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 10.18926/14822
Title Alternative Spa therapy for patients with respiratory disease. Analysis of 1934 patients admitted at Misasa Medical Branch for last 20 years from 1982 to 2001
FullText URL 72_001_008.pdf
Author Tanizaki, Yoshiro| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Nishida, Norikazu| Takata, Shingo| Yokoi, Tadashi|
Abstract 1982年1月より2001年12月までの20年間に当院へ入院した呼吸器疾患患者1934例のうち閉塞性換気障害を示す肺疾患1641例(気管支喘息BA+慢性閉塞性呼吸器疾患COPD)を対象に,5年間ごとに年齢,地域分布などの経年変化について検討を加えた。  1.最近20年間に当院へ入院した閉塞性換気障害を示す呼吸器疾患1641例のうち,気管支喘息は1226例(74.7%)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は,最初の5年間では106例中 57例(53.8%),1987年からの5年間では71.7% (271/378),1992年からの5年間では73.6% (433/588)で,最近の5年間では53.9% (465/862)と最近ではその割合がやや低下する傾向が見られた。  2.全ての気管支喘息のなかでステロイド依存性重症難治性喘息(SDIA)の割合は,最初の5年間をのぞけばほぼ横ばいで最近の5年間では35.3%であった。COPDのなかでの肺気腫の割合は,近年増加の傾向を示し,最初の5年間の4.7% (5/106)に対して最近の5年間では20.2% (174/862)であった。  3.年齢別検討では,閉塞性換気障害を示す全ての症例のうち60才以上の症例の割合は,最初の5年間では30.1%であったが,その後増加の傾向を示し,最近の5年間では68.0%であった。  4.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20年間の鳥取県外(遠隔地)からの入院患者は1641例中853例(52.0%)であった。また,岡山,大阪,広 島,兵庫,東京,愛媛,山口,京都などからの入院症例が多い傾向が見られた。なお,入院患者の出身県は,35都道府県に及んでいた。
Abstract Alternative Analysis of 1934 patients with respiratory disease admitted at Misasa Medical Branch for last 20 years from 1982 to 2001 was performed every 5 years. Of al patients with respiratory disease, 1641 patients had asthma and chronic obstructive pulmonary disease (COPD). 1. Of 1641 patients showing obstructive ventilatory dy sfuncion, 1226 (74.7%) patients fad asthma. The frequency of asthma in all patients with respiratory disease was 53. 8% for the first 5 years from 1982, 71. 7% (271/378) for the second five years, 73.6% (433/588) for'The third 5 years from 1992, and 53.9% (465/862) for the last five years from 1997. 2. The frequency of steroid-dependent intractable asthma (SDIA) was from 29. 0% to 41. 3% except the frequency (68.4%) for the first 5 years. The frequency of pulmonary emphysema in those with COPD was very low (4.7%;5/106) for the first 5 years and the frequency (20.2%;174/862, for the last 5 years) tended to increase. The frequency of patients over age 60 was 30.1% for the first 5 years, and showed a tendency to increase, and 68.0% for the last 5 years. 3. The frequency of patients from distant areas outside Totton prefecture was larger compared to the frequency inside Totton prefecture (853/1641;52.0%). The number of patients from Okayama, Osaka, Hyogo, Tokyo, Ehime, Yamaguchi, and Kyoto was larger than the number from other distant areas.
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 2002-02-01
Volume volume72
Start Page 1
End Page 8
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308041
JaLCDOI 10.18926/14834
Title Alternative HRCT上の肺のLow Attenuation Areaおよび肺機能により評価された高齢者善喘息の特徴
FullText URL 72_009_015.pdf
Author Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Nishida, Norikazu| Takata, Shingo| Yokoi, Tadashi| Nakai, Mutsuo| Tanizaki, Yoshiro|
Abstract The clinical significance of low attenuation area <-950 HU of the lungs on high - resolution computed tomography (HRCT) was evaluated in 80 patients with asthma in relation to patient age, CT number, pulmonary function including % residusal volume (% RV) and % DLco, and generation of leukotrienes B4 and C4 by leucocytes. 1. The % LAA (<- 950 HU) of the lungs showed a tendency to increase significantly with aging; the % LAA was significantly larger in elderly patients over the age of 60 years than in those under the age of 49 years. The CT number was also significantlyincreased with aging. 2. The values of % FVC, % FEV1.0, and FEV1.0% were significantly decreased in elderly patients over age 70 compared with the values in those under age 49. 3. The value of % residual volume (% RV) tended to increase significantly with aging; the value in patients over the age of 70 years was significantly larger in those between the ages of 50 and 59 (p<O.OOl). and under the age of 49 years (p<O.OOl). 4. The % DLco value significantly decreased with aging; the value in patients over age 70 was significantly lower than the value in those between the ages of 50 and 59 (p<O.Ol) and under age 49 (p<O.OOl). 5. A significant correlation was observed between % LAA of the lungs and % RV (r=O. 67, p<0.001), however. any significant correlations were not observed between % LAA and the values of % FVC, % FEV1.0, and FEV1.0% . 6. The generation of LTB4 and LTC4 by leucocytes was not significantly related with patient age. The results suggested that % LAA of the lungs on HRCT tended to increse with aging, accompanied with a significant increase in % RV.
Abstract Alternative 気管支喘息80例(全例非喫煙者)を対象に,high resolution computedt omography (HRCT)上の肺の-950HU以下のLow attenuation area (LAA)の臨床的意義について, 患者年齢, CT number,残気率(% RV),拡散能(% DLco)を含む肺機能検査,白血球のコイコトリエンB4,C4の産生能などとの関連のもとに検討を加えた。 1.% LAAは,年齢が高くなるにつれて増加する傾向を示し,60才以上の症例の% LAAは,49歳以下の症例に比べ有意に高い値を示した。また,CT numberも,年齢が高くなるにつれて有意の増加を示した。 2.% FVC,% FEV1.0およびFEV1.0%値は,いずれも70才以上の症例で49歳以下の症例に比べ有意に低い値を示した。 3.残気率(% RV)は,年齢が高くなるにつれて増加する傾向を示し,70才以上の症例の% RVは,50-59才および49才以下の症例の% RVに比べ有意に高い値を示した。 4.一方,拡散能(% DLco)は,年齢が高くなるにつれて有意に低下する傾向を示し,70才以上の症例の% DLcoは,50-59才および49才以下の症例のDLcoに比べ有意に低い値を示した。 5.% LAAと% RVとの間には有意の相関が見られたが,% LAAと% DLco,および% LAAと換気機能(% FVC,% FEV1.0,FEV1.0%)との間には関連は見られなかった。 6.白血球のLTB4およびLTC4の産生能においては年齢による差は見られなかった。これらの結果は,% LAAが年齢とともに増加すること,そして% LAAは% RVと密接な関連を有していることを示している。
Keywords low attenuation area of the lung CT number residual volume DLco aging
Publication Title 岡大三朝分院研究報告
Published Date 2002-02-01
Volume volume72
Start Page 9
End Page 15
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308131
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
JaLCDOI 10.18926/14836
Title Alternative 高齢者気管支喘息の臨床病態におけるロイコトリエンB4,C4の役割. 気道過敏性とFEV1.0%との関連
FullText URL 72_023_030.pdf
Author Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Nishida, Norikazu| Takata, Shingo| Yokoi, Tadashi| Tanizaki, Yoshiro|
Abstract The generation of leukotrienes B4 (LTB4) and C4 (LTC4) by leucocytes stimulated with Ca ionophore A23187 was examined in 67 patients with asthma. 1. The generation of leukotriene B4 (LTB4) by leucocytes was significantly more increased in patients with asthma than in those with pulmonary emphysema (PE) and healthy subjects. The generation of leukotriene C4 (LTC4) was also signficantly more increased in patients with asthma compared to the generation in those with PE and healthy subjects. The generation of both LTB4 and LTC4 was significantly more increased in patients with PE than in healthy subjects. 2. The generation of both LTB4 and LTC4 was larger in patients with asthma over age 70 than in those of other age groups, however, the difference was not significant. 3. The generation of LTC4 was significantly higher in attack stage than in non-attack stage in all age groups of patients with asthma, however, the generation of LTB4 was not significantly different between the two stages. 4. Bronchial hyperresponsiveness to methacholine in patients with asthma tended to decrease with aging, and the bronchial hyperresponsiveness was to a certain extent correlated with the generation of LTB4, but not LTC4. 5. The generation of LTC4 was correlated with value of FEV1.0%. These results may suggest that both LTB4 and LTC4 participate in the pathophysiology of asthma in the elderly.
Abstract Alternative 気管支喘息67例を対象に, Ca ionophoreA23187刺激時の白血球からのロイコトリエンB4(LTB4)およびC4 (LTC4)の産生を観察し,高齢者喘息の臨床病態におけるLTB4,LTC4の役割について検討した。  1.LTB4の産生は,気管支喘息において肺気腫および健康人に比べ有意に高い値を示した。LTC4の産生も同様に気管支喘息において,肺気腫,健康人に比べ有意に高い値30を示した。LTB4,LTC4いずれの産生も,肺気腫症例において健康人と比べ有意に高い値が観察された。  2.LTB4,LTC4の産生は,70才以上の喘息症例において,他の年齢層の症例に比べより高い値が示されたが,推計学的な有意差は見られなかった。  3.高齢者を含めいずれの年齢層の気管支喘息においても,LTC4の産生は発作時に,非発作時に比べ有意の亢進が見られたが,LTB4に関しては発作時,非発作時の間に有意の差は見られなかった。  4.気道の過敏性は,年齢が高くなるにつれて低下する傾向が見られた。そして,この気道の過敏性はLTB4産生とある程度関連していることが示されたが,LTC4との関連は見られなかった。  5.FEV1.0%値は,ある程度LTC4産生亢進と関連があることが示された。 以上の結果より,70才以上の喘息においても,LTB4,LTC4がその発作時病態に重要な役割を果していることが示唆された。
Keywords asthma LTB4 LTC4 FEV1.0% bronchial hyperresponsiveness
Publication Title 岡大三朝分院研究報告
Published Date 2002-02-01
Volume volume72
Start Page 23
End Page 30
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308466
JaLCDOI 10.18926/14837
FullText URL 72_031_037.pdf
Author Hosaki, Yasuhiro| Mitsunobu, Fumihiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Nishida, Norikazu| Takata, Shingo| Yokoi, Tadashi| Tanizaki, Yoshiro| Ochi, Koji| Tsuji, Takao|
Abstract The purpose of this study is to establish a new, non - invasive diagnostic technique for peripheral circulation in patients with diabetes mellitus in the early stage of arteriosclerosis obliterans (ASO) as one of the complications of diabetes mellitus. We observed peripheral circulation quantitatively by thermography and Laser- Doppler blood flowmetry. The body surface peripheral circulation in 27 patients with diabetes mellitus, including 14 males and 13 females with a mean age of 67.4 years (range from 51-82 years), and with a mean hemoglobin A1C (HbA1C) 019.5% (range from 6.8%-13.0%), and who were suffering coldness, numbness or pain in their feet, was examined using thermography and Laser- Doppler blood flowmetry. 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 after hot-loading] Xl00 (%). Results of recovery ratios for 27 cases were 0% - 93.5%, and the average was 34.0%. At the same time, the blood flow after cold -loading was 0.91 - 5. 36ml/min/lOOg tissue and the average was 2.04ml/min/l00g tissue. We found that the recovery ratio and the blood flow were correlated (r=O. 634, p<O. 0001). The recovery ratio for males was 28.4% and that of females was 39.9%, and there was a tendency for the recovery ratio of females to be higher than males, however, this was not statistically significant. There was a correlation between the recovery ratio and age (r=O.187, p < 0.0001), although, the correlation was low. There was also a slight correlation between the recovery ratio and HbA1C (r=0.041, p<O.OOl). On the other hand, the blood flow of males was 2. 03ml/min/lOOg tissue and that of females was 2.05. There was a tendency for the recovery ratio of females to be higher than males. however. the correlation was not significant. There was a correlation between blood flow and age (r=O. 110, p<0 . 0001) , however, the correlation was low. There was also a slight negative correlation between blood flow and HbA1C (r=-0.179, p<O.OOOl). The ratio of the blood flow after cold -loading at 20t divided by the blood flow after hot -loading at 36 C was 38.1 %-122%, and the average was 80.6%. There was correlation between this ratio and the recovery ratio (r=0.502, p<O.OOOl). The case of the peripheral blood flow recovered immediately to the amount of the hot-loading or access amount of hot-loading after cold-loading, and had a high recovery ratio of thermography. This might mean that the cooled body surface was warmed by overcirculation of blood flow to keep body temperature at 30C in the mean of homeostasis. We showed that thermography and Laser- Doppler blood flowmetry were useful for non - invasive study to separate patients with poor peripheral circulation. We recommend that these methods for evaluation of further treatment, such as with Prostaglandin E1, on peripheral circulation in patients with diabetes mellitus and ASO.
Abstract Alternative 糖尿病患者における閉塞性動脈硬化症の合併を早期に診断,予知,予防する目的で末梢循環障害の程度を非侵襲的にかつ客観的に測定することを試みた。非侵襲的測定方法としてサーモグラフィーとレ-ザードップラー血流計を同時に用い,得られた結果を数量化した。症例は,下肢に冷え症,しびれ感,下肢痛を有した51歳から82歳までの 27症例(平均年齢67.4歳)であった。性別は,男性14例,女性13例,HbA1Cは6.8%-13.0%,辛均9.5%であった。サーモグラフィー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-【20℃冷水負荷後の27℃以上の体表面温度のサーモグラフィーの画素(pixel)の総数】÷【36℃の温水負荷後の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。 サ-モグラフィーにより測定された回復率は0%-93.5%の範囲にあった。平均は34.0%であった。レーザードップラー血流計により20℃冷水負荷後に測定された血流量は0.91-5.36ml/min/100g tissueの範囲にあった。平均は2.04mi/min/100g tissueであった。得られたサーモグラフィーの回復率とレ-ザードップラ-血流計の血流量との間には正の相関関係を認めた(p<0.0001,r=0.634)0 36℃の温水負荷後に測定された血流量とサーモグラフィーの回復率との間には20℃冷水負 荷後同様に相関関係(p-0.0002,r=0.483)を認めたが,相関係数は20℃冷水負荷後に比較して低値であった。性別と回復率との間には男性28%,女性40%で女性の方が回復率が高い傾向にあったが,2群間に有意差を認めなっかた。年齢と回復率の間には正の相関関係(p<0.0001,r=0.187)を認めたが相関係数は低値であった。HbA1Cと回復率との間には正の相関関係(p<0.001,r=0.041)を認めたが相関係数は低値であった。一方,性別と血流量との間には男性2.03,女性2.05ml/min/100g tissueで女性の方が血流量が多い傾向にあったが,2群間に有意差を認めなかった。年齢と血流量との間には正の相関関係(p<0.0001,r=0.110)を認めたが相関係数は低値であった。HbA1Cと血涜量との間には負の相関関係(p<0.0001,r=-0.179)を認めたが相関係数は低値であった。36℃温水負荷時の血流量を100%とした時の20℃冷水負荷時の血流量の割合を求めたところ38.1%~122%の範囲にあった。 平均は80.6%であった。冷水負荷後の血流量の温水負荷時との比と回復率との間には正の相関関係を認めた(p<0.0001,r=0.502)。このことは,末梢血流量が冷水負荷後,速やかに冷水負荷前値に回復するか,あるいはさらに前値よりも上回って増加する症例においては末梢皮膚温度の回復率が高いことが示された。 糖尿病患者における末梢循環障害の程度をサーモグラフィーとレーザ-ドップラー血流計を同時に用い非侵襲的にかつ客観的に測定することが可能であった。今後,両者の併用は糖尿病患者における閉塞性動脈硬化症の合併の早期診断,予知,予防に役立つことのみならず,末梢循環障害の程度に応じた治療とその効果について定量的な評価に有用な方法と考えられた。
Keywords diabetes mellitus (糖尿病) peripheral circulation (末梢循環) thermography (サーモグラフィー) Laser-Doppler blood flowmetry (レーザードプラー血流計) blood flow (血流量)
Publication Title 岡大三朝分院研究報告
Published Date 2002-02-01
Volume volume72
Start Page 31
End Page 37
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308058
JaLCDOI 10.18926/14838
FullText URL 72_038_044.pdf
Author Ashida, Kozo| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Okamoto, Makoto| Nishida, Norikazu| Takata, Shingo| Yokoi, Tadashi| Tanizaki, Yoshiro|
Abstract Changes in the generation of leukotrienes B4 (LTB4) and C4 (LTC4) by leucocytes after spa therapy were examined in 30 patients with asthma. 1. The efficacy of spa therapy was marked in 8 (26.7%), and moderate in 16 (53.3%) of 30 patients with asthma, and slight or no efficacy of the therapy was observed in the residual 6 patients (20.0%). 2. Bronchial reactivity to methacholine was the highest in patients with slight or no efficacy of spa therapy, however. there were no significant differences among the three groups classified by clinical efficacy. 3. The generation of LTC4 was significantly higher in patients with slight or no efficacy compared with the generation in those with marked (p<O. 01) and moderate efficacy (p<O. 001). However, there were no signifcant differences in the generation of LTB4 among them. 4. The generation of LTC4 signifcantly decreased in patients with marked and moderate efficacy after spa therapy. but not in those with slight or no efficacy. The generation of LTB4 was not significantly different before and after spa therapy among patients with marked, moderate, and slight or no efficacy. These results show that the efficacy of spa therapy for patients with asthma is closely related to the generation of LTC4 by leucocytes.
Abstract Alternative 気管支喘息30例を対象に,温泉療法によるロイコトリエンB4 (LTB4),C4 (LTC4)産生の変動および気道過敏性と臨床効果との関連について検討を加えた。  1.温泉療法の臨床効果は,著効8例(26.7%),有効16例(53.3%),やや有 効あるいは無効6例(20.0%)であった。  2.メサコリンに対する気道過敏性は,やや有効あるいは無効例で高い傾向が見られたが,著効,有効例と比べ有意の差は見られなかった。 3.LTC4産生はやや有効あるいは無効例において著効例(P<0.01)や有効例(P<0.001)に比べ有意に高い値が示された。しかし,LTB4産生では臨床効果との関連は見られなかった。  4.著効例および有効例では,温泉療法後にLTB4産生の有意の低下 傾向が見られたが,無効例では有意の変動は見られなかった.また,LTB4産生に関しては温泉療法の臨床効果にかかわらず有意の変動は見られなかった。これらの結果より,気管支喘息に対する温泉療法の臨床効果は,LTC4産生とある程度関連していることを示唆しているものと考えられる。
Keywords asthma spa therapy bronchial hyperresponsiveness LTB4 LTC4
Publication Title 岡大三朝分院研究報告
Published Date 2002-02-01
Volume volume72
Start Page 38
End Page 44
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308539
JaLCDOI 10.18926/14839
Title Alternative 脂質代謝に関連した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α-リノレン酸食の効果
FullText URL 72_045_054.pdf
Author Okamoto, Makoto| Mitsunobu, Fumihiro| Ashida, Kozo| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Nishida, Norikazu| Yokoi, Tadashi| Takata, Shingo| Tanizaki, Yoshiro| Tanimoto, Mitsune|
Abstract Dietary sources of a -linolenic acid, such as perilla seed oil, may have the capacity to inhibit the generation of leukotrienes (LTs) by leucocytes in patients with asthma, as has been reported with the consumption of other long - chain n- 3 fatty a-cids. The factors affecting the suppression of leukotriene (LT) C4 generation by leucocytes were examined by comparing the clinical features of patients with asthma who had been given dietary perilla seed oil (n - 3 fatty acids). Group A consisted of patients in whom the leucocyte generation of dietary perilla seed oil LTC4 was suppressed by this procedure. Group B consisted of those in whom LTC4 generation was not suppressed. LTC4 generation by leucocytes significantly decreased in group A for two (P<0.05) and four weeks (P<O. OS), conversely, significantly increased in group B for four weeks (p<O. OS). The two study groups differed significantly in LTC4 generation by leucocytes after four weeks of dietary supplementation (P<0.05). Ventilatory parameters such as peak expiratory flow (PEF) , forced vital capacity (FVC) and forced expiratory volume in one second (FEV(1.O)) increased significantly after four weeks of dietary supplementation in group A (P<0.05). Values of PEF, FVC, FEV(1.O) and V(25) between groups A and B significantly differed prior to dietary supplementation. Serum levels of total cholesterol, LDL- cholesterol and phospholipid were significantly decreased by dietary supplementation in group A after four weeks. Serum levels of total-choles terol, triglyceride, HDL-Cholesterol, LDL-Cholesterol and phospholipid values between the two study groups differed significantly prior to dietary supplementation. Serum levels of triglyceride and LDL- cholesterol differed significantly between the two study groups after four weeks of dietary supplementation. The effects of dietary supplementation with perilla seed oil to patients with asthma by suppressing the generation of LTC4 is associated with clinical features such as respiratory function and lipometabolism.
Abstract Alternative エゴマ油のようなα-リノレン酸食が他のn-3系不飽和脂肪酸食において報告されてきた様に喘息患者の白血球ロイコトリエン(LTs)産生能を抑制すると考えられる。そこでエゴマ油(n-3系脂肪酸)を摂取した気管支喘息患者の臨床所見を比較することによって白血球ロイコトリエン(LT)C4の抑制に影響する因子を検討した。A群はエゴマ油摂取により白血球LTC4の産生能が抑制された群であり、B群は白血球LTC4の産生能が抑制されなかった群である。A群では食事摂取2週後(P<0.05),4週後(P<0.05)に白血球LTC4産生能が低下した。逆にB群では摂取4週後有意に増加した(P<0.05)0 2群間で食事摂取4遡後に白血球LTC4産生能に有意差がみられた(P<0.05)。ピークフロー値(PEF)、努力性肺活量(FVC)、1秒量(FEV(1))といった呼吸機能はA群において食事摂取4週後に有意に上昇した(P<0.05)。食事摂取前のPEF、FVC、FEV(1)、V(25)はA群,B群の2群間で有意差がみられた。A群において血清総コレステロール、低比重リポ蛋白(LDL)コレステロール、リン脂質は食事摂取4週後に有意に低下した。食事摂取前の血清総コレステロール、中性脂肪、高比重リポ蛋白コレステロール、LDLコレステロール、リン脂質において2群間に有意差がみられた。血清中性脂肪、LDLコレステロールは食事摂取4週後2群間に有意差がみられた。気管支喘息患者のある群へのエゴマ油食はLTC4産生能を抑制し、それには呼吸機能や脂質代謝といった臨床因子が関連していると考えられた。
Keywords alpha -linolenic acid leukotrieneC4 bronchial asthma lipometabolism
Publication Title 岡大三朝分院研究報告
Published Date 2002-02-01
Volume volume72
Start Page 45
End Page 54
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308212
JaLCDOI 10.18926/14840
Title Alternative Multidetector-CT findings of dissecting aortic aneurysum and coronary artery disease. Based on the case of dissecting aortic aneurysum and coronary artery disease.
FullText URL 72_055_061.pdf
Author Ashida, Kozo| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Okamoto, Makoto| Takata, Shingo| Yokoi, Tadashi| Nakai, Mutsuo| Makino, Hirofumi| Tanizaki, Yoshiro|
Abstract 2000年になり多列検出器高速CT (Multi-detector CT,以下MDCT)が出現し,大動脈疾患や心電図同期での冠動脈狭窄病変診断への臨床応用が開始された.当院でも2001年7月からMDCTが稼動し,日常臨床診療に貢献している. 今回,解離性上行大動脈瘤(DeBakeyII)(以下DAA)と冠動脈疾患(LAD# 7の閉塞)を合併した患者を診療した.MDCTによるCT - Angiography (以下CTA)が両者の診断に非常に有用であった.患者の負担は100mlの末梢静脈内への造影剤の投与と約数十秒間の呼吸停止だけで,解離性大動脈瘤並びに冠動脈狭窄病変の診断にそれぞれ非常に有用であった.三次元診断の鮮明な画像が得られ,かつ低侵襲度のMDCT並びにCTAは,今後益々臨床の場で血管造影検査の強力なファーストチョイスの診療手段になると考える.
Abstract Alternative Multidetector-CT (MDCT) and CT-Angio hase proven to be extremely useful in diagnosis of dissecting aortic aneurysum (DM) and coronary artery disease (CAD) . We report a case of DM complicated with CAD which was diagnosed by new MDCT.
Keywords 解敵性大動脈瘤 (disecting aortic aneurysum) 冠動脈 (coronary artery) 狭心症 (anglna Pectoris) 多列検出器CT(マルチスライスCT) (MDCT) CT血管造影 (CT-Angiography)
Publication Title 岡大三朝分院研究報告
Published Date 2002-02-01
Volume volume72
Start Page 55
End Page 61
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308046
JaLCDOI 10.18926/14841
Title Alternative Two male steroid-dependent asthmatics treated with etidronate
FullText URL 72_062_065.pdf
Author Tsugeno, Hirofumi| Okamoto, Makoto| Takata, Singo| Yokoi, Tadashi| Nishida, Kazunori| Ashida, Kozo| Hosaki, Yasuhiro| Mitsunobu, Fumihiro| Tanizaki, Yoshiro| Nakai, Mutsuo| Akiyama, Tsuneo| Hasegawa, Hisakazu| Tsuji, Takao|
Abstract 男性のステロイド依存性気管支喘息患者にエチドロネートを4年間の長期間にわたり投与した経験を得たので報告する。症例は,男性のステロイド依存性気管支喘息で,エチドロネート200mg/日・14日間投与を4ケ月おきに4年間にわたり反復投与し,活性型ビタミンD製剤 (VD)投与と併用した2例と,活性型VD製剤を単独授与した2例。椎体圧迫骨折数,境骨耗骨密度,海綿骨骨密度,皮質骨骨密度について,椎体X線像,PQCT(Stratec XCT960)を用いて4ケ月毎に測定し,48ケ月後の効果を検討した。エチドロネートを投与した症例1では,総骨密度と海綿骨はやや増加を認め皮質骨密度は減少していた。エチドロネートを授与した症例2では,総骨密度,海綿骨,皮質骨密度はいずれも減少を認めたが,VD単独投与した2例よりもやや減少が抑制されていたようであった。VD単独投与した2例ではいずれの項目も減少を認めた。これらの症例からは,エチドロネートは男性のステロイドによる骨傷害にも有効と考えられたが,現在投与継続途中であり,今後さらに検討を続ける必要がある。
Abstract Alternative We report an experience about administration of etidronate to male steroid-dependent asthmatics for a long time. For 4 years, two men with steroid-dependent asthma were treated with etidronate (200 mg / day, for 14 days) every 4 months and 25-hydroxyvitamin D3 (VD) together, and two patients were treated with VD alone. Vertebral fractures were evaluated by the lateral spinal X-ray films, and radial total bone mineral density (BMD) , trabecular BMD and the cortical BMD were measured by pQCT (Stratec XCT960) every four months. Trabecular and total BMD increased but cortical BMD decreased in the case 1 who was treated with both etidronate and VD. In the case 2 with etidronate and VD treatments, total and trabecular BMD decreased, but reduction of these indices seemed to be more suppressed than that in two patients with VD alone. According to these experiences, etidronate may be effective against the steroid-induced bone injury in men. Since periods treatment are not en-ough long to evaluate therapeutic effect of etid-ronate, we will have to continue the examination of these cases further more from now on.
Keywords エチドロネート 男性 ステロイド 気管支喘息
Publication Title 岡大三朝分院研究報告
Published Date 2002-02-01
Volume volume72
Start Page 62
End Page 65
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308188
JaLCDOI 10.18926/14842
Title Alternative The relationship between the magnetic resonance imaging of the lumbar spine and lowback pain
FullText URL 72_066_070.pdf
Author Takata, Shingo| Yokoi, Tadashi| Nishida, Norikazu| Okamoto, Makoto| Tsugeno, Hirofumi| Ashida, Kozo| Hosaki, Yasuhiro| Mifune, Takashi| Mitsunobu, Fumihiro| Tanizaki, Yoshiro| Niiya, Kenji| Tanimoto, Mitsune|
Abstract (目的) MRlは腰痛をきたす疾患の診断に必須な検査法である。腰痛と腰椎MRl所見との関係を明らかにすることを目的として検討した。(対象と方法)腰痛を訴えた30例を対象とし、腰椎MRl所見の頻度を調査した。全例に温泉療法を施行した。  (結果)全症例において腰椎MRl上異常所見を認めた。少なくとも1つ以上の椎間板の変性病変をもつ症例は30例中27例(90% )で、椎間板変性はL4/5levelで最も多く認められた(30例中18例)。椎間板ヘルニア を示す症例は30例中10例(33.3% )であった。神経根圧迫を持つ症例は30例中8例(26.7% )であった。腰椎圧迫骨折を持つ症例は30例中6例(20% )であった。温泉療法により腰痛が改善した症例は30例中17例(56.7% )であった。  (結論)腰痛症患者は腰椎MR止異常所見を有した。温泉療法により腰痛の改善を認めたので、MRL上で認めた形態学的異常は必ずしも機能的異常や症状に直結しないと思われた。
Abstract Alternative (Purpose) Magnetic resonance imaging (MRI) is essential to diagnosis of diseases which happen low back pain. The purpose of this study was to investigate the relationship between low back pain and the characteristics on MRI scans of the lumbar spine. (Materials and Methods) We performed MRI examinations of lumbar spine in 30 patients with low back pain and examined the prevalence of abnormal findings on MRI scans of the lumbar spine in 30 patients with low back pain. (Results) Overall in present study, all patients with low back pain had abnormalities around the lumbar spines on MRI. Disc degeneration was present in one or more lumbar levels in 27 (90% ) of all the subjects. The disc degeneration was most commonly observed at U/LS, where 18 (60% ) of all the subjects displayed evidence of disc degeneration. Disc herniation was found in 10 (33.3% ) of all the subjects. Nerve root compression at one level or more was observed in 8 (26.7% ) of the subjects. Compression fracture at one level or more was observed in 6 (20% ) of all the subjects. Spa therapy improved low back pain in 17 (56. 7% ) of the subjects. (Conclusion) All patients with low back pain had abnormalities around the lumbar spines on MRI. Because spa therapy improved low back pain, morphological abnormalities on MRI scans don't always connect with functional abnormalities and symptoms.
Keywords 腰痛症 (Disc disease) MRl (Magnetic resonance imaglng) 椎間板変性 (Lumbar spine)
Publication Title 岡大三朝分院研究報告
Published Date 2002-02-01
Volume volume72
Start Page 66
End Page 70
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308103
JaLCDOI 10.18926/14885
Title Alternative QOL in RA patients
FullText URL 72_071_073.pdf
Author Yokoi, Tadashi| Senda, Masuo| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Nishida, Norikazu| Tsugeno, Hirofumi| Okamoto, Makoto| Takata, Shingo| Tanizaki, Yoshiro| Inoue, Hajime|
Abstract 近年QOLが重視されるようになってきている。MOS short form 36 health survey (以下SF-36と略す)は,国際的レベルでの基準とされるべく開発された非疾患特異的HRQOL尺度である。今回我々は当院でリハビリテーションをうけているRA患者を対象にSF-36を用いてQOL評価を行った。SFl36の8項目をそれぞれ算出し,国民標準値との比較を行った. すべての項目において標準値を下回っていたが,特に,日常役割機能(身体),日常役割機能(精神),身体の痛み,身体横能において大きな開きを認めた。また,PCSは平均35.8であり,MCSは平均49.1であった。以上より,RA患者は身体に強い痛みを伴っているため精神健康面より身体横能面において制限を有していることが分かった。
Abstract Alternative We have recently regarded the QOL as important. SF-36 is a measure of HRQOL made as an international standard. We investigated the QOL in RA patients who under went rehabilitation in our hospital using SF-36. We calculated 8 items of SF-36 and compared those with Japanese standards. All items in RA patients were lower than Japanese standards. PCS was 35.8 on average and MCS was 49.1 on average.
Keywords SF-36 生活の質 (Quality of Life) 慢性関節リウマチ (Rheumatoid Arthritis)
Publication Title 岡大三朝分院研究報告
Published Date 2002-02-01
Volume volume72
Start Page 71
End Page 73
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308553
JaLCDOI 10.18926/14886
FullText URL 72_074_079.pdf
Author Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Nishida, Norikazu| Yokoi, Tadashi| Takata, Shingo| Tanizaki, Yoshiro|
Abstract 高齢者喘息の病態に対する加齢および喫煙の影響について,若干の検討を加えた。高齢者喘息,特に70才以上の喘息では,HRCT上の1950HU以下の肺のlow attenuation area(LAA)は,苦青年者喘息と比べ有意に増加していた.また,同時にこの年齢層では残気量の有意の増加,拡散能の有意の低下が見られた.% LAAと% 1秒量との間には,喘息の非喫煙例,喫煙例,肺気腫(全例喫煙例),いずれにおいても相関が見られた。しかし,% LAAと拡散能との間には,喘息の喫煙例および肺気腫では相関が見られたが,非喫煙例では有意の相関は見られなかった。これは,喫煙の拡散能におよぽす影響が大きいことを示唆しているものと考えられた。
Abstract Alternative Influences of aging and cigarette smoking on the pathophysiology in elderly patients wish asthma were examined in 152 patients with asthma and 14 patients with pulmonary emphysema. The low attenuation area (LAA) <-950 HU of the lungs on high-resolution computed tomography (HRCT) was significantly larger in patients over age 70 years than in those under age 49 years. A significant increase in residual volume (RV) of the lungs and significant decrease in the value of DLco were observed in these patients over age 70 compared to the values in those under age 49. A significant correlation between % LAA and % FEV1.0 was found in patients with asthma (in both smoker and nonsmoker) and with pulmonary emphysema. However, any correlation between % LAA and the value of DLco was not observed in nonsmoking patients with asthma, suggesting that the influence of smoking on DLco is remarkably larger than the influence of aging.
Keywords 高齢者喘息 (asthma in the elderly) 気腫化傾向 (emphysematous changes) HRCT 残気量 (residual volume) DLco
Publication Title 岡大三朝分院研究報告
Published Date 2002-02-01
Volume volume72
Start Page 74
End Page 79
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308085
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
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 10.18926/14905
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 10.18926/14906
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 10.18926/14907
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 10.18926/14908
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 10.18926/14909
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