JaLCDOI 10.18926/15120
Title Alternative 老年者気管支喘息の各臨床病型における換気機能の特徴
FullText URL 066_021_029.pdf
Author Hosaki, Yasuhiro| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Yokota, Satoshi| Tanizaki, Yoshiro| Ochi, Koji| Harada, Hideo| Ikeda, Satoru| Taketa, Kazuhisa|
Abstract Ventilatory function was examined in 55 patients with asthma (25 older patients over the age of 60 and 30 younger patients under the age of 59) in relation to four clinical types classified by clinical symptoms and signs. 1. Regarding cellular composition of bronchoalveolar lavage (BAL) fluid, number of BAL neutrophils was significantly increased in type II, bronchiolar obstruction type, of older and younger patients compared to that in type la-1 and type la-2 of same patients. In contrast, BAL eosinophilia was observed in type la-2 of both older and younger patients and in type Ib of younger patients. 2. The values of % FVC, FEV(1.0%) and % PEFR were not significantly different among four clinical types of asthma and between older and younger patients, although the values of these ventilatory parameters in type II asthma showed a tendency to be lower compared to other clinical types. 3. The values of % MMF, % V(50), and % V(25), showing ventilatory dysfunction of small airways, were lowest in type II asthma of both older and younger patients among four clinical types. A significant difference in these ventilatory parameters of type II asthma compared to type la-1 asthma was observed in younger patients, but not in older patients. These results show that ventilatory dysfunction of small airways is related to clinical asthma types in younger patients, and to aging rather than asthma types in older patients.
Abstract Alternative 気管支喘息55例(老年症例-65才以上-25例,若年症例-59才以下-30例)における換気機能の特徴について,各臨床病型別に検討を加えた。1.まず対象症例の臨床病型の病態的特徴を,気管支肺胞洗浄(BAL)液中の細胞成分で検討 すると,Ⅱの細気管支閉塞型の症例では,好中球の増加が,またIa-2やIbの過分泌型の症例では好酸球の増加が特徴的であった。2.% FVC,FEVL(1.0%),% PEFRなどの換気パラメーターは,Ⅱ型において他の病型に比べ低値を示す傾向は見られたが,各病型間に有意差は見られなかった。3.% MMF,% V(50),% V(25)などのどちらかと言えば小ないし細気管支領域の換気障害を示す換気パラメーターの値は,老年および若年症例ともⅡ型(細気管支閉塞型)において最も低い値が示された。そして,若年症例では,Ⅱ型の症例においてこれからの換気パラメーターの値は,Ia-1型(単純性気管支攣縮型)に比べ有意に低い値を示した。しかし,老年症例ではⅡ型におけるこれらの換気パラメータ-の値は,他の臨床病型との問に有意の差は見られなかった。
Keywords Ventilatory function (換気機能) Clinical asthma type (臨床病型) BAL cells (BAL細胞) aging (加齢)
Publication Title 岡大三朝分院研究報告
Published Date 1995-09
Volume volume66
Start Page 21
End Page 29
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308008
JaLCDOI 10.18926/15121
Title Alternative 気管支喘息患者の血清コーチゾール値について. 副腎皮質ホルモン投与および年齢との関連
FullText URL 066_030_036.pdf
Author Hosaki, Yasuhiro| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Yokota, Satoshi| Tanizaki, Yoshiro| Ochi, Koji| Harada, Hideo| Ikeda, Satoru| Taketa, Kazuhisa|
Abstract Serum cortisol levels were examined in 94 patients with bronchial asthma in relation to dose of glucocorticoids and age. 1. The level of serum cortisol was significantly lower in group A patients, treated with glucocorticoids (prednisolone of 5mg/day or more) for more than 2 years, (2.4±1.2mcg/㎗) than in group B, treated with glucocorticoids (prednisolone of 5mg or less) for less than 2 years, (6.8±3.7mcg/㎗) (p<0.001) and in group C, treated without glucocorticoids, (12.6±3.9mcg/㎗) (p<0.001). The serum cortisol level was also significantly lower in group B than in group C (p<0.001). 2. The level of serum cortisol was significantly lower in patients over the age of 70 compared to that in those aged between 0 and 39 years (p<0.01) and those between 40 and 49 (p<0.05), and those between 50 and 59 (p<0.02). The level was also lower in patients between 60 and 69 compared to that in those between 0 and 39, however, this was not significant. These results demonstrate that the level of serum cortisol decreases by long-term glucocorticoid regimen and with aging.
Abstract Alternative 気管支喘息94例を対象に,副腎皮質ホルモン投与および年齢との関連のもとに,血清コーチゾール値の変動を観察した。まず副腎皮質ホルモンの投与量および投与期間により以下の3群に分けて検討した。グループA :副腎皮質ホルモン,プレドニソロンに換算して1日5mg以上を2年間以上にわたり使用している症例,グループB:プレドニソロン1日5mg以下で2年間以内の使用症例, グループC:副腎皮質ホルモンを全く使用していない症例。その結果,グループAの血清コーチゾ-ル値(2.4±1.2mcg/㎗)は,グループB (6.8±3.7mcg/㎗)(p 0.01)やC(12.6±3.9mcg/㎗)(p 0.001)に比べ有意に低い値であった。2、グループCでは,70才以上の症例の血清コーチゾ-ル値は,0-39才の症例(p 0.0l),40-49才の症例(p 0.05),そして,50-59才の症例(p 0.02)に比べ有意に低い値であった。これらの結果は,血清コーチゾール値は,副腎 皮質ホルモンの投与量や投与期間以外にも、加齢による影響を受ける可能性を示唆している。
Keywords serum cortisol level (血清コーチゾール) bronchial asthma (気管支喘息) clinical asthma type (臨床病型) glucocorticoids (副腎皮質ホルモン) aging (加齢)
Publication Title 岡大三朝分院研究報告
Published Date 1995-09
Volume volume66
Start Page 30
End Page 36
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307345
JaLCDOI 10.18926/15122
Title Alternative Study on the relationship between the bone mineral densities measured by QCT and biochemical parameters.
FullText URL 066_037_043.pdf
Author Kajimoto, Kazuhiro| Mitsunobu, Fumihiro| Mifune, Takashi| Yokota, Satoshi| Hosaki, Yasuhiro| Tanizaki, Yoshiro| Nakai, Mutsuro| Akiyama, Tsuneo|
Abstract 当院内科に通院または入院中の女性患者24例(57~89才,平均71.8才)を対象とし,定量的QCT法による骨塩量測定と同時に血中骨代謝マーカーを測定し検討を行った。年齢についての検討では,カルシウム(Ca)が70才台で60才台に比べ有意に高値であった以外は年代による有意差は認められなかった。オステオカルシン(OC)とイオン化Ca(Ca(2+))との間にr=-0.50,p<0.01の有意の逆相関を認め,OCとBody mass indexとの間に有意の正の相関(r=0.41,p<0.05)を認めた。平均骨塩量と各生化学parameterとの間には有意な相関はみられなかった。副腎皮質ステロイド剤(ステロイド)投与群では非投与群に比べ,投与群でALP骨型アイソザイム(ALP3)高値,OC低値の傾向がみられた。またステロイド投与症例はすべてOC値が8.4ng/mℓ以下であり,ステロイドによる骨粗鬆症誘発の機序として骨形成の抑制が関与している可能性が考えられた。今後骨塩量と骨代謝マーカーとの関連について,若年者を含めた検討が必要と考えられた。
Abstract Alternative Bone mineral densities (BMD) were measured with QCT (quantitative computed tomography) in 24 females aged 57 to 89 years old to evaluate about relationship between BMD and biochemical parameters on bone metabolism (calcium : Ca, ionized calcium : Ca(2+), alkaline phosphatase : ALP, bone type isozyme of alkaline phosphatase : ALP 3 and osteocalcin : OC) in blood. As for exception that Ca was significantly higher in patients aged of 60's in comparison with those of 70's in the examination with regard to age, no significant differences were observed. Significant opposite correlation (r=-0.50, p<0.01) between OC and Ca(2+) and significant positive correlation (r=0.41, p<0.05) between OC and body bass index were observed. No significant correlation was observed between mean BMD and biochemical parameters. A trend of higher ALP 3 and lower OC was observed in adrenocortical steroid (steroid) administration group in comparison with patients with no steroid therapy. Also in steroid administration group, OC value was below 8.4ng/mℓ in all patients. Thus, it was suspected that the suppression of bone formation was related to the mechanism of osteoporosis induced by steroid. Then, the further studies on the relationship of BMD and these biochemical parameters including those of younger cases were considered necessary to clarify the mechanism of osteoporosis.
Keywords 骨粗鬆症 (Osteoporosis) 骨塩量 (Bone mineral desity) オステオカルシン (Osteocalcin) 骨型アルカリフォスファターゼ (alkaline phosphatase (bone type isozyme)) イオン化カルシウム (ionized calcium)
Publication Title 岡大三朝分院研究報告
Published Date 1995-09
Volume volume66
Start Page 37
End Page 43
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307374
JaLCDOI 10.18926/15123
Title Alternative T cell subpopulation and asthma classification
FullText URL 066_044_048.pdf
Author Mifune, Takashi| Yokota, Satoshi| Hosaki, Yasuhiro| Kajimoto, Kazuhiro| Mitsunobu, Fumihiro| Tanizaki, Yoshiro|
Abstract 気管支喘息症例の臨床病型に対するTリンパ球の役割を明らかにするために,気管支肺胞洗浄液中のCD3,CD4,CD8陽性細胞の比率を検討した。1.Ia気管支攣縮型におけるCD3陽性細胞は75.6±6.52%,Ib:過分泌型では75.4±16.5%,Ⅱ:細気管支閉塞型では61.0±12.5%であり,いずれの病型においても有意な差は認められなかった。2.CD4陽性細胞についてはIa型47.4±6.11%,Ib型39.5±8.70%,Ⅱ型46.3±6.91%,CD8陽性細胞についてはIa型28.3±8.77%,Ib型35.5±12.3%,Ⅱ型29.4±11.5%と過分泌型 で他の2病型とは違う傾向を示したが,有意ではなかった。3.活性化を示すHLA-DR陽性細胞はCD4,CD8陽性細胞とも気管支攣縮型で高い傾向が認 められたが有意ではなかった。以上,今回の検討では各臨床病型間でTリンパ球の関与に明らかな差は見られなかったが,気管支攣縮型に対する活性型Tリンパ球より強い関与の可能性が示唆された。
Abstract Alternative To clarify the role of T lymphocyte to patho physio logical changls in He aiways, the relationship between T cell subpopulation in BALF and each clinical asthma type were investigated. The proportion of BALF CD3 +T cells in patients with Ia : simple bronchoconstriction type was 75.6±6.52%, 75.4±16.5% in those with Ib : hypersecretion type and 61.0±12.5% in those with Ⅱ : bronchiolar obstruction type. No siginificant differences were observed between 3 asthma types. The proportion of BALF CD4 +T cells and CD8 +T cells revealed different tendency in patients with type Ib, compaired to patients with type Ia or type Ⅱ, but this was not significant. A higher proportion of CD4 + and CD8 +T cells in BALF expressing the T cell activation marker HLA-DR was observed in patients with type Ia. compared to those with other clinial asthma types. However, these were not significant.
Keywords 気管支喘息臨床病型 (clinical type of beonchial asthma) Tリンパ球 (T-lymphocyte) CD4陽性リンパ球 (CD4+lymphocyte) CD8陽性リンパ球 (CD8+lymphocyte) 活性化リンパ球 (activated lymphocyte)
Publication Title 岡大三朝分院研究報告
Published Date 1995-09
Volume volume66
Start Page 44
End Page 48
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307211
JaLCDOI 10.18926/15124
Title Alternative Evaluation of airway response to salbutamol sulfate and disodium cromoglycate in bronchial asthma by use of body pletysmograph
FullText URL 066_049_056.pdf
Author Yokota, Satoshi| Mifune, Takashi| Kajimoto, Kazuhiro| Mitsunobu, Fumihiro| Tanizaki, Yoshiro|
Abstract サルブタモール,クロモグリク酸ナトリウム(クロモリン)吸入液を,気管支喘息(以下BA)11例,肺病変のない対照群9例に吸入させ,吸入前および吸入後30分に,sRaw(specific airway resistance)とsGaw(specific airway conductance)を,定容積型体プレチスモグラフ(Sensor Medics Corporation, Anaheim, California, U.S.A.)を用いて測定した。サルブタモールの場合,BAでは吸入後に有意な改善(p<0.01)を認め,対照群でも有意な変化(p<0.05)があったが,改善率(%)はBA が対照群に比べて有意に高かった(p<0.01)。クロモリンの場合,吸入前後での比較では有意差は認めなかったが,吸入後にBAでは改善,対照群では悪化する傾向があり,改善率(%)はBA が対照群に比べて有意に高値(p<0.01)であった。
Abstract Alternative We examined airway response to salbutamol sulfate and disodium cromoglycate (cromolyn) in 11 patients with bronchial asthma (BA), and 9 subjects of controls (no lung diseases), using a constant volume, whole body plethysmograph (Sensor Medics Corporation, Anaheim, California, U.S.A.). The results were expressed by specific airway resistance (sRaw) and specific airway conductance (sGaw), and compared before and 30 minuites after inhalation of agents. The sGaw and sRaw were significantly improved in BA (p<0.01) and in controls (p<0.05) after inhalation of salbutamol sulfate and the improvement rate after inhalation was significantly higher in BA than in controls (p<0.01). In case of cromolyn, there was no significant change of sGaw and sRaw in BA and controls after inhalation, but there was tendency of improvements of sGaw and sRaw in BA, and the improvement rate of these parameters after inhalation was significantly higher in BA than in controls (p<0.01).
Keywords 体プレチスモグラフ (body pletysmograph) 気管支喘息 (bronchial asthma) サルブタモール (salbutamol) クロモリン (disodium cromoglycate)
Publication Title 岡大三朝分院研究報告
Published Date 1995-09
Volume volume66
Start Page 49
End Page 56
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307959
JaLCDOI 10.18926/15125
Title Alternative Spa therapy for chronic respiratory disease. Recent trends of therapy for patients from distant area.
FullText URL 066_057_061.pdf
Author Hosaki, Yasuhiro| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Yokota, Satoshi| Tanizaki, Yoshiro|
Abstract 1995年1月から6月までの半年間に当院へ入院し,温泉療法を受けた慢性呼吸器疾患患者77例について,その地域分布を中心に最近の動向を検討した1.77例中鳥取県内から来院した患者は28例(36.4%)であった。一方,遠隔地(鳥取県外)からの患者は49例(63.6%)であり,遠隔地から入院してくる患者が増加する傾向か見られた。2.遠隔地からの入院患者では,兵庫県からの12例(15.6%)が最も多く,次で岡山県8例(10.4%),大阪府7例(9.1%),山口 県5例(6.5%)の順であった。3.入院患者の年齢分布では,鳥取県内の患者では70才以上の症例が最も多く,次で60-69才の年齢層の順であったが,遠隔地からの患者では,60-69才が最も多く,次で50-59才,40-49才の順であり,鳥取県内に比べ年齢層がやや低い傾向か見られた。4.慢性呼吸器疾患のうちわけは,気管支喘息が62例と最も多く,全体の80.5%を占め,次で慢性閉塞性細気管支炎6例,肺気腫4例,慢性気管支炎3例の順であった。
Abstract Alternative Areas (prefecture) where patients came and patient age were analyzed in 77 patients with respiratory disease who had been admitted at our hospital to have spa therapy during 6 months from January to June in 1995. Of 77 patients, 28 subjects (36.4%) were patients who lived inside Tottori prefecture, and 49 (63.6%) were outside Tottori prefecture (distant area). This suggest that the number of patients from distant area has been increasing. The numbers of patients from Hyogo prefecture (12 subjects ; 15.6%), Okayama (8 ; 10.4%), Osaka (7 ; 9.1%) and Yamaguchi (5 ; 6.5%) were larger than those from other prefectures. Regarding patient age, the numbers of patients over the age of 70 and those aged between 50 and 69 were larger in patients inside Tottori prefecture compared to other age group. In contrast, the numbers of patients aged between 60 and 69, between 50-59, and between 40 and 49 were larger in patients from distant areas than the numbers of other age groups, suggesting mean age of patients from distant areas was lower than that of patients inside Tottori prefecture. The number of patients with bronchial asthma was largest (62 subjects ; 80.5%) among different respiratory diseases.
Keywords 慢性呼吸器疾患 (chronic respiratory disease) 温泉療法 (spa therapy) 遠隔地医療 (therapy for patients from distant area) 年齢 (patient age)
Publication Title 岡大三朝分院研究報告
Published Date 1995-09
Volume volume66
Start Page 57
End Page 61
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307808
JaLCDOI 10.18926/15127
Title Alternative Spa therapy and quality of life in patients with bronchial asthma
FullText URL 066_072_077.pdf
Author Tanizaki, Yoshiro| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Hosaki, Yasuhiro| Yokota, Satoshi| Ochi, Koji| Harada, Hideo| Ikeda, Satoru| Taketa, Kazuhisa|
Abstract 気管支喘息のなかでも,ステロイド依存性重症難治性喘息では,気管支拡張薬その他の抗喘息薬のみでは発作のコントロ-ルが極めて困難であり,したがって副腎皮質ホルモンの長期投与を余儀なくされる。そして,投与薬剤,特に気管支拡張薬の心臓刺激作用や副腎皮質ホルモンの副作用,さらには運動誘発喘息がひき起こされやすいなどの理由により,体動制限が加えられることが多い。このことが,また精神活動の低下へとつながる。したがって,重症難治性喘息患者のQuality of life (QOL)を高めるためには,薬剤の副作用をできるだけ低くするための投与薬剤の減量をはかるとともに,十分な運動のもとに治療を行い全身状態の改善,それにともなう精神活動の活性化をはかる必要がある。かかる観点からすれば,温泉療法は最も理想的な治療法であり,その直接作用(気道への作用:気道浄化作用,気道粘膜正常化作用)により,白,他覚症状の改善,換気機能の改善,気道過敏性の低下などが観察される。また,間接作用(気道以外への作用)により,全身状態の改善,自律神経系の安定化作用,副腎皮質機能の改善作用などが見られる。すなわち,重症難治性喘息に対する温泉療法では,十分な運動のもとに,精神活動の活性化をともなった喘息症状の改善がはかられるため,患者のQOLをより一層高めることができると判断される。
Abstract Alternative Bronchial asthma is in qeneral a disease with good prognosis and can be controlled with usual antiasthmatic drugs. However, there are some patients whose asthma attacks can be controlled only with use of qlucocorticoids. In these patients, adverse side effects of many kinds of drugs containing bronchodilators and qlucocorticoids, and exercise-induced asthma attacks are often observed. Thus, the patients have to keep limitation of exercise during treatment of their asthma attacks, leading to decrease psychical activity. Complex spa therapy for bronchial asthma consists of swimming training in a hot spring pool (exercise), inhalation of iodine salt solution and fango therapy. Spa therapy has two kinds of actions : direct action to airways and indirect action to other organs except airways. The direct action of spa therapy improves subjective and objective symptoms, and ventilatory function, and suppress bronchial hyperresponsiveness. In contrast, improvemment of suppressed function of adrenocortical glands, of mental activity, and of autonomic nerve system is observed as indirect action of spa therapy. These actions play an important role for improvement of QOL of patients with bronchial asthma.
Keywords 温泉療法 (spa therapy) 重症難治性喘息 (lntractable asthma) 運動 (exercise) 精神活動 (phychical activity) QOL
Publication Title 岡大三朝分院研究報告
Published Date 1995-09
Volume volume66
Start Page 72
End Page 77
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307919
JaLCDOI 10.18926/15117
Title Alternative ダニ喘息における気道遊走細胞からのヒスタミン遊離の加齢による減少
FullText URL 066_001_007.pdf
Author Tanizaki, Yoshiro| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Hosaki, Yasuhiro| Yokota, Satoshi| Ochi, Koji| Harada, Hideo| Ikeda, Satoru| Taketa, Kazuhisa|
Abstract Histamine release from bronchoalveolar cells induced by house dust mite (HDm) was compared in patients with atopic asthma sensitive to HDm in relation to age. 1. Total cell number in bronchoalveolar lavage (BAL) fluid was larger in patients over the age of 40 years (9.10×10(6)) than in those aged between 20 and 39 years (6.25×10(6)), however, this was not significant. 2. Number of BAL eosinophils was not significantly different between the two age groups. 3. Number of BAL basophilic cells was significantly higher in younger patients (20-39 years) (1.85±1.03×10(2)/mℓ) than in older patients (40+ years) (0.39±0.24×10(2)/mℓ) (p<0.001). 4. Histamine release from BAL cells induced by HDm was significantly higher in younger patients (38.1±24.8%) than in older patients (0%) (p<0.001). These results suggest that histamine release from BAL cells in patients with HDm allergy decreases with aging.
Abstract Alternative ダニ喘息14例を対象に,ハウスダストエキスによる気道遊走細胞からのヒスタミン遊離と加齢との関連について検討を加えた。1.気管支肺胞洗浄液(BALF)中の総細胞数は,20-39才の症例群(6.25×10(6)) に比べ,40才以 上の症例群(9.1×10(6)) でやや多い傾向が見られたが,推計学的には有意差は見られなかった。2.BALF中好酸球数は,20-39才と40才以上の症例群間に差は見られなかった。3.BALF中好塩基性細胞数は,40才以上の症例群(0.39±0.24×10(2)/mℓ)に比べ,20-39才の症例群(1.85±1.03×10(2)/mℓ)において有意に多い傾向が見られた(P<0.001)。4.ハウスダストエキスによるBALF中細胞からのヒスタミン遊離は,40才以上の症例群(0%) に比べ20-39才の症例群(38.1±24.8%)において有意に高い結果が得られた(P<0.001)。これらの結果より,ダニ喘息(アトピー型喘息)における気道遊走細胞からのヒスタミン遊離は,加齢とともに減少することが示唆された。
Keywords Bronchial asthma House dust allergy Histamine release Bronchoalveolar cells
Publication Title 岡大三朝分院研究報告
Published Date 1995-09
Volume volume66
Start Page 1
End Page 7
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307845
JaLCDOI 10.18926/15118
Title Alternative ステロイド依存性重症難治性気管支喘息患者の血清コルチゾールに対する温泉療法の影響
FullText URL 066_008_013.pdf
Author Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Hosaki, Yasuhiro| Yokota, Satoshi| Tanizaki, Yoshiro|
Abstract Serum cortisol levels before and after spa therapy were compared in 30 patients with steroid-dependent intractable asthma (SDIA) in relation to clinical asthma types. 1. The mean level of serum cortisol in patients with type la-1 asthma was 2.0±0.7mcg/dℓ before spa therapy, and significantly increased to 9.0±3.1mcg/dℓ (p<0.001). The serum cortisol level of patients with type la-2 also significantly increased from 3.3±1.5mcg/dℓ before spa therapy to 5.9±3.1 mcg/dℓ after the therapy (p<0.05). 2. The level of serum cortisol in patients with type Ib increased from 4.0±1.6mcg/dℓ to 7.8±1.4mcg/ dℓ after spa therapy (p<0.001). In contrast, the serum cortisol levels in patients with type II were not significantly different before (2.7±1.3mcg/dℓ) and after spa therapy (3.5±3.0mcg/dℓ). The results showed that an increase in the levels of serum cortisol by spa therapy was more clearly observed in patients with type la-1 asthma compared to that in type la-2 or type Ib, and that, in contrast, the serum cortisol levels in patients with type II asthma did not significantly increase by spa therapy, since their asthma attacks were always severe and chronic in spite of long-term glucocorticoid regimen.
Abstract Alternative ステロイド依存性重症難治性気管支喘息患者30名において温泉療法前後の血清コルチゾール値を,臨床病型に基づいて検討した。1.Ia-1型の症例における血清コルチゾール値は温泉療法前の2.0±0.7μg/dℓから9.0±3.lμg/dℓに有意に増加していた(p<0.001)。Ia-2型でも3.3±1.5μg/dℓから5.9±3.1g/dℓに有意に増加していた(pく0.05)。 2.Ib型では温泉療法前後で4.0±1.6μg/dℓから7.8±1.4μg/dℓに有意に増加した。一方,Ⅱ型の症例では,温泉療法前2.7±1.3μg/dℓ,温泉療法後3.5±3.0μg/dℓで有意な変化は認められなかった。以上のように,温泉療法の血清コルチゾールに対する効果は,Ia-2,Ib型に比較してIa-1型で明らかであった。一方,Ⅱ型の気管支喘息症例の血清コルチゾ-ル値は,温泉療法によって有意な変化を認めなかった。これは長期にわたる副腎皮質ホルモン投与にかかわらず,Ⅱ型の症例の喘息発作は常に慢性的で重篤であるからと考えられる。
Keywords Serum cortisol level (血清コルチゾール値) SDIA (ステロイド依存性重症難治性気管支喘息) clinical asthma type (気管支喘息臨床病型) spa therapy (温泉療法)
Publication Title 岡大三朝分院研究報告
Published Date 1995-09
Volume volume66
Start Page 8
End Page 13
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307485
JaLCDOI 10.18926/15119
Title Alternative 気管支喘息患者の気管支肺胞細胞からのヒスタミンとロイコトリエンC4遊離 ―アトピー性喘息におけるヒスタミンの役割について―
FullText URL 066_014_020.pdf
Author Mitsunobu, Fumihiro| Mifune, Takashi| Kajimoto, Kazuhiro| Hosaki, Yasuhiro| Yokota, Satoshi| Tanizaki, Yoshiro| Ochi, Koji| Harada, Hideo|
Abstract To clarify the main humoral triggering factor (histamine and/or leukotriene) of the early stage of asthma attacks, the release of histamine and leukotriene C4 (LTC4) from bronchoalveolar lavage (BAL) cells stimulated with Ca ionophore A23187 was examined in 7 patients with atopic asthma, and the results were compared to those in 7 nonatopic asthma patients. 1. The proportion of BAL basophilic cells was significantly higher in atopic patients than in nonatopic patients (p<0.05). 2. The content of histamine in BAL fluid was significantly higher in atopic (2.3mcg/mℓ) comparted to that in nonatopic patients (0mcg/mℓ)(p<0.001). The content of LTC4 was high in nonatopic (2.4ng/mℓ) than in atopic patients (0.5ng/ mℓ), however, this was not significant. 3. The release of histamine from BAL cells was 32.6% in atopic and 0% in nonatopic patients, and this was significant (p<0.001). The release of LTC4 from BAL cells was significantly higher in nonatopic (11.3ng/10(6)cell) than in atopic (3.5ng/10(6)cell)(p<0.02). The results demonstrate that histamine play more important role in atopic patients as a main triggering factor of attacks than LTC4. In contrast, in nonatopic patients, LTC4 is more predominant than histamine during early stage of asthma attacks.
Abstract Alternative 気管支喘息発作初期に関与する液性因子(ヒスタミン,ロイコトリエン)の役割を明らかにするために,気管支肺胞洗浄(BAL)細胞からのカルシウムイオノフォアA23187によるヒスタミンとロイコトリエンC4 (LTC4)遊離の検討を行った。対象はアトピー性喘息患者7名,非アトピー性喘息患者7名とした。1.BAL液中の好塩基性細胞の比率は,アトピー性喘息患者において有意に高値を示した。2.BAL液中ヒスタミン濃度は非アトピー性喘息患者(0mcg/mℓ)に比して,アトピー性喘息患者(2.3mcg/mℓ)において有意に高値を示した。一方,BAL液中LTC4濃度は,アトピー性喘息患者(0.5ng/mℓ)に比し て非アトピー性喘息患者(2.4ng/mℓ)において,高値を示したが,有意差は見られなかった。3.BAL細胞からのヒスタミン遊離は非アトピー性喘息患者(0%)に比して,アトピー性喘息患者(32.6%)において有意に高値を示した。LTC4遊離はアトピー性瑞息患者(3.5ng/10(6)胞)に比して,非アトピー性喘息患者(ll.3ng/10(6)細胞)において有意に高値を示した。以上より,喘息発作初期に関与する液性因子としては,アトピー性喘息患者においてはヒスタミンが重要であり,非アトピー性喘息患者においてはLTC4が,重要であることが,明らかになった。
Keywords Histamine LTC4 BAL cells atopic asthma
Publication Title 岡大三朝分院研究報告
Published Date 1995-09
Volume volume66
Start Page 14
End Page 20
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307251
JaLCDOI 10.18926/15160
Title Alternative A case report of mixed connective tissue disease.
FullText URL 065_096_100.pdf
Author Takata, Ichiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Matsumura, Tadashi| Yokota, Satoshi| Tanizaki, Yoshiro|
Abstract 症例は50歳女性で,1991年頃より両肘関節の疼痛とレイノー現象を自覚するようになり前医にて慢性関節リウマチ(Rheumatoid arthritis, 以下RAと略)との診断を受け加療受けるも症状の改善なく,当科を受診した。典型的な慢性関節リウマチの症状に乏しく,他の膠原病の存在を疑って検索したところ,抗RNP抗体陽性等の所見から,混合性結合組織病(mixed connective tissue disease, 以下MCTDと略)と診断した。MCTDは初診時に慢性関節リウマチと誤診される例が多く,慢性関節リウマチに非典型的な症状を伴う場合は,MCTDが鑑別診断として重要と考えられた。
Abstract Alternative A 50-year-old woman, diagnosed as rheumatoid arthritis (RA) in 1991, had been treated with Lobenzarit disodium and non steroidal anti-inflammatory drugs (NSAIDs) before administration at our hospital. Despite the treatment with these drugs, her symptoms did not improve. She was admitted to our hospital for her progressive bilateral elbow joint pain and Raynaud's phenomenon. Although abnormal values of laboratory examinations such as an increased ESR (64mm/1hr), increased level of serum IgG (2854mg/㎗) and a positive RA test were shown, the clinical features of classical RA were not clear. There, she was diagnosed as mixed connective tissue disease (MCTD), because of high level of anti-RNP antibody in serum, Raynaud's phenomenom, multiple arthritis and constrictive ventilatory disturbance. Her symptoms and the results of labolatory examinations were clearly improved by glucocorticoid therapy.
Keywords 混合性結合組織病 (MCTD) 慢性関節リウマチ (Rheumatoid arthritis) 抗RNP抗体 (Anti-RNP antibody)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 96
End Page 100
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307772
JaLCDOI 10.18926/15161
Title Alternative Clinical studies on polypoid lesions of the colon.
FullText URL 065_101_106.pdf
Author Takata, Ichiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Matsumura, Tadashi| Yokota, Satoshi| Tanizaki, Yoshiro| Ochi, Koji| Harada, Hideo| Akiyama, Tsuneo| Nakai, Mutsuo|
Abstract 1990年4月より1994年3月末までの間に岡山大学医学部附属病院三朝分院で経験した早期大腸癌を含む大腸ポリープ88例を対象に,病理組織診断,性別,年齢構成,存在部位,精査動機について検討を行い,以下の成績を得た。(1)ポリープの69.2%は腺腫,13.2%は腺癌(早期癌)であった。(2)男女とも加齢による大腸ポリープ及び大腸癌の頻度の増加がみられた。(3)50歳未満の若年者では右側結腸にポリープが発見されることは稀であったが50歳以上では6.5%に認められ,高齢者における積極的なtotal colonoscopyによる観葉が重要であることが再確認された。(4)精査動機では便潜血陽性が最多を占め,便潜血は大腸ポリープのスクリーニングにおいて有用であることが示された。またフォローアップ目的に大腸ファイバーを施行しポリープや早期癌を発見した例も多く,フォローアップの必要性が示唆された。
Abstract Alternative Polypoid lesions, taken by a colon fiberscope, were examined in 88 patients with polyp, who were admitted to Misasa Medical Branch, Okayama University Medical School for last 4 years. (1) Pathohistological examination of the polypoid lesions resulted in 69.2% of adenoma and 13.2% of adenocarcinoma (early cancer) ; (2) 35.5% of the polypoid lesions was detected in the sigmoid colon, 32.7% in the rectum, 16.8% in the transverse colon, 4.7% in the descending colon, 3.7% in the caecum, 1.9% in the ascending colon ; (3) The number of patients with polypoid lesion or colon cancer was increased with aging ; (4) Patients with the age under 50 years did not have polypoid lesion in the right hemicolon, while 6.5% of elder patients over age 50 has polypoid lesions in the right hemicolon ; (5) Occult blood in stool was the most popular motivation for receiving colonoscopic examinations ; (6) The second popular motivation for colonoscopy was for follow up after previous examinations. These results suggest that patients with age over 50 should be examined more carefully by total colonoscopy, and a hemoccult test in stool is an effective method for screening colonic polypoid lesions and after detection of polypoid lesions or polypectomy, reexamination by total colonoscopy is important at regular intervals.
Keywords 大腸ポリープ (Polyp of the colon) 大腸早期癌 (Early cancer of the colon) 便潜血 (Occult blood in stool)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 101
End Page 106
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307396
JaLCDOI 10.18926/15162
Title Alternative Clinical opplication of a newly developed radiographic system including a fluoroscope equiped with CCD and digital image processor
FullText URL 065_107_114.pdf
Author Akiyama, Tsuneo| Nakai, Mutsuo| Kajimoto, Kazuhiro| Mitsunobu, Fumihiro| Mifune, Takashi| Tanizaki, Yoshiro| Ochi, Koji| Riaz, Chowdhury| Satou, Masataka| Ukon, Hiroe|
Abstract 画像の入力部に世界初100万画素の多画素・高精細のCCD(電荷結合素子)を用いたテレビカメラを搭載したX線テレビ装置とDigital・Radiography装置を導入し,主に消化管検査を中心に多目的に任用した。このシステムは従来のscreen/filmシステムの持つ膨大な情報量を確保しながらCCDカメラのメリットを最大限に生かしており,DRシステムの特長であるリアルタイムのCRT撮影画像表示,透視像のFREEZE確認,動態解析,画像処理等を導入することにより診断能の向上がはかれた。更に,従来X線フィルム・撮像管に比較して被曝量の大幅な低減が期待できた。また,デジタルであるため撮影像をHDに保管すると共にMODにも記録・再生が可能である。今後,PACSやフイルムレス電子媒体保管への展開の可能性についても確認できた。
Abstract Alternative We have clinically applied a newly developed radiographic system which was introduced into our institute in April 1994. This system consists of a fluoroscope, CCD (charge-coupled device) which had a million matrix, and digital image processor. This system has following advantages comparison with a conventional radiographic system ; (1) doses of x-ray exposuce during examination is less, (2) a sharp fluoroscopic image can be obtained by real-time image processing, (3) radiographic images can be kept in the recording device such as hard disc (HD) and magnetic optical disc (MOD) since this has a digital radiographic system. By connecting this system with main online system, it is expected to be able to see the various diagnostic images simulataneously as well as laboratory data at different spots of the hospital which is now available in other hospltal.
Keywords 増感紙/フイルム (Screen/Film) 光電子増倍管 (Image・Intensifier (l・I)) デジタル・イメージング (Digital・Imaging) 電荷結合素子 (CCD) 光磁気ディスク (MOD) デジタルラジオグラフィ (Digital Radiography)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 107
End Page 114
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307511
JaLCDOI 10.18926/15163
Title Alternative Relationship between vertebral transformation (or fracture) and bone mineral density in lumbar vertebrae.
FullText URL 065_115_118.pdf
Author Nakai, Mutsuo| Akiyama, Tsuneo| Kajimoto, Kazuhiro| Mitsunobu, Fumihiro| Mifune, Takashi| Tanizaki, Yoshiro|
Abstract QCTによる腰椎海綿骨骨塩量と,圧迫骨折を含む,椎体(第11胸椎~第4腰椎)の変形率の関係を検討した。椎体変形率と腰椎QCT値の間の強い相関関係が確認され,椎体変形者全体の50%はQCT値70mg/cm(3)以下に分布し,90%は125mg/cm(3)以下に分布した。さらに,この70mg/cm(3)付近での椎体変形者の割合は50%であり,125mg/cm(3)付近での椎体変形の割合は10%であった。QCTによる腰椎海綿骨骨塩量測定値は,腰椎の変形および骨折の危険性を予 測する良好な指標であることが確認できた。
Abstract Alternative In 360 females, Bone mineral density (BMD) in lumbar vertebrae (L2-L4) was assessed by quantitative computed tomography (QCT), and the values obtained were compared with the frequency of vertebral transformation or fracture as assessed by lateral scan image (scanogram) by X-ray CT. A correlation was observed between the frequency of vertebral transformation (or fracture) and lumbar BMD values : BMD under 125mg/cm(3) was observed over 90% of women with vertebral transformation, and BMD under 70mg/cm(3) was found about 50% of them. These results suggest that decrease in BMD in lumbar vertebrae leads to vertebral transformation or fracture. Thus, measurement of BMD by QCT would be very useful in predicting vertebral transformation or fractures.
Keywords 骨粗鬆症 (osteoporosis) 骨塩量 (bone mineral density) QCT (quantitative computed tomography) 腰椎 (lumbar vertebrae)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 115
End Page 118
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307136
JaLCDOI 10.18926/15518
Title Alternative Clinical significance of spa therapy in patients with steroid-dependent intractable asthma
FullText URL 065_119_127.pdf
Author Tanizaki, Yoshiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Yokota, Satoshi| Takata, Ichiro|
Abstract 気管支喘息のなかでも,副腎皮質ホルモン依存性の喘息は,もっとも重症難治性であり,薬物療法のみでコントロールすることは極めて困難である。著者らの現在までの成績では,このようなステロイド依存性重症難治性喘息に対して,温泉療法は有効であった。このことは,喘息の治療,とりわけ重症難治例の治療には温泉療法が必要不可欠であることを示している。今回は,その臨床的有用性および機序について,若干の考察を加えた。1.臨床病型では,Ib型やII型に重症難治症例が多く,温泉療法はこれらの病型に対して有効であった。2.年齢別検討では,発症年齢では30才以上,また現年齢では40才以上の症例に対して温泉療法は有効であった。3.温泉療法による換気機能の改善では,小ないし細気管支領域の閉塞の改善がより高度であった。4.温泉療法により,気道過敏性が低下することが観察された。5.温泉療法により,高度に低下した副腎皮質機能の改善が見られた。5.ヨードゾル吸入,鉱泥湿布療法,温泉プール水泳ないし歩行訓練などが,喘息の治療に適した温泉療法と判断された。
Abstract Alternative It is very difficult or sometimes impossible for phisicians to control steroid-dependent intractable asthma (SDIA) without glucocorticoids because of the severity of asthma and low responsiveness to usual antiasthma drugs. Our previous studies have shown that spa therapy improves the symptoms and signs of patients with SDIA, suggesting that spa therapy is highly required for the treatment of SDIA. In this article, the effects and action mechanisms of spa therapy on SDIA were summarized according to the results previously described. 1. Spa therapy is more effective in patients with hypersecretion (type Ib) and bronchiolar obstruction (type II) than in those with simple bronchoconstriction (type Ia). 2. Spa therapy is more effective in patients with the age at onset over 30, and in those with the age over 40 years. 3. Obstructive dysfunction in small airways is more improved compared to that in medium or large airways by spa therapy for asthma patients. 4. Bronchial hyperresponsiveness of asthma patients is suppressed by spa therapy. 5. Markedly suppressed function of adrenocortical glands is improved by spa therapy. 6. Complex spa therapy including swimming training in a hot spring pool, inhalation of iodine salt solution and fango therapy is effective and clinically useful for the treatment of asthma patients.
Keywords 重症難治性喘息 (intractable asthma) 換気機能 (ventilatory function) ヨードゾル吸入 (inhalation of iodine salt solution) 鉱泥湿布療法 (fango therapy) 温泉プール水泳訓練 (swimming training in a hot spring pool)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 119
End Page 127
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307310
JaLCDOI 10.18926/15147
Title Alternative 気管支喘息における複合温泉療法と気道炎症反応
FullText URL 065_001_008.pdf
Author Tanizaki, Yoshiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Yokota, Satoshi| Takata, Ichiro| Ochi, Koji| Harada, Hideo| Tada, Shinya| Harada, Mine|
Abstract Efficacy of complex spa therapy was studied in 55 patients with bronchial asthma. Complex spa therapy was effective in 47 (85.5%) of the 55 patients with bronchial asthma : marked efficacy was observed in 15 (27.3%), moderate in 32 (58.2%), slight in 6 (10.9%) and no efficacy in 2 patients (3.6%). Improvement of clinical symptoms and findings by complex spa therapy was more clearly observed in patients with an increased proportion of BAL lymphocytes, neutrophils and eosinophils. These findings suggest that complex spa therapy more affects cell infiltration in the airways than bronchoconstriction induced by chemical mediators. Improvement of ventilatory function represented by FEV1.0% value was higher in patients with a low proportion of BAL neutrophils, suggesting that patients with increased number of BAL neutrophils require longer complex spa therapy than those without BAL neutrophilia.
Abstract Alternative 気管支喘息55例を対象に,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)を試み,その臨床効果と気道炎症反応との関連について,若干の検討を加えた。1.複合温泉療法の臨床効果では,著効15例(27.3%),有効32例(58.2%),やや有効6例,無効2例であり,明らかに有効と判断された症 例は,55例中47例(85.5%)であった。2.複合温泉療法は,気管支肺胞洗浄液(BALF)中の細胞成分(リンパ球,好中球,好酸球など)が多い症例,すなわち気道炎症反応がより強い症例により有効であった。このことは,複合温泉療法が,単純性の(化学伝達物質による)気管支攣縮よりも,気道炎症反応をともなった病態により強く影響を及ぼすことを示している。3.複合温泉療法による換気機能の改善(1秒量)は,BAL液中の好中球数が少ない症例においてより高度であった。このことは,BAL液中に高度な好中球増多が見られる症例に対しては,より長期的な複合温泉療法が必要であることを示しているものと考えられた。
Keywords complex spa therapy (複合温泉療法) airway inflammation (気道炎症反応) bronchial asthma (気管支喘息)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 1
End Page 8
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307726
JaLCDOI 10.18926/15148
Title Alternative 気管支喘息における末梢血白血球および気管支肺胞洗浄液中の細胞からのヒスタミンおよびロイコトリエンC(4),B(4)遊離と気道過敏性
FullText URL 065_009_016.pdf
Author Tanizaki, Yoshiro| Kitani, Hikaru| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Yokota, Satoshi| Takata, Ichiro| Ochi, Koji| Harada, Hideo| Tada, Shinya| Harada, Mine|
Abstract The proportions of cells in bronchoalveolar lavage (BAL) fluid, the release of histamine, leukotrienes C(4) and B(4) from leucocytes and BAL cells, and bronchial reactivity to methacholine were examined in 40 patients with asthma in relation to patient age. 1. The proportions of lymphocytes and neutrophils in BAL fluid were higher in older patients over age 60 than in younger patients between 20 and 49. The proportions of eosinophils and basophilic cells in BAL fluid were higher in younger patients than in older patients, and the difference in the proportion of BAL basophilic cells was significant between the two groups (p<0.05). 2. The release of histamine from BAL cells was significantly higher in younger patients than in older patients (p<0.001). The release of LTC(4) from BAL cells was higher in older patients compared to younger patients. 3. Bronchial reactivity to methacholine was higher in younger patients than in older patients. The number of patients reactive to low concentration of methacholine (390μg/mℓ or less) was larger in younger patients (12/16 ; 75.0%) than in older patients (5/14 ; 35.7%). These results suggest that bronchial hyperresponsiveness changes with aging, accompanied by changes in the release of chemical mediators from BAL cells and in the proportion of BAL cells.
Abstract Alternative 気管支喘息を対象に,気管支肺胞洗浄(BAL)液中の細胞の出現頻度,末梢血白血球およびBAL細胞からのヒスタミン,ロイコトリエンC(4),B(4)遊離,気道過敏性などについて,患者年齢との関連のもとに検討を加えた。1.BAL液中のリンパ球および好中球頻度は,60才以上の老齢症例で,20-49才の若青年症例に比べやや高い傾向が見られたが,推計学的には有意の差は見られなかった。BAL液中の好酸球,好塩基細胞の頻度は,若青年症例で,老年症例に比べて高く,特に好塩基性細胞の頻度には両症例群間に有意の差が見られ(P<0.05)。 2.BAL細胞からのヒスタミン遊離は,若青年症例で,老年症例に比べ有意に多い傾向が見られた(P<0.001)。一方,BAL細胞からのロイコトリエンC(4)遊離は,若青年症例に比べ,老年症例で多い傾向が見られたが,両症例群間に有意の差は見られなかった。3.メサコリンに対する気道の反応性は,全般的に若青年症例で,老年症例に比べより強い傾向を示した。そして,390μg/mℓまたはそれ以下の低濃度のメサコリンに反応を示す症例は,若青年症例では16例中12例(75.0%),老年症例では14例中5例(35.7%)であった。以上の結果より,気道過敏性は,BAL細胞からの化学伝達物質遊離の変化やBAL細胞の頻度の変化とともに,加齢の影響を受けることが明らかとなった。
Keywords BAL cells (BAL細胞) histamine (ヒスタミン) leukotrienes (ロイコトリエン) bronchial hyperresponsiveness (気道過敏性) asthma (気管支喘息)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 9
End Page 16
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307646
JaLCDOI 10.18926/15149
Title Alternative A case report of severe allergic reactionsinduced by black fly bites
FullText URL 065_017_021.pdf
Author Kitani, Hikaru| Takata, Ichiro| Yokota, Satoshi| Kajimoto, Kazuhiro| Mitsunobu, Fumihiro| Mifune, Takashi| Tanizaki, Yoshiro|
Abstract 多数のブユに刺されたのを契機に重症反応を呈するようになった29歳男性例について,アレルギー学的検討を行った。血清IgE値が高値(4591U/ml)であったが,免疫グロブリン,抗核抗体,血清補体価,CD4,CD8陽性リンパ球出現頻度などいずれも正常であり,またハウスダスト,カンジダその他16種類の吸入性抗原,ミツバチ,スズメバチ,アシナガバチ,ゴキブリ,ヤブカ,ユスリカなどの昆虫抗原に対する特異的IgE抗体はいずれも陰性であった。一方ニッポンヤマブユ抗原による好塩基球からのヒスタミン遊離は陰性であったが,皮膚反応,IgE抗体は陽性を示したことから,本症例における重症化因子としてIgE系反応の関与が示唆された。なおEBウイルス抗体価の検討では,EBV-EADR抗体はすべて陰性,EBNA-EIA抗体はIgG抗体のみ陽性であり,EBウイルスの既感染状態と判断されたが,病因との関連は明らかではなかった。
Abstract Alternative Allergic examinations were studied on the 29 years old male case, who suffered from severe systemic reactions by black fly bites, after the episode of much black fly bites in 1987. The level of serum IgE was high in the case, and both skin reaction and specitic IgE antibodies to whole body extract of black fly (Simulium nacojapi) were positive. The results obtained here suggest that IgE-mediated allergic reaction would play an important role in the severe systemic reactions induced by black fly bites.
Keywords 昆虫アレルギー (lnsect allergy) ブユ (Black fly) IgE系反応 (lgE-mediated reaction)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 17
End Page 21
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307240
JaLCDOI 10.18926/15152
Title Alternative ステロイド依存性重症難治性喘息における気道反応の特徴
FullText URL 065_040_047.pdf
Author Mifune, Takashi| Kitani, Hikaru| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Yokota, Satoshi| Takata, Ichiro| Tanizaki, Yoshiro| Ochi, Koji| Harada, Hideo| Tada, Shinya| Harada, Mine|
Abstract Characteristics of airway response in steroid-dependent intractable asthma (SDIA) were examined in 86 asthma patients (43 with SDIA and 43 with non-SDIA) divided into three age groups: 20-39, 40-59 and 60+ years, by observing cellular composition of bronchoalveolar lavage (BAL) fluid and ventilatory function. 1. The level of serum cortisol was significantly lower in patients with SDIA than in those with non-SDIA in all age groups. 2. The proportion of lymphocytes in BAL fluid was significantly decreased in patients with SDIA compared to results in non-SDIA patients in the age between 40-59, and over 60+ years, While BAL neutrophils were significantly increased in SDIA patients compared to results in non-SDIA patients in the age group over 60 years. 3. Of ventilatory parameters, the values of % FVC, FEV(1.0%), % MMF and % V(25) were significantly lower in SDIA patients over the age of 60 compared with non-SDIA subjects of the same age group. These results show that in SDIA patients the proportion of BAL lymphocytes decreases and the proportion of BAL neutrophils increases with aging, and that ventilatory function in SDIA patients also decreases with aging compared to non-SDIA patients.
Abstract Alternative 年齢により3群(20-39才,40-59才,60才以上)に分類された気管支喘息86例(ステロイド依存性重症難治性喘息:SDIA;43例,非SDIA;43例)を対象に,気管支肺胞洗浄液(BALF)中の細胞成分および換気機能よりSDIAにおける気 道反応の特徴を検討した。1.血清コーチゾ-ル値は,SDIA症例において, 非SDIA症例に比べいずれの年齢層においても有意の低値を示した。2.BALF中リンパ球頻度は,40-59才および60才以上のSDIA症例において,同年齢の非SDIA症例に比べ有意の低値を示した。一方,BALF中好中球頻度は,60才以上のSDIA症例で,同年齢層の非SDIA症例に比べ有意に高い値を示 した。また,BALF中好酸球頻度は,いずれの年齢層においても,SDIAと非SDIA症例の間に有意の差は見られなかった。3.換気機能では,% FVC, FEV1.0%,% MMF, % V(25)などの換気パラメーターは,60才以上の SDIA症例において,同年齢層の非SDIA症例に比べて有意の低値を示した。 これらの結果は,40-59才あるいは60才以上のSDIA症例では,非SDIA症例に比べ,BALF中リンパ球頻度の低下,好中球頻度の増加,換気パラメーター値の低下などがより高度に見られることを示している。
Keywords bronchial asthma (気管支喘息) bronchoalveolar cells (気管支肺胞洗浄液中の細胞) ventilatory function (換気機能) glucocorticoids (グルココーチコイド) serum cortiosol levels (血清コーチゾール値)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 40
End Page 47
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307402
JaLCDOI 10.18926/15153
Title Alternative Clinical feature of bronchial asthma in relation to patient age
FullText URL 065_048_054.pdf
Author Mifune, Takashi| Takata, Ichiro| Yokota, Satoshi| Kajimoto, Kazuhiro| Mitsunobu, Fumihiro| Kitani, Hikaru| Tanizaki, Yoshiro|
Abstract 高齢気管支喘息症例の病態を解明するために30才以降の気管支喘息症例について年齢層別に臨床的特徴を検討した。1)60才以上の高齢気管支喘息症例は全体の41.1%を占めており,年齢層別では50-59才,60-69才の症例が多く認められた。2)ほとんどの症例が成人発症喘息であり,高齢気管支喘息では92.3%が中高年発症型気管支喘息であった。3)加齢に伴って細気管支閉塞型気管支喘息の増加か認められた。4)血清IgE値は50-59才で再増加し,histamine release,LTC(4)産生は40149才で高値であった。5)40-69才の年齢層でステロイド依存性難治性喘息が多く認められた。以上高齢気管支喘息症例は中高年発症型喘息の病態の特徴を有しており,中高年発症型気管支喘息の病態の解明が必要と考えられた。
Abstract Alternative To examine clinical characteristics of asthma in elderly (over 60 years), age at onset, clinical asthma types, glucocorticoid therapy, serum IgE levels and release of chemical mediators (histamine and leukotriene C(4)) were examined in 145 asthmatics over 30 years and divided into five age groups ; 30-39, 40-49, 50-59, 60-69, 70-79 years. 1. The freqeuncy of asthmatics was 13.7% in age group between 30 and 39, 14.4% between 40 and 49, 30.8% between 50 and 59, 28.8% between 60 and 69, 12.3% between 70 and 79 years, respectively. The frequency of elder asthmatics (over age 60) was 41.1%. 2. The frequency of adult onset asthma (over 20 years) was 90.3% of all subjects, and the frequency of late onset asthma (over 40 years) was 92.3% of elderly subjects over age 60. 3. Numbers of asthmatics with bronchiolar obstruction type show a tendency to increase with aging. 4. Serum IgE level was increased in subjects aged 50-59 years. Histamine release (%) and release of leukotriene C(4) from peripheral leukocytes were higher in age group between 40 and 49 compared to those in the other age groups. 5. Number of patients with steroid-dependent intractable asthma was increased in age group between 40 and 69. These results suggest that elderly asthmatics show the characteristics of late onset asthma, and further examinations of late onset asthma is important to clarify the pathogenesis of asthma in elderly.
Keywords 高齢気管支喘息 (bronchial asthma in elderly) 中高年発症型喘息 (late onset asthma) 臨床病態 (clinical types of asthma) ステロイド依存性重症難治性喘息 (steroid dependent intractable asthma) ケミカルメディエーター (chemical mediator)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 48
End Page 54
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307608