JaLCDOI 10.18926/14934
Title Alternative 気管支喘息症例における皮質骨海綿化
FullText URL 070_053_060.pdf
Author Tsugeno, Hirofumi| Nakai, Mutsuro| Okamoto, Makoto| Harada, Seishi| Takata, Shingo| Mifune, Takashi| Mitsunobu, Fumihiro| Ashida, Kozo| Hosaki, Yasuhiro| Akiyama, Tsuneo| Tsuji, Takao| Tanizaki, Yoshiro|
Abstract In previous studies, we have demonstrated that chronic administration of systemic glucocorticoids decreases cortical bone mineral density (BMD), cortical bone volume, bone strength, and induces development of pathologic fractures in asthmatic patients. We have also demonstrated that glucocorticoid administration appears to be responsible for the process of cortical bone porosity at both endosteal and intracortical sites in postmenopausal asthmatic patients. There is a difference of gonadal hormones between male and female. To investigate the influence of hormonal difference on glucocorticoid-induced cortical bone porosity, we studied cortical bone volume and BMD in both male and female patients with asthma in this report. A total of 99 asthmatic patients (male 26 cases, female 73 cases) were enrolled in the study. Peripheral quantitative computed tomography (pQCT) was used to measure cortical BMD and relative cortical volume. The cortical volume-density relationship appeared to remain constant regardless of the level of systemic glucocorticoid administration, age or sex, suggesting cortical bone porosity causes similar and simultaneous decreases in cortical bone volume and density. In conclusion, glucocorticoid administration appears to be responsible for the process of cortical bone porosity at both endosteal and intracortical sites despite the gonadal hormonal differences.
Abstract Alternative 【目的】これまでに我々は,気管支喘息症例において経口ステロイドによる皮質骨骨密度,容積の減少が骨折に関与する新知見を報告し,閉経後女性では皮質骨骨密度一容積の減少はステロイド投与量にかかわらず一定であることを報告してきた。この皮質骨骨密度-容積の関係において性差による違いを検討するために,男性,女性患者の両方について検討を行った。【方法】対象はステロイド依存性喘息99例(男性26例,女性73例)。性別,年齢,経口ステロイド積算総投与量により6群に分類した。椎体圧迫骨折はⅩ線側面像にて評価 し,皮質骨容積比および皮質骨骨密度はpQCT(Stratec XCT960)を用いて測定した。それぞれの群の皮質骨骨密度-容積比の関係を算出し比較検定をおこなった。【結果】それぞれの群の皮質骨の骨密度と容積比は有意に相関した。それぞれの群の皮質骨骨密度-容積比の傾きは,いずれも有意差を認めなかった。【結論】気管支喘息症例におけるステロイド投与による皮質骨の骨密度と容積の減少は,性別にかかわらずほぼ一定で,皮質骨は内側と外側において同様に海綿化してゆくと考えられた。
Keywords bronchial asthma systemic glucocorticoid cortical bone cortical porosity peripheral quantitative computed tomography
Publication Title 岡大三朝分院研究報告
Published Date 1999-12
Volume volume70
Start Page 53
End Page 60
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308477
JaLCDOI 10.18926/14933
Title Alternative 気管支喘息患者における白血球ロイコトリエン産生能に対する不飽和脂肪酸食の効果に影響する因子
FullText URL 070_043_052.pdf
Author Okamoto, Makoto| Mitsunobu, Fumihiro| Ashida, Kozo| Mifune, Takashi| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Harada, Seishi| Takada, Shingo| Tanizaki, Yoshiro| Kataoka, Mikio| Niiya, Kenji| Harada, Mine|
Abstract Dietary supplementation with perilla seed oil, a vegetable oil rich in α -lin- olenic acid, inhibits the generation of leukotrienes(LTs) by leucocytes in patients with bronchial asthma. We examined the factors that affect the suppression of LT generation by leucocytes with perilla seed oil-rich supplementation in patients with asthma, by comparing the clinical features of patients with asthma, whose generation of leukotriene (LT) C4 was suppressed by dietary supplementation with perilla seed oil (n-3 fatty acids) (group A), with those of patients who showed no suppression of LTC4 generation (group B). Group A showed a significant increase in the generation of LTB4 and L TC4 by leucocytes after corn oil-rich supplementation (n-6 fatty acids), and a significant decrease in the generation of LTB4 and LTC4 after perilla seed oil-rich supplementation (n-3 fatty acid). However, this was not observed in group B. The level of serum IgE and peak expiratory flow (PEF) in group A were significantly higher than in group B. Furthermore, the serum levels of LDL-cholesterol, β-lipoprotein and phospholipid were significantly lower in group A than in group B. These results suggest that the clinical features differ between these two asthmatic populations with respect to suppression of LTB4 and LTC4 generation by n-3 fatty acids in perilla seed oil-rich supplementation.
Abstract Alternative a-リノレン酸の豊富なエゴマ油の食事は気管支喘息患者の白血球ロイコトリエン(LT)産生能を抑制する。気管支喘息患者の内,エゴマ油食によりLTC4の産生が抑制された群(A群)と抑制されない群(B群)の臨床データを比較することにより,気管支喘息患者の白血球ロイコトリエン産生能に影響する因子を検討した。A群はコーン油(n-6系脂肪酸)の豊富な食事後,白血LTB4,LTC4の産生能が増加し,エゴマ油(n-3系脂肪酸)の豊富な食事後LTB4,LTC4の産生能が減少した。これらの変化はB群では認められなかった。A群のIgE値,ピークフロー(PEF)値はB群に比し,有意に高値であった。またLDL-コレステロール,β-リポ蛋白,リン脂質はA群ではB群に比し,有意に低値であった。これらの結果はエゴマ油の豊富な食事のn-3系脂肪酸によるLTB4,LTC4の産生能の抑制に関して2群の気管支喘息患者群間に臨床データの相違があることを示唆している。
Keywords エゴマ油 (perilla seed oil) 気管支喘息 (bronchial asthma) ロイコトリエン (leukotrienes) IgE 脂質代謝 (lipometabolism)
Publication Title 岡大三朝分院研究報告
Published Date 1999-12
Volume volume70
Start Page 43
End Page 52
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308623
JaLCDOI 10.18926/14927
Title Alternative サーモグラフィーによる体表面温度の測定 3.体表面温度の回復率と末消血流量との相関
FullText URL 070_036_042.pdf
Author Hosaki, Yasuhiro| Takata, Shingo| Mitsunobu, Fumihiro| Mifune, Takashi| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Harada, Seishi| Tanizaki, Yoshiro| Ochi, Koji| Tsuji, Takao|
Abstract The body surface peripheral circulation in 12 cases, including 9 patients with diabetes mellitus who were suffering coldness, numbness or pain in their feet, and 3 healthy volunteers was examined using Laser-Doppler blood flowmetry. At the same time, the body surface temperature was estimated by thermography. Thermographic results were analyzed quantitatively by calculating a recovery ratio as : Recovery ratio = [Total counts of thermography(Pixels) over temperature (T) after cold loading] ÷ [Initial counts over T before cold loading] x 100(%). The recovery ratio and the blood flow were correlated, r=0.68, p<O.01. The peripheral circulation of 16 patients with diabetes mellitus was observed at three different conditions including, l)placed at room temperature at 20℃for 15 min, 2) submerged and warmed for 5 min in a hot bath at 36℃(i.e. hot loading), and 3) submerged and cooled for 5 min in a water bath at 20℃ (i.e. cold loading). Three different baseline temperatures, 26℃, 27℃ and 28 ℃, were used in processing the thermographic results into pictures. The highest correlation (r=0.59, p=0.0002) was obtained under the condition of cold loading using a baseline temperature limitation of27℃.The difference ratio (%) of blood flow was calculated as the blood flow at cold loading divided by the blood flow at hot loading in these 16 patients. The difference ratio of the blood flow and the recovery ratio of thermography were correlated, r=0.46, p<O.OOO1. We found a strong correlation between the results of Laser-Doppler blood flowmetry and one of thermographic methods used to monitor peripheral circulation in patients with diabetes mellitus. Cold loading using a baseline temperature limitation of 27℃ were recommended for further examinations. Patients with low blood flow as well as with large differences in their peripheral circulation between cold loading and hot loading had severe coldness in their body surface temperature. We showed the usefulness of the results of thermography, when quantified by picture processing using computer software, in relation with the results of Laser-Doppler blood flowmetry.
Abstract Alternative 末梢神経障害を有する糖尿病患者の末梢循環障害の程度を数量的に検討する目的で、下肢に冷感ならびにしびれ感または疼痛を訴える糖尿病患者9症例と健常ボランティア3例の計12例(平均年齢59歳)についてサーモグラフィーを用いて体表面温度を測定した。更に,サーモグラフィーで得られた結果と末梢皮膚血流量をレーザードプラー血流計を用いて測定して得られた結果と比較した。サーモグラフィーによる測定で得られた結果は回復率として数量化して表示された。回復率の算出方法は回復率= [冷水負荷後の特定温度27℃以 上の体表面温度のサーモグラフィーのPixelの総数]÷ [冷水負荷前の特定温度27℃以上の体表面温度のサーモグラフィーのPixelの総数]×100%で求めた。レーザードプラ-血流計を用いて測定して得られた末梢血流量は左右それぞれ5カ所,計10カ所の測定値の平均で表示した。その結果,末梢皮膚温度の回復率と末梢皮膚の血流量との問には正の相関関係(r=0.68,p<0.01)が認められた。次に,末梢皮膚血流量について,室温20℃安静15分後,温水36℃浸水負荷10分後,冷水20℃浸水負荷30分後の異なる3条件について、またサーモグラフィーで得られた結果を,画像処理の過程で用いられた,26℃,27℃,28℃の3つの異なる特定温度との関連について検討を行なった。対象は,下肢に冷感ならびにしびれ感または疼痛を訴える糖尿病患者16症例(平均年齢69歳,平均HbAIC9.6%)について測定した。その結果,末梢皮膚 血流量は冷水20℃浸水負荷30分後に測定して得られた結果と,回復率は特定温度27℃で画像処理して得られた結果とが最も相関が高い(r=0.59,p=0.0002)ことが示された。`次に,相関が高い条件は,室温20℃安静15分後に血流量を測定した場合(r=0.483,p=0.0002)であった。そして温 水36℃浸水負荷10分後に測定して得られた結果とが最も相関関係が低い結果となった。更に,冷水20℃浸水負荷30分後に測定して得られた結果を温水36℃浸水負荷10分後に測定して得られた結果で割った比を%で表示したところ回復率とこの比との間には正の相関関係(r=0.46,p<0.0001)が認められた。このことから,温水36℃負荷時と,冷水20℃負荷時との差が大きい患者 において末梢皮膚温度の低下が著しいことが示された。これまで悲観血的に測定されてきたサーモグラフィーによる末梢循環の数量的評価の試みは,レーザー血流計による結果と組み合わせることで,両者の間に正の相関関係が示されたことにより,今後,数量化された客観的評価を可能にした。
Keywords サーモグラフィー (thermography) レーザードプラー血流計 (Laser-Doppler blood flowmetry) 糖尿病 (diabetes mellitus) 末梢循環 (peripheral circulation) 冷水負荷 (cold loading)
Publication Title 岡大三朝分院研究報告
Published Date 1999-12
Volume volume70
Start Page 36
End Page 42
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308240
JaLCDOI 10.18926/14926
Title Alternative 気管支喘息症例における気道過敏性と鼻腔・副鼻腔疾患の関係に関する検討
FullText URL 070_028_035.pdf
Author Mifune, Takashi| Takata, Shingo| Okamoto, Makoto| Tsugeno, Hirofumi| Ashida, Kozo| Harada, Seishi| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Tanizaki, Yoshiro| Harada, Mine|
Abstract Pathological changes of nasosinus occur often in subjects with bronchial asthma. Coexisting nasosinus lesion may affect pathophysiology of lower respiratory tract in asthmatics. The extent of nasal and sinus lesion was quantified in 17 patients with bronchial asthma, and their relationships to atopic status, asthma severity and bronchial hyperresponsiveness were evaluated in this study. Opacification degree of maxillary sinuses and nasal mucosa thickening were quantified using CT scans. The opacification degree was evaluated as (total opacification area)/(total maxillary sinus area). Although the opacification degree of maxillary sinuses in atopic patients showed no significant difference compared with that in non-atopic patients, maximum nasal mucosa thickening in atopic patients had a significant difference compared with that in non-atopic patients (p=0.028). In severe asthmatics, the opacification degree of maxillary sinuses was significantly more prominent compared with those in moderate and mild asthmatics (p=0.0005, p=0.036, respectively). Significantly marked nasal mucosa thickening was recognized in mild asthmatics compared with that in moderate asthmatics (p=0.0462). Regarding bronchial hyperresponsiveness, a significant correlation between Dmin and the opacification degree of maxillary sinuses was observed (rs= -0.551, p=0.0276). Nasal mucosa thickening had no correlation with bronchial hyperresponsiveness. The results suggest that sinusitis may affect bronchial hyperresponsiveness and asthma severity. Treatment of sinusitis may lead to improvement of asthma symptoms.
Abstract Alternative 鼻腔・副鼻腔疾患はしばしば気管支喘息症例に合併が認められ,喘息症例の下気道病態に影響を及ぼしている可能性が考えられる。今回,気管支喘息17例において,CTを用いて上顎洞の不透明化率・鼻腔粘膜肥厚を計測し,アトピー性の有無,喘息の重症度,気道過敏性との関係を検討した。上顎洞不透明化率は全上顎洞面積の総計に対する不透明化領域面積総計として計算を行った。上顎洞不透明化率はアトピー性の有無で差は認められなかったが,鼻腔粘膜はアトピー性喘息症例で有意に肥厚していた。重症気管支喘息における上顎 洞不透明化率は,中等症および軽症喘息症例に比べ有意に高値であった。鼻腔粘膜肥厚は中等症喘息症例に比べ,軽症症例で有意に肥厚していた。気道過敏性(Dmin)は上顎洞不透明化率とのあいだに弱い負の相関が認められた(rs=-0.551,p=0.0276).鼻粘膜肥厚と気道過敏性は相関が認められなかった。今回の結果から副鼻腔病変が気道過敏性・喘息重症度に影響を及ぼしている可能性が考えられ.副鼻腔疾患の治療により喘息症状の改善に繋がる可能性が考えられた。
Keywords 気管支喘息 (bronchial asthma) 副鼻腔炎 (sinusitis) CT所見 (CT findings) 気道過敏性 (hyperresponsiveness)
Publication Title 岡大三朝分院研究報告
Published Date 1999-12
Volume volume70
Start Page 28
End Page 35
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308098
JaLCDOI 10.18926/14925
Title Alternative 気管支喘息における胸部HRCT所見の臨床[光延文裕1]的意義
FullText URL 070_017_027.pdf
Author Mitsunobu, Fumihiro| Mifune, Takashi| Ashida, Kozo| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Okamoto, Makoto| Harada, Seishi| Nakai, Mutsuo| Tanizaki, Yoshiro|
Abstract The significance of the low attenuation area (LAA) of the lungs on high resolution computed tomography (HRCT) has not been determined in patients with asthma. We examined the relationship between the percentage of lung area with CT numbers lower than -950HU (% LAA) and the mean CT number in 81 patients with reversible airway obstruction (asthma) and in 22 healthy subjects, as well as the relationship between maximal % LAA and various parameters of pulmonary function, smoking history, disease severity and allergic type in the asthmatic subjects. The mean CT number was obtained by scans at three anatomic levels, and maximal % LAA was the % LAA which had the largest value of those measured at the three anatomic levels of the lung. We found that: 1. The mean CT number was closely related to the maximal % LAA of the lungs in all subjects studied (r= -0.916, p<O.OOO1). 2. The maximal % LAA in asthmatics with a previous smoking history (median: 20.1) was significantly larger than that in asthmatics without a smoking history (median: 10.8), and that in healthy subjects with (median: 8.8) and without a history of smoking (median: 10.4). 3. The maximal % LAA was significantly correlated with FEV1/FVC (r=-0.611, p<O.OOO1) and TLC (r=0.391, p=0.0068) in the asthmatic subjects. 4. The maximal % LAA was significantly correlated with the severity of asthma (p<O.01), but not with the etiology of asthma. This study suggests that the maximal % LAA is influenced by disease severity in patients with asthma, and that a smoking history has a more significant effect on the pulmonary function of asthmatics than healthy individuals.
Abstract Alternative 【目的】気管支喘息症例において胸部HRCTを用いて% LAA(Lowattenuationarea)を評価し,臨床病態との関連を検討する。 【対象と方法】気管支喘息症例81例ならびに健常者22例を対象とした。大動脈弓部,下葉分岐部,横隔膜上3cmの3スライスを撮影し,胸部CT値の演算によりCT値が-950HU以下の% LAA,さらに3スライス中の最大% LAAと3スライスの平均CT値を算出した。その値と年齢,発症年齢,罹病期間,性別,喫煙歴,重症度,病型,肺機能との関連を検討した。【結果】1.最大% LAAは平均CT値と強い相関を示した(r=-0.916,p<0.0001)。2.最大% LAAは喫煙喘息患者において非喫煙喘息患者,喫煙ならびに非喫煙健常者に比較して喫煙者において有意に高値を示した。% LAAは喫煙者,非喫煙者ともに重症例において有意に高値を示した。3.最大% LAAは肺機能では1秒率(r=-0.611,p<0.0001),全肺気量(r=-0.391,p<0.0001)と有意な相関を示した。4.最大% LAAは喘息の重症度とは有意の竿間を示したが,病型とは関連は見られなかった。 【考案】喘息患者におけるHRCTによる最大% LAAは喫煙,重症度,肺機能と関連を示しており,気管支喘息の臨床病態を反映する可能性が示唆された。
Keywords low attenuation area high resolution computed tomography reversible airway obstruction
Publication Title 岡大三朝分院研究報告
Published Date 1999-12
Volume volume70
Start Page 17
End Page 27
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308175
JaLCDOI 10.18926/14922
Title Alternative Ⅰ型アレルギー反応および副腎皮質ホルモンは気管支喘息における末梢血白血球のロイコトリエンB4およびC4産生に影響をおよぼす
FullText URL 070_009_016.pdf
Author Tanizaki, Yoshiro| Mitsunobu, Fumihiro| Mifune, Takashi| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Harada, Seishi| Takata, Shingo| Ochi, Koji| Koide, Norio|
Abstract The generation. of leukotrienes 84 (LT84) and C4 (LTC4) by leucocytes stimulated with Ca ionophore A23187 was examined in 71 patients with asthma (42 with atopic and 29 with nonatopic asthma) and 23 healthy controls. Of these patients,22 had SDIA (steroid-dependent intractable asthma). 1. The generation of LT84 and LTC4 by leucocytes was significantly more enhanced in patients with atopic, non-SOIA asthma than in healthy subjects, but not in patients with nonatopic asthma. The generation of LT84 and LTC4 in atopic asthma was significantly more decreased in patients with SOIA than in those with non-SOIA. 2. The LTC4 generation was significantly larger in attack stage than in attack-free stage of patients with atopic and nonatopic asthma when they had not SOIA. However, no significant difference was found in LT84 generation between attack and nonattack stages in these patients. 3. In patients with SOIA, no significant differences were observed in the generation of LT84 and LTC4 between attack and nonattack stages. The results suggest that IgE-mediated allergy and asthma attacks enhance and glucocorticoids inhibit the generation of LT84 and LTC4 by leucocytes.
Abstract Alternative 気管支喘息71例および健康人23名を対象に、Ca ionophore A23187刺激時の末梢血白血球のロイコトリエンB4 (LTB4)およびC4(LTC4)の産生能について検討を加えた。なお、71例中ステロイド依存性重症難治性喘息(SDIA)は22例であった。1.アトピー性、16非SDIA症例におけるLTB4、LTC4産生は、健康人と比べ有意に高い値を示したが、非アトピー性喘息では健康人との間に有意の差は見られなかった。また、アトピー性喘息では、SDIA症例において非SDIA症例に比べ、LTB4、LTC4産生が有意に抑制されていた。2.非SDIA症例では、アトピー性、非アトピー性を問わず、LTC4産生は、非発作時に比べ発作時に有意に亢進した状態であった。しかし、LTB4産生には、非発作時、発作時との間に有意の差は見られなかった。3.SDIA症例では、LTB4、LTC4産生と発作との有意の関連は見られなかった。以上の結果より、IgE にmediateされるアレルギー反応や喘息発作はLTB4、LTC4産生に促進的に、また副腎皮質ホルモンは抑制的に作用することが示唆された。
Keywords bronchial asthma LT84 LTC4 IgE-mediated allergy glucocorticoids
Publication Title 岡大三朝分院研究報告
Published Date 1999-12
Volume volume70
Start Page 9
End Page 16
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308654
JaLCDOI 10.18926/14921
Title Alternative Spa therapy for patients with asthma. A study on 437 patients with asthma admitted for last 5 years.
FullText URL 070_001_008.pdf
Author Tanizaki, Yoshiro| Mitsunobu, Fumihiro| Mifune, Takashi| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Harada, Seishi| Takata, Shingo| Ochi, Koji|
Abstract 1994年1月より1998年12月までの5年間に当院へ入院した呼吸器疾患のなかで気管支喘息を対象に,年齢,地域分布などの経年変化について検討を加えた。1.最近5年間に当院へ入院した呼吸器疾患患者は664例で,このうち,気管支喘息は437例(65.8% )であった。呼吸器疾患のなかで気管支喘息に占める割合の経年変化では,1995年度が最も高く(74.4% ),1997,1998年度にはやや低下(ともに60.7% )の傾向が見られた。2.入院患者の地域分布では,鳥取県内からの入院患者に比べ,遠隔地(鳥取県外)からの入院患者が比較的多く,いずれの年度においても50% 以上(平均57.3% )であった。また,岡山,大阪,兵庫,広島,山口,愛媛県などからの入院症例が多い傾向か見られた。3.年齢別検討では,いずれの地域においても,高齢者の入院症例か多く,鳥取県内では70才以上の症例の頻度(平均35.1% )が,また遠隔地(鳥取県外)では60-69才の症例の頻度(平均37.7% )が高い傾向か見られた。
Abstract Alternative The parients with asthma who were admitted at our hospital for last 5 years (1994-1998) were examined in relation to age and areas where patients came. 1. Of 664 patients with respiratory disease admitted for last 5 years, 437 patients (65.8% ) had asthma. The frequency of asthma in all patients with respiratory disease was the highest (74.4% ) in 1995, and decreased in 1997 and 1998 (60.7% ). 2. The number of patients with asthma from distant areas (outside Tottori prefecture) was constantly larger than the number of those inside Tottori prefecture in each year. The number of patients from Okayama, Osaka, Hyogo, Hiroshima, Yamaguchi, and Ehime was larger than the number from other distant areas. 3. Regarding the distribution of age of these patients, the number of patients over the age of 60 was more frequently observed, regardless of the area where patients came. Larger number of patients over the age of 70 (35.1% ) was found in those inside Tottori prefecture, while the number of patients between the ages of 60 and 69 (37.7% ) was larger in those from distant areas.
Keywords 気管支喘息 (asthma) 温泉療法 (spa therapy) 高齢患者 (aged patients) 遠隔地 (distant area)
Publication Title 岡大三朝分院研究報告
Published Date 1999-12
Volume volume70
Start Page 1
End Page 8
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308420
JaLCDOI 10.18926/14912
FullText URL 071_073_075.pdf
Author Ashida, Kozo| Tsugeno, Hirofumi| Hosaki, Yasuhiro| Mitsunobu, Fumihiro| Mifune, Takashi| Nishida, Norikazu| Okamoto, Makoto| Takata, Shingo| Tanizaki, Yoshiro| Tsuji, Takao|
Abstract 症例は80才,女性。76才時[平成7年11月]より肝機能異常[アルカリフォスファターゼ高値]を認め,肝機能異常出現1年7ケ月後,血清学的検索で原発性胆汁性肝硬変症が疑われたが,無治療にて外来で経過を観察を行った。アルカリフォスファターゼ値は漸増傾向を示し,トランスアミナーゼ値の異常も伴ってきたため,平成12年11月精査目的で入院。組織検査等で無症候性原発性胆汁性肝硬変症[PBC]と診断した。PBCは中年・女性に好発する疾患で,高齢【特に後期高齢者]での発症は極めて稀である。4年間の自然経過も含め,興味深いと考えられたので報告する。
Keywords 原発性胆汁性肝硬変症 (primary biliary cirrhosis) 高齢 (elderly) 自然経過 (natural course)
Publication Title 岡大三朝分院研究報告
Published Date 2001-02-01
Volume volume71
Start Page 73
End Page 75
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308230
JaLCDOI 10.18926/14910
Title Alternative ステロイド依存性気管支喘息症例の病的骨折と皮質骨傷害の検討
FullText URL 071_059_067.pdf
Author Tsugeno, Hirofumi| Goto, Bunrei| Nakai, Mutsuro| Okamoto, Makoto| Takata, Singo| Mifune, Takashi| Hosaki, Yasuhiro| Mitsunobu, Fumihiro| Ashida, Kozo| Akiyama, Tsuneo| Tsuji, Takao| Tanizaki, Yoshiro|
Abstract In a previous study, we demonstrated that chronic administration of systemic glucocorticoids decreases cortical bone mineral density (BMD) and induces development of pathologic fractures in asthmatic patients. To investigate cortical bone porosity due to glucocorticoids, we studied cortical bone volume, BMD, bone strength, and fractures in patients with asthma in this report. A total of 82 postmenopausal asthmatic patients were enrolled in the study. Vertebral fractures were diagnosed via plain spinal radiograms. Peripheral quantitative computed tomography (pQCT) was used to measure cortical BMD, relative cortical volume, and Strength Strain Index (SSI). Multiple regression analysis, Student's t test, and other statistical analyses were performed. Patients with systemic glucocorticoids therapy had lower cortical BMD, relative cortical volume, SSI, and more number of vertebral fractures than patients without it. Lifetime cumulative dose of glucocorticoids was related to cortical BMD, relative cortical volume, SSI, and the number of vertebral fractures. The cortical volumedensity relationship appeared to remain constant regardless of systemic glucocorticoid administration. The number of vertebral fractures correlated highly with cortical BMD, relative cortical volume, and SSI at the radius. In conclusion, systemic glucocorticoid administration decreases cortical bone density, cortical bone volume, and bone strength. G lucocorticoid administration appears to be responsible for the process of cortical bone porosity at both endosteal and intracortical sites. Given that both cortical bone density and volume provide bone strength, cortical bone porosity was seen to contribute to glucocorticoid - induced bone strength loss and fractures.
Abstract Alternative 【目的】骨強度には皮質骨の状態が主に関与するため,全身ステロイド療法に伴う病的骨折と皮質骨障害について検討した。【方法】閉経後女性気管支喘息患者82例で,ステロイド依存性群と非依 存群において,椎体骨折数,槙骨皮質骨骨密度,皮質骨容量,骨強度(SSI)をⅩ線側面像とpQCTを用いて検討した。 【結果】ステロイド依存群はステロイド非依存群に比べて,椎体圧迫骨折数は有意に多く,榛骨皮質骨骨密度,皮質骨容積比,骨強度は各々有意に低下していた。また,皮質骨骨密度と容積は一定の割合で減少していた。椎体圧迫骨折数は皮質骨骨密度,皮質骨容積比,骨強度の全てと高い相関を認めた。 【結論】ステロイド依存性気管支暗息症例においては,皮質骨の骨 密度と容量が同時に減少して骨強度が減少することによって,病的骨折が発症すると考えられた。
Keywords glucocorticoid cortical bone pQCT osteoporosis
Publication Title 岡大三朝分院研究報告
Published Date 2001-02-01
Volume volume71
Start Page 59
End Page 67
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308222
JaLCDOI 10.18926/14909
Title Alternative 脂肪の変化と関連した気管支喘息に対するn-3系脂肪酸食の効果 ― n-6系脂肪酸との比較
FullText URL 071_050_058.pdf
Author Okamoto, Makoto| Mitsunobu, Fumihiro| Ashida, Kozo| Mifune, Takashi| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Takata, Shingo| Tanizaki, Yoshiro| Harada, Mine|
Abstract N-3 fatty acids have been reported to be effective for asthma. In the present study, the effects of perilla seed oil (n-3 fatty acids) on asthma were compared with the effects of corn oil (n-6 fatty acids) in terms of pulmonary function, lipometabolism and the generation of leukotriene C4 (LTC4) by leucocytes. A total of 28 asthmatic patients were randomly divided into two groups : Group A patients (15 subjects) consumed perilla seed oil-rich supplementation, while Group B patients (13 subjects) consumed corn oil-rich supplementation for 4 weeks. Generation of LTC4 by leucocytes, respiratory function and the serum levels of lipids were compared between the two groups. The generation of LTC4 by leucocytes decreased significantly in Group A subjects following perilla seed oil-rich supplementation for 2(P < 0.05) and 4 weeks(P < 0.01). A significant difference in the generation of LTC4 was observed between the two groups after different dietary supplementations for 4 weeks (P < 0.05). Significantly increased values for PEF (P < 0.01), FVC (P < 0.05) and FEV1.0 (P < 0.05) were found in Group A subjects following perilla seed oil supplementation for 4 weeks, compared with the initial value prior to supplementation. A significant decrease in the serum level of total cholesterol, LDL-cholesterol and phospholipid was detected in Group A subjects following perilla seed oil supplementation for 4 weeks. The present results suggest that peril la seed oil-rich supplementation is effective in the treatment of asthma in terms of its ability to suppress LTC4 generat ion by leucocytes, and in inducing an improvement in pulmonary function associated with changes in the serum level of lipids.
Abstract Alternative n-3系脂肪酸は喘息に有効であることが報告されている。今回、エゴマ油(n-3系脂肪酸)の喘息に対する効果を呼吸機能、イコトリエンC4(LTC4)産生能の観点から、コーン油(n-6系脂肪酸)のそれと比較した。28例の喘息患者を無作為に2群に分け、A群(15例) はエゴマ油食を、B群(13例)はコーン油食をそれぞれ4週間摂取した。白血球LTC4産生能、呼吸機能、血清脂質を2群間で比較した。白血球LTC4産生能はエゴマ抽食を摂取したA群で2週後(P < 0.05)、4過後(P < 0.01)に有意に低下した。食事摂取4過後に岳群間でLTC4産生能に有意差が認められた(P < 0.05)。エゴマ油食を4過摂取したA群ではピークフロー(P < 0.05)、肺活量(P < 0.01)、1秒量(P < 0.05)が食事摂取前に比し、有意に増加した。またA群ではエゴマ坤食摂取4週後に血清総コレステロール値、LDL-コレステロール値、リン脂質の有意な低下がみられた。こ れらの結果より、エゴマ油食は白血球LTC4産生能を抑制することにより、呼吸機能を改善し、血清脂質の変化と関連して、喘息の治療に有効であることが示唆された。
Keywords perilla seed oil (エゴマ抽) a -1inolenic acid (α-リノレン酸) leukotriene C4 (ロイコトリエンC4) respiratory function (呼吸機能) 脂質代謝
Publication Title 岡大三朝分院研究報告
Published Date 2001-02-01
Volume volume71
Start Page 50
End Page 58
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308088
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
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 10.18926/14906
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 10.18926/14905
Title Alternative 胸部高分解能CT(HRCT)による肺野low attenuation area(LAA)の定量的評価 ―気管支喘息および肺気腫症例の比較検討―
FullText URL 071_019_028.pdf
Author Mitsunobu, Fumihiro| Mifune, Takashi| Ashida, Kozo| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Okamoto, Makoto| Harada, Seishi| Nakai, Mutsuo| Tanizaki, Yoshiro|
Abstract Background: Assessment of low attenuation areas and lung densitometry on high resolution computed tomography (HRCT) have been reported in studies of patients with chronic obstructive pulmonary disease. Objective : The purpose of this study was to examine if HRCT could separate asthmatic patients from normal control subjects and patients with emphysema. Methods : Subjects were divided into three groups : 24 patients with bronchial asthma, 23 patients with pulmonary emphysema and 15 normal controls. HRCT scans of the lung were performed at three different levels at both end inspiration and expiration in all patients and control subjects. Results : The mean CT number of three slices was significantly lower in asthmatic subjects compared with normal individuals at both end inspiration (p < 0.05) and expiration (p < 0.01). The relative area of the lung with an attenuation value lower than -950 HU (% LAA) for three slices was significantly higher in asthmatic subjects than in normal individuals at end inspiration (p < 0.05), but there was no significant difference at end expiration. The mean CT number and % LAA obtained from studies that were performed at three cm above the top of the diaphragm provided the best separation among three anatomic levels. In comparison between asthmatic and emphysema patients, both parameters were significantly different in asthmatic subjects than in those with emphysema at both end inspiration and expiration on each scan and in the total scans (p < 0.001). Conclusions : HRCT is a useful method to separate asthmatic subjects from patients with emphysema and normal subjects.
Abstract Alternative 【目的】肺野low attenuation area(LAA)は、慢性閉塞性肺疾患(COPD)における肺気腫の存在ならびに程度を反映することが知られている。そこで喘息患者におけるLAAの意義を明らかにすることを目的として、COPD患者、コントロールとの比較検討を行った。  【対象と方法】喘息症例24例、COPD症例23例、コントロール15例を対象として、上・中・下肺野の3スライスで深吸気、深呼気時において胸部高分解能CT(HRCT)を施行し3群間で比較検討を行った。CTパラメーターとしては、平均m値、肺野面積に対する-950HU以下のLAAの割合(% LAA)を採用した。  【結果】1.3スライスの平均CT値は、吸気および呼気とも3群間での有意の差が認められた。2.3スライスの% LAAは、吸気では3群間での有意の差が認められたが、呼気では喘息とコントロール間での有意の差は認められなかった。3.COPD症例では、吸気、呼気ともに平均CT値は他の2群より有意に低値を示し、% LAAは他の2群よりより有意に高値を示した。4.3群間の平均CT値と% LAAの相違は下肺野のスライスで最も顕著であった。  【考案】平均CT値および% LAAは、喘息、COPD、コントロールにおいて有意に異なっており、喘息およぴCOPDの病態を反映する可能性が示唆された。
Keywords HRCT asthma emphysema
Publication Title 岡大三朝分院研究報告
Published Date 2001-02-01
Volume volume71
Start Page 19
End Page 28
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308115
JaLCDOI 10.18926/14904
Title Alternative 高齢者気管支喘息における気道過敏性と温泉療法
FullText URL 071_010_018.pdf
Author Tanizaki, Yoshiro| Mitsunobu, Fumihiro| Mifune, Takashi| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Takata, Shingo| Ochi, Koji|
Abstract Clinical effects of spa therapy were examined in 150 patients with asthma in relation tobronchial hyperresponsiveness and patient age. 1. The efficacy rate of spa therapy was larger as the patient age was higher: the rate was 73.3% in patients under age 49, 81.8% in those between the ages of 50 and 59, 86.4% in those between the ages of 60 and 69, and 90.6% in those over age 70. The mean of efficacy rates was 83.3% in all subjects. 2. The bronchial hyperresponsiveness (BH) was lower as patient age was higher: the BH in patients between the ages of 60 and 69 and in those over age 70 was significantly lower compared to the BH in those under age 49 (p < O.OOl). 3. Clinical effects of spa therapy tended to be lower in patients with increased bronchial hyperresponsiveness. The bronchial hyperresponsiveness showed a tendency to decrease after spa therapy in whom the therapy was effective, however, the BH did not change in patients with slight or no efficacy during spa therapy.
Abstract Alternative 1.温泉療法では,年齢が高くなるほどその有効率も高くなると言う傾向が見られ、49才以下の症例では73.3% ,50-59才の症例では81.8% , 60-69才の症例では86.4% ,70才以上では90.6% であり,全症例の平均有効率は73.3% であった。  2.気道過敏性は,年齢が高くなるほど低下する傾向が見られ,60-69才および70才以上の症例の気道過敏性は,49才以下の症例と比べ有 意に低い値を示した(P < 0.001)。  3.温泉療法の臨床効果は,気道過敏性が強くなるにつれて低下する傾向が見られた。また,温泉療法の著効例や有効例では,治療により 気道過敏性が低下してくるが、やや有効例や無効例では,気道過敏性はほとんど変化しないことが示された。
Keywords spa therapy asthma bronchial hyperresponsiveness patient age
Publication Title 岡大三朝分院研究報告
Published Date 2001-02-01
Volume volume71
Start Page 10
End Page 18
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308660
JaLCDOI 10.18926/14903
Title Alternative Spa therapy for 999 patients with respiratory disease admitted at Misasa Medical Branch for last 7 years
FullText URL 071_001_009.pdf
Author Tanizaki, Yoshiro| Mifune, Takashi| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Takata, Shingo| Ochi, Koji|
Abstract 1993年1月より1999年12月までの7年間に当院へ入院した呼吸器疾患999例のうち閉塞性換気障害を示す829例(気管支慌息BA+COPD)を対象に,年齢,地域分布などの経年変化について検討を加えた。 1.最近7年間に当院へ入院した閉塞性呼吸器疾患患者829例のうち, 気管支喘息は636例(76.7% )であった。閉塞性呼吸器疾患のなかで気管支喘息の占める割合の経年変化では,1996年度が最も高く(84.5% )その後徐々に低下する傾向か見られ1999年度では65.5% であった。一方′肺気腫は近年増加の傾向を示し,19993年度では5.6% であったが.1999年度では25.6% であった。  2.入院患者の地域分布では,鳥取県内からの入院患者に比べ,遠隔地(鳥取県外)からの入院患者が比較的多く,この7年間の鳥取県外(遠隔地)からの入院患者は829例中433例(52.2% )であった。また,岡山,大阪,兵庫,広島,山口,愛媛,東京,神奈川などからの入院症例か多い傾向が見られた。  3.年齢別検討では,いずれの地域においても,高齢者の入院症例が多く,鳥取県内,県外を問わず,70才以上の症例の頻度が明らかに高い傾向か見られた.そして,50才以上の症例の全症例に対する頻度は,鳥取県内では80.9% ,県外では96.7% であり,県内ではその多くが,また県外ではそのほとんどが50才以上の症例であった。
Abstract Alternative The patients with asthma or COPD who were admitted at our hospital for last 7 years (1993-1999) were examined in relation to patient age and areas where patients came. 1. Of 829 patients with obstructive ventilatory dysfunction, 636 patients (76.7% ) had asthma. The frequency of asthma in all patients with obstructive ventilatory dysfunction was the highest (84.5% ) in 1993 and showed a tendency to decrease to 65.5% in 1999. In contrast, the frequency ofpulmonary emphysema tended to increase from 5.6% in 1993 to 25.6% in 1999. 2. The number of patients with asthma or COPD from distant areas (outside Tottori prefecture) was larger (433 patients; 52.2% ) than the number of those inside Tottori prefecture (396 patients) for 7 years. The number of patients from Okayama, Osaka, Hyogo, Hiroshima, Yamaguchi, Ehime, Tokyo, and Kanagawa was. larger than the number from other distant areas. 3 . Regarding the distribution of age of these patients, the number of patients over the age of 50 in all subjects was larger in patients from distant areas (96.7% ) than in those inside Tottori prefecture (80.9% )
Keywords 気管支喘息 (asthma) 肺気腫 (pulmonary emphysema) 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 2001-02-01
Volume volume71
Start Page 1
End Page 9
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308210
Author Takata, Shingo| Ashida, Kozo| Hosaki, Yasuhiro| Hamada, Masanori| Iwagaki, Naofumi| Kikuchi, Hiroshi| Mitsunobu, Fumihiro|
Published Date 2008-03-01
Publication Title 岡大三朝医療センター研究報告
Volume volume76
Content Type Departmental Bulletin Paper
Author Takata, Shingo| Ashida, Kozo| Hosaki, Yasuhiro| Hamada, Masanori| Iwagaki, Naofumi| Kikuchi, Hiroshi| Mitsunobu, Fumihiro|
Published Date 2008-03-01
Publication Title 岡大三朝医療センター研究報告
Volume volume76
Content Type Departmental Bulletin Paper
Author Takata, Shingo| Ashida, Kozo| Hosaki, Yasuhiro| Hamada, Masanori| Iwagaki, Naofumi| Kikuchi, Hiroshi| Mitsunobu, Fumihiro|
Published Date 2008-03-01
Publication Title 岡大三朝医療センター研究報告
Volume volume76
Content Type Departmental Bulletin Paper
Author Hamada, Masanori| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Iwagaki, Naofumi| Takata, Shingo| Kikuchi, Hiroshi|
Published Date 2008-03-01
Publication Title 岡大三朝医療センター研究報告
Volume volume76
Content Type Departmental Bulletin Paper