JaLCDOI 10.18926/14963
Title Alternative サーモグラフィーによる体表面温度の測定 2.温水負荷の効果
FullText URL 069_068_075.pdf
Author Hosaki, Yasuhiro| Takata, Shingo| Mitsunobu, Fumihiro| Mifune, Takashi| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Harada, Seishi| Tanizaki, Yoshiro| Ochi, Koji| Harada, Hideo| Tsuji, Takao|
Abstract The body surface temperature of 41 patients suffering coldness, numbness or pain in their feet was examined using thermography. Thermographic results were analyzed quantitatively by calculating a recovery ratio as: Recovery ratio =[Total counts of thermography (Pixels) over temperature (T) after cold loading] ÷ [Initial counts over T before cold loading] x 100(%). Three different baseline temperatures, 26℃. 27℃ and 28℃, were used in processing the thermographic results into pictures. The recovery ratio was susceptible to temperature, and we recommend a baseline temperature limitation of 27℃ for clinical study. A bi-modal distribution of recovery ratio was observed in 18 patients with diabetes mellitus. One group (6 subjects) had high recovery ratio between 80%-100%, and another group (10 subjects) had a low recovery ratio between 0%-19%. The results of thermography were also influenced by weather. To reduce the effect of outside temperature, we used pre-loading with hot water at 36℃ for 5 min (hot loading). A large difference in recovery ratio between presence and absence of hot loading was observed in 6 of the 30 subjects. The difference was over-estimated in more than 20% of recovery ratio without hot loading as compared with hot loading in these 6 subjects. The effect of drugs on peripheral circulation, such as beraprost sodium and sarpogrelate hydrochloride, was clear and quantified using thermography under these conditions of hot loading.
Abstract Alternative 下肢に冷感ならびにしびれ感または疼痛を訴える患者41症例についてサーモグラフィーを用いて体表面温度を測定した。測定で得られた結果は回復率として数量化して表示された。回復率の算出方法は回復率=[冷水負荷後の特定温度T℃以上の体表面温度のサーモグラフィーのPixelの総数]÷[温水負荷前の特定温度T℃以上の体表面温度のサーモグラフィーのPixelの総数]× 100%で求めた。サーモグラフィーで得られた結果と画像処理の過程で用いられた,26℃,27℃,28℃の3つの異なる特定温度T℃ との関連について検討を行なった。その結果,回復率は特定温度T℃に影響を受けやすいことが明らかとなった。下肢の体表面温度の低い臨床症例においては27℃の条件が適当と考えられた。前述の41症例中の18症例の糖尿病患者について検討を行なった。そのサーモグラフィーの結果は,比較的回復率の高い(80%~100%)群の6症例と比較的回復率の低い(0%~19%)群の10症例の2群に別れた。わずかに残り2症例が20%から79%の間であった。下肢の症状が気温の低い時期に出親しやすいためにサーモグラフィーの検査を冬期に行なう必要性が高まった。しかし,天候の影響を受けやすいために冷水負荷前の測定領域の下肢が冷えすぎているために20℃の室温に15分間の安静時間では体表面温度が十分に暖まることが出来ず,27℃以上の領域として測定範囲全体を観察できない 問題に直面した。この間温点を解決する手段として36℃の温水に5分間下肢を入れて暖める温水負荷を加えることにした。そこで, 温水負荷を行なった症例30症例について,温水負荷を行なう前(室温)の回復率と温水負荷を行なった後の回復率について比較検討を行なったところ,20%にあたる6症例において温水負荷を行なわなかった場合に20%以上の回復率の過剰評価が認めら れた。温水負荷を行なうことにより年間を通じて天候の影響を最小限にすることが可能となり,この結果,長期間の内服薬の末梢循環に及ぼす影響の測 定を行なった場合に,季節の影響を最小限にしてサーモグラフィーにより回復率を用いて数値化された測定結果を検討することが可能となった。具体的に末梢循環の改善に薬効が有ると言われている薬剤であるベラプロストおよびサルポグレラートを3ヵ月間内服した場合の前後のサーモグラフィーで得られた回復率について検討を行なった。その結果はベラプロストにおいては,6.9%から41.9%に上昇または回復率の6.1倍の上昇を認めた。サルポグレラートにおいては,1.9%から17.3%に上昇または回復率の9.1倍の上昇を認めた。以上より,温水負荷を加えたサーモグラフィーの測定結果の数値化は下肢に症状の有る患者の末梢循環の評価ならびに薬効の評価の比較に有用であることが表わされた。
Keywords サーモグラフィー (thermography) 糖尿病 (diabetes mellitus) 末梢循環 (peripheral circulation) 冷水負荷 (cold loading) 温水負荷 (hot loading)
Publication Title 岡大三朝分院研究報告
Published Date 1998-12
Volume volume69
Start Page 68
End Page 75
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308316
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 10.18926/14961
Title Alternative 鼻腔・副鼻腔疾患を合併する気管支喘息症例に対するクラリスロマイシン投与の効果
FullText URL 069_057_062.pdf
Author Mifune, Takashi| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Harada, Seishi| Okamoto, Makoto| Yumoto, Eiichirou| Takata, Shingo| Tanizaki, Yoshiro|
Abstract We experienced a case of 59-year-old woman with intractable asthma, who had aspirin intolerance. Despite various treatments including systemic corticosteroid administration, she was often admitted due to severe asthma attacks. Furthermore, she had allergic rhinitis and sinusitis. Computed tomography (CT) scans of sinonasal cavity revealed marked thickness of nasal mucosa and air-fluid level in maxillary sinuses. Although her asthma symptoms such as wheezing and dyspnea were improved by administration of bronchodilator, systemic corticosteroids and beclomethasone diisoccyanate (BDI) accompanied with spa therapy, her peak expiratory flow (PEF) showed no improvement. After readmission due to asthma attacks, clarithromycin (CAM) administration for sinonasal disorders was started. The PEF value showed marked improvement after starting CAM administration, and pulmonary functions and bronchial hyperresponsiveness were also improved. It is suggested from her clinical course that CAM may have beneficial effects in asthmatic patients with sinonasal disorders.
Abstract Alternative 気管支喘息にアレルギー性鼻炎や副鼻腔炎を合併する症例は頻回に経験される。副鼻腔炎症状の増悪が喘息症状の増悪を引き起こす症例も存在し,鼻腔・副鼻腔における炎症が気管支喘息の病態と何らかの関係を持っていることが考えられる。今回,59才の難治性アスピリン喘息症例を呈示する。副腎皮質ホルモンの全身投与を含めた様々な治療にも関わらず頻回に重篤な喘息発作を呈し,入退院を繰り返している症例である。アレルギー性鼻炎も合併し,CTでは著明な鼻粘膜肥厚と上顎洞の鏡面形成が認められた。入院後の投薬や温泉療法によって呼吸困難は改善したが,ピークフロー値は上昇が認められないまま退院となった。再入院後,副鼻腔炎に対しクラリスリマイシン投与を開始したところ、ピークフロー値は著明に改善を示し,肺機能・気道過敏性も改善した。この症例のように,鼻腔・副鼻腔疾患を合併する気管支喘息症例に対しては,クラリスロマイシン投与が有効である可能性が考えられた。
Keywords bronchial asthma allergic rhinitis sinusitis clarithromycin peak expiratory flow (PEF)
Publication Title 岡大三朝分院研究報告
Published Date 1998-12
Volume volume69
Start Page 57
End Page 62
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308388
JaLCDOI 10.18926/14959
Title Alternative n-3系脂肪酸食の気管支喘息に対する臨床効果:n-6系脂肪酸との比較
FullText URL 069_040_048.pdf
Author Okamoto, Makoto| Ashida, Kozo| Mitsunobu, Fumihiro| Mifune, Takashi| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Harada, Seishi| Yumoto, Eiichiro| Takata, Shingo| Tanizaki, Yoshiro| Kataoka, Mikio| Harada, Mine|
Abstract N-3 fatty acids, such as fish oil, have been reported to have some beneficial effects in patients with bronchial asthma by suppressing leukocyte function, followed by reduction of the need for pharmacologic agents. To examine the effects of dietary supplementation with perilla seed oil rich in α-linolenic acid (ALA), 23 patients with asthma took corn oil rich in linoleic acid (LA) for the former two weeks, perilla seed oil for the later two weeks. The asthmatic patients were classified into two groups by the changes of the generation of leukotrienes B4 (LTB4), C4 (LTC4), and B5 (LTB5) during the two courses of dietary modification: one was sensitive to dietary modification, and the other was insensitive to dietary supplementation. We compared the two groups in clinical characteristics. Significant differences were observed in peak flow (PEF), forced expiratory volume in one second (FEV1.0), IgE, sex, obesity index (OI), concentration of serum total cholesterol, albumin, low density lipoprotein {LDL)-cholesterol, β-lipoprotein and phospholipids between two groups. This study indicated that these factors influence the generation of LTB4, C4 and B5 of asthmatic patients in dietary supplementation.
Abstract Alternative 気道への炎症性白血球の集合が気管支喘息の病態に関わっている。魚油などのn-3系脂肪酸が白血球の機能を抑制することにより気管支喘息患者に良好な効果をもたらし,薬剤の必要性を減じたとの報告がなされている。α-リレノン酸を豊富に含有するエゴマ油食の効果を調べるため,気管支喘息患者23名に2コースの食事-リノール酸の豊富なコーン油食を2週間摂取後,エゴマ油食を2週間-を摂取してもらった。喘息患者は2コースの食事間のロイコトリエンB4(LTB4),CA(LTC4),B5(LTB5)の変化から2群-1群は食事に対し感受性のある群,もう1つは感受性の無い群-に分類した。我々はこの2群を臨床的に検討したところ,ピークフロー(PEF),1秒量(FEV10),IgE,性別,肥満率(OⅠ),血清総コレステロール,アルブミン,低比重リポ蛋白(LDL)-コレステロール,β-リポ蛋白,リン脂質において2群間に有意差が認められた。今回の研究から,これらの因子が,喘息患者において,LTB4,LTC4,LTB5の産生に対する食事療法の効果に影響を及ぼしていることが示唆された。
Keywords n-3系脂肪酸 (n-3 fatty acids) エゴマ油 (perilla seed oil) 気管支喘息 (bronchial asthma) LTB4 LTC4
Publication Title 岡大三朝分院研究報告
Published Date 1998-12
Volume volume69
Start Page 40
End Page 48
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308199
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
JaLCDOI 10.18926/14954
Title Alternative 肺気腫患者における吸入抗原に対するIgE抗体
FullText URL 069_021_027.pdf
Author Mitsunobu, Fumihiro| Mifune, Takashi| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Harada, Seishi| Yumoto, Eiichiro| Takata, Shingo| Tanizaki, Yoshiro| Ochi, Koji| Harada, Hideo| Hasegawa, Harumi|
Abstract To analyze the pathophysiological changes ot the airways in emphysema, bronchial responsiveness and the generation of leukotrienes B4 (LTB4) and C4 (LTC4) by peripheral leucocytes were examined in 22 patients with emphysema. The subjects were divided into two groups according to the presence or absence of IgE antibodies against inhalant allergens; RAST positive group and RAST negative group. 1. Smoking history, mean CT number and mean maximum % low attenuation area (% LAA) <-950HU of the lung on high resolution computed tomography (HRCT), and DLco value suggested that there were emphysematous changes of the lung in all subjects. However, these findings were not different between the two groups. 2. The level of serum IgE was significantly higher in RAST positive group than in RAST negative group. 3. The mean % increase in FEV1.0 after inhalation of β-agonists was higher in RAST positive group than in RAST negative group. The % increase more than 15% was found in 4 of the 9 subjects (44.4%) in RAST positive group and 2 of the 12 (16.7%) in RAST negative group. 4. The generation of LTC4 by leucocytes was significantly higher in RAST positive group than in RAST negative group (p<0.01). The generation of LTB4 was not significantly different between the two groups. The results suggest that IgE-mediated allergy participates in the bronchial responsiveness of patients with emphysema.
Abstract Alternative 肺気腫患者の気道病変を解析する目的で,22例の肺気腫患者を対象に,その気道反応および白血球のロイコトリエンB4,C4産生能について検討を加えた。この際対象症例はIgE抗体の有無によってRAST陽性症例RAST陰性症例に分類された。1.喫煙歴,平均CT値,high resolution computed tomography(HRCT)上の-950HU以下の% low attenuation area(% LAA),DLcoなどの値は,いずれも対象症例が高度な気腫化病変を有してい ることを示した。2.血清IgE値は,RAST陽性例で陰性例に比べ有意の高値を示した。3.β受容体刺激薬吸入後のFEV1.0の増加は,RAST陽性例で陰性例に比べ高度であった。そして,吸入後のFEV1.0が15%以上の増加を示した症例は,RAST陽性例では9例中4例(44.4%),陰性例では12例中2例(16,7%)であった。4.白血球のLTC4産生量は,RAST陽性例で陰性例に比べ有意に高い値であったが,LTB4産生は両者間に有意の差は見られなかった。以上の結果より,IgEにmediateされるアレルギー反応が,肺気腫患者 の気道反応に関与している可能性が示唆された。
Keywords emphysema bronchial responsiveness FEV1.0 LTB4 LTC4
Publication Title 岡大三朝分院研究報告
Published Date 1998-12
Volume volume69
Start Page 21
End Page 27
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308178
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 10.18926/14951
Title Alternative 気管支喘息における末梢血白血球のロイコトリエンB4およびC4産生能
FullText URL 069_009_014.pdf
Author Tanizaki, Yoshiro| Mitsunobu, Fumihiro| Mifune, Takashi| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Harada, Seishi| Yumoto, Eiichiro| Takata, Shingo| Ochi, Koji| Harada, Hideo|
Abstract The generation of leukotrienes B4 (LTB4) and C4 (LTC4) by leucocytes stimulated with Ca ionophore A23187 was examined in 16 patients with asthma (8 with atopic and 8 with nonatopic asthma) and 12 healthy controls. 1. The LT84 generation by leucocytes was not significantly different between patients with asthma and healthy controls. The generation of LTC4 was significantly larger in patients with asthma than in healthy controls. The LTC4 generation was also significantly larger in patients with attacks (58.4 ± 38.5 ng/5x10(6) cells) than in those without attacks (23.3 ± 25.9 ng/5x10(6) cells)(p<0.05). 2.ln atopic asthma, the LTC4 production was significantly larger in patients with attacks (84.7 ± 35.4 ng/5x10(6) cells) compared to the production in those without attacks (40.4 ± 27.2 ng/5x10(6) cells)(p<0.02). However, the production of LTB4 was not significantly different between attack and attack-free stages. 3. In nonatopic asthma, the LTC4 production was also significantly higher in patients with attacks (32.2 ± 26.3 ng/5x10(6) cells) than in those without attacks (12.2 ± 3.5 ng/5x10(6) cells)(p<0.05). However, the LTB4 production was not significantly different between attack and nonattack stages. 4. The LTC4 production was significantly larger in atopic asthmatics compared to the production in nonatopic subjects both in attack and nonattack stages. These results suggest that the generation of LTC4 by leucocytes of patients with asthma is closely related to IgE-mediated reaction and asthma attacks.
Abstract Alternative 気管支喘息16例(アトピー型喘息8例,非アトピー型喘息8例)を対象に,Ca ionophore A23187 刺激時の末梢血白血球のロイコトリエンB4(LTB4)およびC4(LTC4)産生能について検討した。1.LTB4産生能は,喘息症例と健康人 の間に有意の差は見られなかった。LTC4産生能は,健康人に比べ喘息症例で有意に高い傾向が見られた。また,喘息症例では,非発作時(23.3±25.9ng/5xl0(6)cells)に比べ発作時(58.4±38.5ng/5xl0(6)cells)に有意に高い値を示した(p<0.05)。アトピー型喘息では,非発作時(40.4±27.2mg/5xl0(6)cells) に比べ発作時(84.7±35.4ng/5xl0(6)cells) に有意の高値を示したが(p<0.02),LTB4 産生に関しては両者間に有意の差は見られなかった。3.非アトピー型喘息においても同様,非発作時(12.2±3.2ng/5xl0(6) cells) に比べ発作時 (32.2±26.3ng/5xl0(6)cells)で有意の高値であったが(P<0.05), LTB4 では有意差は見られなかった。4.LTC4産生能は,発作時、非発作時とも,アトピー型喘息で非アトピー型喘息に比べ有意に高いことが示唆された。以上の結果より,喘息症例における白血球のLTC4産生能はIgE にmediateされる反応と密接な関連がある可能性が示唆された。
Keywords bronchial asthma LTB4 LTC4 IgE-mediated reaction asthma attacks
Publication Title 岡大三朝分院研究報告
Published Date 1998-12
Volume volume69
Start Page 9
End Page 14
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308181
JaLCDOI 10.18926/14950
Title Alternative Clinical significance of spa therapy in the treatmentof patients with chronic obstructive pulmonary disease (COPD). A study on 511 patients with COPD admitted for last 5 years
FullText URL 069_001_008.pdf
Author Tanizaki, Yoshiro| Mitsunobu, Fumihiro| Mifune, Takashi| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Harada, Seishi| Yumoto, Eiichiro| Takata, Shingo| Ochi, Koji| Harada, Hideo|
Abstract 1993年1月より1997年12月までの5ヵ年間に当院へ入院した慢性閉塞性呼吸器疾患511例を対象に,疾患の種類,年齢,地域分布などについて検討を加えた。1.最近5年間に当院へ入院した呼吸器疾患患者は594例で,このうち,慢性閉塞性呼吸器疾患患者は511例(86.0%)であった。これらの慢性閉塞性呼吸器疾患のなかでは,気管支喘息が416例(81.4%)と最も多く,その他.慢性気管支炎20例,閉塞性細気管支炎27例,肺気腫48例であった。2.慢性閉塞性呼吸器疾患のなかでは,肺気腫の症例が増加する傾向が見られた。3.慢性閉塞性呼吸器疾患の年齢別検討では,鳥取県内では,70才以上の症例が,また遠隔地(鳥取県外)では60-69才の症例の頻度が高い傾向が見られた。4.入院患者の地域分布では,鳥取県内からの入院患者に比べ,遠隔地(鳥取県外)からの入院患者が比較的多く,その比率は1997年度で48.4%であった。また,その分布別検討では,岡山県,兵庫県,大阪府,広島県,山口県,愛媛県からの入院患者が多い傾向が見られた。
Abstract Alternative The kind of respiratory disease, age, and areas where patients came from were analyzed in 511 patients with chronic obstructive pulmonary disease (COPD) admitted at Misasa Medical Branch for last 5 years from 1993 to 1997. 1.For the last 5 years 594 patients with respiratory diseases were admitted at Misasa Medical Branch. Of these patients 511 (86.0%) were those with COPD. Of the 511, 416 (81.4%) were patients with asthma, 20 with chronic bronchitis, 27 with obstructive bronchiolitis, and 48 with pulmonary emphysema. 2.The number of patients with pulmonary emphysema showed a tendency to increase in recent years. 3.Regarding the distribution of age of these patients, the number of patients over the age of 60 was larger than the number of patients under the age of 59:patients between the ages of 60 and 69 were more frequently observed in those coming from distant area (outside Tottori prefecture), and those over the age of 70 in those coming from Tottori prefecture. 4. The number of patients from distant areas (outside Tottori prefecture) was considerably larger (48.4% in 1997) compared to the number of patients from Tottori prefecture. The number of patients from Okayama, Hyogo, Osaka, Hiroshima, Yamaguchi and Ehime was predominantly larger than the number of patients from other distant areas.
Keywords 慢性閉塞性呼吸器疾患 (COPD) 気管支喘息 (bronchial asthma) 温泉療法 (spa therapy) 高齢患者 (aged patients) 遠隔地 (distant area)
Publication Title 岡大三朝分院研究報告
Published Date 1998-12
Volume volume69
Start Page 1
End Page 8
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308114
JaLCDOI 10.18926/14941
Title Alternative Analysis of Factors Regarding Spa Therapy in Patients with Rheumatoid Arthritis
FullText URL 070_073_078.pdf
Author Yoshio, Keiko| Taguma, Masae| Noumi, Mayumi| Nakamura, Sumie| Harada, Seishi| Tanizaki, Yoshiro|
Abstract 1998年4月より9月までの6ヶ月間に当院へ入院し温泉療法をうけた慢性関節リウマチ患者6例を対象に,温泉治療経験の有無,年齢,機能障害度(クラス),罹患年数の4項目が温泉療法効果に及ぼす影響につき検討した。温泉治療経験の有無では治療経験を有する患者においてMHAQ(modified health assessment questionnaile),患者による疼痛評価,患者による全般活動性評価に有意な改善が見られ,年齢(75才以上,75才未満)では,75才未満においてMHAQに有意な改善傾向が見られた。機能障害度(クラス3以上,クラス2以下),罹患年数(15年以上,15年未満)においては有意差は見られなかった。温泉の永続効果を保つためには,年1~2回の入院を繰り返すことが効果的であることが示唆された。
Abstract Alternative In patients with rheumatoid arthritis (RA) who received spa therapy (ST) on admission, we examined factors for treatment response. This study included 6 RA patients and the following 4 parameters were investigated: presence or absence of previous ST, age, duration of RA, and grade of the functional disorder. Treatment response was evaluated according to the American College of Rheumatology core set measures. With respect to the presence or absence of previous ST, modified health assessment questionnaire (MHAQ), pain scale and patient global assessments in the group with previous ST were significantly improved compared to those in the group without previous ST. With respect to age, MHAQ in the group consisting of patients less than 75 years old was significantly improved compared to that in the group consisting of patients 75 years old or older. With respect to the grade of the functional disorder (class 2 or lower vs. class 3 or higher) and the duration of RA (less than 15 years vs. 15 years or more), there were no significant differences. These results suggest that repeated therapy is more effective in ST and treatment response may be relatively poor in elderly patients with RA aged over 75 years.
Keywords 慢性関節リウマチ 温泉療法
Publication Title 岡大三朝分院研究報告
Published Date 1999-12
Volume volume70
Start Page 73
End Page 78
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308424
JaLCDOI 10.18926/14936
Title Alternative 腰椎MRI画像と腰痛の関係
FullText URL 070_067_072.pdf
Author Takata, Shingo| Yumoto, Eiichirou| Okamoto, Makoto| Tsugeno, Hirofumi| Harada, Seishi| Hosaki, Yasuhiro| Mifune, Takashi| Mitsunobu, Fumihiro| Tanizaki, Yoshiro| Harada, Mine|
Abstract The purpose of this study was to examine the potential role of magnetic resonance imaging (MRI) in the evaluation of low back pain (LBP). The study group, 19 patients with low back pain (2 subjects aged 32-39 years and 17 aged 59-78), underwent MRI of the lumbar spine. Disc degeneration at L4/5 was the most common finding (68.4%). Overall in present study, all patients with LBP had abnormalities around the lumbar spine (evidence of disc degeneration, deformity of lumbar spine, disc bulging or protrusion, facet hypertrophy, nerve root compression and so on).
Abstract Alternative この研究の目的は腰痛評価におけるMRIの役割を検討することであった。対象は腰痛を訴え腰椎MRIを受けた19名(32歳から39歳2名,59歳から78歳17名)であった。椎間板変成はL4/5levelで最も多く認められた(68.4%)。本研究において腰痛を有する全患者に腰椎の異常(椎間板変性,disc bulging, protrusion, facet hypertrophy,神経根圧迫,腰椎変形など)を認めた。
Keywords MRI (Magnetic resonance imaging) 腰椎 (Lumbar spine) 椎間板変性 (Disc disease)
Publication Title 岡大三朝分院研究報告
Published Date 1999-12
Volume volume70
Start Page 67
End Page 72
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308559
JaLCDOI 10.18926/14935
Title Alternative A Case of Recurrent Churg-Strauss Syndrome Associated with Bronchial Asthma
FullText URL 070_061_066.pdf
Author Harada, Seishi| Tsugeno, Hirofumi| Mitsunobu, Fumihiro| Mifune, Takashi| Hosaki, Yasuhiro| Ashida, Kozo| Okamoto, Makoto| Takata, Shingo| Yamamoto, Toshio| Tanizaki, Yoshiro|
Abstract 入院中にChurg-Strauss症候群の再燃を来した症例を報告した。症例は気管支喘息を有する73歳の女性で,持続する両下肢の知覚障害を主訴に当院に入院した。入院2週頃より微熱,下腹部不快感が続き右下肢のdrop foot,下血を呈した。末梢血では著明な好酸球増多を認め,内視鏡検査で直腸潰瘍を認めた。3年前の両下肢の知覚障害出現時にも同様の症状を経験しており,Churg-Strauss症候群の再燃と診断し,ステロイド治療を開始することにより新たな後遺症を残すことなく寛解に至った。Churg-Strauss症候群の発症・再燃の機序を考える上で貴重な症例と考え,文献的考察を加え報告する。
Abstract Alternative A recurrent case of Churg-Strauss syndrome (CSS) associated with bronchial asthma is reported. A 73-year-old woman with bronchial asthma was admitted to our hospital because of persistent sensory disturbance of the bilateral lower limbs. About 2 weeks or more after admission, slight fever and an unpleasant sensation in the lower abdomen appeared and continued. Several days later, drop foot and melena developed. The eosinophil count was markedly increased and the endoscopic examination revealed rectal ulcers. Since the patient had a same experience of these symptoms three years ago, the recurrence of CSS was strongly suggested. Immediately after steroid treatment was started, these newly developed symptoms were relieved with no segulae. We reported the present case, which may be useful for clarifying the onset of CSS, with a review of the literature.
Keywords Churg-Strauss症候群 (Churg-Strauss syndrome) アレルギー性肉芽腫性血管炎 (allergic granulomatous angiitis) 血管炎症候群 (vasculitis syndrome) 気管支喘息 (bronchial asthma) 好酸球増多 (eosinophilia)
Publication Title 岡大三朝分院研究報告
Published Date 1999-12
Volume volume70
Start Page 61
End Page 66
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308532
JaLCDOI 10.18926/14934
Title Alternative 気管支喘息症例における皮質骨海綿化
FullText URL 070_053_060.pdf
Author Tsugeno, Hirofumi| Nakai, Mutsuro| Okamoto, Makoto| Harada, Seishi| Takata, Shingo| Mifune, Takashi| Mitsunobu, Fumihiro| Ashida, Kozo| Hosaki, Yasuhiro| Akiyama, Tsuneo| Tsuji, Takao| Tanizaki, Yoshiro|
Abstract In previous studies, we have demonstrated that chronic administration of systemic glucocorticoids decreases cortical bone mineral density (BMD), cortical bone volume, bone strength, and induces development of pathologic fractures in asthmatic patients. We have also demonstrated that glucocorticoid administration appears to be responsible for the process of cortical bone porosity at both endosteal and intracortical sites in postmenopausal asthmatic patients. There is a difference of gonadal hormones between male and female. To investigate the influence of hormonal difference on glucocorticoid-induced cortical bone porosity, we studied cortical bone volume and BMD in both male and female patients with asthma in this report. A total of 99 asthmatic patients (male 26 cases, female 73 cases) were enrolled in the study. Peripheral quantitative computed tomography (pQCT) was used to measure cortical BMD and relative cortical volume. The cortical volume-density relationship appeared to remain constant regardless of the level of systemic glucocorticoid administration, age or sex, suggesting cortical bone porosity causes similar and simultaneous decreases in cortical bone volume and density. In conclusion, glucocorticoid administration appears to be responsible for the process of cortical bone porosity at both endosteal and intracortical sites despite the gonadal hormonal differences.
Abstract Alternative 【目的】これまでに我々は,気管支喘息症例において経口ステロイドによる皮質骨骨密度,容積の減少が骨折に関与する新知見を報告し,閉経後女性では皮質骨骨密度一容積の減少はステロイド投与量にかかわらず一定であることを報告してきた。この皮質骨骨密度-容積の関係において性差による違いを検討するために,男性,女性患者の両方について検討を行った。【方法】対象はステロイド依存性喘息99例(男性26例,女性73例)。性別,年齢,経口ステロイド積算総投与量により6群に分類した。椎体圧迫骨折はⅩ線側面像にて評価 し,皮質骨容積比および皮質骨骨密度はpQCT(Stratec XCT960)を用いて測定した。それぞれの群の皮質骨骨密度-容積比の関係を算出し比較検定をおこなった。【結果】それぞれの群の皮質骨の骨密度と容積比は有意に相関した。それぞれの群の皮質骨骨密度-容積比の傾きは,いずれも有意差を認めなかった。【結論】気管支喘息症例におけるステロイド投与による皮質骨の骨密度と容積の減少は,性別にかかわらずほぼ一定で,皮質骨は内側と外側において同様に海綿化してゆくと考えられた。
Keywords bronchial asthma systemic glucocorticoid cortical bone cortical porosity peripheral quantitative computed tomography
Publication Title 岡大三朝分院研究報告
Published Date 1999-12
Volume volume70
Start Page 53
End Page 60
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308477
JaLCDOI 10.18926/14933
Title Alternative 気管支喘息患者における白血球ロイコトリエン産生能に対する不飽和脂肪酸食の効果に影響する因子
FullText URL 070_043_052.pdf
Author Okamoto, Makoto| Mitsunobu, Fumihiro| Ashida, Kozo| Mifune, Takashi| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Harada, Seishi| Takada, Shingo| Tanizaki, Yoshiro| Kataoka, Mikio| Niiya, Kenji| Harada, Mine|
Abstract Dietary supplementation with perilla seed oil, a vegetable oil rich in α -lin- olenic acid, inhibits the generation of leukotrienes(LTs) by leucocytes in patients with bronchial asthma. We examined the factors that affect the suppression of LT generation by leucocytes with perilla seed oil-rich supplementation in patients with asthma, by comparing the clinical features of patients with asthma, whose generation of leukotriene (LT) C4 was suppressed by dietary supplementation with perilla seed oil (n-3 fatty acids) (group A), with those of patients who showed no suppression of LTC4 generation (group B). Group A showed a significant increase in the generation of LTB4 and L TC4 by leucocytes after corn oil-rich supplementation (n-6 fatty acids), and a significant decrease in the generation of LTB4 and LTC4 after perilla seed oil-rich supplementation (n-3 fatty acid). However, this was not observed in group B. The level of serum IgE and peak expiratory flow (PEF) in group A were significantly higher than in group B. Furthermore, the serum levels of LDL-cholesterol, β-lipoprotein and phospholipid were significantly lower in group A than in group B. These results suggest that the clinical features differ between these two asthmatic populations with respect to suppression of LTB4 and LTC4 generation by n-3 fatty acids in perilla seed oil-rich supplementation.
Abstract Alternative a-リノレン酸の豊富なエゴマ油の食事は気管支喘息患者の白血球ロイコトリエン(LT)産生能を抑制する。気管支喘息患者の内,エゴマ油食によりLTC4の産生が抑制された群(A群)と抑制されない群(B群)の臨床データを比較することにより,気管支喘息患者の白血球ロイコトリエン産生能に影響する因子を検討した。A群はコーン油(n-6系脂肪酸)の豊富な食事後,白血LTB4,LTC4の産生能が増加し,エゴマ油(n-3系脂肪酸)の豊富な食事後LTB4,LTC4の産生能が減少した。これらの変化はB群では認められなかった。A群のIgE値,ピークフロー(PEF)値はB群に比し,有意に高値であった。またLDL-コレステロール,β-リポ蛋白,リン脂質はA群ではB群に比し,有意に低値であった。これらの結果はエゴマ油の豊富な食事のn-3系脂肪酸によるLTB4,LTC4の産生能の抑制に関して2群の気管支喘息患者群間に臨床データの相違があることを示唆している。
Keywords エゴマ油 (perilla seed oil) 気管支喘息 (bronchial asthma) ロイコトリエン (leukotrienes) IgE 脂質代謝 (lipometabolism)
Publication Title 岡大三朝分院研究報告
Published Date 1999-12
Volume volume70
Start Page 43
End Page 52
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308623
JaLCDOI 10.18926/14927
Title Alternative サーモグラフィーによる体表面温度の測定 3.体表面温度の回復率と末消血流量との相関
FullText URL 070_036_042.pdf
Author Hosaki, Yasuhiro| Takata, Shingo| Mitsunobu, Fumihiro| Mifune, Takashi| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Harada, Seishi| Tanizaki, Yoshiro| Ochi, Koji| Tsuji, Takao|
Abstract The body surface peripheral circulation in 12 cases, including 9 patients with diabetes mellitus who were suffering coldness, numbness or pain in their feet, and 3 healthy volunteers was examined using Laser-Doppler blood flowmetry. At the same time, the body surface temperature was estimated by thermography. Thermographic results were analyzed quantitatively by calculating a recovery ratio as : Recovery ratio = [Total counts of thermography(Pixels) over temperature (T) after cold loading] ÷ [Initial counts over T before cold loading] x 100(%). The recovery ratio and the blood flow were correlated, r=0.68, p<O.01. The peripheral circulation of 16 patients with diabetes mellitus was observed at three different conditions including, l)placed at room temperature at 20℃for 15 min, 2) submerged and warmed for 5 min in a hot bath at 36℃(i.e. hot loading), and 3) submerged and cooled for 5 min in a water bath at 20℃ (i.e. cold loading). Three different baseline temperatures, 26℃, 27℃ and 28 ℃, were used in processing the thermographic results into pictures. The highest correlation (r=0.59, p=0.0002) was obtained under the condition of cold loading using a baseline temperature limitation of27℃.The difference ratio (%) of blood flow was calculated as the blood flow at cold loading divided by the blood flow at hot loading in these 16 patients. The difference ratio of the blood flow and the recovery ratio of thermography were correlated, r=0.46, p<O.OOO1. We found a strong correlation between the results of Laser-Doppler blood flowmetry and one of thermographic methods used to monitor peripheral circulation in patients with diabetes mellitus. Cold loading using a baseline temperature limitation of 27℃ were recommended for further examinations. Patients with low blood flow as well as with large differences in their peripheral circulation between cold loading and hot loading had severe coldness in their body surface temperature. We showed the usefulness of the results of thermography, when quantified by picture processing using computer software, in relation with the results of Laser-Doppler blood flowmetry.
Abstract Alternative 末梢神経障害を有する糖尿病患者の末梢循環障害の程度を数量的に検討する目的で、下肢に冷感ならびにしびれ感または疼痛を訴える糖尿病患者9症例と健常ボランティア3例の計12例(平均年齢59歳)についてサーモグラフィーを用いて体表面温度を測定した。更に,サーモグラフィーで得られた結果と末梢皮膚血流量をレーザードプラー血流計を用いて測定して得られた結果と比較した。サーモグラフィーによる測定で得られた結果は回復率として数量化して表示された。回復率の算出方法は回復率= [冷水負荷後の特定温度27℃以 上の体表面温度のサーモグラフィーのPixelの総数]÷ [冷水負荷前の特定温度27℃以上の体表面温度のサーモグラフィーのPixelの総数]×100%で求めた。レーザードプラ-血流計を用いて測定して得られた末梢血流量は左右それぞれ5カ所,計10カ所の測定値の平均で表示した。その結果,末梢皮膚温度の回復率と末梢皮膚の血流量との問には正の相関関係(r=0.68,p<0.01)が認められた。次に,末梢皮膚血流量について,室温20℃安静15分後,温水36℃浸水負荷10分後,冷水20℃浸水負荷30分後の異なる3条件について、またサーモグラフィーで得られた結果を,画像処理の過程で用いられた,26℃,27℃,28℃の3つの異なる特定温度との関連について検討を行なった。対象は,下肢に冷感ならびにしびれ感または疼痛を訴える糖尿病患者16症例(平均年齢69歳,平均HbAIC9.6%)について測定した。その結果,末梢皮膚 血流量は冷水20℃浸水負荷30分後に測定して得られた結果と,回復率は特定温度27℃で画像処理して得られた結果とが最も相関が高い(r=0.59,p=0.0002)ことが示された。`次に,相関が高い条件は,室温20℃安静15分後に血流量を測定した場合(r=0.483,p=0.0002)であった。そして温 水36℃浸水負荷10分後に測定して得られた結果とが最も相関関係が低い結果となった。更に,冷水20℃浸水負荷30分後に測定して得られた結果を温水36℃浸水負荷10分後に測定して得られた結果で割った比を%で表示したところ回復率とこの比との間には正の相関関係(r=0.46,p<0.0001)が認められた。このことから,温水36℃負荷時と,冷水20℃負荷時との差が大きい患者 において末梢皮膚温度の低下が著しいことが示された。これまで悲観血的に測定されてきたサーモグラフィーによる末梢循環の数量的評価の試みは,レーザー血流計による結果と組み合わせることで,両者の間に正の相関関係が示されたことにより,今後,数量化された客観的評価を可能にした。
Keywords サーモグラフィー (thermography) レーザードプラー血流計 (Laser-Doppler blood flowmetry) 糖尿病 (diabetes mellitus) 末梢循環 (peripheral circulation) 冷水負荷 (cold loading)
Publication Title 岡大三朝分院研究報告
Published Date 1999-12
Volume volume70
Start Page 36
End Page 42
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308240
JaLCDOI 10.18926/14926
Title Alternative 気管支喘息症例における気道過敏性と鼻腔・副鼻腔疾患の関係に関する検討
FullText URL 070_028_035.pdf
Author Mifune, Takashi| Takata, Shingo| Okamoto, Makoto| Tsugeno, Hirofumi| Ashida, Kozo| Harada, Seishi| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Tanizaki, Yoshiro| Harada, Mine|
Abstract Pathological changes of nasosinus occur often in subjects with bronchial asthma. Coexisting nasosinus lesion may affect pathophysiology of lower respiratory tract in asthmatics. The extent of nasal and sinus lesion was quantified in 17 patients with bronchial asthma, and their relationships to atopic status, asthma severity and bronchial hyperresponsiveness were evaluated in this study. Opacification degree of maxillary sinuses and nasal mucosa thickening were quantified using CT scans. The opacification degree was evaluated as (total opacification area)/(total maxillary sinus area). Although the opacification degree of maxillary sinuses in atopic patients showed no significant difference compared with that in non-atopic patients, maximum nasal mucosa thickening in atopic patients had a significant difference compared with that in non-atopic patients (p=0.028). In severe asthmatics, the opacification degree of maxillary sinuses was significantly more prominent compared with those in moderate and mild asthmatics (p=0.0005, p=0.036, respectively). Significantly marked nasal mucosa thickening was recognized in mild asthmatics compared with that in moderate asthmatics (p=0.0462). Regarding bronchial hyperresponsiveness, a significant correlation between Dmin and the opacification degree of maxillary sinuses was observed (rs= -0.551, p=0.0276). Nasal mucosa thickening had no correlation with bronchial hyperresponsiveness. The results suggest that sinusitis may affect bronchial hyperresponsiveness and asthma severity. Treatment of sinusitis may lead to improvement of asthma symptoms.
Abstract Alternative 鼻腔・副鼻腔疾患はしばしば気管支喘息症例に合併が認められ,喘息症例の下気道病態に影響を及ぼしている可能性が考えられる。今回,気管支喘息17例において,CTを用いて上顎洞の不透明化率・鼻腔粘膜肥厚を計測し,アトピー性の有無,喘息の重症度,気道過敏性との関係を検討した。上顎洞不透明化率は全上顎洞面積の総計に対する不透明化領域面積総計として計算を行った。上顎洞不透明化率はアトピー性の有無で差は認められなかったが,鼻腔粘膜はアトピー性喘息症例で有意に肥厚していた。重症気管支喘息における上顎 洞不透明化率は,中等症および軽症喘息症例に比べ有意に高値であった。鼻腔粘膜肥厚は中等症喘息症例に比べ,軽症症例で有意に肥厚していた。気道過敏性(Dmin)は上顎洞不透明化率とのあいだに弱い負の相関が認められた(rs=-0.551,p=0.0276).鼻粘膜肥厚と気道過敏性は相関が認められなかった。今回の結果から副鼻腔病変が気道過敏性・喘息重症度に影響を及ぼしている可能性が考えられ.副鼻腔疾患の治療により喘息症状の改善に繋がる可能性が考えられた。
Keywords 気管支喘息 (bronchial asthma) 副鼻腔炎 (sinusitis) CT所見 (CT findings) 気道過敏性 (hyperresponsiveness)
Publication Title 岡大三朝分院研究報告
Published Date 1999-12
Volume volume70
Start Page 28
End Page 35
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308098
JaLCDOI 10.18926/14925
Title Alternative 気管支喘息における胸部HRCT所見の臨床[光延文裕1]的意義
FullText URL 070_017_027.pdf
Author Mitsunobu, Fumihiro| Mifune, Takashi| Ashida, Kozo| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Okamoto, Makoto| Harada, Seishi| Nakai, Mutsuo| Tanizaki, Yoshiro|
Abstract The significance of the low attenuation area (LAA) of the lungs on high resolution computed tomography (HRCT) has not been determined in patients with asthma. We examined the relationship between the percentage of lung area with CT numbers lower than -950HU (% LAA) and the mean CT number in 81 patients with reversible airway obstruction (asthma) and in 22 healthy subjects, as well as the relationship between maximal % LAA and various parameters of pulmonary function, smoking history, disease severity and allergic type in the asthmatic subjects. The mean CT number was obtained by scans at three anatomic levels, and maximal % LAA was the % LAA which had the largest value of those measured at the three anatomic levels of the lung. We found that: 1. The mean CT number was closely related to the maximal % LAA of the lungs in all subjects studied (r= -0.916, p<O.OOO1). 2. The maximal % LAA in asthmatics with a previous smoking history (median: 20.1) was significantly larger than that in asthmatics without a smoking history (median: 10.8), and that in healthy subjects with (median: 8.8) and without a history of smoking (median: 10.4). 3. The maximal % LAA was significantly correlated with FEV1/FVC (r=-0.611, p<O.OOO1) and TLC (r=0.391, p=0.0068) in the asthmatic subjects. 4. The maximal % LAA was significantly correlated with the severity of asthma (p<O.01), but not with the etiology of asthma. This study suggests that the maximal % LAA is influenced by disease severity in patients with asthma, and that a smoking history has a more significant effect on the pulmonary function of asthmatics than healthy individuals.
Abstract Alternative 【目的】気管支喘息症例において胸部HRCTを用いて% LAA(Lowattenuationarea)を評価し,臨床病態との関連を検討する。 【対象と方法】気管支喘息症例81例ならびに健常者22例を対象とした。大動脈弓部,下葉分岐部,横隔膜上3cmの3スライスを撮影し,胸部CT値の演算によりCT値が-950HU以下の% LAA,さらに3スライス中の最大% LAAと3スライスの平均CT値を算出した。その値と年齢,発症年齢,罹病期間,性別,喫煙歴,重症度,病型,肺機能との関連を検討した。【結果】1.最大% LAAは平均CT値と強い相関を示した(r=-0.916,p<0.0001)。2.最大% LAAは喫煙喘息患者において非喫煙喘息患者,喫煙ならびに非喫煙健常者に比較して喫煙者において有意に高値を示した。% LAAは喫煙者,非喫煙者ともに重症例において有意に高値を示した。3.最大% LAAは肺機能では1秒率(r=-0.611,p<0.0001),全肺気量(r=-0.391,p<0.0001)と有意な相関を示した。4.最大% LAAは喘息の重症度とは有意の竿間を示したが,病型とは関連は見られなかった。 【考案】喘息患者におけるHRCTによる最大% LAAは喫煙,重症度,肺機能と関連を示しており,気管支喘息の臨床病態を反映する可能性が示唆された。
Keywords low attenuation area high resolution computed tomography reversible airway obstruction
Publication Title 岡大三朝分院研究報告
Published Date 1999-12
Volume volume70
Start Page 17
End Page 27
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308175
JaLCDOI 10.18926/14922
Title Alternative Ⅰ型アレルギー反応および副腎皮質ホルモンは気管支喘息における末梢血白血球のロイコトリエンB4およびC4産生に影響をおよぼす
FullText URL 070_009_016.pdf
Author Tanizaki, Yoshiro| Mitsunobu, Fumihiro| Mifune, Takashi| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Harada, Seishi| Takata, Shingo| Ochi, Koji| Koide, Norio|
Abstract The generation. of leukotrienes 84 (LT84) and C4 (LTC4) by leucocytes stimulated with Ca ionophore A23187 was examined in 71 patients with asthma (42 with atopic and 29 with nonatopic asthma) and 23 healthy controls. Of these patients,22 had SDIA (steroid-dependent intractable asthma). 1. The generation of LT84 and LTC4 by leucocytes was significantly more enhanced in patients with atopic, non-SOIA asthma than in healthy subjects, but not in patients with nonatopic asthma. The generation of LT84 and LTC4 in atopic asthma was significantly more decreased in patients with SOIA than in those with non-SOIA. 2. The LTC4 generation was significantly larger in attack stage than in attack-free stage of patients with atopic and nonatopic asthma when they had not SOIA. However, no significant difference was found in LT84 generation between attack and nonattack stages in these patients. 3. In patients with SOIA, no significant differences were observed in the generation of LT84 and LTC4 between attack and nonattack stages. The results suggest that IgE-mediated allergy and asthma attacks enhance and glucocorticoids inhibit the generation of LT84 and LTC4 by leucocytes.
Abstract Alternative 気管支喘息71例および健康人23名を対象に、Ca ionophore A23187刺激時の末梢血白血球のロイコトリエンB4 (LTB4)およびC4(LTC4)の産生能について検討を加えた。なお、71例中ステロイド依存性重症難治性喘息(SDIA)は22例であった。1.アトピー性、16非SDIA症例におけるLTB4、LTC4産生は、健康人と比べ有意に高い値を示したが、非アトピー性喘息では健康人との間に有意の差は見られなかった。また、アトピー性喘息では、SDIA症例において非SDIA症例に比べ、LTB4、LTC4産生が有意に抑制されていた。2.非SDIA症例では、アトピー性、非アトピー性を問わず、LTC4産生は、非発作時に比べ発作時に有意に亢進した状態であった。しかし、LTB4産生には、非発作時、発作時との間に有意の差は見られなかった。3.SDIA症例では、LTB4、LTC4産生と発作との有意の関連は見られなかった。以上の結果より、IgE にmediateされるアレルギー反応や喘息発作はLTB4、LTC4産生に促進的に、また副腎皮質ホルモンは抑制的に作用することが示唆された。
Keywords bronchial asthma LT84 LTC4 IgE-mediated allergy glucocorticoids
Publication Title 岡大三朝分院研究報告
Published Date 1999-12
Volume volume70
Start Page 9
End Page 16
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308654
JaLCDOI 10.18926/14921
Title Alternative Spa therapy for patients with asthma. A study on 437 patients with asthma admitted for last 5 years.
FullText URL 070_001_008.pdf
Author Tanizaki, Yoshiro| Mitsunobu, Fumihiro| Mifune, Takashi| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Harada, Seishi| Takata, Shingo| Ochi, Koji|
Abstract 1994年1月より1998年12月までの5年間に当院へ入院した呼吸器疾患のなかで気管支喘息を対象に,年齢,地域分布などの経年変化について検討を加えた。1.最近5年間に当院へ入院した呼吸器疾患患者は664例で,このうち,気管支喘息は437例(65.8% )であった。呼吸器疾患のなかで気管支喘息に占める割合の経年変化では,1995年度が最も高く(74.4% ),1997,1998年度にはやや低下(ともに60.7% )の傾向が見られた。2.入院患者の地域分布では,鳥取県内からの入院患者に比べ,遠隔地(鳥取県外)からの入院患者が比較的多く,いずれの年度においても50% 以上(平均57.3% )であった。また,岡山,大阪,兵庫,広島,山口,愛媛県などからの入院症例が多い傾向か見られた。3.年齢別検討では,いずれの地域においても,高齢者の入院症例か多く,鳥取県内では70才以上の症例の頻度(平均35.1% )が,また遠隔地(鳥取県外)では60-69才の症例の頻度(平均37.7% )が高い傾向か見られた。
Abstract Alternative The parients with asthma who were admitted at our hospital for last 5 years (1994-1998) were examined in relation to age and areas where patients came. 1. Of 664 patients with respiratory disease admitted for last 5 years, 437 patients (65.8% ) had asthma. The frequency of asthma in all patients with respiratory disease was the highest (74.4% ) in 1995, and decreased in 1997 and 1998 (60.7% ). 2. The number of patients with asthma from distant areas (outside Tottori prefecture) was constantly larger than the number of those inside Tottori prefecture in each year. The number of patients from Okayama, Osaka, Hyogo, Hiroshima, Yamaguchi, and Ehime was larger than the number from other distant areas. 3. Regarding the distribution of age of these patients, the number of patients over the age of 60 was more frequently observed, regardless of the area where patients came. Larger number of patients over the age of 70 (35.1% ) was found in those inside Tottori prefecture, while the number of patients between the ages of 60 and 69 (37.7% ) was larger in those from distant areas.
Keywords 気管支喘息 (asthma) 温泉療法 (spa therapy) 高齢患者 (aged patients) 遠隔地 (distant area)
Publication Title 岡大三朝分院研究報告
Published Date 1999-12
Volume volume70
Start Page 1
End Page 8
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308420
JaLCDOI 10.18926/14911
Title Alternative A case of systemic lupus erythematosus (SLE) associated with disseminated intravascular coagulation (DIC)
FullText URL 071_068_072.pdf
Author Takata, Singo| Okamoto, Makoto| Tsugeno, Hirofumi| Harada, Seishi| Hosaki, Yasuhiro| Mifune, Takashi| Mitsunobu, Fumihiro| Tanizaki, Yoshiro| Niiya, Kenji| Harada, Mine|
Abstract 播種性血管内凝固症候群(DIC)を合併した全身性エリテマトーデス(SLE)を経験したので報告する。症例は73歳女性。64歳時慢性関節リウマチ(RA)と診断された。1999年1月食欲低下を訴え当科受診した。血小板減少、FDP高値、PT上昇等よりDIC発症を疑った。膠原病では凝固系の異常を認めるが、本症例では凝固系が完進しDICを来したと考えられた。 本症例はリウマチ因子陽性であったが、朝のこわばり等典型的なRAの所見に乏しく他の膠原病の合併を疑い、腎障害、血小板減少、抗Sm抗体、抗核抗体陽性よりSLEと診断した。
Abstract Alternative A case of disseminated intravascular coagulation (DIC) in a patient with systemic lupus erythematosus (SLE) was described. A 73-year-old female was diagnosed as having rheumatoid arthritis when she was 64 years old. In Jan, 1999, the patient was admitted to our hospital with the complaint of loss of appetite. She was suspected of DIC because of thrombocytopenia, increased fibrin degradation product and prolonged prothrombin test. Abnormality in coagulation system is recognized in collagen disease. In this case coagulation system was activated and DIC occurred. In this case rheumatoid factor was positive. But she was suspected of complicating other collagen disease because she was poor in typical characteristics of rheumatoid arthritis, such as morning stiffness. SLE was diagnosed on the basis of renal injury, thrombocytopenia, positive anti-Sm antibody and positive antinuclaer antibody in this case.
Keywords 慢性関節リウマチ (Rheumatoid arthritis) 全身性エリテマトーデス (Systemic lupus erythematosus) 播種性血管内凝固症候群 (Disseminated intravascular coagulation syndrome)
Publication Title 岡大三朝分院研究報告
Published Date 2001-02-01
Volume volume71
Start Page 68
End Page 72
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308643