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 10.18926/14885
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 10.18926/14905
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 10.18926/14837
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 10.18926/14974
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
Author Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Nishida, Norikazu| Nagata, Takuya| Takata, Shingo| Yokoi, Tadashi| Tanizaki, Yoshiro|
Published Date 2003-02-01
Publication Title 岡大三朝医療センター研究報告
Volume volume73
Content Type Departmental Bulletin Paper
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
Author 芦田 耕三|
Published Date 1997-03-25
Publication Title
Content Type Thesis or Dissertation
JaLCDOI 10.18926/14951
Title Alternative 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産生能
FullText URL 069_009_014.pdf
Author Tanizaki, Yoshiro| Mitsunobu, Fumihiro| Mifune, Takashi| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Harada, Seishi| Yumoto, Eiichiro| Takata, Shingo| Ochi, Koji| Harada, Hideo|
Abstract The generation of leukotrienes B4 (LTB4) and C4 (LTC4) by leucocytes stimulated with Ca ionophore A23187 was examined in 16 patients with asthma (8 with atopic and 8 with nonatopic asthma) and 12 healthy controls. 1. The LT84 generation by leucocytes was not significantly different between patients with asthma and healthy controls. The generation of LTC4 was significantly larger in patients with asthma than in healthy controls. The LTC4 generation was also significantly larger in patients with attacks (58.4 ± 38.5 ng/5x10(6) cells) than in those without attacks (23.3 ± 25.9 ng/5x10(6) cells)(p<0.05). 2.ln atopic asthma, the LTC4 production was significantly larger in patients with attacks (84.7 ± 35.4 ng/5x10(6) cells) compared to the production in those without attacks (40.4 ± 27.2 ng/5x10(6) cells)(p<0.02). However, the production of LTB4 was not significantly different between attack and attack-free stages. 3. In nonatopic asthma, the LTC4 production was also significantly higher in patients with attacks (32.2 ± 26.3 ng/5x10(6) cells) than in those without attacks (12.2 ± 3.5 ng/5x10(6) cells)(p<0.05). However, the LTB4 production was not significantly different between attack and nonattack stages. 4. The LTC4 production was significantly larger in atopic asthmatics compared to the production in nonatopic subjects both in attack and nonattack stages. These results suggest that the generation of LTC4 by leucocytes of patients with asthma is closely related to IgE-mediated reaction and asthma attacks.
Abstract Alternative 気管支喘息16例(アトピー型喘息8例,非アトピー型喘息8例)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)産生能について検討した。1.LTB4産生能は,喘息症例と健康人 の間に有意の差は見られなかった。LTC4産生能は,健康人に比べ喘息症例で有意に高い傾向が見られた。また,喘息症例では,非発作時(23.3±25.9ng/5xl0(6)cells)に比べ発作時(58.4±38.5ng/5xl0(6)cells)に有意に高い値を示した(p<0.05)。アトピー型喘息では,非発作時(40.4±27.2mg/5xl0(6)cells) に比べ発作時(84.7±35.4ng/5xl0(6)cells) に有意の高値を示したが(p<0.02),LTB4 産生に関しては両者間に有意の差は見られなかった。3.非アトピー型喘息においても同様,非発作時(12.2±3.2ng/5xl0(6) cells) に比べ発作時 (32.2±26.3ng/5xl0(6)cells)で有意の高値であったが(P<0.05), LTB4 では有意差は見られなかった。4.LTC4産生能は,発作時、非発作時とも,アトピー型喘息で非アトピー型喘息に比べ有意に高いことが示唆された。以上の結果より,喘息症例における白血球のLTC4産生能はIgE にmediateされる反応と密接な関連がある可能性が示唆された。
Keywords bronchial asthma LTB4 LTC4 IgE-mediated reaction asthma attacks
Publication Title 岡大三朝分院研究報告
Published Date 1998-12
Volume volume69
Start Page 9
End Page 14
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308181
JaLCDOI 10.18926/15087
Title Alternative 気管支喘息症例に対する鼻腔内ステロイド療法
FullText URL 067_057_062.pdf
Author Mifune, Takashi| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Yokota, Satoshi| Tsugeno, Hirofumi| Takeuchi, Kazuaki| Nawa, Yuichiro| Tanizaki, Yoshiro| Ochi, Koji| Harada, Hideo|
Abstract Bronchial asthma is often accompanied with allergic rhinitis or chronic sinusitis. Mucosal abnormalities of sinonasal cavity may influence lower respiratory responses in patients with asthma. We experienced a case of 72-year-old woman with asthma, who had dyspnea on exertion and a large volume of expectoration of more than 100mℓ a day. Furthermore she had nasal symptoms (nasal obstruction and rhinorrea) with prominent post-nasal discharge. Computed tomography (CT) scans of sinonasal cavity revealed marked thickness of nasal mucosa. Although her asthma symptoms such as wheezing and dyspnea improved by administration of bronchodialators, antiallergic agent, and beclomethason di isocyanate (BDI) accompanied with spa therapy after admission, the volume of expectoration revealed no decrease and her peak expiratory flow (PEF) didn't increase. The volume of expectoration and the PEF showed marked improvement after starting of intranasal glucocorticoid therapy. It is suggested from her clinical course that treatment with intranasal glucocorticoids is very important in asthmatic patients with mucosal abnormalities of sinonasal cavity.
Abstract Alternative 気管支喘息症例には,アレルギー性鼻炎や慢性副鼻腔炎の合併が認められる。鼻腔内への吸入ステロイド投与が喘息症状を改善したという報告も存在し,鼻腔病変が下気道の反応に何らかの影響を及ぼしている可能性が考えられる。今回,気管支喘息にて入院した72才の女性の症例を呈示する。労作性呼吸困難と多量の喀痰排出が認められ,入院後の投薬や温泉療法にて呼吸困難は改善したが,喀痰排出は減少せず,ピークフロー値も上昇が認められなかった。明らかな後鼻漏が認められ,CTにて両側鼻腔粘膜の著明な肥厚の所見が見られたため,鼻腔内吸入ステロイド投与を開始した。開始後,喀痰排出量,ピークフロー値は著明な改善を示した。この症例のように,鼻腔あるいは副 鼻腔に対する治療が喘息症状を改善する症例が存在する可能性が考えられた。
Keywords bronchial asthma (気管支喘息) rhinitis (鼻炎) intranasal steroid therapy (鼻腔内吸入ステロイド療法) expectoration (喀痰排出) peak expiratory flow (ピークフロー)
Publication Title 岡大三朝分院研究報告
Published Date 1996-11
Volume volume67
Start Page 57
End Page 62
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307814
Author Mitsunobu, Fumihiro| Ashida, Kozo| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Okamoto, Makoto| Nishida, Norikazu| Nagata, Takuya| Takata, Shingo| Yokoi, Tadashi| Nakai, Mutsuo| Tanizaki, Yoshiro| Tanimoto, Mitsune|
Published Date 2003-02-01
Publication Title 岡大三朝医療センター研究報告
Volume volume73
Content Type Departmental Bulletin Paper
JaLCDOI 10.18926/15007
Title Alternative 温泉療法による気管支喘息患者の心理的障害の改善
FullText URL 067_043_049.pdf
Author Yokota, Satoshi| Mifune, Takashi| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Takeuchi, Kazuaki| Nawa, Yuichiro| Tanizaki, Yoshiro| Tada, Shinya| Harada, Mine|
Abstract To evaluate improvement of mental disorders by spa therapy for 1-2 months, three kinds of psychological examinations, CMI (Cornel Medical Index), SDS (Selfrating Depression Scale) and CAI (Comprehensive Asthma Inventory) tests, were performed in 37 patients with asthma before and after spa therapy. 1. In CMI test, the scores of physical symptoms, respiratory symptoms, and CIJ symptoms significantly decreased after spa therapy. The score of psychical symptoms tended to decrease after the therapy, however, this was not significant. 2. The mean score of the subjects over 40 points in SDS test significantly decreased from 45.7 points before spa therapy to 37.5 after the therapy. 3. Mental disorders evaluated by various categories in CAI test were significantly improved after spa therapy. The average score in CAI test significantly decreased from 37.1 to 27.8 after the therapy. These results demonstrate that psychological disorders in patients with asthma are improved by spa therapy.
Abstract Alternative 気管支喘息に対する温泉療法(1-2ヶ月)による心理的障害の改善を評価するために,3種類の心理学的調査:CMI(Cornel Medical Index),SDS(Selfrationg Depression Scale),CAI(Comprehensive Asthma Inventory)を,気管支喘息患者37例を対象として,入院時と退院時に実施し比較した。①CMIでは,身体的自覚症,呼吸器系症状およびCIJ症状が,温泉療法後に有意に改善した。②SDS値が40以上の症例において,温泉療法後,平均値は45.7から37.5へ有意に減少した。③CAIの種々の心理学的項目により評価した心理的障害は,温泉療法後に有意に改善した。各心理項目の平均値であるCAIスコアは,治療後,37.1から27.8へ有意に低下した。これらの結果から,気管支喘息患者に観察される心理的障害は,温泉療法により改善することが示唆された。
Keywords 気管支喘息 (Bronchial asthma) 温泉療法 (Spa therapy) 心理テスト(CMI, SDS, CAI) (CMI test, SDS test, CAI test)
Publication Title 岡大三朝分院研究報告
Published Date 1996-11
Volume volume67
Start Page 43
End Page 49
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002307273
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
Author Ashida, Kozo| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Iwagaki, Naofumi| Nagata, Takuya| Fujii, Makoto| Takata, Shingo| Yokoi, Tadashi| Hamada, Masanori| Tanizaki, Yoshiro|
Published Date 2004-02-01
Publication Title 岡大三朝医療センター研究報告
Volume volume74
Content Type Departmental Bulletin Paper
JaLCDOI 10.18926/14972
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 10.18926/14954
Title Alternative 肺気腫患者における吸入抗原に対するIgE抗体
FullText URL 069_021_027.pdf
Author Mitsunobu, Fumihiro| Mifune, Takashi| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Harada, Seishi| Yumoto, Eiichiro| Takata, Shingo| Tanizaki, Yoshiro| Ochi, Koji| Harada, Hideo| Hasegawa, Harumi|
Abstract To analyze the pathophysiological changes ot the airways in emphysema, bronchial responsiveness and the generation of leukotrienes B4 (LTB4) and C4 (LTC4) by peripheral leucocytes were examined in 22 patients with emphysema. The subjects were divided into two groups according to the presence or absence of IgE antibodies against inhalant allergens; RAST positive group and RAST negative group. 1. Smoking history, mean CT number and mean maximum % low attenuation area (% LAA) <-950HU of the lung on high resolution computed tomography (HRCT), and DLco value suggested that there were emphysematous changes of the lung in all subjects. However, these findings were not different between the two groups. 2. The level of serum IgE was significantly higher in RAST positive group than in RAST negative group. 3. The mean % increase in FEV1.0 after inhalation of β-agonists was higher in RAST positive group than in RAST negative group. The % increase more than 15% was found in 4 of the 9 subjects (44.4%) in RAST positive group and 2 of the 12 (16.7%) in RAST negative group. 4. The generation of LTC4 by leucocytes was significantly higher in RAST positive group than in RAST negative group (p<0.01). The generation of LTB4 was not significantly different between the two groups. The results suggest that IgE-mediated allergy participates in the bronchial responsiveness of patients with emphysema.
Abstract Alternative 肺気腫患者の気道病変を解析する目的で,22例の肺気腫患者を対象に,その気道反応および白血球のロイコトリエンB4,C4産生能について検討を加えた。この際対象症例はIgE抗体の有無によってRAST陽性症例RAST陰性症例に分類された。1.喫煙歴,平均CT値,high resolution computed tomography(HRCT)上の-950HU以下の% low attenuation area(% LAA),DLcoなどの値は,いずれも対象症例が高度な気腫化病変を有してい ることを示した。2.血清IgE値は,RAST陽性例で陰性例に比べ有意の高値を示した。3.β受容体刺激薬吸入後のFEV1.0の増加は,RAST陽性例で陰性例に比べ高度であった。そして,吸入後のFEV1.0が15%以上の増加を示した症例は,RAST陽性例では9例中4例(44.4%),陰性例では12例中2例(16,7%)であった。4.白血球のLTC4産生量は,RAST陽性例で陰性例に比べ有意に高い値であったが,LTB4産生は両者間に有意の差は見られなかった。以上の結果より,IgEにmediateされるアレルギー反応が,肺気腫患者 の気道反応に関与している可能性が示唆された。
Keywords emphysema bronchial responsiveness FEV1.0 LTB4 LTC4
Publication Title 岡大三朝分院研究報告
Published Date 1998-12
Volume volume69
Start Page 21
End Page 27
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308178
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 10.18926/14933
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 10.18926/14925
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 10.18926/14963
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