mifune, Takashi| Ashida, Kozo| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Okamoto, Makoto| Harada, Seishi| Nakai, Mutsuo| Tanizaki, Yoshiro|
Abstract Background: Assessment of low attenuation areas and lung densitometry on high resolution computed tomography (HRCT) have been reported in studies of patients with chronic obstructive pulmonary disease. Objective : The purpose of this study was to examine if HRCT could separate asthmatic patients from normal control subjects and patients with emphysema. Methods : Subjects were divided into three groups : 24 patients with bronchial asthma, 23 patients with pulmonary emphysema and 15 normal controls. HRCT scans of the lung were performed at three different levels at both end inspiration and expiration in all patients and control subjects. Results : The mean CT number of three slices was significantly lower in asthmatic subjects compared with normal individuals at both end inspiration (p < 0.05) and expiration (p < 0.01). The relative area of the lung with an attenuation value lower than -950 HU (% LAA) for three slices was significantly higher in asthmatic subjects than in normal individuals at end inspiration (p < 0.05), but there was no significant difference at end expiration. The mean CT number and % LAA obtained from studies that were performed at three cm above the top of the diaphragm provided the best separation among three anatomic levels. In comparison between asthmatic and emphysema patients, both parameters were significantly different in asthmatic subjects than in those with emphysema at both end inspiration and expiration on each scan and in the total scans (p < 0.001). Conclusions : HRCT is a useful method to separate asthmatic subjects from patients with emphysema and normal subjects.
Abstract Alternative 【目的】肺野low attenuation area(LAA)は、慢性閉塞性肺疾患(COPD)における肺気腫の存在ならびに程度を反映することが知られている。そこで喘息患者におけるLAAの意義を明らかにすることを目的として、COPD患者、コントロールとの比較検討を行った。  【対象と方法】喘息症例24例、COPD症例23例、コントロール15例を対象として、上・中・下肺野の3スライスで深吸気、深呼気時において胸部高分解能CT(HRCT)を施行し3群間で比較検討を行った。CTパラメーターとしては、平均m値、肺野面積に対する-950HU以下のLAAの割合(% LAA)を採用した。  【結果】1.3スライスの平均CT値は、吸気および呼気とも3群間での有意の差が認められた。2.3スライスの% LAAは、吸気では3群間での有意の差が認められたが、呼気では喘息とコントロール間での有意の差は認められなかった。3.COPD症例では、吸気、呼気ともに平均CT値は他の2群より有意に低値を示し、% LAAは他の2群よりより有意に高値を示した。4.3群間の平均CT値と% LAAの相違は下肺野のスライスで最も顕著であった。  【考案】平均CT値および% LAAは、喘息、COPD、コントロールにおいて有意に異なっており、喘息およぴCOPDの病態を反映する可能性が示唆された。
Keywords HRCT asthma emphysema
Publication Title 岡大三朝分院研究報告
Published Date 2001-02-01
Volume volume71
Start Page 19
End Page 28
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308115
JaLCDOI 10.18926/14974
Title Alternative 気管支喘息におけるCTによる気腫性変化。喫煙症例と非喫煙症例の比較。
FullText URL 068_008_014.pdf
Author Tanizaki, Yoshiro| Mitsunobu, Fumihiro| Ashida, Kozo| Mifune, Takashi| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Okamoto, Makoto| Iwagaki, Naofumi| Yamamoto, Kazuhiko| Nakai, Mutsuo| Akiyama, Tsuneo|
Abstract The percentage of attenuation area < -950HU (% LAA) on high resolution computed tomography (HRCT) was compared between 17 smoking and 24 nonsmoking patients with asthma. 1. FEV1/FVC value was lower in smoking patients (56.4%) than in nonsmoking patients (66.0%), however, the difference was not significant. 2. The percentage of LAA of the lung was larger in smoking patients compared with that in nonsmoking patients in all the three anatomic levels: the % LAA was 14.4% in nonsmoking and 20.3% in smoking patients at lower lung level (3cm above the top of the diaphragm). However, this was not significant. The maximal % LAA among the three lung levels on HRCT was 21.6±12.5% in smoking, and 15.7±11.9% in nonsmoking patients. This suggested that the maximal % LAA was larger in smoking patients, however, this was not significant. 3. The mean CT number of the lung on HRCT was smaller in smoking patients (-897.3HU) than in nonsmoking patients (-884.7HU). 4. Three of 4 nonsmoking patients whose % LAA was more than 30% had severe intractable asthma with long-term glucocorticoid therapy. The results suggest the possibility that smoking influences the % LAA of the lung on HRCT in asthma. It could be also speculated that % LAA is influenced by severity of asthma.
Abstract Alternative HRCT (high resolution computed tomography)による-950HU以下の肺野のlow attenuation area(LAA)について,17例の喫煙喘息症例と24例の非喫煙喘息症例で比較検討した。1.FEV1.0%値は,喫煙症例(56.4%)で非喫煙症例(66.0%)に比べ低い値が示されたが,両群間に有意の差は見られなかった。2.% LAAは,肺野のいずれの高さにおいても,非喫煙症例に比べ喫煙症例で高い傾向が見られたが,有意の差ではなかった。Maximal % LAAは,喫煙症例で21.6%,非喫煙症例15.7%であり,同様に喫煙症例で高い傾向が見られたが,有意の差は見られなかった。3.平均CT値は,非喫煙症例(-884.7HU)に比べ,喫煙症例(-897.3HU)で低い値であった。4.% LAAが30%以上を示 す4例の非喫煙症例のうち,3例がステロイド依存性の重症難治性喘息であった。これらの結果より,喫煙が肺野の% LAAに影響をあたえる可能性もあるものの,疾患の重症度がより影響が強い可能性が示唆された。
Keywords bronchial asthma FEV1 % LAA mean CT number HRCT
Publication Title 岡大三朝分院研究報告
Published Date 1997-12
Volume volume68
Start Page 8
End Page 14
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308579
JaLCDOI 10.18926/14975
Title Alternative 気管支喘息におけるHRCTによるLow attenuation area(LAA)と平均CT numberとの関連
FullText URL 068_015_021.pdf
Author Mitsunobu, Fumihiro| Ashida, Kozo| Mifune, Takashi| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Okamoto, Makoto| Iwagaki, Naofumi| Yamamoto, Kazuhiko| Tanizaki, Yoshiro| Nakai, Mutsuo| Akiyama, Tsuneo| Hasegawa, Harumi|
Abstract The maximal percent low attenuation area < -950 HU (% LAA) among three anatomic lung levels on high resolution computed tomography (HRCT) was examined in patients with asthma, classified by the degree of % LAA, in relation to the mean CT number, % FVC of the predicted value, and FEV 1/FVC (FEV1%). 1 . The mean CT number was closely related to the degree of % LAA of the lungs. The mean CT number was significantly lower in patients with high % LAA (mean CT number-915.3HU, % LAA 37.6%) than in those with low % LAA (-852.9HU, 4.7%). 2. The FEV1% value was significantly lower in patients with high % LAA (47.8%) than in those with low % LAA (62.2%)(p<0.05). The % FVC value was also significantly lower in patients with high % LAA (77.1%) compared to the value in those with low % LAA (101.2%). The results suggest that a large volume of LAA<-950HU of the lungs can be observed in patients with asthma, and the % LAA is closely correlated with mean CT number and the values of FEV1% and % FVC.
Abstract Alternative HRCT (high resolution computed tomography)により,-950HU以下のlow attenuation area(LAA)を3つの高さの肺野レベルで観察し,そのなかの最も高い値をmaximal% LAAとして表し,この値と平均CT number, % FVCおよびFEV1.0%の値と比較検討した。1.平均CT numberは,maximal% LAAと密接な関連を示した。そして,平均CT numberは,% LAAが低い症例(% LAA :4.7%, mean CT number:-852.9HU)に比べ,% LAAが高い症例(% LAA :37.6%, mean CT number:-915.3HU)において低い傾向が見られた。2.FEV1.0%値は,% LAA値が低い症例(62.2%)に比べ% LAA値が高い症例(47.8%)において有意に低い値を示した(P<0.05)。% FVC値も同様% LAA値が低い症例(101.2%)に比べ高い症例(77.1%)で低い値を示したが両群間に有意の差は見られなかった。これらの結果より,気管支喘息においも,HRCT上肺野で-950HU以下のLow attenuation area(LAA)を示す症例が見られること,そして,% LAAは,mean CT number,FEV1.0%や% FVC値とある程度関連していることが示唆された。
Keywords bronchial asthma % LAA mean CT number FEV1 FVC
Publication Title 岡大三朝分院研究報告
Published Date 1997-12
Volume volume68
Start Page 15
End Page 21
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308351
JaLCDOI 10.18926/15126
Title Alternative Pelvimetry with smaller radiation field by CC・DR system- An examination on applying to lateral radiography of the pelvis (Guthmann) ―
FullText URL 066_062_071.pdf
Author Nakai, Mutsuo| Akiyama, Tsuneo| Nakagiri, Yoshiyasu| Kobayashi, Yasuaki|
Abstract 100万画素CCDカメラを用いたI.I.-DR装置(CC・DRシステム)をX線骨盤計測に適用するため,被曝線量をはじめとするいくつかの点を検討した。照射野内の被曝線量は従来の高感度Screen-Film システムであるG12/HRSと同等以下に抑えることが可能であった。また,CC・DRシステムの9インチ円形照射野は一般的に用いられている大角フィルム面積の1/3であり,胎位の95%を占めるといわれている頭位の撮影においては胎児の生殖腺はもちろん, 赤色骨髄を多く含む脊椎への被曝を大幅に低減できた。また,新たに開発された距離計測ソフトウェアーの正確度は良好で,通常lmm以下の誤差で測定が可能であることを確認した。その他,装置に標準装備されている自動露出機構の特性についても報告し,最後に撮影時の留意点についても検討した。
Abstract Alternative To apply CC・DR system (image intensifier digital radiography system including one million pixel CCD camera)to X-ray pelvimetry, We examined exposure dose of X-ray, radiation field, and accuracy of X-ray pelvimetry by the system. The hazards of radiation by CC・DR system were less than those of radiation by G12/HRS which is high sensitive screen-film system. 9 inch round radiation field by CC・DR system was one third of the area of 14×14 inch film. In cephalic presentation which occurs in about 95% of pregnancies, the damages of radiation by CC・DR system to fetal gonads and spinal bones including bone marrow much were less than those by usual X-ray examination. The accuracy of a distance measuring software devised newly for pelvimetry was reliable, and we could measure diameters with less than 1 mm deviations. Also we report the characteristics of automatic exposure controller annexed to this TV system and enumerate points to which we pay attention on taking a radiograph. Furthermore, It is expected that CC・DR system was useful to apply to superio-interior pelviography (Martius).
Keywords 骨盤計測 (Pelvimetry) グースマン法 (Guthmann Position) デジタルラジオグラフィー (digital radiography) 被曝線量 (exposure dose)
Publication Title 岡大三朝分院研究報告
Published Date 1995-09
Volume volume66
Start Page 62
End Page 71
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307350
JaLCDOI 10.18926/15150
Title Alternative Study of the preparation with sodium picosulfate and PEG intestinal lavage solution for total colonoscopy.
FullText URL 065_022_026.pdf
Author Ochi, Koji| Harada, Hideo| Chowdhury, Riaz| Tanaka, Juntaro| Matsumoto, Shuji| Seno, Toshinobu| Mizushima, Takaaki| Mitsunobu, Fumihiro| Tanizaki, Yoshiro| Akiyama, Tsuneo| Nakai, Mutsuo| Hasuoka, Hideaki| Kato, Tadahiro|
Abstract Total colonoscopyの前処置における被検者の負担軽減と良好な腸管洗浄を得る目的で,50例の大腸内視鏡検査において,前日の食事制限せず, sodium picosulfate 20mℓ前夜服用,検査当日PEG腸管洗浄液1ℓ以上服用する前処置法の有用性について検討した。本前処置法によってPEG腸管洗浄液平均1230mℓの服用により,50例中48例で観察可能な腸管洗浄が得られ,PEG腸管洗浄液の服用量の減量が可能であった。腹痛,嘔気,腹鳴などの症状出現例は認めたが,重篤な副作用は認めなかった。腸管洗浄度の点で,高齢者の大腸内視鏡検査の前処置として有用である。以上よりSodium Picosulfate 20mℓをPEG腸管洗浄液と併用することにより,優れた腸管洗浄度を得られると同時にPEG腸管洗浄液服用量の減量か可能であり,total colonoscopyの前処置として有用であることが示された。
Abstract Alternative The following results were obtained from a total colonoscopic study of 50 patients who received preparation with 20mℓ of sodium picosulfate (Laxoberon®) and PEG intestinal lavage solution (Niflec®) prior to the examination. (l) The present method in combination with a mean of 1230mℓ of PEG intestinal lavage solution allowed colonic cleaning for which observation was available in 48 of 50 patients. (2) With this method. no adverse reactions were observed except for mild abdominal pain, nausea, and rugitus in a few patients. (3) This method was particularly as a preparation for colonoscopic examination in elderly patients. Thus, we conclude that preparation with 20mℓ of sodium picosulfate and PEG intestinal lavage solution is useful for colonoscopic examination.
Keywords 大腸内視鏡検査 (colonoscopy) 前処置 (preparation)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 22
End Page 26
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307186
JaLCDOI 10.18926/15161
Title Alternative Clinical studies on polypoid lesions of the colon.
FullText URL 065_101_106.pdf
Author Takata, Ichiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Matsumura, Tadashi| Yokota, Satoshi| Tanizaki, Yoshiro| Ochi, Koji| Harada, Hideo| Akiyama, Tsuneo| Nakai, Mutsuo|
Abstract 1990年4月より1994年3月末までの間に岡山大学医学部附属病院三朝分院で経験した早期大腸癌を含む大腸ポリープ88例を対象に,病理組織診断,性別,年齢構成,存在部位,精査動機について検討を行い,以下の成績を得た。(1)ポリープの69.2%は腺腫,13.2%は腺癌(早期癌)であった。(2)男女とも加齢による大腸ポリープ及び大腸癌の頻度の増加がみられた。(3)50歳未満の若年者では右側結腸にポリープが発見されることは稀であったが50歳以上では6.5%に認められ,高齢者における積極的なtotal colonoscopyによる観葉が重要であることが再確認された。(4)精査動機では便潜血陽性が最多を占め,便潜血は大腸ポリープのスクリーニングにおいて有用であることが示された。またフォローアップ目的に大腸ファイバーを施行しポリープや早期癌を発見した例も多く,フォローアップの必要性が示唆された。
Abstract Alternative Polypoid lesions, taken by a colon fiberscope, were examined in 88 patients with polyp, who were admitted to Misasa Medical Branch, Okayama University Medical School for last 4 years. (1) Pathohistological examination of the polypoid lesions resulted in 69.2% of adenoma and 13.2% of adenocarcinoma (early cancer) ; (2) 35.5% of the polypoid lesions was detected in the sigmoid colon, 32.7% in the rectum, 16.8% in the transverse colon, 4.7% in the descending colon, 3.7% in the caecum, 1.9% in the ascending colon ; (3) The number of patients with polypoid lesion or colon cancer was increased with aging ; (4) Patients with the age under 50 years did not have polypoid lesion in the right hemicolon, while 6.5% of elder patients over age 50 has polypoid lesions in the right hemicolon ; (5) Occult blood in stool was the most popular motivation for receiving colonoscopic examinations ; (6) The second popular motivation for colonoscopy was for follow up after previous examinations. These results suggest that patients with age over 50 should be examined more carefully by total colonoscopy, and a hemoccult test in stool is an effective method for screening colonic polypoid lesions and after detection of polypoid lesions or polypectomy, reexamination by total colonoscopy is important at regular intervals.
Keywords 大腸ポリープ (Polyp of the colon) 大腸早期癌 (Early cancer of the colon) 便潜血 (Occult blood in stool)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 101
End Page 106
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307396