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 10.18926/15000
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 10.18926/14999
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
JaLCDOI 10.18926/14994
Title Alternative Three cases of rheumatoid arthritis with biliary tract cancer
FullText URL 068_107_114.pdf
Author Iwagaki, Naofumi| Tsugeno, Hirofumi| Mifune, Takashi| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Okamoto, Makoto| Tanizaki, Yoshiro|
Abstract 一般的に,慢性関節リウマチには悪性腫瘍の合併は少ないと言われている。特に,消化器系あるいは胆道系悪性腫瘍を合併したという報告は極めて少ない。我々は慢性関節リウマチの経過中,胆道系悪性腫瘍を合併した3例を経験した。3症例はそれぞれ胆嚢癌,肝内胆管癌,乳頭部癌を合併していた。非常に稀な症例であり,文献的考案を含め報告する。
Abstract Alternative The relationships between rheumatoid arthritis and malignant disease have been a focus of controversy for many years. Many studies of patients with rheumatoid arthritis have found no increases in overall cancer rates. Although significant elevations in rates of lymphoma, myeloma and malignant disease in patients treated with immunosuppressive drugs have been reported, it has been considered that gastrointestinal and biliary tract cancer in patients with rheumatoid arthritis is rare. We recently experienced three cases of rheumatoid arthritis with biliary tract cancer. They were gall bladder, cancer, bile duct cancer and cancer of papilla of Vater. Patients with rheumatoid arthritis should be carefully monitored for malignant disease.
Keywords 慢性関節リウマチ (rheumatoid arthritis) 胆道系悪性腫瘍 (biliary tract cancer) 胆嚢癌 (gall bladder cancer) 胆管癌 (bile duct cancer) 乳頭部癌 (cancer of papilla of Vater)
Publication Title 岡大三朝分院研究報告
Published Date 1997-12
Volume volume68
Start Page 107
End Page 114
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308182
JaLCDOI 10.18926/14993
Title Alternative Diet therapy with α-linolenic acid-enriched perilla seed oil on pulmonary emphysema.
FullText URL 068_099_106.pdf
Author Tsugeno, Hirofumi| Ashida, Kozo| Mitsunobu, Fumihiro| Mifune, Takashi| Okamoto, Makoto| Iwagaki, Naofumi| Hosaki, Yasuhiro| Tsuji, Takao| Tanizaki, Yoshiro|
Abstract 症例は67歳,男性。主訴は労作時呼吸困難。【第一回目入院】平成7年9月から12月まで入院し,薬物療法,複合温泉療法を行なった。自覚症状はやや改善がみられたが,呼吸機能検査所見の改善は得られなかった。【第二回目入院】平成8年8月から12月まで入院。n-3系脂肪酸強化食事療法も併用した。自覚症状および,呼吸機能検査上,FVC,FEV(1.0),PEFなどに改善を認めた。n-3系脂肪酸はアラキドン酸代謝を通してロイコトリエン合成に関与すると推定されるが,経過中に白血球のLTB(4)産生能の減少を認めた。この症例は肺気腫に対するn-3系脂肪酸強化食事療法の有用性が示唆され,病態を考える上でも興味深いと考えられたので報告する。
Abstract Alternative An effective treatment of advanced stages of chronic obstructive pulmonary disease (COPD) has not been estadlished yet. We report out recent experience of one patient with pulmonary emphysema treated with dietary supplementation with n-3 fatty acid for two months. He presented improvements in clinical symptoms and pulmonary function, and suppression in generation of leukotriene B(4) (LTB(4) )by peripheral leukocytes. Weconsequently suppose that dietary treatment with n-3 fatty acids (perilla seed oil) may be beneficial for the treatment of pulmonary emphysema by inhibiting the conversion of arachidonic acid (AA) to leukotrienes (LTs) and prostanoids competitively.
Keywords 肺気腫 (pulmonary emphysema) n-3系脂肪酸 (n-3 fatty acid) 食事療法 (diet therapy) ロイコトリエン合成 (leukotriene)
Publication Title 岡大三朝分院研究報告
Published Date 1997-12
Volume volume68
Start Page 99
End Page 106
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308310
JaLCDOI 10.18926/14991
Title Alternative 呼吸器疾患のリハビリテーション.気管支喘息の病態的特徴と関連した温泉療法の効果
FullText URL 068_080_093.pdf
Author Tanizaki, Yoshiro| Mifune, Takashi| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Iwagaki, Naofumi| Yamamoto, Kazuhiko|
Abstract The number of patients with respiratory disease in the elderly has been increasing in recent years. Pathophysiological characteristic of respiratory diseases in older patients is clearly different from that in younger patients. In this study, rehabilitation for patients with respiratory disease, particularly bronchial asthma, in the elderly was discussed in relation to pathophysiology of asthma. Complex spa therapy has two kinds of actions, direct and indirect actions. Subjective and objective symptoms of patients with asthma are improved by spa therapy for 1-2 months, accompanied with improvement of ventilatory function, and decrease in bronchial hyperresponsiveness and respiratory resistance. In addition to these direct action of spa therapy, increase in strength of respiratory muscle, stability of autonomic nerve syetem, psychical relaxation, and inprovement of suppressed function of adrenocortical glands are observed as indirect action of spa therapy. Regarding clinical asthma type classified by pathophysiological changes of the airways, spa therapy was more effective in patients with hypersecretion and bronchiolar obstruction. These results suggest that complex spa therapy is available as rehabilitation and/or treatment for patients with respiratory disease.
Abstract Alternative 近年老年者の呼吸器疾患が増加しつつある。老年者の呼吸器疾患の病態的特徴は若年者のそれとは明らかに異なっている。本論文では,老年者の呼吸器疾患,なかでも気管支喘息に対する温泉療法を中心としたリ-ビリテ-ションについて,その病態的特徴と関連して若干の知見を述べる。複合温泉療法は2つの作用,すなわち直接作用と間接作用を有している。患者の自,他覚症状は1-2カ月の温泉療法により明らかに改善傾向を示すが,同時に,換気機能の改善,気道過敏性や気道抵抗の低下が観察される。これらの温泉療法の直接作用のはか,呼吸筋の増強,自律神経系の安定化,精神的リラックス,低下した副腎皮質機能の改善,などの間接作用も観察される。気道の病態生理的特徴より分類した喘息の臨床病型に関しては,過分泌や細気管支閉塞を伴うような病 型に対して,温泉療法は有効性が高い。これらの結果は,複合温泉療法が呼吸器疾患の治療ないしリハビリテーションとして有用であることを示している。
Keywords 気管支喘息 (Bronchial asthma) リハビリテーション (rehabilitation) 複合温泉療法 (complex spa therapy) 換気機能 (ventilatory function) 副腎皮質 (adrenocortical glands)
Publication Title 岡大三朝分院研究報告
Published Date 1997-12
Volume volume68
Start Page 80
End Page 93
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308151
JaLCDOI 10.18926/14987
Title Alternative Clinical effect of spa therapy on lumbargo
FullText URL 068_051_058.pdf
Author Okamoto, Makoto| Ashida, Kozo| Yamamoto, Kazuhiko| Iwagaki, Naofumi| Tsugeno, Hirofumi| Hosaki, Yasuhiro| Mifune, Takashi| Mitsunobu, Fumihiro| Tanizaki, Yoshiro| Tada, Shinya| Harada, Mine|
Abstract 腰痛症患者12例を対象に温泉療法の臨床効果について検討した。臨床効果の判定は,日本整形外科学会の腰痛治療成績判定基準に基づき,自覚症状,他覚症状,及び日常生活動作などの項目を中心に,治療前後で比較検討した。その結果,自覚症状,日常生活動作,総計では,治療前に比べ治療後に有意の改善がみられた。また改善指数や改善率での検討でも温泉療法の有効性が示唆された。年齢別(60才以上と60才未満),入院期間(80日以上と80日未満)別の 検討では,65才未満の症例,80日以上の入院の症例において,改善指数,改善率が,有意差はみられなかったもののより高い傾向がみられた。
Abstract Alternative Clinical effect of spa therapy was evaluated in 12 patients with lumbargo by a scoring system based on the standard judgement of therapy for lumbargo by Japanese Society of Orthopedics. The score for each category of subjective symptoms, objective symptoms, daily life activity, and disorder of urinary bladder, and total score calculated from each score were compared before and after spa therapy. A significant improvement of subjective symptoms, daily life activity, and total score was observed after spa therapy. However objective symptom was not significantly improved. The effects of spa therapy was larger in patients under age of 65, and in those who had long-term spa therapy more than 80 days during their admission. The results suggest that spa therapy IS effective for patients with lumbargo.
Keywords 腰痛症 (lumbargo) 温泉療法 (spa therapy) 腰痛治療判定基準 (scoring system based on the standard judgement of therapy for lumbargo)
Publication Title 岡大三朝分院研究報告
Published Date 1997-12
Volume volume68
Start Page 51
End Page 58
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308321
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 10.18926/14985
Title Alternative Dietary supplementation in bronchial asthma. Suppression of the generation of leukotrienes by N-3 fatty acids.
FullText URL 068_041_044.pdf
Author Ashida, Kozo| Mitsunobu, Fumihiro| Mifune, Takashi| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Okamoto, Makoto| Iwagaki, Naofumi| Tanizaki, Yoshiro| Tsuji, Takao| Yamamoto, Junko| Okita, Misako|
Abstract N-3系脂肪酸の気管支喘息に対する有用性が示唆されているが,その評価は定まっていない。今回,5人の気管支喘息患者に対しN-3系脂肪酸であるαリノレン酸を豊富に含有するエゴマ油を用いた食事療法を行い,臨床症状,ピークフロー値,末梢白血球からのロイコトリエン産生能,血漿リン脂質中の脂肪酸組成につき検討を行った。2週間の食事療法の前後でピークフロー値は有意な改善を示し(p<0.05),カルシウムイオノファー刺激によるロイコトリエン(LT)産生能は治療前後でLTB4が77.6ng/5×106cellsから41.6ng/5×10(6)cells(p<0.05)に,LTC4は64.0ng/5×10(6)cellsから38・8ng/5×10(6)cells(p<0.05)とともに有意な改善を認めた。また血漿リン脂質中のN-3系脂肪酸(αリノレン酸,エイコサペンタエン酸,ドコサヘキサエン酸)も有意な上昇を認めた。以上よりN-3系脂肪酸(エゴマ油)を用いた食事療法の有用性が示唆された。
Abstract Alternative The therapeutic trials using N-3 fatty acids such as fish oil have been reported in patients with bronchial asthma, while its effect is still controversial. The effects of dietary supplementation with perilla seed oil rich in alpha-linolenic acid (α-LNA), parent n-3 fatty acid, were studied in five patients with asthma. The symptoms of asthma and mean peak flow rates (PFR) both early in the morning and in the evening were improved 2 weeks after the dietary supplementation and the increases of peak flow rates were significant (p<0.05). The generation of leukotriene B4 (LB4) by peripheral leukocytes stimulated with Ca ionophore A23187 was significantly suppressed from 77.6 ng/5×10(6) cells to 41.6ng/5×10(6) cells by the supplementation (P<0.05). The generation of leukotriene C4 (LTC4) by leukocytes was also significantly suppressed from 64.0 ng/5×10(6) cells to 38.8ng/5×10(6) cells after the manipulation with perilla seed oil (P<0.05). The concentration of N-3 fatty acids (such as α-LNA, eicosapentaenoic, and docosahekisaenoic acids) in plasma phospholipid increased significantly after the dietary supplementation (P<0.05). These results suggest that dietary supplementation with perilla seed oil is beneficial for the treatment of asthma.
Keywords シソ油 (perilla seed oil) 気管支喘息 (bronchial asthma) ロイコトリエンB4 (LTB4) ロイコトリエンC4 (LTC4) 脂肪酸 (fatty acids)
Publication Title 岡大三朝分院研究報告
Published Date 1997-12
Volume volume68
Start Page 41
End Page 44
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308166
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 10.18926/14978
Title Alternative Effect of spa therapy on peak expiratory flow in patients with bronchial asthma
FullText URL 068_028_033.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 気管支喘息に対する温泉療法の効果をピークフローメーターを用いて継時的(第1週,第5過,第9週)に検討した。1.軽症・中等症では,第5週で有意にピークフロー (PEF)値は上昇した.重症気管支喘息例では第9週に有意な改善を認めた。2.20%以上のPEF値の改善を認めた症例の割合は第5週では,軽症・中等症・重症群で40~50%であったが,第9週では軽症群で80%,重症群で54.5%に増加していた。中等症群では第5週と同等であった。3.第1週のPEFが200(L/m)以下の症例では第5週,第9過とPEFの有意な改善を示したが,200<PEF≦300の症例,300<PEFの症例では有意な改善は認められなかった。4.PEF≦200(L/m)の症例群において,20%以上のPEFの改善を示す症例は,第5週で57%,第9週で69%と高率であった。200<PEF≦300の症群,300PEFの症例群では第9週で40%以上の症例が20%以上のPEFの改善を示した。
Abstract Alternative The aim of this study was to investigate effects of spa therapy on peak expiratory flow (PEF) in patients with bronchial asthma. Morning PEF metry was studied in fifty asthmatics who had spa therapy (swimming training in a hot spring pool, inhalation of iodine salt solution and fango therapy) for 5 - 9 weeks. Mean values of morning PEF at the initial stage, 5 and 9 weeks after spa therapy were assessed. In mild and moderate asthmatics, PEF significantly improved 5 weeks after spa therapy. In severe asthmatics, PEF showed significant increase 9 week. The number of subjects with PEF improvement more over 20%, compared with the intial value of PEF, were 50% at 5 weeks and 80% at 9 weeks after spa therapy in mild asthmatics. In moderate asthmatics, however, the number little changed between 5 (39.3%) and 9 weeks (38.9%) after the therapy. In severe asthmatics, 57.1% at 5 and 68.8% at 9 weeks. In asthmatics with the initial value of PEF<200L/m (low PEF group), the value showed significant increase 5 and 9 weeks after the therapy compared with the initial value. In asthmatics with the initial values of 200≦PEF<300 (middle PEF group) and 300≦PEF (high PEF group), the values showed no significant increase. The number of subjects with PEF improvement more than 20% showed a tendency to increase 9 weeks in low, middle and high PEF group, compared to the value after spa therapy (57.1% to 68.8%, 21.4% to 50% and 35.7% to 42.9%, respectively ).
Keywords bronchial asthma spa therapy peak expiratory flow (PEF)
Publication Title 岡大三朝分院研究報告
Published Date 1997-12
Volume volume68
Start Page 28
End Page 33
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308119
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 10.18926/14974
Title Alternative 気管支喘息におけるCTによる気腫性変化。喫煙症例と非喫煙症例の比較。
FullText URL 068_008_014.pdf
Author Tanizaki, Yoshiro| Mitsunobu, Fumihiro| Ashida, Kozo| Mifune, Takashi| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Okamoto, Makoto| Iwagaki, Naofumi| Yamamoto, Kazuhiko| Nakai, Mutsuo| Akiyama, Tsuneo|
Abstract The percentage of attenuation area < -950HU (% LAA) on high resolution computed tomography (HRCT) was compared between 17 smoking and 24 nonsmoking patients with asthma. 1. FEV1/FVC value was lower in smoking patients (56.4%) than in nonsmoking patients (66.0%), however, the difference was not significant. 2. The percentage of LAA of the lung was larger in smoking patients compared with that in nonsmoking patients in all the three anatomic levels: the % LAA was 14.4% in nonsmoking and 20.3% in smoking patients at lower lung level (3cm above the top of the diaphragm). However, this was not significant. The maximal % LAA among the three lung levels on HRCT was 21.6±12.5% in smoking, and 15.7±11.9% in nonsmoking patients. This suggested that the maximal % LAA was larger in smoking patients, however, this was not significant. 3. The mean CT number of the lung on HRCT was smaller in smoking patients (-897.3HU) than in nonsmoking patients (-884.7HU). 4. Three of 4 nonsmoking patients whose % LAA was more than 30% had severe intractable asthma with long-term glucocorticoid therapy. The results suggest the possibility that smoking influences the % LAA of the lung on HRCT in asthma. It could be also speculated that % LAA is influenced by severity of asthma.
Abstract Alternative HRCT (high resolution computed tomography)による-950HU以下の肺野のlow attenuation area(LAA)について,17例の喫煙喘息症例と24例の非喫煙喘息症例で比較検討した。1.FEV1.0%値は,喫煙症例(56.4%)で非喫煙症例(66.0%)に比べ低い値が示されたが,両群間に有意の差は見られなかった。2.% LAAは,肺野のいずれの高さにおいても,非喫煙症例に比べ喫煙症例で高い傾向が見られたが,有意の差ではなかった。Maximal % LAAは,喫煙症例で21.6%,非喫煙症例15.7%であり,同様に喫煙症例で高い傾向が見られたが,有意の差は見られなかった。3.平均CT値は,非喫煙症例(-884.7HU)に比べ,喫煙症例(-897.3HU)で低い値であった。4.% LAAが30%以上を示 す4例の非喫煙症例のうち,3例がステロイド依存性の重症難治性喘息であった。これらの結果より,喫煙が肺野の% LAAに影響をあたえる可能性もあるものの,疾患の重症度がより影響が強い可能性が示唆された。
Keywords bronchial asthma FEV1 % LAA mean CT number HRCT
Publication Title 岡大三朝分院研究報告
Published Date 1997-12
Volume volume68
Start Page 8
End Page 14
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308579
JaLCDOI 10.18926/14973
Title Alternative Clinical significance of spa therapy in the treatment of patients with chronic obstructive pulmonary disease (COPD). A study on 520 patients with COPD admitted for last5 years.
FullText URL 068_001_007.pdf
Author Tanizaki, Yoshiro| Mifune, Takashi| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Iwagaki, Naofumi| Yamamoto, Kazuhiko|
Abstract 1992年1月より1996年12月までの5力年間に当院へ入院した慢性閉塞性呼吸器疾患520例を対象に,疾患の種類,年齢,地域分布などについて検討を加えた。1.最近5年間に当院へ入院した呼吸器疾患患者は588例で,このうち,慢性閉塞性呼吸器疾患患者は520例(88.4%)であった。これらの慢性閉塞性呼吸器疾患のなかでは,気管支喘息が433例(83.3%)と最も多く,その他,慢性気管支炎19例,閉塞性細気管支炎33例,肺気腫35例であった。2.慢性閉塞性呼吸器疾患の年齢別検討では,鳥取県内および遠隔地(鳥取県外)いずれの症例においても,60-69才および70才以上の症例が多い傾向が見られた。3.入院患者の地域分布では,鳥取県内からの入院患者に比べ,遠隔地(鳥取県外)からの入院患者がより多く,その分布別検討では,岡山県,兵庫県,大阪腐,広島県,山口県,愛媛県からの入院患者が多い傾向が見られた。
Abstract Alternative The kind of respiratory diseases, age, and areas where patients came from were discussed in 520 patients with chronic obstructive pulmonary diseas (COPD) admitted at Misasa Medical Branch for last 5 years from 1992 to 1995. 1. For the last 5 years 588 patients with respiratory diseases were admitted at Misasa Medical Branch. Of these patients, 520 were those with chronic obstructive pulmonary disease (COPD). Of the 520, 433 (83.3%) were patients with asthma" 19 with chronic bronchitis, 33 with obstructive bronchiolitis, and 35 with pulmonary emphysema. 2. Regarding the distribution of age of these patients, patients between the ages of 60 and 69, and those over the age of 70 were more frequently observed, regardless of the area where patients came from (inside or outside Tottori prefecture). 3. The number of patients from distant areas (outside Tottori prefecture) was larger than the number of those inside Tottori prefecture. The number of patients from Okayama, Hyogo, Hiroshima, Osaka, Yamaguchi, and Ehime prefectures was predominantly larger than the number from other distant areas.
Keywords 慢性閉塞性呼吸器疾患 (COPD) 気管支喘息 (bronchial asthma) 温泉療法 (spa therapy) 高齢患者 (aged patients) 遠隔地 (distant area)
Publication Title 岡大三朝分院研究報告
Published Date 1997-12
Volume volume68
Start Page 1
End Page 7
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308043
JaLCDOI 10.18926/14972
Title Alternative 気管支喘息におけるアレルギー性鼻炎と花粉抗原に対するIgE抗体
FullText URL 068_022_027.pdf
Author Mifune, Takashi| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Iwagaki, Naofumi| Yamamoto, Kazuhiko| Tanizaki, Yoshiro| Ochi, Koji| Harada, Hideo|
Abstract IgE antibodies against inhalant allergens were estimated in 53 patients with bronchial asthma in relation to allergic rhinitis. Of them, 20 patients (37.7%) had allergic rhinitis. 1. Asthma + allergic rhinitis were often observed in patients between the ages of 0 and 39. In contrast, asthma alone in those over age 60. 2. A RAST score was positive in house dust mite (HDm)(50.9%), cockroach(24.5%), and Candida (26.4%) in these patients, and the positive rate was not different between patients with and without allergic rhinitis. 3. The frequency of positive RAST against Japanese cedar and rice plants was higher in patients with allergic rhinitis (42.9% and 18.5%) than in those without allergic rhinitis (28.6 and 3.7%), however, the each positive rate or RAST against the two allergens was not significantly different between those with AR and without AR. 4. The number of patients with AR induced by pollen alone (pollinosis) was not large ( 5/53, 9.4%) in the patients with asthma. It was clarified from the results that allergic rhinitis was often observed in asthma patients, but not pollinosis. and that IgE antibodies against Japanese cedar and rice plants were found even in patients without AR.
Abstract Alternative 気管支喘息53例を対象に,吸入抗原に対するIgE抗体とアレルギー性鼻炎の合併の有無との関連について若干の検討を加えた。対象53例中20例(37.7%)にアレルギー性鼻炎の合併が見られた。 1.喘息+アレルギー性鼻炎の合併は,0-39才の年齢層で最も多い傾向であったが,一方,喘息単独は60才以上の症例に多く見られた。2,IgE抗体の陽性率は,それぞれHDm50.9%,ごきぶり 24.5%,カンジダ26.4%であった。これら抗原のRAST陽性率は,アレルギー性鼻炎合併例と非合併例の問に有意の差は見られなかった。3.スギおよびイネ科の花粉に対するRAST陽性率はアレルギー性鼻炎合併例で(スギ42.9%,イネ科18.5%),非合併例に比べ(28.6%と3.7%)高い傾向が見られたが,両群間に有意の差は見られなかった。4.花粉抗原によるアレルギー性鼻炎(花粉症)の頻度は9.4% (53例中5列)とあまり高くはなかった。以上の結果より,気管支喘息患者でしばしばアレルギー性鼻炎の合併が見られること,(しかし, 花粉症は少ない),そして,スギおよびイネ科の花粉に対するIgE抗体は,アレルギー性鼻炎の合併のない症例においても観察されること,などが明らかにされた。
Keywords bronchial asthma allergic rhinitis IgE antibodies house dust mite Japanese cedar
Publication Title 岡大三朝分院研究報告
Published Date 1997-12
Volume volume68
Start Page 22
End Page 27
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308327
JaLCDOI 10.18926/14964
Title Alternative The effects of perilla seed oil ointment for atopic dermatitis
FullText URL 069_076_081.pdf
Author Miyamoto, Miyuki| Akiyama, Chiaki| Noumi, Michiyo| Takata, Junko| Nisimura, Nobuko| Nakamura, Sumie| Kawakami, Yasuhiro| Okamoto, Makoto| Ashida, Kozo| Mitsunobu, Fumihiro| Tanizaki, Yoshiro|
Abstract 近年アトピー性皮膚炎が増加しており,工ゴマ油を使った食事療法がアレルギー抑制に有用であることが報告されている。そこで今回,エゴマ油を外用剤として使用するため,亜鉛華単軟膏を基剤とした工コマ軟膏を作製し,アトピー性皮膚炎患者3例を対象にその臨床応用を試みた。その結果,掻痒感の軽減に効果がみられ,また皮膚症状では,丘疹.表皮剥離,苔癬化,落屑などの所見が改善される傾向が見られた。
Abstract Alternative The perilla seed oil contains rich α-linolenic acid (α-LNA), parent n-3 fatty acid. The dietary intake of n-3 fatty acid, such as perilla seed oil, has been reported to have some clinical effects in patients with allergic disease. In this report, we prepared the perilla seed oil ointment for atopic dermatitis and the effects of the ointment was evaluated in three patients with atopic dermatitis. This ointment suppressed skin itch, and improved papules, excoriation, lichenification and desquamation of the skin. These results suggest that the perilla seed oil ointment has some effectiveness including suppression of inflammatory changes of the skin in patients with atopic dermatitis.
Keywords アトピー性皮膚炎 エゴマ軟膏 掻痒感
Publication Title 岡大三朝分院研究報告
Published Date 1998-12
Volume volume69
Start Page 76
End Page 81
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308418
JaLCDOI 10.18926/14963
Title Alternative サーモグラフィーによる体表面温度の測定 2.温水負荷の効果
FullText URL 069_068_075.pdf
Author Hosaki, Yasuhiro| Takata, Shingo| Mitsunobu, Fumihiro| Mifune, Takashi| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Harada, Seishi| Tanizaki, Yoshiro| Ochi, Koji| Harada, Hideo| Tsuji, Takao|
Abstract The body surface temperature of 41 patients suffering coldness, numbness or pain in their feet was examined using thermography. Thermographic results were analyzed quantitatively by calculating a recovery ratio as: Recovery ratio =[Total counts of thermography (Pixels) over temperature (T) after cold loading] ÷ [Initial counts over T before cold loading] x 100(%). Three different baseline temperatures, 26℃. 27℃ and 28℃, were used in processing the thermographic results into pictures. The recovery ratio was susceptible to temperature, and we recommend a baseline temperature limitation of 27℃ for clinical study. A bi-modal distribution of recovery ratio was observed in 18 patients with diabetes mellitus. One group (6 subjects) had high recovery ratio between 80%-100%, and another group (10 subjects) had a low recovery ratio between 0%-19%. The results of thermography were also influenced by weather. To reduce the effect of outside temperature, we used pre-loading with hot water at 36℃ for 5 min (hot loading). A large difference in recovery ratio between presence and absence of hot loading was observed in 6 of the 30 subjects. The difference was over-estimated in more than 20% of recovery ratio without hot loading as compared with hot loading in these 6 subjects. The effect of drugs on peripheral circulation, such as beraprost sodium and sarpogrelate hydrochloride, was clear and quantified using thermography under these conditions of hot loading.
Abstract Alternative 下肢に冷感ならびにしびれ感または疼痛を訴える患者41症例についてサーモグラフィーを用いて体表面温度を測定した。測定で得られた結果は回復率として数量化して表示された。回復率の算出方法は回復率=[冷水負荷後の特定温度T℃以上の体表面温度のサーモグラフィーのPixelの総数]÷[温水負荷前の特定温度T℃以上の体表面温度のサーモグラフィーのPixelの総数]× 100%で求めた。サーモグラフィーで得られた結果と画像処理の過程で用いられた,26℃,27℃,28℃の3つの異なる特定温度T℃ との関連について検討を行なった。その結果,回復率は特定温度T℃に影響を受けやすいことが明らかとなった。下肢の体表面温度の低い臨床症例においては27℃の条件が適当と考えられた。前述の41症例中の18症例の糖尿病患者について検討を行なった。そのサーモグラフィーの結果は,比較的回復率の高い(80%~100%)群の6症例と比較的回復率の低い(0%~19%)群の10症例の2群に別れた。わずかに残り2症例が20%から79%の間であった。下肢の症状が気温の低い時期に出親しやすいためにサーモグラフィーの検査を冬期に行なう必要性が高まった。しかし,天候の影響を受けやすいために冷水負荷前の測定領域の下肢が冷えすぎているために20℃の室温に15分間の安静時間では体表面温度が十分に暖まることが出来ず,27℃以上の領域として測定範囲全体を観察できない 問題に直面した。この間温点を解決する手段として36℃の温水に5分間下肢を入れて暖める温水負荷を加えることにした。そこで, 温水負荷を行なった症例30症例について,温水負荷を行なう前(室温)の回復率と温水負荷を行なった後の回復率について比較検討を行なったところ,20%にあたる6症例において温水負荷を行なわなかった場合に20%以上の回復率の過剰評価が認めら れた。温水負荷を行なうことにより年間を通じて天候の影響を最小限にすることが可能となり,この結果,長期間の内服薬の末梢循環に及ぼす影響の測 定を行なった場合に,季節の影響を最小限にしてサーモグラフィーにより回復率を用いて数値化された測定結果を検討することが可能となった。具体的に末梢循環の改善に薬効が有ると言われている薬剤であるベラプロストおよびサルポグレラートを3ヵ月間内服した場合の前後のサーモグラフィーで得られた回復率について検討を行なった。その結果はベラプロストにおいては,6.9%から41.9%に上昇または回復率の6.1倍の上昇を認めた。サルポグレラートにおいては,1.9%から17.3%に上昇または回復率の9.1倍の上昇を認めた。以上より,温水負荷を加えたサーモグラフィーの測定結果の数値化は下肢に症状の有る患者の末梢循環の評価ならびに薬効の評価の比較に有用であることが表わされた。
Keywords サーモグラフィー (thermography) 糖尿病 (diabetes mellitus) 末梢循環 (peripheral circulation) 冷水負荷 (cold loading) 温水負荷 (hot loading)
Publication Title 岡大三朝分院研究報告
Published Date 1998-12
Volume volume69
Start Page 68
End Page 75
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308316
JaLCDOI 10.18926/14962
Title Alternative ステロイド依存性重症難治性気管支喘息症例における胃粘膜病変の検討
FullText URL 069_063_067.pdf
Author Mifune, Takashi| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Harada, Seishi| Okamoto, Makoto| Yumoto, Eiichirou| Takata, Shingo| Tanizaki, Yoshiro|
Abstract Recently, we experienced two asthmatic patients with advanced gastric cancer. The two patients had steroid-dependent intractable asthma (SDIA) who had been on administration of corticosteroids for more than 2 years. To determine the influence of pathophysiology of SDIA on stomach mucous lesion, gastroscopic examinations and immunological examinations were performed in eight patients with SDIA, compared with 25 patient with non-SDIA. In patients with SDIA, gastric cancer, its precursor condition and immunosuppressive state were observed. These results suggest that the immunosuppressive state in SDIA induced by the long-term administration of corticosteroids may lead to the risk of gastric cancer development.
Abstract Alternative 最近,進行胃癌を合併した気管支喘息症例を2例経験した。2症例ともにステロイド依存性重症難治性喘息(SDIA)症例であり,SDIAが胃悪性腫瘍に関与している可能性が考えられた。今回,SDIA症例における胃粘膜病変の臨床像および背景因子を検討する目的で,8例のSDIA症例における胃内視鏡検査,末梢血液分画,免疫グロブリン定量を行い,非SDIA症例と比較検討を行った。SDIA症例においては胃癌・前癌状態が認められたが,非SDIA例では認められなかった。SDIA群において,末梢血白血球は有意に増加し,リンパ球分画・IgGは有意に減少していた。これらの結果より,ステロイド依存性重症難治性気管 支喘息症例においては免疫状態が抑制され,胃悪性腫瘍が発生する危険性があるものと考えられた。
Keywords ステロイド依存性重症難治性 (steroid-dependent intractable asthma (SDIA)) 胃癌 (gastric cancer) 免疫抑制 (immunosuppression) リンパ球 (lymphocytes) IgG
Publication Title 岡大三朝分院研究報告
Published Date 1998-12
Volume volume69
Start Page 63
End Page 67
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308665
JaLCDOI 10.18926/14961
Title Alternative 鼻腔・副鼻腔疾患を合併する気管支喘息症例に対するクラリスロマイシン投与の効果
FullText URL 069_057_062.pdf
Author Mifune, Takashi| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Harada, Seishi| Okamoto, Makoto| Yumoto, Eiichirou| Takata, Shingo| Tanizaki, Yoshiro|
Abstract We experienced a case of 59-year-old woman with intractable asthma, who had aspirin intolerance. Despite various treatments including systemic corticosteroid administration, she was often admitted due to severe asthma attacks. Furthermore, she had allergic rhinitis and sinusitis. Computed tomography (CT) scans of sinonasal cavity revealed marked thickness of nasal mucosa and air-fluid level in maxillary sinuses. Although her asthma symptoms such as wheezing and dyspnea were improved by administration of bronchodilator, systemic corticosteroids and beclomethasone diisoccyanate (BDI) accompanied with spa therapy, her peak expiratory flow (PEF) showed no improvement. After readmission due to asthma attacks, clarithromycin (CAM) administration for sinonasal disorders was started. The PEF value showed marked improvement after starting CAM administration, and pulmonary functions and bronchial hyperresponsiveness were also improved. It is suggested from her clinical course that CAM may have beneficial effects in asthmatic patients with sinonasal disorders.
Abstract Alternative 気管支喘息にアレルギー性鼻炎や副鼻腔炎を合併する症例は頻回に経験される。副鼻腔炎症状の増悪が喘息症状の増悪を引き起こす症例も存在し,鼻腔・副鼻腔における炎症が気管支喘息の病態と何らかの関係を持っていることが考えられる。今回,59才の難治性アスピリン喘息症例を呈示する。副腎皮質ホルモンの全身投与を含めた様々な治療にも関わらず頻回に重篤な喘息発作を呈し,入退院を繰り返している症例である。アレルギー性鼻炎も合併し,CTでは著明な鼻粘膜肥厚と上顎洞の鏡面形成が認められた。入院後の投薬や温泉療法によって呼吸困難は改善したが,ピークフロー値は上昇が認められないまま退院となった。再入院後,副鼻腔炎に対しクラリスリマイシン投与を開始したところ、ピークフロー値は著明に改善を示し,肺機能・気道過敏性も改善した。この症例のように,鼻腔・副鼻腔疾患を合併する気管支喘息症例に対しては,クラリスロマイシン投与が有効である可能性が考えられた。
Keywords bronchial asthma allergic rhinitis sinusitis clarithromycin peak expiratory flow (PEF)
Publication Title 岡大三朝分院研究報告
Published Date 1998-12
Volume volume69
Start Page 57
End Page 62
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308388