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
Author Takata, Shingo| Hosaki, Yasuhiro| Ashida, Kozo| Hamada, Masanori| Iwagaki, Naofumi| Kikuchi, Hiroshi| Mitsunobu, Fumihiro|
Published Date 2008-03-01
Publication Title 岡大三朝医療センター研究報告
Volume volume76
Content Type Departmental Bulletin Paper
JaLCDOI 10.18926/14912
FullText URL 071_073_075.pdf
Author Ashida, Kozo| Tsugeno, Hirofumi| Hosaki, Yasuhiro| Mitsunobu, Fumihiro| Mifune, Takashi| Nishida, Norikazu| Okamoto, Makoto| Takata, Shingo| Tanizaki, Yoshiro| Tsuji, Takao|
Abstract 症例は80才,女性。76才時[平成7年11月]より肝機能異常[アルカリフォスファターゼ高値]を認め,肝機能異常出現1年7ケ月後,血清学的検索で原発性胆汁性肝硬変症が疑われたが,無治療にて外来で経過を観察を行った。アルカリフォスファターゼ値は漸増傾向を示し,トランスアミナーゼ値の異常も伴ってきたため,平成12年11月精査目的で入院。組織検査等で無症候性原発性胆汁性肝硬変症[PBC]と診断した。PBCは中年・女性に好発する疾患で,高齢【特に後期高齢者]での発症は極めて稀である。4年間の自然経過も含め,興味深いと考えられたので報告する。
Keywords 原発性胆汁性肝硬変症 (primary biliary cirrhosis) 高齢 (elderly) 自然経過 (natural course)
Publication Title 岡大三朝分院研究報告
Published Date 2001-02-01
Volume volume71
Start Page 73
End Page 75
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308230
JaLCDOI 10.18926/14956
Title Alternative MR-angiographyで経過を観察しえた慢性関節リウマチに合併した巨細胞動脈炎の1例
FullText URL 069_035_039.pdf
Author Harada, Seishi| Mitsunobu, Fumihiro| Kodama, Fumiko| Hosaki, Yasuhiro| Mifune, Takashi| Tsugeno, Hirofumi| Okamoto, Makoto| Yumoto, Eiichiro| Takata, Shingo| Tanizaki, Yoshiro|
Abstract We report a patient who developed giant cell (temporal) arteritis during treatment of rheumatoid arthritis. The patient was a 57-year-old Japanese woman and had been well controlled with anti-rheumatic drugs, when she presented to our hospital with severe bitemporal headaches and marked fatigue. An exclusive diagnosis was rapidly made and she was diagnosed as having giant cell arteritis based on the classification criteria by American College of Reumatology. Additionally, magnetic resonance (MR) angiography was performed, from which stenotic change in the bilateral superficial temporal arteries was strongly suspected and then corticosteroid therapy was quickly started. The patient followed an uneventful course without developing any complications such as visual dysfunctions. Therapeutic effect was confirmed by MR-angiographic findings obtained 4 weeks after the initiation of therapy.
Abstract Alternative 慢性関節リウマチ治療経過中に巨細胞動脈炎(側頭動脈炎)を合併した1例を報告した。症例は抗リウマチ剤投与で良好にコントロールされていた慢性関節リウマチの57歳の女性で,強い両側頭部痛と全身倦怠感を主訴に来院した。アメリカリウマチ学会(ACR)の分類基準に基づき巨細胞動脈炎と診断し,MR-アンギオグラフィーで両側浅側頭動脈の狭窄性変化を強く疑い,発症 早期よりステロイド投与を開始した。眼合併症等を来すことなく良好な経過をとり,治療開始4週間後のMR-アンギオグラフィー再検でその治療効果を確認し得た。MR-アンギオグラフィーで巨細胞動脈炎病変部を観察しえた報告は極めて少なく,文献的考察を加え報告する。
Keywords 巨細胞動脈炎 (giant cell arteritis) 側頭動脈炎 (temporal arteritis) 慢性関節リウマチ (rheumatoid arthritis) MRアンギオグラフィー (MR-angiography)
Publication Title 岡大三朝分院研究報告
Published Date 1998-12
Volume volume69
Start Page 35
End Page 39
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308121
Author Takata, Shingo| Ashida, Kozo| Hosaki, Yasuhiro| Hamada, Masanori| Iwagaki, Naofumi| Kikuchi, Hiroshi| Mitsunobu, Fumihiro|
Published Date 2008-03-01
Publication Title 岡大三朝医療センター研究報告
Volume volume76
Content Type Departmental Bulletin Paper
JaLCDOI 10.18926/14960
Title Alternative n-3系脂肪散を強化した食事療法が有効と考えられた肺気腫の一例
FullText URL 069_049_056.pdf
Author Tsugeno, Hirofumi| Ashida, Kozo| Mitsunobu, Fumihiro| Mifune, Takashi| Okamoto, Makoto| Hosaki, Yasuhiro| Tanizaki, Yoshiro| Tsuji, Takao|
Abstract An effective treatment for the advanced stages of chronic obstructive pulmonary disease (COPD) has not been established yet. We report our recent experience of one patient with pulmonary emphysema treated by dietary supplementation of n-3 fatty acid for two months. He presented improvements in clinical symptoms and pulmonary function, and suppression of leukotriene B(4) generation by peripheral leukocytes. We consequently suppose that dietary treatment with n-3 fatty acids (perilla seed oil) may offer benefits for the treatment of pulmonary emphysema by competitively inhiabiting the conversion of arachidonicacid to leukotrienes and prostanoids.
Abstract Alternative 今回我々は,肺気腫の症例に対してn-3系脂肪酸を強化した食事療法をおこない,臨床症状,呼吸機能検査所見ともに速やかに改善を認め,同時に白血球のロイコトリエンB4産生能が著明に減少した一例を経験したので報告する。 症例は67歳,男性。主訴は労作時呼吸困難。【第一回目入院】3カ月間入院し,薬物療法,温泉を用いた理学療法を行った。自覚症状はやや改善が見られたが,呼吸機能検査所見の改善は得られなかった。【第二回目入院】1年後に再入院。n-3系脂肪酸強化食事療法も併用した。自覚症状および,呼吸機能検査上,FVC,FEV1.0,PEFなどに改善を認めた。n-3系脂肪酸はアラキドン酸代謝を通してロイコトリエン合成に関与すると推定されるが,経渦中に白血球のLTB4産生能の減少を認めた。この症例は肺気腫に対するn-3系脂肪酸強化食 事療法の有用性が示唆され,病態を考える上でも興味深いと考えられた。
Keywords pulmonary emphysema n-3 fatty acid leukotriene diet therapy
Publication Title 岡大三朝分院研究報告
Published Date 1998-12
Volume volume69
Start Page 49
End Page 56
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308253
JaLCDOI 10.18926/14962
Title Alternative ステロイド依存性重症難治性気管支喘息症例における胃粘膜病変の検討
FullText URL 069_063_067.pdf
Author Mifune, Takashi| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Harada, Seishi| Okamoto, Makoto| Yumoto, Eiichirou| Takata, Shingo| Tanizaki, Yoshiro|
Abstract Recently, we experienced two asthmatic patients with advanced gastric cancer. The two patients had steroid-dependent intractable asthma (SDIA) who had been on administration of corticosteroids for more than 2 years. To determine the influence of pathophysiology of SDIA on stomach mucous lesion, gastroscopic examinations and immunological examinations were performed in eight patients with SDIA, compared with 25 patient with non-SDIA. In patients with SDIA, gastric cancer, its precursor condition and immunosuppressive state were observed. These results suggest that the immunosuppressive state in SDIA induced by the long-term administration of corticosteroids may lead to the risk of gastric cancer development.
Abstract Alternative 最近,進行胃癌を合併した気管支喘息症例を2例経験した。2症例ともにステロイド依存性重症難治性喘息(SDIA)症例であり,SDIAが胃悪性腫瘍に関与している可能性が考えられた。今回,SDIA症例における胃粘膜病変の臨床像および背景因子を検討する目的で,8例のSDIA症例における胃内視鏡検査,末梢血液分画,免疫グロブリン定量を行い,非SDIA症例と比較検討を行った。SDIA症例においては胃癌・前癌状態が認められたが,非SDIA例では認められなかった。SDIA群において,末梢血白血球は有意に増加し,リンパ球分画・IgGは有意に減少していた。これらの結果より,ステロイド依存性重症難治性気管 支喘息症例においては免疫状態が抑制され,胃悪性腫瘍が発生する危険性があるものと考えられた。
Keywords ステロイド依存性重症難治性 (steroid-dependent intractable asthma (SDIA)) 胃癌 (gastric cancer) 免疫抑制 (immunosuppression) リンパ球 (lymphocytes) IgG
Publication Title 岡大三朝分院研究報告
Published Date 1998-12
Volume volume69
Start Page 63
End Page 67
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308665
JaLCDOI 10.18926/15096
Title Alternative 気管支喘息に対する複合温泉療法の作用機序 3.気道炎症反応との関連
FullText URL 067_099_106.pdf
Author Hosaki, Yasuhiro| Mifune, Takashi| Mitsunobu, Fumihiro| Ashida, Kozo| Yokota, Satoshi| Tsugeno, Hirofumi| Takeuchi, Kazuaki| Nawa, Yuichiro| Tanizaki, Yoshiro| Ochi, Koji| Harada, Hideo|
Abstract The degree and characteristic of airway inflammation were evaluated by the proportions of bronchoalveolar lavage (BAL) cells. Clinical asthma types such as Ia. simple bronchoconstriction, Ib. bronchoconstriction + hypersecretion, and Ⅱ. bronchiolar obstruction correlate with airway inflammation. The increased proportion BAL neutrophils is characteristic of type Ⅱ asthma, and increase in BAL eosinophil count is often observed in type Ib asthma. Bronchial hyperresponsiveness also correlates with airway inflammation. Action of spa therapy has been speculated to be related to airway inflammation, since the therapy has no action inhibiting IgE-mediated allergic reaction. In fact, spa therapy is more effective in patients with type Ib and type Ⅱ than in those with type Ia showing slight degree of airway inflammation. Bronchial hyperresponsiveness is also improved by spa therapy. From a point of view, the direct action of spa therapy may be to clean airways and improve damaged mucous membrane of the airways, leading to suppression of airway inflammation.
Abstract Alternative 気道炎症反応の程度や特徴が,気管支肺胞洗浄液(BAL)中の細胞成分によって評価された。Ia.単純性気管支攣縮型,Ib.気管支攣縮+過分泌型,Ⅱ.細気管支閉塞型などの各臨床病型は気道炎症反応と関連している。BAL液中好中球増多は,Ⅱ型喘息の特徴的所見であり,また好酸球増多はIb型喘息でしばしば観察される。気道過敏性もまた気道炎症反応と関連している。温泉療法の作用機序としては,温泉療法にIgEにmediateされるアレルギー反応(液性因子相)を抑制する作用がないことから,気道炎症反応(細胞性因子相)の抑制が推測されている。実際,温泉療法は,気道炎症反応が軽度なIa型喘息に比べ,Ib型やⅡ型などの明らかに気道炎症反応をともなう病型に対してより有効である。気道過敏性もまた温泉療法により改善される。これらの 結果から,温泉療法は,気道を清浄化し,気道粘膜を正常化することによって,気道炎症反応を抑制していくものと考えられる。
Keywords Spa therapy (温泉療法) Airway inflammation (気道炎症反応) BAL eosinophilia (BAL好酸球増多) BAL neutrophilia (BAL好中球増多) Bronchial asthma (気管支喘息)
Publication Title 岡大三朝分院研究報告
Published Date 1996-11
Volume volume67
Start Page 99
End Page 106
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307894
JaLCDOI 10.18926/15094
Title Alternative 気管支喘息に対する複合温泉療法の作用機序 2.内分泌・自律神経系および心因的要素に対する効果
FullText URL 067_092_098.pdf
Author Mifune, Takashi| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Yokota, Satoshi| Tsugeno, Hirofumi| Takeuchi, Kazuaki| Nawa, Yuichiro| Tanizaki, Yoshiro| Saito, Katsuyoshi|
Abstract Actions of spa therapy on endocrine-autonomic nerve system and psychological factors were analyzed in patients with bronchial asthma. In endocrine function, serum levels of cortisol and ACTH tended to increase after spa therapy. In autonomic nerve system, decrease in concentrations of serum adrenalin and noradrenalin was observed after spa therapy, and the difference between the initial levels before spa therapy and the levels after the therapy was significant in serum levels of adrenalin. However, serum levels of substance P and Bradykinin were not affected by spa therapy. To evaluate the action of spa therapy on mental condition in patients with asthma, four kinds of psychological tests, CMI, SDS, CAl and SD, were carried out. Improvement of mental disorders in patients with asthma is observed after spa therapy in all psychological tests. These results suggest that spa therapy acts effectively on endocrine-autonomic nerve system and improve psychological conditions.
Abstract Alternative 内分泌・自律神経系および心因的要素に対する温泉療法の効果が,気管支喘息を対象に検討された。内分泌系では,血中コーチゾ-ルおよびACTH値が,温泉療法後に上昇することが示された。また,自律神経系では,血中アドレナリンおよびノルアドレナリン濃度が温泉療法により減少することが示され,特に,血中アドレナリンは温泉療法前後の濃度に有意の差が見られた。しかしながら,血中サブスタンスPおよびブラジキニン濃度には,温泉療法による有意の変動は見られなかった。心因的要素に対する温泉療法の作用を検討するため,CMI,SDS,CAIおよびSDの4種類の心身医学的検査が行われた。その結果,いずれの心身医学的検査においても,温泉療法により疾患に不利に働く心因的要素が改善する傾向が見られた。これらの結果より,温泉療法が内分泌・自律神経系に対して有用な作用を有し,また,疾患に不利な心因的要素を改善させる作用を有していることがある程度示唆された。
Keywords Bronchial asthma (気管支喘息) Spa therapy (温泉療法) Endocrine-autonomic nerve system (内分泌・自律神経系) Psychological disorders (心的要素)
Publication Title 岡大三朝分院研究報告
Published Date 1996-11
Volume volume67
Start Page 92
End Page 98
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307879
JaLCDOI 10.18926/15093
Title Alternative 気管支喘息に対する複合温泉療法の作用機序 1.温泉療法の評価方法との関連
FullText URL 067_085_091.pdf
Author Mitsunobu, Fumihiro| Mifune, Takashi| Hosaki, Yasuhiro| Ashida, Kozo| Yokota, Satoshi| Tsugeno, Hirofumi| Takeuchi, Kazuaki| Nawa, Yuichiro| Tanizaki, Yoshiro| Ochi, Koji| Harada, Hideo|
Abstract Action mechanisms of complex spa therapy (swimming training in a hot spring pool, inhalation with iodine salt solution, and fango therapy) were studied in relation to patient age, clinical asthma type, and airway inflammation. Actions of spa therapy were observed by two clinical effects : direct and indirect effects. Improvement of subjective symptoms, ventilatory function, and bronchial hyperresponsiveness was observed as direct effects of spa therapy, and improvement of suppressed function of adrenocortical glands as indirect effects of the therapy. The clinical effects of spa therapy were higher in patients over the age of 40. Regarding clinical asthma type, the effects were larger in patients with type Ib and type II asthma than in those with type Ia. The efficacy of spa therapy was closely related with airway inflammation in patients with type Ib and type II asthma.
Abstract Alternative 複合温泉療法(温泉プール水泳訓練,ヨードゾル吸入,鉱泥湿布療法)の作用機序が,年齢,臨床病型,気道炎症反応との関連のもとに検討された。温泉療法の作用機序は,2種類の臨床効果,すなわち,直接効果と間接効果により観察された。自,他覚症状の改善,換気機能の改善,そして,気道過敏性の改善などが,温泉療法の直接効果として,また,副腎皮質機能の改善が間接効果とし て観察された。温泉療法の臨床効果は,40才以上の症例においてより有効であり,また,臨床病型別では、Ia型に比べ,Ib型およびⅡ型においてより有効であった。Ib型やⅡ型の気管支喘息では,温泉療法の作用機序と気道炎症反応との間に密接な関連が認められた。
Keywords complex spa therapy (複合温泉療法) clinical asthma type (臨床病型) ventilatory function (換気機能) bronchial hyperresponsiveness (気道過敏性) adrenocortical glands (副腎皮質)
Publication Title 岡大三朝分院研究報告
Published Date 1996-11
Volume volume67
Start Page 85
End Page 91
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307192
JaLCDOI 10.18926/15298
Title Alternative ステロイド依存性重症難治性喘息に対する複合温泉療法の作用機序
FullText URL 063_001_006.pdf
Author Tanizaki, Yoshiro| Kitani, Hikaru| Okazaki, Morihiro| Mifune, Takashi| Mitsunobu, Fumihiro| Takatori, Akimasa| Okuda, Hiroyuki| Ochi, Koji| Harada, Hideo| Kimura, Ikuro|
Abstract Effects of complex spa therapy, which comprises swimming training in a hot spring pool, inhalation of iodine salt solution and fango therapy, were analyzed in patients with steroid-dependent intractable asthma (SDIA) by comparison between the subjects with and without efficacy of the therapy. 1. The complex spa therapy was effective in the patients with lower levels of FEV(1.0%) and % PEFR. 2. The complex spa therapy was not always effective in the patients with a low value of % V(25), which represents depressed airflow in the small airways. 3. The efficacy of the complex spa therapy was found in the patients showing a low value of % V(25) accompanied by BAL neutrophilia, but not found in those without increased proportion (more than 10% ) of neutrophils in BAL fluid. The results reveal that the complex spa therapy is effective in patients with SDIA showing low values of FEV(1.0%) and % PEFR, and in those with a low value of % V(25) and BAL neutrophilia.
Abstract Alternative ステロイド依存性重症難治性喘息を対象に,温泉プール水泳訓練,ヨードゾル吸入療法.鉱泥湿布療法からなる複合温泉療法の臨床効果の解析を行った。1.複合温泉療法は,FEV(1.0%)および% PEFR値の低い症例により有効であった。2.複合温泉療法は、細気管支領域の換気障害を示すと考えられる% V(25)値が低い症例に対して,必ずしも有効ではなかった。3.複合温泉療法の効果は,BAL液中好中球増多(10%以上)が見られ、かつ% V(25)値が低い症例により有効であったが、同様に% V(25)値が低くても,BAL液中に好中球増多 が見られない症例に対しては,有効ではなかった。以上の結果より,複合温泉療法はFEV(1.0%)や% PEFR値の低く,またBAL液中好中球増多が見られ,かつ% V(25)値が低いようなステロイド依存性重症難治性喘息に対して有効性が高いことが示唆された。
Keywords complex spa therapy (複合温泉療法) ventilatory function (換気機能) BAL neutrophilia (BAL好中球増多) bronchial asthma (気管支喘息)
Publication Title 岡大三朝分院研究報告
Published Date 1992-06
Volume volume63
Start Page 1
End Page 6
ISSN 0913-3771
language 英語
File Version publisher
NAID 120002307537
JaLCDOI 10.18926/15303
Title Alternative 気管支喘息におけるActivated Tリンパ球について,喘息発作との関連
FullText URL 064_011_016.pdf
Author Tanizaki, Yoshiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Sugimoto, Keisuke| Yokota, Satoshi| Hiramatsu, Junichi| Kawaraya, Masashi| Harada, Hideo| Tada, Shinya| Kimura, Ikuro|
Abstract The number of CD4(+) T-Iymphocytes, CD4/CD8 ratio, and the number of IL2R(+) T-Iymphocytes (CD25) were examined in 14 patients with bronchial asthma, and the results were compared in three different asthma stages : symptom-free stage, wheeze stage, and attack stage. 1. The proportion of blood CD4(+) T-lymphocytes was more decreased in patients with asthma attacks than in those without symptoms. The CD4/CD8 ratio was also more decreased in patients with attacks than in those without symptoms. However, these differences were not significant. 2. The proportion of blood activated T cells (IL2R(+) cells, CD25) was significantly increased in patients with attacks than in those without symptoms. The proportion of activated T cells in 5 asthma patients was 2.9±0.8% in symptom-free stage and 6.6±1.1% in attack stage(p<0.001). These findings show that numbers of activated T-lymphocytes in peripheral blood were increased during asthma attacks, and this increase suggests the participation of activated T cells in the pathogenesis of asthma.
Abstract Alternative 気管支喘息14例を対象に,末梢血CD4(+)リンパ球の頻度,CD4/CD8比およびIL2R(+)Tリンパ球の頻度について,喘息発作との関連のもとに検討を加えた。1.CD4(+)リンパ球の頻度は,非発作時の症例で最も高く,喘鳴のみの症例,発作の見られる症例へと順次低くなる傾向が見られたが,推計学的には有意の差は見られなかった。CD4/CD8比も同様に,非発作時に最も高く,発作を有する症例では非発作時に比べ低い値を示したが,推計学的には有意の差は見られなかった。2.IL2R(+)Tリンパ球(activated Tリンパ球)の頻度は,非発作時の症例で最も低く(3.5±1.1%),喘鳴のみをともなう症例(3.8±1.1%),発作の見られる症例(5.8±1.9%)へと順次高くなる傾向を示し,発作のある症例では,非発作および喘鳴のみの症例に比べ有意に高い値 を示した。また,非発作時と発作のある時期にIL2R(+)Tリンパ球を観察し得た5症例では,非発作時2.9±0.8%,発作のある時期6.6±1.1%であり,発作のある時期に有意の高値を示した(p<0.001)。これらの結果は,発作のある時期にはactivated Tリンパ球の頻度が増加すること,そして,この増加はactivated Tリンパ球が喘息発作の病態と密接な関連を有していることを示唆するものと考えられた。
Keywords CD4(+) T cells (CD4(+)リンパ球) CD4/CD8 ratio (CD4/CD8比) IL2R(+) T cells (IL2R(+)Tリンパ球) bronchial asthma (気管支喘息)
Publication Title 岡大三朝分院研究報告
Published Date 1993-06
Volume volume64
Start Page 11
End Page 16
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307394
JaLCDOI 10.18926/15008
Title Alternative 中高年発症型喘息患者におけるIgE系アレルギー反応の加令による変化
FullText URL 067_050_056.pdf
Author Mitsunobu, Fumihiro| Mifune, Takashi| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Yokota, Satoshi| Tanizaki, Yoshiro| Ochi, Koji| Harada, Hideo|
Abstract Age-related changes in IgE-mediated allergic reaction were examined in patients with late onset asthma, whose asthma occured over the age at onset of 40. 1. The number of patients with a high serum IgE level over 3001U/mℓ was larger in those between the ages at onset of 40 and 49 and over age at onset 60 than in those between the ages at onset 50 and 59. 2. A positive RAST score to Hdm and cockroach allergens was more frequently found in patients between 40 and 49 and over age 60 at onset compared to those between 50 and 59 at onset. In contrast, the number of patients with a positive RAST to Candida was larger in those between 50 and 59 at onset than in those of between 40 and 49 and over 60 at onset. 3. Severe asthma was more frequently and slight asthma was less frequently observed in patients between 50 and 59 at onset than in those of the other age at onset groups. These results suggest that IgE-mediated allergic reaction in patients between the ages at onset of 50 and 59 is different from that in those with early onset asthma, and that the reaction in patients between the ages at onset 40 and 49 and over 60 resembles to the reaction in those with early onset asthma.
Abstract Alternative 発症年令が40才以上の中高年発症型喘息患者におけるIgE系アレルギー反応の加令による変化について検討を加えた。1.発症年令が40から49才と60才以上の患者では,50から59才の患者に比して血清IgE値が300IU/mℓ以上の高値を示す頻度が高い傾向が見られた。2.ダニ,ゴキブリに対するRAST陽性率は発症年令が50から59才の患者に比して,40から49才と60才以上の患者で高値を示した。一方,カンジダに対するRAST陽性率は,発症年令が40から49才と60才以上の患者に比して,50から59才の患者で高値を示した。3.発症年令が50から59才の患者では,他の発症年令の患者に比べて,重症例が多く,軽症例が少ない傾向が見られた。以上の結果から,発症年令が50から59才の患者のIgE系アレルギー反応は若年発症型喘息患者と異なり,発症年令が40から49才と60才以上の患者のIgE系アレルギー反応は若年発症型喘息患者と 類似することが示唆された。
Keywords IgE RAST 吸入抗原 (inhalant Allergen) 気管支喘息 (Bronchial asthma) 加令 (aging)
Publication Title 岡大三朝分院研究報告
Published Date 1996-11
Volume volume67
Start Page 50
End Page 56
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307989
Author Ashida, Kozo| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Nishida, Norikazu| Nagata, Takuya| Yokoi, Tadashi| Takata, Shingo| 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 10.18926/15312
Title Alternative 老年者気管支喘息における気道炎症細胞.喘息重症度と関連した気道細胞反応の特徴
FullText URL 064_083_088.pdf
Author Tanizaki, Yoshiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Sugimoto, Keisuke| Yokota, Satoshi| Hiramatsu, Junichi| Nakagiri, Yoshiyasu| Harada, Hideo| Kimura, Ikuro|
Abstract Cellular composition of bronchoalveolar lavage (BAL) fluid was examined in 11 elderly asthmatics over the age of 70, and the results were compared with those of 11 younger asthmatics under the age of 50. In the subjects with mild asthma, the proportion of BAL cells in the elderly subjects was 86.2% macrophages, 11.0% lymphocytes, 1.9% neutrophils, 0.9% eosinophils and 0.08% basophilic cells. The proportion of neutrophils and eosinophils in the BAL fluid was slightly higher in younger subjects with mild asthma compared with that in elderly subjects, although no significant difference was found between the two groups. In subjects with severe asthma, the proportions of lymphocytes, neutrophils, eosinophils and basophilic cells were more increased in both younger and older patients compared to those with mild asthma, and a significant increase in the number of BAL eosinophils was found in younger subjects with severe asthma compared to those with mild asthma (p < 0.05). However, no significant difference was present in the proportion of BAL cells between younger and older patients with severe asthma. The results reveal that BAL cells are more increased in subjects with suvere asthma than in those with mild asthma in both younger and older subjects, and show the possibility that this increase is more predominant in neutrophils in older subjects and in eosinophils in younger subjects.
Abstract Alternative 70才以上の老年者気管支喘息11例(平均年齢71.4才)を対象に,重症度と気道細胞反応との関連について検討を加えた。なお,対照として50才以下の喘息症例11例(平均年齢33.5才)を選んだ。1.老年者の軽症型喘息における気管支肺胞洗浄(BAL)液中の出現細胞の頻度は,マクロファージが86.2%,リンパ球が11.0%,好中球が1.9%,好酸球が0.9%,好塩基性細胞が0.08%であった。BAL液中の好中球,好酸球の頻度は若青年症例でやや高い傾向が見られたが,両群間に有意の差は見られなかった。重症例では,老年症例,若青年症例とも,軽症例に比べリンパ球,好中球,好酸球などのBAL細胞の出現頻度が増加しており,特に好酸球では若青年症例の重症例で軽症例に比べ有意に高い頻度が観察された。これらの結果は, リンパ球,好中球,好酸球などのBAL細胞は,軽症例に比べ重症例で増加してくること,そして,その増加は老年症例では好中球,若青年症例では好酸球の増加が特徴的であることを示唆しているものと考えられた。
Keywords Neutrophils (好中球) Eosinophils (好酸球) Bronchoalveolar lavage (気管支肺胞洗浄) asthma severity (喘息重症度)
Publication Title 岡大三朝分院研究報告
Published Date 1993-06
Volume volume64
Start Page 83
End Page 88
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307736
Author Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Nishida, Norikazu| Nagata, Takuya| Takata, Shingo| Yokoi, Tadashi| 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 10.18926/15332
Title Alternative 気管支肺胞洗浄液中リンパ球増多と患者年齢およびIgE系アレルギー反応との関連について
FullText URL 064_097_104.pdf
Author Tanizaki, Yoshiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kimura, Ikuro|
Abstract The proportion and number of lymphocytes in the airways were analyzed in 15 patients with a high proportion of lymphocytes in bronchoalveolar lavage (BAL) fluid (more than 30%) and in 17 patients with less than 20% of BAL lymphocytes. 1. Both atopic and nonatopic asthma patients with a high proportion of BAL lymphocytes were aged more than 50 years. In contrast, the age of patients with less than 20% of BAL lymphocytes ranged widely, from 29 to 63 years, in the two asthma types. 2. Age at onset of the disease, serum IgE levels, and ventilatory function test were not related to the proportion of BAL lymphocytes. 3. In patients with a high proportion of BAL lymphocytes, the mean proportion of these cells was 47.3% in atopic patients and 36.4% in non-atopic patients, i. e., there was no significant difference between the two asthma types. The absolute number of BAL lymphocytes in these patients was significantly higher in atopic (5.62×10(6)) than in nonatopic asthma (0.77×10(6)) (p<0.01). These findings show that an increased number of lymphocytes in the airways is clearly related to patient age and IgE-mediated allergic reaction.
Abstract Alternative 気管支肺胞洗浄(BAL)液中のリンパ球頻度が30%以上の15例および20%以下の17例の気管支喘息患者を対象に,BAL液中リンパ球頻度と年齢およびIgE系反応との関連について検討を加えた。1.BALリンパ球が高頻度(30%以上)を示す症例は,アトピー型,非アトピー型を問わず,50才以上の年齢層に多い傾向が見られた。一方,BALリンパ球20%以下の症例の年齢は,29-63才まで幅広く分布していた。2.発症年齢,血清IgE値,換気機能とBAL液中リンパ球頻度との間には関連は見られなかった。3.BAL液中リンパ球頻度が高い症例では,アトピー型では平均リンパ球頻度は47.3%,非アトピー型では36.4%であったが,両群間には有意の差は見られなかった。しかし,BAL液中のリンパ球の絶対数は,アトピー型(5.62×10(6))において,非アトピー型(0.77×10(6)) に比べ有意に高い値を示した(p<0.01)。これらの結果は,気道内リンパ球の増加は,患者年齢とIgE系反応と密接に関連していることを示唆している。
Keywords BAL lymphocytes patient age IgE-mediated allergic reaction bronchial asthma
Publication Title 岡大三朝分院研究報告
Published Date 1993-06
Volume volume64
Start Page 97
End Page 104
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307637
JaLCDOI 10.18926/14953
Title Alternative 肺気腫患者におけるロイコトリエンB4,C4産生能と高分解能CTによる平均CT値との関連
FullText URL 069_015_020.pdf
Author Mitsunobu, Fumihiro| Mifune, Takashi| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Harada, Seishi| Yumoto, Eiichiro| Takata, Shingo| Ochi, Koji| Harada, Hideo| Hasegawa, Harumi|
Abstract The generation of leukotrienes B4 (LTB4) and C4 (LTC4) by peripheral leukocytes stimulated with Ca ionophore A23187 was examined in 17 patients with pulmonary emphysema. They were divided into three groups according to the mean CT number; A (<-940 HU), B (-940 ≦, <-930 HU), and C (-930 HU ≦ ).1. The values of FVC (% predicted), FEV1.0% and DLco (% predicted) showed a tendency to decrease as the mean CT number was smaller. The value of % FVC was significantly lower in patients with group A than in those with group C (p<0.05). 2. The generation of both LTB4 and LTC4 was significantly higher in patients with emphysema compared to the generation in healthy subjects (LTB4;p<0.05, LTC4;P<0.05). 3. The generation of LTB4 and LTC4 in patients with emphysema was higher as the mean CT number was larger (severity of the disease become less). The LTC4 production was significantly higher in patients with group C(mild or moderate type of emphysema) than in those with group A(advanced type of emphysema). These results suggest that the generation of LTB4 and LTC4 is higher in patients with mild or moderate type of emphysema than in those with advanced type of the disease.
Abstract Alternative 肺気腫患者17名を対象として,カルシウムイオノフォアA23187による末梢血白血球からのロイコトリエンB4(LTB4), ロイコトリエンC4(LTC4)の産生能の検討を行った。対象は高分解能CTによる平均CT値によってA(<940HU), B(-940≦,<-930HU),C(-930HU≦)の3群に分類した。1.% FVC,FEV1.0%,% DLcoが低下するにつれて平均CT値が低下する傾向が見られた。% FVC値はC群に比較して,A群において有意に低値を示した(p<0.05)。2.LTB4とLTC4の産生能は健常人に比較して,肺気腫患者において有意に高値を示した(LTB4;p<0.05,LTC4;p<0.05)。3.肺気腫患者におけるLTB4とLTC4の産生能は平均CT値が上昇するにつれて(軽症症例ほど)高値を示した。またLTC4産生能はC群(早期肺気腫症例)においてA群(進行肺気腫症例)に比して有意に高値を示した。以上より肺気腫におけるLTB4,LTC4産生能は進行例に比較すると,軽・中等症例において高値であることが示唆された。
Keywords emphysema mean CT number LTB4 LTC4
Publication Title 岡大三朝分院研究報告
Published Date 1998-12
Volume volume69
Start Page 15
End Page 20
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308094
JaLCDOI 10.18926/AMO/32622
FullText URL fulltext.pdf
Author Tanizaki, Yoshiro| Kitani, Hikaru| Okazaki, Morihiro| Mifune, Takashi| Mitsunobu, Fumihiro| Tanimizu, Masakuni| Honke, Naoko| Kusaura, Yasuharu| Ochi, Koji| Harada, Hideo| Soda, Ryo| Takahashi, Kiyoshi| Kimura, Ikuro|
Abstract Twenty-one patients with atopic asthma were classified into three types according to their symptoms (clinical diagnosis): Ia, simple bronchoconstriction; Ib, bronchoconstriction + hypersecretion; and II, bronchiolar obstruction, and this classification was compared with a classification made according to clinical findings and examinations (score diagnosis). Type Ib asthma was characterized by the increased incidence of eosinophils in bronchoalveolar lavage fluid (BALF), while type II was characterized by ventilatory dysfunction in small airways and the increased incidence of neutrophils in BALF. Four patients, whose expectoration was between 50 and 99ml/day, of the 12 with type Ia assessed by clinical diagnosis were evaluated as type Ib by score diagnosis. One patient with type II by clinical diagnosis was assessed as questionable type II by score diagnosis. In the other 16 patients, the clinical and score diagnoses were the same.
Keywords bronchial asthma classification ventilatory function cellular composition of BALF sore diagnosis
Amo Type Article
Published Date 1992-08
Publication Title Acta Medica Okayama
Volume volume46
Issue issue4
Publisher Okayama University Medical School
Start Page 295
End Page 301
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 1442153
Web of Science KeyUT A1992JL44200010
JaLCDOI 10.18926/AMO/32659
FullText URL fulltext.pdf
Author Tanizaki, Yoshiro| Kitani, Hikaru| Okazaki, Morihiro| Mifune, Takashi| Mitsunobu, Fumihiro| Honke, Naoko| Kusaura, Yasuharu| Kimura, Ikuro|
Abstract <p>Bronchial asthma was classified by the pathophysiology and by the mechanism of onset of the disease. Forty asthmatics who had serum IgE levels lower than 200 IU/ml were evaluated by two classification methods. 1. In asthma classified by a score based on clinical findings and examinations, the characteristics of the findings and examination results were compared among three asthma types, i.e., Ia. simple broncho-constriction type, Ib. bronchoconstriction+hypersecretion type, and II. bronchiolar obstruction type. Type Ib patients, in addition to manifesting hypersecretion, had a significantly higher proportion of eosinophils in the bronchoalveolar lavage (BAL) fluid compared to other asthma types. Significantly decreased values for ventilatory parameters and an increased proportion of BAL neutrophils were found in type II compared with other asthma types. 2. In a new classification by mechanism of onset, asthma was classified into three types according to the degree of participation of IgE-mediated reactions associated with specific IgE antibodies and serum levels of total IgE: asthma induced by definite IgE-mediated reaction (atopic asthma), possible IgE-mediated reactions (asthma), and asthma induced by non-IgE-mediated reaction (asthma syndrome).</p>
Keywords asthma asthma syndrome classification by pathophysiology classification by mechanism of onset
Amo Type Article
Published Date 1992-10
Publication Title Acta Medica Okayama
Volume volume46
Issue issue5
Publisher Okayama University Medical School
Start Page 381
End Page 387
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 1442158
Web of Science KeyUT A1992JX49500009