Author Mizushima, Takaaki| Ochi, Koji| Emori, Yasuyuki| Tanioka, Hiroaki| Sawa, Kiminari| Fujioka, Shinichi| Shinji, Toshiyuki| Koide, Norio| 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
Author Seno, Toshinobu| Ochi, Koji| Mizushima, Takaaki| Shinji, Toshiyuki| Koide, Norio|
Published Date 2004-02-01
Publication Title 岡大三朝医療センター研究報告
Volume volume74
Content Type Departmental Bulletin Paper
Author Takuma, Masae| Masui, Etsuko| Hayashimoto, Kanae| Asaumi, Noboru| Tachibana, Hideo| Ochi, Koji| Harada, Hideo|
Published Date 1991-08
Publication Title 環境病態研報告
Volume volume62
Content Type Others
Author Hosaki, Yasuhiro| Mitsunobu, Fumihiro| Ashida, Kozo| Tsugeno, Hirofumi| Nishida, Norikazu| Nagata, Takuya| Takata, Shingo| Yokoi, Tadashi| Tanizaki, Yoshiro| Ochi, Koji| Fukuda, Tetsuya| Shiratori, Yasushi|
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 Hiramatsu, Kazuhisa| Asano, Motoi| Matsushita, Koki| Miyoshi, Tomoko| Nakamura, Sukio| Mizushima, Takaaki| Koide, Norio| Kataoka, Hitomi| Ochi, Koji| 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 10.18926/11664
Title Alternative A dietary survey in patients with chronic pancreatitis
FullText URL 062_011_015.pdf
Author Hayashimoto, Kanae| Ochi, Koji| Harada, Hideo| Tanaka, Juntaro| Takuma, Masae| Masui, Etsuko| Tanizaki, Yoshiro| Matsumoto, Shuji| Seno, Toshinobu| Izushi, Michihiro|
Abstract 食事療法は慢性膵炎治療の基本として重要であるが,その具体的な内容についてはあまり明確にされていない。今回,筆者らは慢性膵炎例の食事に関する全国調査の一部を担当したので,その成績を報告し,問題点と対策について考察した。対象は慢性膵炎間欠期の患者56名(男44名,女12名)である。(1)エネルギー摂取量では1日1,400kcal以下が16名(29%)にみられ,肥満度80~90%が7名および80%以下が9名という栄養状態と考え合わせて,食事の回数を増やしてでも摂取エネルギーの改善をはかる必要がある。(2)蛋白質および脂質摂取量についても同様な成績であり,消化酵素剤を投与しながら量的,質的な改善をはかる必要がある。(3)糖質については質的改善をはかる必要がある。(4)ビタミンとミネラルも不足傾向にあった。野菜の摂取不足が顕著であった。(5)診断確定後も禁酒できない患者が男17名(39%),女1名(8%)にみられ,その指導が重要な課題である。
Abstract Alternative Importance of diet therapy has been emphasized in chronic pancreatitis. However, concrete measures and programs of the diet therapy have remained to be studied. Therefore, Intractable Pancreatic Disease Study Group recently carried out a nation-wide questionnaire survey on the diets in patients with chronic pancreatitis under the auspIces of the Ministry of Health and Welfare. Attendant physicians were requested to report the nutritional states of their patients and the kinds and amounts of foods taken by their patients on three consecutive days. The nutritional state was evaluated by a body weight index calculated by the following formula:Body Weight Index (%) = Present Body Weight / Ideal Body Weight X 100. Daily nutritional intake (calorie, protein, fat, carbohydrate, and others) was calculated by dieticians according to the Food Exchange Table published by the Japanese Association of Diabetes. The present study constitutes a part of the group study. Patients consisted of 44 men and 12 women who fulfilled the diagnostic criteria proposed by the Japanese Society of Gastroenterology;20 men and 3 women had secondary diabetes mellitus. Following results and conclusions were obtained. (1) Average daily calorie intake of the patients was 1,759kcal as compared with 2,057kcal in the general population in Japan. Sixteen patients (28.6%) showed daily calorie intake less than 1,400 kcal and consequently poor nutritional states (6 patients with body weight indices less than 80% and 10 with 80-90%). It is important, therefore, to try to improve the daily calorie intake by increasing the frequency of diets in these patients. (2) Average daily intake of protein was 72.1 g (animal protein 38.1 g), only slightly less than 79.2 g (animal protein 41.7 g) in the general population. However, as many as 16 patients (28.6%) showed daily protein intake of less than 60 g and poor nutritional states as described above. It is important, therfore, to encourage patients to maintain the daily protein intake of more than 60 g by increasing the frequency of diets with oral administration of digestive enzymes. (3) Average daily intake of fat was 39.9 g (animal fat 23.8 g), approximately 20 g less than 58.3 g (animal fat 28.0 g) in the general population. As many as 17 patients (30.4%) showed daily fat intake of less than 30 g , and 16 of the 17 patients showed poor nutritional states as described above. It is important, therefore, to encourage patients to maintain the daily fat intake of more than 30 g (especially by increasing the amounts of vegetable oil) by increasing the frequency of diets with oral administration of digestive enzymes. (4) Average daily intake of carbohydrate was 278 g, almost equal to 289 g in the general population. However, many patients took as much as 48 g of carbohydrate in the from of cakes, plain sugar and alcohol beverages. Seventeen men (39%) and one woman (8%) had continued drinking alcohol beverages even after the diagnosis was made. It is important, therefore, to encourage patients to improve the quality of carbohydrate intake, although it is admittedly difficult to realize the ideal. (5) Intake of vitamins and minerals (especially calcium) also tended to be insufficient. Green vegetables were especially insufficient. (6) In conclusion, it is utmost important in chronic pancreatitis to perform periodical evaluation of nutritional intake and feed back the information to the treatment through a close patient-dietician-doctor relationship.
Keywords 慢性膵炎 (Chronic pancreatitis) 食事療法 (Diet therapy in chronic pancreatitis) 栄養状態 (Nutrition in chronic pancreatitis)
Publication Title 環境病態研報告
Published Date 1991-08
Volume volume62
Start Page 11
End Page 15
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002313896
JaLCDOI 10.18926/11666
Title Alternative Trial of a mass screening survery for detecting early pancreatic cancer
FullText URL 062_005_010.pdf
Author Matsumoto, Shuji| Ochi, Koji| Tanaka, Juntaro| Seno, Toshinobu| Harada, Hideo|
Abstract 早期膵癌を発見するためのスクリーニング法を確立するため,1986年6月1日から1990年6月30日までの期間のprospective studyを行った。対象は,人間ドックを目的として来院した患者を主とする三朝分院の外来患者1,748名である。一次スクリーニング検査として,血清アミラーゼ,エラスターゼI,腹部超音波検査(US)を施行し155名の要精検者が得られ,要精検率は8.9%であった。155名の要精検者に,二次検査として,USの再精査,ERCP,腹部CTを施行した。その結果,早期膵癌患者1名,進行膵癌患者4名を発見し,膵癌発見率は0.29%と良好な成績であった。加えて,一次スクリーニングの検査項目を限定することによりcost-benifitを改善することができた。発見された膵癌患者の3名は60歳代であった。また,年代別要精検率は加齢とともに上昇した。1年以後にfollow-up検査を受けた患者の数は641名でfoilow-up率は36.7%であり,そのなかから膵癌は発見されなかった。60歳代のfollow-up率は40歳以上60歳未満のそれにくらべて有意の低値をとった。早期膵癌の見逃しを少なくするためには,今後,60歳代を中心とする患者のfollow-up率をさらに高めることが必要である。
Abstract Alternative To find an effective mass screening method for detecting early pancreatic cancer among asymptomatic populations and patients with vague abdominal symptoms, a prospective study was attempted on 1748 patients who came to Medical Clinic of Misasa Branch Hospital, Okayama University Medical School mostly for a routine annual chek-up from June 1, 1986 through June 30, 1990. These patients underwent first-step screeing tests including serum amylase, elastase I and routine abdominal ultrasonography (US). Consequently 155 patients (8.9% of the total 1748 patients) showed abnormal findings and underwent secondstep tests including US, ERCP and computed tomography. Final diagnosis was early pancreatic cancer in one patient and advanced pancreatic cancer in four. Three of the 5 patients with pancreatic cancer were in their sixties. Detection rate of pancreatic cancer (0.29%) in this series was satisfactory as compared with the results of previous reports with US alone. The rate of second-step examination increased with age. Six hundred and forty-one patients (36.7% of the 1748 patients) underwent follow-up examinations more than one year after the previous test. No pancreatic cancer was detected in the 641 patients. The rate of follow-up examination in patients in their sixties was significantly lower than in those in their forties or fifties. It is important to improve the follow-up rate in patients in their sixties, because they are at a high risk for pancreatic cancer as suggested by the present study.
Keywords 膵集検 (Mass screening for pancreatic cancer) 膵癌の早期診断 (Early diagnosis of pancreatic cancer) 早期膵癌 (Small pancreatic cancer)
Publication Title 環境病態研報告
Published Date 1991-08
Volume volume62
Start Page 5
End Page 10
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002313927
JaLCDOI 10.18926/11674
Title Alternative Development of stepping measurement device for evaluation of and training in walking
FullText URL 061_123_128.pdf
Author Matsumoto, Shuji| Ochi, Koji| Tanaka, Juntaro| Tachibana, Hideo| Seno, Toshinobu| Harada, Hideo| Tsuboi, Keiichi| Miyake, Hirofumi| Kimura, Ikuro|
Abstract 急性膵炎の回復後その発症原因の検索において発見された小膵癌の3例を報告し,膵炎の発症原因の一つとして膵癌を常に念頭におく必要があることを強調した。またスクリーニング検査および精査において小膵癌を診断する手順について考察を加えた。症例1は初回発作の回復後に,症例2および症例3は再発発作の回復後に急性膵炎の発症原因の検索を目的に紹介された。いずれの症例においても血清腫瘍マーカーは正常植を示し,腹部USおよびCTは腫瘍から尾側の膵管の拡張を示したが腫瘍そのものは描出はできなかった。症例1ではERCP像から膵体部癌を強く疑い,症例2と症例3ではERCP像と細胞診陽性所見から膵頭部癌と確診し,手術を行った。腫瘍の最大径は症例1では0.9cm,症例2では1.5cm,症例3では2.0cmであり,いずれも転移を認めず根治切除可能であった。
Abstract Alternative Although gait training equipment such as the bicycle ergometer and treadmill exists for patients whose walking ability is high, there is no appropriate gait training mehtod or training instrument for patients whose walking ability has become impaired, who often use a cane or walker, etc. in the course of daily life. In the case of gait training for persons whose walking ability involves impaired locomotion, there is always the danger of a fall. Consequently, a caregiver is required, and the effect of the training is cut by half because the patient's anxiety about falling is exacerbated. Slow stepping affords strengthening and balance training of the leg muscles for patients whose walking ability has become low, and walking ability is improved. However,whether such training appropriately carries out stepping and the degree of the effect of such training has not been evaluated. Therefore, we have developed a stepping measturement device that monitors stepping for evaluation and training of walking ability. This system consists of two mat switches for stepping, a measuring circuit for stepping detection, and a book-sized personal computer with a PC card-type AD converter. This system can detect a left or right single stance phase and a double stance phase relative to the ON, OFF condition of the mat switch. After measurement, the following items are analyzed and displayed : ・number of steps, ・average time of double stance phase, ・the average time of single stance phase, and so on. Finally, we measured the stepping of subjects whose walking ability is low, and showed the relationship between daily walking conditions and stepping conditions. The effectiveness of this system was considered in light of the results.
Keywords 小膵癌 (Small pancreatic cancer) 膵癌の早期発見 (Early diagnosis of pancreatic cancer) 急性膵炎 (Acute pancreatitis)
Publication Title 環境病態研報告
Published Date 1990-09
Volume volume61
Start Page 123
End Page 128
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002313750
JaLCDOI 10.18926/11698
Title Alternative Diabetic complications in the advanced stage of chronic pancreatitis.
FullText URL 061_079_088.pdf
Author Ochi, Koji| Tachibana, Hideo| Matsumoto, Shuji| Seno, Toshinobu| Tanaka, Juntaro| Harada, Hideo|
Abstract 慢性膵炎が進行すると膵内外分泌不全に対する治療が主体となる。かつては膵疾患に由来する糖尿病(膵性糖尿病)においては糖尿病性合併症の発症が少ないとされていたが,慢性膵炎の長期経過観察例の増加とともにその頻度が一次性糖尿病にくらべて必ずしも低くないことが指摘されるようになった。そこで今回,厚生省難治性膵疾患調査研究班「慢性膵炎の新しい治療法の開発」小委員会の研究活動の一環として膵性糖尿病の治療法を再検討することになったのを機会に,その手始めに野性糖尿病の合併症に関する従来の報告を整理した。その結果,一次性糖尿病の場合にくらべて,細小血管症(網膜症,腎症,神経障害)はほぼ同程度であるが軽症例が多いこと,大血管症(心筋梗塞,脳硬塞,動脈硬化症)は少ないことが示唆された。そのほか,膵性糖尿病の合併症の発症に関与すると考えられる諸因子についても概説した。
Abstract Alternative Exocrine dysfunction (maldigestion) and endocrine dysfunction (diabetes) are malll clinical features in the advanced stage of chronic pancreatitis. Diabetic complications were previously considered to be infrequent in diabetes secondary to chronic pancreatitis (pancreatic diabetes). However, the recent improvement in life expectancy and closer observation of the clinical course of patients with chronic pancreatitis have revealed that diabetic complications are not infrequent in pancreatic diabetes as compared with primary diabetes mellitus and that diabetes is one of the most important prognostic factors in chronic pancreatitis. We, therefore, reviewed recent articles on the topics before beginning a national survey of diabetic complications in patients with pancreatic diabetes. It has been suggested that : (1) diabetic microangiopathy (retinopathy, nephropathy and peripheral neuropathy) is almost as frequent in secondary diabetes as in primary diabetes, although the severity is less in secodary diabetes : (2) peripheral neuropathy is frequent in alcoholic chronic pancreatitis : (3)macroangiopathy (myocardial infarction, cerebral thrombosis, atherosclerosis) is less frequent in pancreatic diabetes. We also discussed various factors which may precipitate the diabetic complications.
Keywords 膵性糖尿病 (Pancreatic diabetes) 慢性膵炎 (Chronic pancreatitis) 合併症 (Complications)
Publication Title 環境病態研報告
Published Date 1990-09
Volume volume61
Start Page 79
End Page 88
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002313469
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 10.18926/11708
Title Alternative Re-evaluation of spa-drink therapy for digestive diseases
FullText URL 061_073_078.pdf
Author Tanaka, Juntaro| Seno, Toshinobu| Matsumoto, Shuji| Ochi, Koji| Harada, Hideo|
Abstract 従来飲泉などの温泉治療は経験的知識にもとづいて行われる部分が多かったが,今後は科学的検査法を用いて有用性,適応疾患,適応病態,などを決定する必要がある。筆者らは,最近紹介された簡便な消化器検査法を用いて消化器疾患に対する飲泉療法の適応を再吟味しているので,これまでに得られた成績を中心に概説した。すなわち,(1)飲泉は1回でも連日の飲用でも,胃粘膜血流を改善する作用がある。(2)胃排出機能に対しては調整的効果を有する。(3)連日の飲泉は膵外分泌機能を改善する。したがって慢性の胃,膵疾患において粘膜血流障害,胃運動機能異常あるいは膵外分泌機能低下に起因する病気・病態に対しては積極的に飲泉療法を試みるべきである。温泉水の温度は40℃前後,飲泉の量は150~200ml,タイミングは食間空腹時がよい。
Abstract Alternative With the advent of new instruments for examining the digestive organs, we have attempted to re-evaluate the efficacy and indications of spa-drink therapy for digestive diseases. This report deals with an overview of the results we have obtained so far. Effect of oral intake of thermal water (Misasa thermal water, 38-42℃, 150-200 ml) on gastric mucosal blood flow was evaluated, using an endoscopic organ reflex spectrophotometry together along with an Olympus XQ - 10 forward viewing gastrofiberscope. Single intake of thermal water as well as long-term spa-drink therapy (two times a day between meals for more than two weeks) brought about an improvement of gastric mucosal blood flow. Gastric emptying function was evaluated with an acetaminophen method. Single intake of thermal water brought about disordered gastric emptying (excessively accelerated or suppressed). However, long-term spa-drink therapy brought about an improvement (normalization) of gastric emptying function. Exocrine pancreatic function was evaluated with a synthetic peptide, N-BT-PABA, and also by measuring fecal chymotrypsin actIvIty. Longterm spa-drink therapy brought about an improvement of exocrine pancreatic function. Motility of the gall-bladder was evaluated by abdominal ultra-sonography. Long-term spa-drink therapy gave no effect on the motility of the gallbladder. In conclusion, our recent study indicate that : (1) single oral intake of thermal water as well as longterm spa-drink therapy is effective for gastric diseases related to decreased gastric mucosal blood flow (treatment of intractable peptic ulcer and chronic gastritis, and prevention of recurrence of peptic ulcer) ; (2) long-term spa-drink therapy is effective for dyspepsia syndrome; (3) long-term spa-drink therapy is effective as a supplemental method in the treatment of exocrine pancreatic dysfunction (chronic pancreatitis) ; (4) thermal water should be taken between meals.
Keywords 飲泉療法 (Spa-drink therapy) 消化器機能 (Digestive function) 胃粘膜血流 胃排出能 膵外分泌 胆嚢機能
Publication Title 環境病態研報告
Published Date 1990-09
Volume volume61
Start Page 73
End Page 78
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002313368
JaLCDOI 10.18926/15041
Title Alternative Alcohol-induced pancreatitis
FullText URL 062_052_070.pdf
Author Harada, Hideo| Tanaka, Juntaro| Ochi, Koji| Matsumoto, Shuji| Seno, Toshinobu| lzushi, Michihiro| Tanizaki, Yoshiro|
Abstract 膵炎のうちもっとも頻度が高いアルコール性膵炎(AIP)の疫学,臨床像および発生機序に関する従来の知見を総括した。AIPの大多数は慢性膵炎である。通常は長期にわたる多量の飲酒を背景に発症するが,遺伝的素因および食事因子も重要な役割を演じる。発症初期には血中膵酵素の上昇をともなう腹痛が病像を支配するが,進展すると膵外分泌不全による消化吸収障害と膵内分泌不全による糖尿病が病像を支配するようになる。アルコール性慢性膵炎は非アルコール性慢性膵炎にくらべて確診時にすでに進展した症例が多く,合併症が多く,進行が早く,予後が悪い。死亡の主たる原因は癌の併発と糖尿病の合併症で,膵炎の急性増悪発作がこれにつぐ。併発する癌のなかでは膵癌よりもむしろ上部気道および上部消化管の癌が多い。発生機序としてはDuctal-Plug説とToxic-Metabolic説が有力であるが,最近は細 胞内膵酵素活性化説とFree Radical説も注目をあびている。
Abstract Alternative This paper is to review the literature on the epidemiology, clinical pictures and etiopathogenesis of alcohol-induced pancreatitis (AIP). The incidence of AIP has been increasing worldwide, paralleling the increase in alcohol consumption. AIP manifests itself following a longterm consumption of large amounts of alcohol. There is no known threshold value of alcohol consumption in terms of the risk of developing AIP, although the logarithm of the risk of developing AIP is lineally correlated with the amount of alcohol intake. Why some alcoholics develop pancreatitis whereas others with equal consumption of ethanol are spared remains to be explained. Therefore, two additional factors are considered to play important roles in developing AIP : genetic predisposition and diet. The majority of AIP IS chronic pancreatitis (AICP), although a minority can be acute pancreatitis (AIAP). AIAP shows somewhat higher morbidity and mortality than the common variety of acute pancreatitis. If recovered from an attack, AIAP shows morphological and functional restoration. AICP manifests itself with an acute attack of abdominal pain, insidious onset of abdominal pam, or a pain-free variety. An acute attack in AICP resemble that m AIAP ; often these two can be differentiated only by follow-up studies. AICP shows no morphological and functional restoration, and often shows progressive deterioration. Abdominal pain with elevated serum pancreatic enzymes is a predominant clinical picture m the early stage of AICP, whereas in the late stage symptoms and signs deriving from exocrine insufficiency (maldigestion) and endocrine insufficiency (pancreatic diabetes) begin to dominate the clinical pictures. AICP is in the more advanced stage and shows more complications than nonalcoholic chronic pancreatitis at the time of diagnosis. In addition, AICP shows more rapid progress and higher morbidity and mortality. The incidence of microangiopathy in pancreatic diabetes resemble that in primary diabetes, being higher in patients with a longer history of diabetes, those on insulin treatment and those under poorer control. Main causes of death are development of cancer in the upper respiratory and gastrointestinal tract and diabetic complications (hypoglycemic shock, renal failure, and intractable pneumonia), and acute attack of pancreatitis leads to death less frequently. Ductal-Plug theory and classical Toxic-Metabolic theory are most popular to explain the pathogenesis of AIP ; however, increasing evidence has been reported that oxygen free radicals and intracellular activation of zymogens by lysosomal enzymes may be involved in the pathogenesis.
Keywords アルコール性膵炎 (Alcohol-induced pancreatitis) 慢性膵炎 急性膵炎
Publication Title 環境病態研報告
Published Date 1991-08
Volume volume62
Start Page 52
End Page 70
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002307918
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 10.18926/15299
Title Alternative ステロイド依存性重症難治性喘息に対する温泉療法の重要性。過去10年間の181例を対象に。
FullText URL 064_001_010.pdf
Author Tanizaki, Yoshiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Sugimoto, Keisuke| Yokota, Satoshi| Hiramatsu, Junichi| Kawaraya, Masashi| Ochi, Koji| Harada, Hideo| Tada, Shinya| Kimura, Ikuro|
Abstract Characteristics of 181 patients with steroid-dependent intractable asthma (SDIA) who were admitted to our hospital and had spa therapy for last 10 years were examined in relation to the methods of spa therapy. For last 10 years, three kinds ofspa therapies were administered: spa therapy A (swimming training in a hot spring pool) in the first atage (1982-1985), spa therapy B (swimming training + inhalation of iodine salt solution) in the middle stage (1986 -1989), and spa therapy C (swimming training + inhalation of iodine salt solution + fango therapy) in the last stage (1990-1991) of this study. 1. The number of patients with SDIA who were admitted to our hospital and had spa therapy tended to increase from 2 in 1986 to 35 in 1991. 2. The number of SDIA patients over the age of 60 or over the age at onset of 40 tended to increase from the first stage to the last stage. 3. The proportion of patients from distant areas (prefectures other than Tottori) was decreasing for the last stage, although the number of these patients was increasing in recent years. 4. The proportions of patients divided by serum IgE levels and by clinical asthma types did not change for last 10 years. 5. The proportion of type Ib and type II asthma was considerably high in patients with SDIA for last 10 years. 6. Clinical effects of spa therapy were observed in 21 of the 30 (70.0%)patients with SDIA in the first stage (1982-1985) with spa therapy A, 68 of the 83 (74.7%) patients with SDIA in the middle stage (1986-1989) with spa therapy B, and 61 of the 68 (89.7%) patients with SDIA in the last stage (1990-1991) with spa therapy C.
Abstract Alternative 最近10年間に三朝分院へ入院し,温泉療法を受けたステロイド依存性重症難治性喘息181例を対象に,温泉療法の方法との関連のもとに,対象患者の背景について検討を加えた。最近10年間に3種類の温泉療法が行われた。温泉療法A(温泉プール水泳訓練)は初期(1982-1985),温泉療法B(水泳訓練+ヨードゾル吸入)は中期(1986-1989),また,温泉療法C(水泳訓練+ヨードゾル吸入+鉱泥湿布療法)は後期(1990-1991)に行われた。1.当院へ入院し,温泉療法を受けたステロイド依存性重症難治性喘息(SDIA)患者の数は,1986年の2例から1991年の35例へと増加の傾向を示した。2.SDIA患者のうち,60才以 上の症例および40才以降の発症症例の数は,1986年以降急激な増加傾向を示した。3.鳥取県以外の他県(遠隔地)からの入院患者の頻度は,近年減少の傾向を示したが,その絶対数は増加の傾向であった。4.血清IgE値はいずれの時期においても200IU/mℓ以下の症例が多い傾向が見られた。5.臨床病型では,通常の喘息に比べIb型およびII型の頻度が高い傾向が見られた。6.温泉療法の臨床効果は,温泉療法Aが行われた初期では70.0%,温泉療法Bの中期では74.7%,温泉療法Cの後期では89.7%であった。
Keywords swimming training in a hot spring pool (温泉プール水泳訓練) inhalation of iodine salt solution (ヨードゾル吸入) fango therapy (鉱泥湿布療法) SDIA
Publication Title 岡大三朝分院研究報告
Published Date 1993-06
Volume volume64
Start Page 1
End Page 10
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307391
JaLCDOI 10.18926/15305
Title Alternative 気管支喘息における気道炎症反応の臨床的意義。慢性閉塞性細気管支炎との比較検討
FullText URL 064_024_030.pdf
Author Tanizaki, Yoshiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Sugimoto, Keisuke| Yokota, Satoshi| Hiramatsu, Junichi| Kawaraya, Masashi| Ochi, Koji| Harada, Hideo| Tada, Shinya| Kimura, Ikuro|
Abstract Clinical significanoce of airway inflammation was assessed in 28 patients with bronchial asthma, and the results were compared with those in 9 patients with chronic obstructive bronchiolitis (COB). 1. Total cell number in bronchoalveolar lavage(BAL) fluid was markedly increased in patients with COB (51.0×10(6)), which was significantly greater than that in those with bronchial asthma (9.6×10(6) ). 2. The proportion of BAL macrophages was significantly higher in patients with bronchial asthma than in those with COB. However, the, absolute number of BAL macrophages was not significantly different between them. 3. The proportion of BAL lymphocytes was higher in patients with bronchial asthma than in those with COB, but this difference was not signifcant. In contrast, the absolute number of BAL lymphocytes was significantly greater in patients with COB than in those with bronchial asthma. 4. The proportion and the number of BAL neutrophils were markedly increased in patients with COB compared to those with bronchial asthma. 5. The proportion and the number of BAL eosinophils were higher in patients with bronchial asthma than in those with COB, although these defferences were not significant. The results suggest that airway inflammation in bronchial asthma is not so intensive as that in COB.
Abstract Alternative 気管支喘息28例および慢性閉塞性細気管支炎9例を対象に,気道炎症反応の臨床的意義について検討を加えた。1.気管支肺胞洗浄(BAL)液中の総細胞数は,慢性閉塞性細気管支炎において著明に増加しており(51.0×10(6)),気管支喘息(9.6×10(6))との間に有意の差が見られた。2.BAL液中マクロファージの頻度は気管支喘息において,慢性閉塞性細気管支炎に比べ有意に高い値を示したが,絶対数での比較では両疾患群間に有意の差は見られなかった。 3.BAL液中リンパ球の頻度は,気管支喘息においてやや高い傾向が見られたが,絶対数の比較では慢性閉塞性細気管支炎において有意に高い値であった。 4.BAL液中の好中球は,その頻度および絶対数とも慢性閉塞性細気管支炎において著明に増加しており,これは気管支喘息と比べ有意に高い値であった。 5.BAL液中好酸球の頻度および絶対数は,気管支喘息においてやや高い値であったが,両疾患群間に有意の差は見られなかった。以上の結果より,気管支喘息における気道炎症反応は,慢性閉塞性細気管支炎ほど高度ではない ことが明らかにされた。
Keywords airway inflammation (気道炎症反応) bronchial asthma (気管支喘息) chronic obstructive bronchiolitis (慢性閉塞性細気管支炎) lymphocytes (リンパ球) neutrophils (好中球)
Publication Title 岡大三朝分院研究報告
Published Date 1993-06
Volume volume64
Start Page 24
End Page 30
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307730
JaLCDOI 10.18926/15307
Title Alternative 気管支喘息におけるハウスダストアレルギー. 血清IgE値とIgE抗体価と年齢との関連
FullText URL 064_031_035.pdf
Author Tanizaki, Yoshiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Sugimoto, Keisuke| Yokota, Satoshi| Hiramatsu, Junichi| Ochi, Koji| Harada, Hideo| Tada, Shinya| Kimura, Ikuro|
Abstract Serum IgE levels and IgE antibody values in relation to patient age were examined in 50 patients with house dust mite (HDm) sensitive asthma, 1. IgE antibody values to HDm were highest in patients between the ages of 10 and 19, and the values generally low in those over the age of 40. 2. High IgE antibody values to HDm were accompanied by high serum IgE levels in patients between 10 and 19. IgE antibody values and serum IgE levels were in general low in patients over age 40. In patient under age 9, serum IgE levels were less than 500 IU/ml in 5 of the 10 subjects despite an increased value of IgE antibodies to HDm. These results suggest that an increased production of IgE antibodies to HDm is usually accompanied by an increased production of total IgE in younger subjects. However, an increase in production of IgE antibodies is not always related to an increase in production of total IgE in patients under age 9. The results also show that production of IgE antibodies to HDm and total IgE is in general low in older patients despite the hyperreactivity to HDm.
Abstract Alternative ハウスダストが原因抗原であるアトピー型気管支喘息50例を対象に,血清IgE値とIgE抗体価を年齢との関連のもとに検討した。1.IgE抗体価は10-19才の年齢層の症例において最も高く,一方40才以上の症例では全般的に低い傾向が見られた。2.10-19才の年齢層の症例では,IgE抗体価の高値と同時に血清IgE値も高い値を示したが,40才以上の症例では,IgE抗休価および血清IgE値いずれも10-19才の症例に比べ全般的に低い値を示した。9才以下の症例では,IgE抗体価の高値にもかかわらず,血清IgE値は比較的低く,500IU/ml以下を示した症例が10例中5例に観察された。これらの結果は,若年症例では,IgE抗体の産生亢進と総IgEの産生亢進が同時に見られること が多いが,9才以下ではIgE抗体産生亢進に総IgE産生亢進が必ずしもともなわない場合があることを示している。また,40才以上の症例では,ハウスダストに対する過敏性は有しているものの,IgE抗体価および血清IgEは全般的に低い値を示す傾向が示唆された。
Keywords Serum IgE (血清IgE) IgE antibodies (IgE抗体) house dust mite (ダニ) 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 31
End Page 35
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307674
JaLCDOI 10.18926/15308
Title Alternative 老年者気管支喘息における液性および細胞性免疫反応について
FullText URL 064_075_082.pdf
Author Tanizaki, Yoshiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Sugimoto, Keisuke| Yokota, Satoshi| Hiramatsu, Junichi| Kawaraya, Masashi| Ochi, Koji| Harada, Hideo| Tada, Shinya| Kimura, Ikuro|
Abstract Humoral and cellular immune responses in bronchial asthma were examined by comparing the results of older asthmatics (group OA) with those of older healthy subjects (group OH) and of younger asthmatics (group YA). In humoral immune response, IgE-mediated immune system expressed by elevated serum IgE levels and IgE antibodies for house dust mite (HDm) and/or Candida albicans was clearly found in older asthmatics, while there was no finding showing the presence of IgE-mediated immune response in older healthy subjects. There was no significant difference in levels of serum IgG and IgA among the three groups. However, the serum IgM level was significantly lower in older asthmatics than in younger asthmatics. IgE antibodies to HDm and/or Candida albicans were more frequently found in older asthmatics compared with older healthy subjects. In contrast, IgG(4) antibodies to HDm were not different among the three groups. IgG(4) antibodies to Candida albicans were significantly higher in both older groups than in younger group. However, there was no significant difference between asthmatic and healthy subjects in the elderly. Delayed skin reaction to PPD was significantly more decreased in older asthmatics. These results show that bronchial asthma in the elderly is characterized by the presence of IgE-mediated immune response and by the changes of immune response with aging.
Abstract Alternative 気管支喘息における液性および細胞性免疫反応について,老年者気管支喘息,老年者健常人,および若年者気管支喘息の間で比較検討を行った。1.まず,液性免疫では,血清IgE値高値,ハウスダストやカンジダに対するIgE抗体陽性などのIgE系反応は,老年者気管支喘息においては明らかに観察されたが,老年者健常人では全く観察されなかった。血清IgGおよびIgA値には3者間に有意の差は見られなかったが,血清IgMは,若年者喘息に比べ老年者喘息で有意に低い値を示した。2.ハウスダストやカンジダに対するIgE抗体は老年者喘息において老年者健常人に比べより高い頻度で陽性であったが,一方,ハウスダストに対するIgG(4)抗体は3者聞に有意の差は見られなかった。また,カンジダに対するIgG(4)抗体は,老年者喘息および健常人において,若年者喘息に比べ有意の高値を示した。しかし,老年者の喘息と健常人との間には有意の差は見られなかった。3.PPDによる遅延型皮膚反応は,若年者喘息に比べ老年者喘息において有意の減弱傾向を示した。これらの結果は,老年者喘息はIgE系反応を有していること,そして,加齢による免疫反応の変化の影響を受けること,を示している。
Keywords IgE IgG(4) Immunoglobulings (免疫グロブリン) PPD Bronchial asthma (気管支喘息) 加齢
Publication Title 岡大三朝分院研究報告
Published Date 1993-06
Volume volume64
Start Page 75
End Page 82
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307261
JaLCDOI 10.18926/15316
Title Alternative 老年者の気管支喘息. アレルギー反応と気道細胞反応
FullText URL 063_039_043.pdf
Author Tanizaki, Yoshiro| Kitani, Hikaru| Okazaki, Morihiro| Mifune, Takashi| Mitsunobu, Fumihiro| Tanimizu, Masakuni| Honke, Naoko| Kusaura, Yasuhiro| Ochi, Koji| Harada, Hideo| Kimura, Ikuro|
Abstract Clinical features of bronchial asthma in the elderly were analyzed by observlng IgE-mediated allerglc reactions evaluated by immediate skin reaction and specific IgE antibodies to allergens, ventilatory function and cellular composition in bronchoalveolar lavage (BAL) fluid. 1. The frequency of positive immediate skin reaction and positive RAST score to allergens was in general low in the elderly patients over age 70. 2. Ventilatory function was widely variegated, and fifteen cases (60%) of the 25 Subjects showed considerably high values of FEV(l.0%), % PEFR, % MMF, % V(50) and % V(25), and the mean value of FEV(1.0%) in these cases was 71.3%. 3. The decreased value of % V(25) was related to BAL neutrophilia in 2 cases, but any correlation was not found between BAL neutrophilia and decreased value of % V(25) in 9 csese of the eleven subjects who had the BAL examination. The results show that in asthma of elderly patients, IgE-mediated allergic reactions are weak, and that a decreased value of % V(25) can be observed without BAL neutrophilia.
Abstract Alternative 70才以上の老年者気管支喘息の特徴について,アレルゲンに対する即時型皮膚反応および特異的IgE抗体,換気機能,気管支肺胞洗浄液(BAL)中の細胞成分などにより検討した。1.アレルゲンに対する即時型皮膚反応および特異的IgE抗体の陽性率は,全般的にかなり低い傾向を示した。2.換気機能にはかなりのばらつきが見られたが,25例中15例(60%)では,,いずれの換気パラメー ターもかなり高い値を示し,これらの症例の平均FEV(1.0%)は71.3%であった。3.BALを施行した11例中,% V(25)値の低下とBAL中好中球増多との間に関連の見られた症例は2例のみで,他の9例では% Ⅴ(25)値の高度な低下にもかかわらず,BAL中の好中球増多は見られなかった。これらの結果より,老年者気管支喘息では,IgEにmediateされるアレルギー反応は全般的に弱いこと,またBAL液中好中球増多なしに% V(25)値の高度な低下が出現してくることが示された。
Keywords elderly subjects (老年者) lgE-mediated allergic reaction (IgE系反応) ventilatory function (換気機能) BAL neutrophilia (BAL好中球) 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 39
End Page 43
ISSN 0913-3771
language 英語
File Version publisher
NAID 120002307727
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 10.18926/15325
Title Alternative 気管支喘息患者における細胞性免疫,ガンジダ抗原に対する遅延型反応の抑制
FullText URL 063_069_073.pdf
Author Tanizaki, Yosiro| Kitani, Hikaru| Okazaki, Morihiro| Mifune, Takashi| Mitsunobu, Fumihiro| Harada, Hideo| Ochi, Koji| Kimura, Ikuro|
Abstract Delayed cutaneous hypersensitivity towards Candida albicans was examined in 200 patients with bronchial asthma in relation to patient age and the level of total IgE. 1. Delayed skin reactivity towards C.albicans was depressed in the patients between the ages of 10 and 20 and in those over the age of 61. A significant difference was present in delayed skin reactivity between the groups of 10-20 and 41-50 years old. 2. The frequency of the patients with positive delayed skin reactivity towards C.albicans was the highest in those with low levels of total IgE (0 -100 IU/ml) and the low est in those with high levels of total IgE (over than 1001 IU/ml). The results suggest that cell-mediated immunity towards C.albicans is depressed re lating to atopics in the patients between 10 and 20 and to aging in the patients over 61.
Abstract Alternative 気管支喘息200例を対象にカンジダに対する即時型および遅延型皮膚反応を観察し,これらの皮膚反応と年令,血清IgE値との関連について検討を加えた。1. カンジダに対する遅延型皮膚反応は,10~20才の年齢層および61才以上の年齢層の症例において,その陽性率の低下が観察された。そして,10~20才の年齢層と41~50才の年齢層の症例では,両者間で陽性率の有意の差が見られた(p<0.001)。2. カンジダに対する遅延型皮膚反応の陽性率は,血清IgE値が低い(0~100 IU/ml)症例において最も高く,一方血清IgE値が高い(1001IU/ml以上)症例において最も低いという傾向が見られた。これらの結果は,カンジダに対する細胞性免疫は,10~20才の年齢層ではアトピーと,また61才以上の年齢層では加齢と関連して抑制されることを示唆するものと考えられる。
Keywords cell-mediated immunity (細胞性免疫) bronchial asthma (気管支喘息) atopics (アトピー) aging (加齢) カンジダ
Publication Title 岡大三朝分院研究報告
Published Date 1992-06
Volume volume63
Start Page 69
End Page 73
ISSN 0913-3771
language 英語
File Version publisher
NAID 120002307949