Author Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Iwagaki, Naofumi| Nagata, Takuya| Fujii, Makoto| Takata, Shingo| Yokoi, Tadashi| Hamada, Masanori| Tanizaki, Yoshiro|
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
JaLCDOI 10.18926/14999
Title Alternative 肺活量(FVC)低値を示す気管支喘息の臨床的特徴
FullText URL 067_008_013.pdf
Author Mitsunobu, Fumihiro| Mifune, Takashi| Hosaki, Yasuhiro| Ashida, Kozo| Yokota, Satoshi| Tsugeno, Hirofumi| Takeuchi, Kazuaki| Nawa, Yuichiro| Tanizaki, Yoshiro| Ochi, Koji| Harada, Hideo|
Abstract Clinical features of asthma patients with a low % FVC (<75%) were studied in relation to clinical asthma type and disease severity. 1. The value of % FVC was not related to patient age. 2. A significant association between % FVC value and clinical asthma type was found. The value of % FVC was significantly lower in subjects with type Ⅱ asthma (bronchiolar obstruction) than in those with type Ia-1 and type Ia-2 (simple bronchoconstriction) (p<0.001). 3. % FVC value significantly correlated with disease severity. The value in the subjects tended to decrease as their asthma conditions were more severe. 4. The % FVC value in the subjects was improved after treatment (complex spa therapy). These results demonstrate that a significant correlation is present between low % FVC and disease severity in asthma patients with a low % FVC.
Abstract Alternative % 肺活量が75%以下の低値を示す気管支喘息について,その臨床的特徴を,臨床病型や重症度との関連のもとに検討した。1.% 肺活量と年齢との間には関連は見られなかった。2.% 肺活量と臨床病型との問には有意の関連が見られ,Ⅱ型喘息(細気管支閉塞型)における% 肺活量は,Ia-1型やIa-2型などの単純性気管支攣縮型に比べ,有意に低い値を示した。3.% 肺活量はまた喘息の重症度と有意の関連を示した。これらの症例では,喘息の重症度が増すにつれて,% 肺活量は減少する傾向が見られた。4.これら症例の低値を示す% 肺活量は,治療(複合温泉療法)により改善される傾向が見られた。以上の結果より,これらの症例(% 肺活量が75%以下)では,% 肺活量と喘息の重症度との間にある程度の関連があることが明らかになった。
Keywords % FVC低値 (Low % FVC) 気管支喘息 (Bronchial asthma) 臨床病型 (Clinical asthma type) 重症度 (asthma severity) 温泉療法 (Spa therapy)
Publication Title 岡大三朝分院研究報告
Published Date 1996-11
Volume volume67
Start Page 8
End Page 13
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308511
JaLCDOI 10.18926/14998
Title Alternative BAL液中好中球増加をともなわないⅡ型喘息について
FullText URL 067_001_007.pdf
Author Tanizaki, Yoshiro| Mifune, Takashi| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Yokota, Satoshi| Tsugeno, Hirofumi| Takeuchi, Kazuaki| Tsuji, Takao|
Abstract Clinical features of asthma patients with bronchiolar obstruction (type Ⅱ asthma) were studied in relation to the proportion of neutrophils in bronchoalveolar lavage (BAL) fluid. Of 13 subjects studied, 7 were accompanied with BAL neutrophilia (53.5%) (BALn(+)) and 6 were without BAL neutrophilia (3.5%) (BALn(-)). 1. The mean age was higher in BALn(-) (66.0 years) than in BALn(+) patients (55.0 years). 2. Bronchial reactivity to methacholine was slightly higher in BALn(-) patients than in those with BALn(+). 3. The value of FEV1.0% was significantly lower in BALn(+) patints than in those with BALn(-) (p<0.01). 4. The proportion of BAL lymphocytes was signicantly more decreased in BALn(+) patients compared to the proportion in those with BALn(-) (p<0.001). 5. the values of serum IgG, IgA, and IgM were not significantly different between BALn(+) and BALn(-) patients, however, the value of IgG was more decreased in BALn(+) patients than in those with BALn(-). These results suggest that two kinds of type Ⅱ asthma ; one is with BAL neutrophilia related to suppressed immunity, and another is without BAL neutrophilia in part due to aging.
Abstract Alternative 細気管支閉塞型(Ⅱ型)喘息の臨床的特徴が,BAL液中の好中球頻度との関連のもとに検討された。対象13例のうち,7例がBAL液中好中球増加(平均好中球頻度;53.5%)をともなう症例(BALn(+))で,残りの6例はBAL液中好中球増加 をともなわない(3.5%)症例(BALn(-))であった。1.平均年齢は,BALn(+)症例(55.0才)に比べ,BALn(-)症例(66.0才)でより高い傾向が見られた。2.メサコリンに対する気道過敏性は,BALn(+)症例に比べBALn(-)症例でやや高い傾向が見られたが,両者間に有意の差は見られなかった。3.FEV1.0%値は,BALn(-)症例に比べBALn(+)症例で有意に低い値を示した(P<0.05)。4.BAL液中リンパ球頻度はBALn(+)症例でBALn(-)症例に比べ有意に低い値を示した(P<0.001)。5.血清IgG,IgAおよびIgM値には両者間に有意の差は見られなかったが,IgG値はBALn(+)症例でより低い傾向が見られた。これらの結果より,Ⅱ型喘息にはBAL液中好中球増加を示す症例と示さない症例の2種類があること,そして前者は免疫能の低下と,そして後者は加齢とある程度の関連があることが示唆された。
Keywords 気管支喘息 (Bronchial asthma) 細気管支閉塞 (Bronchiolar obstruction) BAL好中球 (BAL neutrophilia) 免疫能低下 (Suppressed immunity) 加齢 (Aging)
Publication Title 岡大三朝分院研究報告
Published Date 1996-11
Volume volume67
Start Page 1
End Page 7
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308171
Author Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Hamada, Masanori| Iwagaki, Naofumi| Fujii, Makoto| Takata, Shingo| Tanizaki, Yoshiro|
Published Date 2004-12-01
Publication Title 岡大三朝医療センター研究報告
Volume volume75
Content Type Departmental Bulletin Paper
JaLCDOI 10.18926/14979
Title Alternative 気管支喘息症例における臨床的特徴と鼻腔・副鼻腔のCT所見の関連について
FullText URL 068_034_040.pdf
Author Mifune, Takashi| Yamamoto, Kazuhiko| Iwagaki, Naofumi| Okamoto, Makoto| Tsugeno, Hirofumi| Ashida, Kozo| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Tanizaki, Yoshiro| Tada, Shinya| Harada, Mine|
Abstract Extent of nasal and maxillary mucosa lesion was estimated in 26 asthmatics using computed tomographic scan in relation to clinical features of the disease. 1. No significant differences were present in nasal mucosal thickening between atopic and non-atopic subjects. No significant differences were also present in occupancy rate of mucosa in maxillary sinuses between the two asthma types. 2. Nasal mucosal thickening was not significant different between subjects with steroid-dependent intractable asthma (SDIA) and those without SDIA. Maxillary mucosal lesions were more extensive in subjects with SDIA than in those without SOIA. However, no significant differences were observed in occupancy rate between the two types. 3. No significant differences were observed in nasal mucosal thickenings between in subjects with and without aspirin-induced asthma (AlA). Although maxillary mucosa lesion in subjects with AlA was more extensive than that in those without AlA, the differences was not significant. 4. There was not any correlation between nasal mucosal thickening and amount of expectoration per day. However, significant differences were observed in maxillary sinus lesion between subjects with less amount (<50mℓ/day) and those with large amount of expectoration (100mℓ/day≦)(p<0.002), and between subjects with moderate amount (50-99mℓ/ day) and those with large amount of expectoration (p<0.002). The results might suggest that in asthmatics with large amount of expectoration, sinus diseases affect pathophysiology of asthma, and asthmatics with large amount of expectoration should have therapy for sinus disease to improve asthmatic status.
Abstract Alternative 気管支喘息26症例において喘息の臨床的特徴と,鼻腔・上顎洞のCT所見の関連について検討を加えた。1.鼻腔粘膜肥厚はアトピー症例,非アトピー症例間で有意な差は認められなかった。上顎洞における粘膜肥厚比率(1slice上の上顎洞面積に対し,上顎洞粘膜が占める割合)も,アトピー・非アトピーで差は認められなかった。2.ステロイド依存群・非依存群においても,鼻腔粘膜肥厚・上顎洞粘膜肥厚に有意な差は認められなかった。3.アスピリン喘息症例においては,非アスピリン喘息症例に比べ,上顎洞粘膜肥厚が顕著であっ たが有意ではなかった。鼻腔粘膜肥厚は2群間で差は認められなかった。4.発作時の一日喀痰量との関連では一日喀痰量が100mℓ以上の症例群では,喀痰量が50mℓ以下の群・50-100mℓの群に比較して有意に上顎洞粘膜肥厚比率が高値を示した。鼻腔粘膜比率に関しては3群間で有意な差を認めなかった。以上の結果から,喀痰量の多い気管支喘息症例では,その病態に副鼻腔病変が影響を及ぼしている可能性が考えられ,副鼻腔病変に対する治療により,気管支喘息が改善する可能性が考えられた。
Keywords bronchial asthma sinusitis nasal disease CT scan expectoration
Publication Title 岡大三朝分院研究報告
Published Date 1997-12
Volume volume68
Start Page 34
End Page 40
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308538
JaLCDOI 10.18926/14955
Title Alternative 気管支喘息患者における努力肺活量(% FVC)の低下と気道炎症ならびに臨床病型との関連
FullText URL 069_028_034.pdf
Author Mitsunobu, Fumihiro| Mifune, Takashi| Hosaki, Yasuhiro| Ashida, Kozo| Yokota, Satoshi| Tsugeno, Hirofumi| Tanizaki, Yoshiro| Ochi, Koji| Harada, Hideo|
Abstract Clinical features of asthmatics with a low % FVC (<80%) were studied in relation to airway inflammation and clinical asthma types. 1. Twenty four (75.0%) of the 32 subjects with a low % FVC had steroid-dependent intractable asthma. 2. A significant association between % FVC value and clinical asthma type was found. The value of % FVC was significantly lower in subjects with type II asthma (bronchiolar obstruction), in which significantly decreased proportion of lymphocytes,and significantly increased proportion of neutrophils in bronchoalveolar lavage (BAL) fluid were observed, than in those with type la-1 (simple bronchoconstriction) with (P<0.001) and without glucocorticoid therapy (P<0.02). 3. The % FVC value was significantly improved after treatment in type lb (hypersecretion) with BAL eosinophilia, but not in those with type II with BAL neutrophilia. These results demonstrate that marked decrease of % FVC in patients with asthma correlated with airway inflammation, and that airway reversibility by medication is very low in patients with type II asthma.
Abstract Alternative 努力肺活量(% FVC)低値を示す気管支喘息の臨床病態を明らかにするために気道炎症ならびに臨床病型との関連について検討を行った。% FVCが80%未満の気管支喘息患者32名を対象として,スパイロメトリー,気管支肺胞洗浄(BAL)を施行し,臨床病態を解析し,治療効果の評価を行なった。1.対象中24名(75%)の患者がステロイド依存性重症難治性喘息であった。2.細気管支閉塞型喘息患者において,% FVC値の有意の低下が認められ,BAL液中のリンパ球の減少と好中球の増加が認められた。3.FVC値,FEV1.0億の治療による改善は,BAL液中好酸球の増加を示す過分泌型喘息においては認められが,BAL液中好中球の増加を示す細気管支閉塞型喘息においては認められなかった。 以上より喘息患者における% FVC値の低下は気道炎症と関連しており,細気管支閉塞型喘息における治療による可逆性は著しく低下していることが示唆された。
Keywords ventilatory function FEV1.0 bronchoalveolar lavage bronchial reversibility
Publication Title 岡大三朝分院研究報告
Published Date 1998-12
Volume volume69
Start Page 28
End Page 34
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308252
JaLCDOI 10.18926/14907
Title Alternative 気管支喘息症例における末梢血白血球のロイコトリエンC4産生能とロイコトリエン受容体括抗薬プランルカストの効果に関する検討
FullText URL 071_036_041.pdf
Author Mifune, Takashi| Takada, Shingo| Okamoto, Makoto| Tsugeno, Hirofumi| Ashida, Kozo| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Tanizaki, Yoshiro| Harada, Mine|
Abstract The correlation between the efficacy of 4-weeks administration with pranlukast, leukotriene receptor antagonist, and LTs generation by peripheral leukocytes were evaluated in 18 patients with mild-persistent asthma. The efficacy of pranlukast administration was assessed by symptom, morning PEF and pulmonary function. Pranlukast were effective in 12/18(67%) patients. In those patients, LTC4 generation before pranlukast administration was significantly high, compared with that in pranlukast-ineffective patients. LTC4 generation decreased after 4-weeks administration with pranlukast in effective patients. In ineffective patients, however, LTC4 generation increased after 4-weeks administration. LTB4 had shown no significant difference between effective and ineffective patients before administration, and LTB4 decreased after 4-weeks in both groups. Proport ion of peripheral eosinophi Is in effective patients were higher than that in ineffective patients, however not significant. After 4-weeks, proportion of eosinophi Is was decreased in effective patients and increased in ineffective patients. These findings suggest that pranlukast is effective for patients with high LTC4 generation and has the effect to suppress the accumulation of eosinophils in such patients.
Abstract Alternative 軽症気管支喘息18例にロイコトリエン受容体桔抗薬プランルカストを4週間投与し,その効果と末梢血白血球からのLTC4,LTB4産生能の関係を検討した.プランルカストの効果は臨床症状,起床時ピークフロー値,肺機能の変化によって判定し,効果群,非効果群の2群に分類した.18例中12例(67%)の症例がプランルカスト投与により,臨床症状の軽減,ピークフロー値の増加,肺機能の改善が認められた.効果群におけるプランルカスト投与前のLTC4値は,非効果群のLTC4値に比較して有意に高値であった.4週間の投与後には 効果群ではLTC4値は減少し,非効果群では増加した.両群のLTB4値はプランルカスト投与前で有意な差は認められず,投与後には両群で減少した.投与前の好酸球分画は,効果群において非効果群に比べ高値であったが,有意な差は認められなかった.4週間の投与後,効果群においては好酸球は減少し,非効果群においては増加した.以上の結果より,プランルカストは末梢血白血球のLTC4産生能が高い症例において効果的であり,好酸球集積を抑制する作用を有すると考えられる.
Keywords bronchial asthma pranlukast leukotriene receptor antagonist LTC4
Publication Title 岡大三朝分院研究報告
Published Date 2001-02-01
Volume volume71
Start Page 36
End Page 41
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308269
JaLCDOI 10.18926/14975
Title Alternative 気管支喘息におけるHRCTによるLow attenuation area(LAA)と平均CT numberとの関連
FullText URL 068_015_021.pdf
Author Mitsunobu, Fumihiro| Ashida, Kozo| Mifune, Takashi| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Okamoto, Makoto| Iwagaki, Naofumi| Yamamoto, Kazuhiko| Tanizaki, Yoshiro| Nakai, Mutsuo| Akiyama, Tsuneo| Hasegawa, Harumi|
Abstract The maximal percent low attenuation area < -950 HU (% LAA) among three anatomic lung levels on high resolution computed tomography (HRCT) was examined in patients with asthma, classified by the degree of % LAA, in relation to the mean CT number, % FVC of the predicted value, and FEV 1/FVC (FEV1%). 1 . The mean CT number was closely related to the degree of % LAA of the lungs. The mean CT number was significantly lower in patients with high % LAA (mean CT number-915.3HU, % LAA 37.6%) than in those with low % LAA (-852.9HU, 4.7%). 2. The FEV1% value was significantly lower in patients with high % LAA (47.8%) than in those with low % LAA (62.2%)(p<0.05). The % FVC value was also significantly lower in patients with high % LAA (77.1%) compared to the value in those with low % LAA (101.2%). The results suggest that a large volume of LAA<-950HU of the lungs can be observed in patients with asthma, and the % LAA is closely correlated with mean CT number and the values of FEV1% and % FVC.
Abstract Alternative HRCT (high resolution computed tomography)により,-950HU以下のlow attenuation area(LAA)を3つの高さの肺野レベルで観察し,そのなかの最も高い値をmaximal% LAAとして表し,この値と平均CT number, % FVCおよびFEV1.0%の値と比較検討した。1.平均CT numberは,maximal% LAAと密接な関連を示した。そして,平均CT numberは,% LAAが低い症例(% LAA :4.7%, mean CT number:-852.9HU)に比べ,% LAAが高い症例(% LAA :37.6%, mean CT number:-915.3HU)において低い傾向が見られた。2.FEV1.0%値は,% LAA値が低い症例(62.2%)に比べ% LAA値が高い症例(47.8%)において有意に低い値を示した(P<0.05)。% FVC値も同様% LAA値が低い症例(101.2%)に比べ高い症例(77.1%)で低い値を示したが両群間に有意の差は見られなかった。これらの結果より,気管支喘息においも,HRCT上肺野で-950HU以下のLow attenuation area(LAA)を示す症例が見られること,そして,% LAAは,mean CT number,FEV1.0%や% FVC値とある程度関連していることが示唆された。
Keywords bronchial asthma % LAA mean CT number FEV1 FVC
Publication Title 岡大三朝分院研究報告
Published Date 1997-12
Volume volume68
Start Page 15
End Page 21
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308351
JaLCDOI 10.18926/14906
Title Alternative 気管支喘息患者における肺機能とHRCT上のlow attenuation areaに対する喫煙の影響
FullText URL 071_029_035.pdf
Author Mitsunobu, Fumihiro| Mifune, Takashi| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Takada, Shingo| Yokoi, Tadashi| Tanizaki, Yoshiro|
Abstract The influence of smoking on pulmonary function and emphysematous changes of the lung (percentage of attenuation area < -950 HU (% LAA) on high resolution computed tomography (HRCT) was examined in 49 patients with bronchial asthma. 1. In patients with asthma, the % residual volume (RV) in many nonsmokers was less than 129%, in contrast, the % RV in many smokers was between 130% and 189% , which was higher than that in nonsmokers. 2. Significant correlations between % RV and 96LAA value, and between % RV and CT number were observed both in nonsmokers and smokers with asthma, in which as % RV more increased, % LAA value was larger, and CT number was lower. 3. % DLco value was lower in smoking patients with asthma, whose % RV was between 130% and 189% and larger than 190% , however, the % DLco value did not change in nonsmoking patients despite of higher valure in % RV. 4. A significant correlation was also observed between % FEV1.0 value and % RV both in smoking and nonsmoking patients with asthma; as % RV value more increased, % FEV1.0 value was lower. 5. Any correlation between % FVC value and % RV was not observed. These results suggest that smoking affects the % LAA of the lung on HRCT and % DLco in patients with asthma.
Abstract Alternative 気管支喘息49例を対象に、肺機能およびHigh resolution computed tomography(HRCT)上のLow attenuation are (LAA) <-950HUで示される肺気腫様変化に及ぼす喫煙の影響について検討した。  1.気管支喘息患者のうち、非喫煙例では% 残気量(% RV)は多くの症例(65.6% )で129% 以下であったが、一方喫煙症例では130% から189% を示す症例が最も多く見られた(60.0% )。非喫煙例および喫煙例いずれにおいても、 2.% RVと% LAA、% RVとCT number 間に有意の相関が見られた: % RVが上昇するにつれて、% LAA値は増加し、CT numberは低下する傾向が見られた。  3.喫煙例では、% RVが130-189% あるいは190% 以上の症例で、% DLco値 が明かに低値を示す症例が見られたが、非喫煙症例では% RVが高い値を示しても% DLcoの低下はみられなかった。  4.喫煙例、非喫煙例いずれにおいても、% FEV1.0倍と% RV値の問には有意の相関が見られ、% RV値が上昇するにつれて、% FEV1.0値は低下する傾向が見られた。  5.% FVCと% RVの問には相関は見られなかった。以上の結果より、喫煙は気管支喘息患者のHRCT上の% LAAおよび% DLcoに影響を与えることが示唆された。
Keywords asthma smoking % LAA of the lungs FEV1.0 DLco
Publication Title 岡大三朝分院研究報告
Published Date 2001-02-01
Volume volume71
Start Page 29
End Page 35
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308294
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
Author Tanizaki, Yoshiro| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Hamada, Masanori| Iwagaki, Naofumi| Fujii, Makoto| Takata, Shingo|
Published Date 2004-12-01
Publication Title 岡大三朝医療センター研究報告
Volume volume75
Content Type Departmental Bulletin Paper
JaLCDOI 10.18926/14986
Title Alternative 気管支喘息患者における腰椎海綿骨骨塩量と脊椎圧迫骨折の臨床的特徴
FullText URL 068_045_050.pdf
Author Tsugeno, Hirofumi| Nakai, Mutsuro| Okamoto, Makoto| Mifune, Takashi| Mitsunobu, Fumihiro| Ashida, Kozo| Hosaki, Yasuhiro| Akiyama, Tsuneo| Tsuji, Takao| Tanizaki, Yoshiro|
Abstract Clinical risk factors associated with the development of osteoporosis and vertebral fractures were evaluated in patients with asthma in relation to sex, age, and dose of glucocorticoids (GC). In 75 asthmatic patients including 44 steroid-dependent asthma, the bone mineral density (BMD) of the lumber spines was measured by quantitative computed tomography (QCT). Thirty five patients of them were followed up with radiographs over a period of 0.5 to 4 years (average: 2.6±1.3 years). The BMD was significantly lower in older (p<O.01) or female (p<0.05) patients. All the five patients developing vertebral compression fractures were female and more than 64 y.o., and received systemic glucocorticoid (GC) therapy for more than 3 years with a lot of cumulative gramdosage of GC. No significant correlation was demonstrated between the BMD and the dose of systemic GC per day, but multiple regression analysis demonstrated a significant relationship (p<O.o1) between the BMD and lifetime cumulative gramdosage of GC. Multiple regression analysis also demonstrated significant relationships (p<O.01) between the BMD and clinical factors such as age and sex. These results indicates that the bone loss and vertebral fractures of patients with asthma are influenced by the patient's age, sex, and the lifetime cumulative GC dose.
Abstract Alternative 対象は気管支喘息75症例。このうち44例はステロイド依存性難治症例であった。35症例については,0.5年から4年間(平均:2.6±1.3年間)の経時的観察もおこなわれた。これらの症例の骨塩量に影響を及ぼす因子について検討をおこなった。高齢者,女性に有意な低骨塩量を認めた。重回帰分析にて年齢,性別,経口副腎ステロイド投与総量などの項目に骨塩量と有意な関連が認められた。また,35症例中5例に脊椎圧迫骨折が発生し,いずれも骨塩量が低く,高齢者,女性,長期ステロイド内服例であった。これらのことから気管支喘息患者においては,女性,高齢者,長期ステロイド内服例に骨塩量減少や脊椎圧迫骨折のリスクが高いと考えられた。また,ステロイド続発性骨粗鬆症の発生には,ステロイドの現在の一日内服量よりもこれまでの総積算内服量が重要と考えられた。
Keywords 気管支喘息 (bronchial asthma) 骨粗鬆症 (osteoporosis) 椎体骨折 (vertebral fracture) ステロイド療法 (glucocorticoid therapy)
Publication Title 岡大三朝分院研究報告
Published Date 1997-12
Volume volume68
Start Page 45
End Page 50
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308467
JaLCDOI 10.18926/15006
Title Alternative 気管支喘息におけるエゴマ油と白血球のロイコトリエンB4,C4合成
FullText URL 067_035_042.pdf
Author Ashida, Kozo| Mifune, Takashi| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Yokota, Satoshi| Tsugeno, Hirofumi| Tanizaki, Yoshiro| Yamamoto, Junko| Tsuji, Takao|
Abstract In recent years, it has been noted that there is a close correlation between leukotrienes and late asthmatic reaction (LAR). In this study, effects of dietary supplementation with perilla seed oil rich in alpha-linolenic acid, which is speculated to affect the generation of leukotrienes through metabolism of arachidonic acid (AA), were evaluated in 6 patients with asthma. The symptoms and ventilatory function were improved after 2-week dietary supplementation with perilla seed oil. The generation of LTB4 and LTC4 by peripheral leucocytes stimulated with Ca ionophore A23187 was significantly suppressed by the dietary supplementation (LTB4 and LTC4 ; p<0.05). Regarding the composition of fatty acids in serum phospholipids, the concentrations of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and AA tended to increase after the supplementation, accompanied with an increase in the ratio of EPA to AA. These results suggest that dietary supplementation with perilla seed oil brings beneficial effects in the treatment of asthma.
Abstract Alternative 近年,ロイコトリエンと遅発型気管支反応(LAR)との密接な関連が注目されている。本論文では,アラキドン酸(AA)代謝を通してロイコトリエン合成に関与すると推定される,αリノレン酸を多く含むエゴマ油による食事療法の臨床効果を,気管支喘息を対象に検討した。臨床症状および換気機能は,2週間のエゴマ油投与で明らかな改善差傾向を示した。Ca ionophore A23187刺激時の白血球のLTB4およびLTC4産生は,エゴマ油投与により,投与前に比べ有意の減少を示した(p<0.05)。血中脂肪酸に関しては,イエイコサペンタエン酸(EPA),ドコサヘキサエン酸(DHA)およびAA濃度は,エゴマ油投与により増加傾向を示し,同時にEPA/AA比も増加する傾向が見られた。以上の結果より,エゴマ油による食事療法は,治療上有用であると考えられた。
Keywords n-3系脂肪酸 (n-3 fatty acids) 気管支喘息 (bronchial asthma) アラキドン酸 (arachidonic acid) LTB4 LTC4
Publication Title 岡大三朝分院研究報告
Published Date 1996-11
Volume volume67
Start Page 35
End Page 42
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307804
Author Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Iwagaki, Naofumi| Nagata, Takuya| Fujii, Makoto| Takata, Shingo| Yokoi, Tadashi| Hamada, Masanori| Tanizaki, Yoshiro|
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
JaLCDOI 10.18926/15000
Title Alternative Ⅱ型(細気管支閉塞)喘息と閉塞性細気管支炎における細気管支領域の炎症反応の差
FullText URL 067_014_020.pdf
Author Mifune, Takashi| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Yokota, Satoshi| Tsugeno, Hirofumi| Takeuchi, Kazuaki| Nawa, Yuichiro| Tanizaki, Yoshiro| Tada, Shinya| Harada, Mine|
Abstract Ventilatory function and inflammatory cells in airways were compared between patients with type Ⅱ (bronchiolar obstruction) asthma and those with obstructive bronchiolitis. 1. Age and age at onset were higher in patients with type Ⅱ asthma than in those with obstructive bronchiolitis. IgE-mediated allergic reaction was observed in patients with type Ⅱ asthma, but not in those with obstructive bronchiolitis. 2. In ventilatory function tests, all ventilatory parameters examined were lower in patients with type Ⅱ asthma compared to those with obstructive bronchiolitis, and the differences were significant in FEV1.0% (p<0.001), % MMF (p<0.02), and V50 (p<0.01). 3. The proportion of BAL neutrophils was very high in type Ⅱ asthma (55.7%) and obstructive bronchiolitis (74.4%), however, this was not significant. 4. Absolute numbers/BAL fluid of total cells, BAL macrophages and BAL neutrophils were significantly higher in patients with obstructive bronchiolitis than in those with type Ⅱ asthma. 5. The results on absolute number/mℓ of BAL cells demonstrated that number of BAL neutrophils markedly larger in patients with obstructive bronchiolitis compared to those with type Ⅱ asthma. These results show that high proportion of BAL neutrophils was observed in the two respiratory diseases, however, the degree of inflammation in airways was markedly greater in obstructive bronchiolitis.
Abstract Alternative Ⅱ型喘息と閉塞性細気管支炎の臨床的特徴について,換気機能および気道炎症反応を中心に検討を加えた。1.年齢,および発症年齢とも閉塞性細気管支炎に比べⅡ型喘息において高い傾向が見られた。IgE系反応はⅡ型喘息では観察されたが,閉塞性細気管支炎では見られなかった。2.換気機能では,測定された全ての換気パラメーターにおいて,その値は閉塞性細気管支炎に比べⅡ型喘息でより低い値を示し,FEV1.0%,% MMFおよび% V50では有意の差が見られた。3.BAL液中好中球頻度は,Ⅱ型喘息(55.7%),閉塞性細気管支炎(74.4%)いずれにおいても高い値を示したが,両者間に有意の差は見られなかった。4.一方,BAL液中の絶対数では,Ⅱ型喘息に比べ,閉塞性細気管支炎において,総細胞数,マクロファージおよび好中球数が有意の高値を示した。5.また,lmℓあたりの細胞数の比較でも,閉塞性細気管支炎で好中球数が著明な高値を示した。これらの結果より,この2疾患では気道内好中球増多は同様に見られるものの,その気道炎症の程度は明らかに閉塞性細気管支炎でより高度であることが示された。
Keywords Ⅱ型喘息 (Type Ⅱasthma) 閉塞性細気管支炎 (Obstructive bronchiolitis) 換気機能 (Ventilatory function) BAL好中球 (BAL neutrophiIs) IgE系反応 (IgE-mediated allergy)
Publication Title 岡大三朝分院研究報告
Published Date 1996-11
Volume volume67
Start Page 14
End Page 20
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307471
JaLCDOI 10.18926/15001
Title Alternative アトピー型および非アトピー型気管支喘息の発作発症機序の差異について・・・ロイコトリエンC4の役割について
FullText URL 067_021_027.pdf
Author Ashida, Kozo| Mifune, Takashi| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Yokota, Satoshi| Tsugeno, Hirofumi| Tanizaki, Yoshiro|
Abstract Concentrations of main bronchoconstricting chemical mediators, histamine and leukotriene C4 (LTC4), were measured in bronchoalveolar lavage (BAL) fluid, and when cells (peripheral leukocytes and BAL cells) were stimulated by Ca ionophore A23187, in 7 atopic and 7 nonatopic asthma patients. 1. The proportion of basophilic cells was significantly larger in atopic than in nonatopic asthma (p<0.05), however no significant difference was present in the other BAL cells between the two asthma types. 2. Concentration of histamine in BAL fluid was significantly higher in atopic than that in nonatopic asthma, however, difference in that of LTC4 was not found between them. 4. The release of LTC 4 from BAL cells was higher in nonatopic than that in atopic asthma, but this was not significant. In contrast, the release of histamine was significantly higher in atopic compared to that in nonatopic asthma (p<0.001) when the cells were stimulated by Ca ionophore A23187. These results suggest that both histamine and LTC4 participate in the onset mechanism of atopic asthma, and only LTC4 in that of nonatopic asthma.
Abstract Alternative 気管支喘息患者14人(アトピー型,非アトピー型各7人)につき気管支肺胞洗浄(BAL)液及び気管支肺胞洗浄細胞と末梢血白血球をカルシウムイオノファA23187で刺激し,主要な気管支収縮メディエーターであるヒスタミンとロイコトリエンC4(LTC4)の濃度を測定した。1.BAL中細胞の比率では好塩基球のみ非アトピー型に比べアトピー型で優位に高い値であった。(p<0.05) 2.BAL液のヒスタミンの濃度はアトピー型で有意に高い値であったが,ロイコトリエンC4はアトピー型,非アトピー型で有意な差を認めなかった。3.BAL細胞からのカルシウムイオノファA23187刺激によるロイコトリエンC4産生はアトピー型に比べ非アトピー型で高い値であったが,有意差は認めなかった。一方,同刺激によるヒスタミン遊離は非アトピー型よりアトピー型で有意 に高値であった。(p<0.001)。以上の結果よりアトピ-型の気管支喘息の発症機序にはヒスタミン,ロイコトリエンC4の両者が,非アトピー型に於いてはロイコトリエンC4のみが主として関与していること可能性が示唆された。
Keywords Histamine LTC4 atopic nonatopic BAL cells
Publication Title 岡大三朝分院研究報告
Published Date 1996-11
Volume volume67
Start Page 21
End Page 27
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307446
JaLCDOI 10.18926/14908
Title Alternative 寒冷負荷の末梢循環に及ぼす影響
FullText URL 071_042_049.pdf
Author Hosaki, Yasuhiro| Mitsunobu, Fumihiro| Mifune, Takashi| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Takata, Shingo| Yokoi, Tadashi| Tanizaki, Yoshiro| Ochi, Koji| Tsuji, Takao|
Abstract The purpose of this study is the effect of partial cold-loading on whole body peripheral circulation. The body surface peripheral circulation in 24 cases (25 years old to 86 years old, the average was 64.3 years) who were suffering coldness, numbness or pain in their feet was examined using Laser-Doppler blood flowmetry. The peripheral circulation at the base of the 2nd toe of the right foot was estimated after the foot was submerged and cooled for 5 min in a water bath at 20°C (i. e. cold-loading). At the same time, the distant body surface peripheral circulation was estimated at the base of the 2nd finger of the right hand. Simultaneous observations were made of blood flow, blood mass and blood velocity. The peripheral blood flow of the upper limbs at a room temperature of 20°C (pre-loading) was 5.00 ml/min 100 9 tissue on average. The average blood rnass was 287 and the average blood velocity was 0.516. On the other hand, the average peripheral blood flow of the lower limbs was 2.23, the average blood mass was 149 and the average blood velocity was 0.574. This result shows that the blood flow and blood mass of the upper limbs were more than in the lower limbs. The average blood flow at the upper limbs decreased to 3.69 from 5.00 (or at 26.2% ) when the lower limbs were submerged and cooled for 5 min in a water bath at 20°C (i. e. cold-loading). On the other hand, blood flow of the lower limb was 1.51 m l under a condition of cold-loading, and decreased 32.3% from 2.23. Blood mass of the upper limb was 241 on average and decreased 16.0% from 287. Blood mass of the lower limb was 113 on average and decreased 24.2% from 149. There was no difference between blood velocity of the upper limb under the conditions of room temperature at 20°C (0.516) and cold-loading (0.501). However, blood velocity of the lower limb increased to 0.642 from 0.574. After the end of cold loading, there was some tendency for blood flow, blood rnass and blood velocity to return to the amount at pre-loading. Twenty minutes after the end of cold-loading, blood flow increased to 5.74 (14.8% ) compared with pre-loading (5.00). However, blood flow of the lower limb remained at only 83.9% (1.87) of the amount at pre-loading (2.23). These results show that partial cold-loading of the lower limb had a quantitative effect on the distant peripheral circulation. The speculated mechanism of this phenomenon is that it to protects against loosing body heat from the body surface under the conditions of local cold-loading. Our body has defense mechanisms to decrease whole body peripheral circulation to protect against loosing body heat.
Abstract Alternative 局所寒冷負荷の全身の末梢循環に及ぼす影響について検討する目的で,下肢の20℃冷水負荷時における上肢末梢循環の変化をレーザードプラー血流計を用いて数量的に測定し検討を行なった。症例は,下肢に冷え症,しびれ感を有した25歳から86歳までの24症例(平均年齢64.3歳)であった。下肢,上肢の末梢循環を20℃冷水負荷時に,末梢血流量,血液量,血流速度について観察した。上肢の末梢血流量は20℃室内安静時平均5.00mβ/min/100g tissue,血液量は287,血流速度は0.516であった。下肢は血流量2.23,血液量は149,血流速度は0.574であった。上肢の血流量,血液量ともに下肢より多いことが示された。しかし同一症例における上肢と下肢との間の血流量,血液量,血流速度に相関関係は認めなかった。下肢の20℃ 冷水負荷中の上肢の血流量は平均3.69で有意に低下(26.2%)した。下肢はその間1.51で有意に低下(32.3%)した。上肢の血液量は平均241で有意に低下(16.0%)した。下肢はその間113で有 意に低下(24.2%)した。上肢の血流速度は平均0.501で不変であった。下肢はその間0.642で有意に増加(11.8%)した。冷水負荷直後よりそれぞれ負荷前に復帰する傾向を示した。負荷後20分では上肢の血流量は平均5.74で負荷前値に比べて増加(14.8%)傾向を示した。下肢は1.87で負荷前値に比べて低値(83.9%)に留まる傾向にあった。下肢の冷水負荷は上肢の末梢循環にも影響を及ぼすことが数量的に示された。局所の寒冷負荷による体温の低下を防ぐために反射的に全身の皮膚の末梢循環量を低下させていることが示された。
Keywords Laser-Doppler blood flowmetry (レーザードプラー血流計) cold loading (冷水負荷) peripheral circulation (末梢循環) blood flow (血流量) blood velocity (血流速度)
Publication Title 岡大三朝分院研究報告
Published Date 2001-02-01
Volume volume71
Start Page 42
End Page 49
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308072
Author Kikuchi, Hiroshi| Shiozawa, Nobuyoshi| Takata, Shingo| Ashida, Kozo| Mitsunobu, Fumihiro|
Published Date 2013-12-12
Publication Title International Journal of Chronic Obstructive Pulmonary Disease
Volume volume9
Content Type Journal Article
JaLCDOI 10.18926/14835
Title Alternative 気管支喘息における気管支肺胞洗浄液中の細胞成分に対する加齢および副腎皮質ホルモンの影響
FullText URL 72_016_022.pdf
Author Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Nishida, Norikazu| Takata, Shingo| Yokoi, Tadashi| Tanizaki, Yoshiro|
Abstract Effects of aging and glucocorticoid therapy on bronchoalveolar lavage (BAL) cells, particularly lymphocytes, neutrophils and eosinophils, were examined in 81 patients with asthma. 1. The proportion of BAL lymphocytes tended to increase with aging in asthmatics under age 69 years, and the proportion was significantly higher in patients with asthma between the ages of 60 and 69 than in those under age 39 and between the ages of 40 and 49. 2. The proportions of BAL neutrophils and eosinophils were not related to aging. 3. The proportion of BAL lymphocytes was higher in patients without glucocorticoid therapy than in those with steroid-dependent intractable asthma (SOIA) in those under age 69 years. In patients between the ages of 50 and 59, the proportion of BAL lymphocytes was significantly higher in patients without glucocorticoids than in those with SOIA. 4. The proportion of BAL neutrophils was higher in patients without glucocorticoid therapy than in those with SOIA, and the difference was significant in patients between the ages of 60 and 69. 5. The proportion of BAL eosinophils was not related to glucocorticoid therapy. These results suggest that the proportion of BAL lymphocytes and neutrophils is affected by aging and glucocorticoid therapy, but not BAL eosinophils.
Abstract Alternative 気管支喘息81例を対象に,気管支肺胞洗浄(BAL)液中の細胞成分,特にリンパ球,好中球および好酸球に対する加齢および副腎皮質ホルモ ンの影響について検討を加えた。 1.BAL液中のリンパ球頻度は,69才以下の症例では加齢とともに増加する傾向を示し,60-69才の年齢層では,39才以下および40-49才の年齢層の症例に比べ有意に高い値を示した。  2.BAL液中の好中球および好酸球頻度と加齢との間には関連が見られなかった。  3.BAL液中のリンパ球頻度は,69才以下の症例では,ステロイド依存性重症難治性喘息(SDIA)に比べ,ステロイド非使用例で有意に高い値を示し,50-59才の年齢層ではその差は有意であった。  4.BAL液中好中球頻度は,ステロイド非使用例に比べSDIA症例において高い値を示し,60-69才の年齢層ではその差は有意であった。  5.BAL液中好酸球頻度は,ステロイド使用の有無との関連は見られなかった。これらの結果は,BAL液中リンパ球および好中球頻度は加齢や副腎皮質ホルモン投与の影響を受けるが,BAL液中好酸球額度には影響しないことを示唆している。
Keywords aging asthma glucocorticoid therapy BAL cells
Publication Title 岡大三朝分院研究報告
Published Date 2002-02-01
Volume volume72
Start Page 16
End Page 22
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308605
Author Mitsunobu, Fumihiro| Ashida, Kozo| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Nishida, Norikazu| Nagata, Takuya| Yokoi, Tadashi| Takata, Shingo| Tanizaki, Yoshiro|
Published Date 2003-02-01
Publication Title 岡大三朝医療センター研究報告
Volume volume73
Content Type Departmental Bulletin Paper