start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue= article-no= start-page=1 end-page=9 dt-received= dt-revised= dt-accepted= dt-pub-year=2001 dt-pub=20010201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Spa therapy for 999 patients with respiratory disease admitted at Misasa Medical Branch for last 7 years kn-title=呼吸器疾患に対する温泉療法. 最近7年間(1993年-1999年)の入院症例999例を対象に en-subtitle= kn-subtitle= en-abstract=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% ) kn-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。 en-copyright= kn-copyright= en-aut-name=TanizakiYoshiro en-aut-sei=Tanizaki en-aut-mei=Yoshiro kn-aut-name=谷崎勝朗 kn-aut-sei=谷崎 kn-aut-mei=勝朗 aut-affil-num=1 ORCID= en-aut-name=MifuneTakashi en-aut-sei=Mifune en-aut-mei=Takashi kn-aut-name=御舩尚志 kn-aut-sei=御舩 kn-aut-mei=尚志 aut-affil-num=2 ORCID= en-aut-name=MitsunobuFumihiro en-aut-sei=Mitsunobu en-aut-mei=Fumihiro kn-aut-name=光延文裕 kn-aut-sei=光延 kn-aut-mei=文裕 aut-affil-num=3 ORCID= en-aut-name=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=保ア泰弘 kn-aut-sei=保ア kn-aut-mei=泰弘 aut-affil-num=4 ORCID= en-aut-name=AshidaKozo en-aut-sei=Ashida en-aut-mei=Kozo kn-aut-name=芦田耕三 kn-aut-sei=芦田 kn-aut-mei=耕三 aut-affil-num=5 ORCID= en-aut-name=TsugenoHirofumi en-aut-sei=Tsugeno en-aut-mei=Hirofumi kn-aut-name=柘野浩史 kn-aut-sei=柘野 kn-aut-mei=浩史 aut-affil-num=6 ORCID= en-aut-name=OkamotoMakoto en-aut-sei=Okamoto en-aut-mei=Makoto kn-aut-name=岡本誠 kn-aut-sei=岡本 kn-aut-mei=誠 aut-affil-num=7 ORCID= en-aut-name=TakataShingo en-aut-sei=Takata en-aut-mei=Shingo kn-aut-name=高田真吾 kn-aut-sei=高田 kn-aut-mei=真吾 aut-affil-num=8 ORCID= en-aut-name=OchiKoji en-aut-sei=Ochi en-aut-mei=Koji kn-aut-name=越智浩二 kn-aut-sei=越智 kn-aut-mei=浩二 aut-affil-num=9 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=2 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=3 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=4 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=5 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=6 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=7 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=8 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=9 en-affil= kn-affil=岡山大学医学部臨床検査医学 en-keyword=気管支喘息 (asthma) kn-keyword=気管支喘息 (asthma) en-keyword=肺気腫 (pulmonary emphysema) kn-keyword=肺気腫 (pulmonary emphysema) en-keyword=温泉療法 (Spa therapy) kn-keyword=温泉療法 (Spa therapy) en-keyword=高齢患者 (aged patients) kn-keyword=高齢患者 (aged patients) en-keyword=遠隔地 (distant area) kn-keyword=遠隔地 (distant area) END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue= article-no= start-page=10 end-page=18 dt-received= dt-revised= dt-accepted= dt-pub-year=2001 dt-pub=20010201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=高齢者気管支喘息における気道過敏性と温泉療法 kn-title=Spa therapy and bronchial hyperresponsiveness in elderly patients with asthma en-subtitle= kn-subtitle= en-abstract=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。 kn-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. en-copyright= kn-copyright= en-aut-name=TanizakiYoshiro en-aut-sei=Tanizaki en-aut-mei=Yoshiro kn-aut-name=谷崎勝朗 kn-aut-sei=谷崎 kn-aut-mei=勝朗 aut-affil-num=1 ORCID= en-aut-name=MitsunobuFumihiro en-aut-sei=Mitsunobu en-aut-mei=Fumihiro kn-aut-name=光延文裕 kn-aut-sei=光延 kn-aut-mei=文裕 aut-affil-num=2 ORCID= en-aut-name=MifuneTakashi en-aut-sei=Mifune en-aut-mei=Takashi kn-aut-name=御舩尚志 kn-aut-sei=御舩 kn-aut-mei=尚志 aut-affil-num=3 ORCID= en-aut-name=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=保ア泰弘 kn-aut-sei=保ア kn-aut-mei=泰弘 aut-affil-num=4 ORCID= en-aut-name=AshidaKozo en-aut-sei=Ashida en-aut-mei=Kozo kn-aut-name=芦田耕三 kn-aut-sei=芦田 kn-aut-mei=耕三 aut-affil-num=5 ORCID= en-aut-name=TsugenoHirofumi en-aut-sei=Tsugeno en-aut-mei=Hirofumi kn-aut-name=柘野浩史 kn-aut-sei=柘野 kn-aut-mei=浩史 aut-affil-num=6 ORCID= en-aut-name=OkamotoMakoto en-aut-sei=Okamoto en-aut-mei=Makoto kn-aut-name=岡本誠 kn-aut-sei=岡本 kn-aut-mei=誠 aut-affil-num=7 ORCID= en-aut-name=TakataShingo en-aut-sei=Takata en-aut-mei=Shingo kn-aut-name=高田真吾 kn-aut-sei=高田 kn-aut-mei=真吾 aut-affil-num=8 ORCID= en-aut-name=OchiKoji en-aut-sei=Ochi en-aut-mei=Koji kn-aut-name=越智浩二 kn-aut-sei=越智 kn-aut-mei=浩二 aut-affil-num=9 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=2 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=3 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=4 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=5 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=6 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=7 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=8 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=9 en-affil= kn-affil=岡山大学医学部臨床検査医学 en-keyword=spa therapy kn-keyword=spa therapy en-keyword=asthma kn-keyword=asthma en-keyword=bronchial hyperresponsiveness kn-keyword=bronchial hyperresponsiveness en-keyword=patient age kn-keyword=patient age END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue= article-no= start-page=19 end-page=28 dt-received= dt-revised= dt-accepted= dt-pub-year=2001 dt-pub=20010201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=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― kn-title=Quantitative evaluation by high resolution computed tomography (HRCT) of patients with asthma and emphysema en-subtitle= kn-subtitle= en-abstract=【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。 kn-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. en-copyright= kn-copyright= en-aut-name=MitsunobuFumihiro en-aut-sei=Mitsunobu en-aut-mei=Fumihiro kn-aut-name=光延文裕 kn-aut-sei=光延 kn-aut-mei=文裕 aut-affil-num=1 ORCID= en-aut-name=MifuneTakashi en-aut-sei=Mifune en-aut-mei=Takashi kn-aut-name=御舩尚志 kn-aut-sei=御舩 kn-aut-mei=尚志 aut-affil-num=2 ORCID= en-aut-name=AshidaKozo en-aut-sei=Ashida en-aut-mei=Kozo kn-aut-name=芦田耕三 kn-aut-sei=芦田 kn-aut-mei=耕三 aut-affil-num=3 ORCID= en-aut-name=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=保ア泰弘 kn-aut-sei=保ア kn-aut-mei=泰弘 aut-affil-num=4 ORCID= en-aut-name=TsugenoHirofumi en-aut-sei=Tsugeno en-aut-mei=Hirofumi kn-aut-name=柘野浩史 kn-aut-sei=柘野 kn-aut-mei=浩史 aut-affil-num=5 ORCID= en-aut-name=OkamotoMakoto en-aut-sei=Okamoto en-aut-mei=Makoto kn-aut-name=岡本誠 kn-aut-sei=岡本 kn-aut-mei=誠 aut-affil-num=6 ORCID= en-aut-name=HaradaSeishi en-aut-sei=Harada en-aut-mei=Seishi kn-aut-name=原田誠之 kn-aut-sei=原田 kn-aut-mei=誠之 aut-affil-num=7 ORCID= en-aut-name=NakaiMutsuo en-aut-sei=Nakai en-aut-mei=Mutsuo kn-aut-name=中井睦郎 kn-aut-sei=中井 kn-aut-mei=睦郎 aut-affil-num=8 ORCID= en-aut-name=TanizakiYoshiro en-aut-sei=Tanizaki en-aut-mei=Yoshiro kn-aut-name=谷崎勝朗 kn-aut-sei=谷崎 kn-aut-mei=勝朗 aut-affil-num=9 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=2 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=3 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=4 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=5 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=6 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=7 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=8 en-affil= kn-affil=岡山大学医学部附属病院三朝分院放射線科 affil-num=9 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 en-keyword=HRCT kn-keyword=HRCT en-keyword=asthma kn-keyword=asthma en-keyword=emphysema kn-keyword=emphysema END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue= article-no= start-page=29 end-page=35 dt-received= dt-revised= dt-accepted= dt-pub-year=2001 dt-pub=20010201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=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 kn-title=Correlation between pulmonary function and low attenuation area (LAA) on HRCT III patients with asthma in relation to smoking en-subtitle= kn-subtitle= en-abstract=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。 kn-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. en-copyright= kn-copyright= en-aut-name=MitsunobuFumihiro en-aut-sei=Mitsunobu en-aut-mei=Fumihiro kn-aut-name=光延文裕 kn-aut-sei=光延 kn-aut-mei=文裕 aut-affil-num=1 ORCID= en-aut-name=MifuneTakashi en-aut-sei=Mifune en-aut-mei=Takashi kn-aut-name=御舩尚志 kn-aut-sei=御舩 kn-aut-mei=尚志 aut-affil-num=2 ORCID= en-aut-name=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=保ア泰弘 kn-aut-sei=保ア kn-aut-mei=泰弘 aut-affil-num=3 ORCID= en-aut-name=AshidaKozo en-aut-sei=Ashida en-aut-mei=Kozo kn-aut-name=芦田耕三 kn-aut-sei=芦田 kn-aut-mei=耕三 aut-affil-num=4 ORCID= en-aut-name=TsugenoHirofumi en-aut-sei=Tsugeno en-aut-mei=Hirofumi kn-aut-name=柘野浩史 kn-aut-sei=柘野 kn-aut-mei=浩史 aut-affil-num=5 ORCID= en-aut-name=OkamotoMakoto en-aut-sei=Okamoto en-aut-mei=Makoto kn-aut-name=岡本誠 kn-aut-sei=岡本 kn-aut-mei=誠 aut-affil-num=6 ORCID= en-aut-name=TakadaShingo en-aut-sei=Takada en-aut-mei=Shingo kn-aut-name=高田真吾 kn-aut-sei=高田 kn-aut-mei=真吾 aut-affil-num=7 ORCID= en-aut-name=YokoiTadashi en-aut-sei=Yokoi en-aut-mei=Tadashi kn-aut-name=横井正 kn-aut-sei=横井 kn-aut-mei=正 aut-affil-num=8 ORCID= en-aut-name=TanizakiYoshiro en-aut-sei=Tanizaki en-aut-mei=Yoshiro kn-aut-name=谷崎勝朗 kn-aut-sei=谷崎 kn-aut-mei=勝朗 aut-affil-num=9 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=2 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=3 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=4 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=5 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=6 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=7 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=8 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=9 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 en-keyword=asthma kn-keyword=asthma en-keyword=smoking kn-keyword=smoking en-keyword=% LAA of the lungs kn-keyword=% LAA of the lungs en-keyword=FEV1.0 kn-keyword=FEV1.0 en-keyword=DLco kn-keyword=DLco END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue= article-no= start-page=36 end-page=41 dt-received= dt-revised= dt-accepted= dt-pub-year=2001 dt-pub=20010201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=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 kn-title=Correlation between efficacy of Pranlukast and LTC4 generation by peripheral leukocytes en-subtitle= kn-subtitle= en-abstract=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. kn-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. en-copyright= kn-copyright= en-aut-name=MifuneTakashi en-aut-sei=Mifune en-aut-mei=Takashi kn-aut-name=御舩尚志 kn-aut-sei=御舩 kn-aut-mei=尚志 aut-affil-num=1 ORCID= en-aut-name=TakadaShingo en-aut-sei=Takada en-aut-mei=Shingo kn-aut-name=高田真吾 kn-aut-sei=高田 kn-aut-mei=真吾 aut-affil-num=2 ORCID= en-aut-name=OkamotoMakoto en-aut-sei=Okamoto en-aut-mei=Makoto kn-aut-name=岡本誠 kn-aut-sei=岡本 kn-aut-mei=誠 aut-affil-num=3 ORCID= en-aut-name=TsugenoHirofumi en-aut-sei=Tsugeno en-aut-mei=Hirofumi kn-aut-name=柘野浩史 kn-aut-sei=柘野 kn-aut-mei=浩史 aut-affil-num=4 ORCID= en-aut-name=AshidaKozo en-aut-sei=Ashida en-aut-mei=Kozo kn-aut-name=芦田耕三 kn-aut-sei=芦田 kn-aut-mei=耕三 aut-affil-num=5 ORCID= en-aut-name=MitsunobuFumihiro en-aut-sei=Mitsunobu en-aut-mei=Fumihiro kn-aut-name=光延文裕 kn-aut-sei=光延 kn-aut-mei=文裕 aut-affil-num=6 ORCID= en-aut-name=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=保ア泰弘 kn-aut-sei=保ア kn-aut-mei=泰弘 aut-affil-num=7 ORCID= en-aut-name=TanizakiYoshiro en-aut-sei=Tanizaki en-aut-mei=Yoshiro kn-aut-name=谷崎勝朗 kn-aut-sei=谷崎 kn-aut-mei=勝朗 aut-affil-num=8 ORCID= en-aut-name=HaradaMine en-aut-sei=Harada en-aut-mei=Mine kn-aut-name=原田実根 kn-aut-sei=原田 kn-aut-mei=実根 aut-affil-num=9 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=2 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=3 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=4 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=5 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=6 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=7 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=8 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=9 en-affil= kn-affil=岡山大学医学部第二内科 en-keyword=bronchial asthma kn-keyword=bronchial asthma en-keyword=pranlukast kn-keyword=pranlukast en-keyword=leukotriene receptor antagonist kn-keyword=leukotriene receptor antagonist en-keyword=LTC4 kn-keyword=LTC4 END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue= article-no= start-page=42 end-page=49 dt-received= dt-revised= dt-accepted= dt-pub-year=2001 dt-pub=20010201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=寒冷負荷の末梢循環に及ぼす影響 kn-title=Effect of partial cold-loading on peripheral circulation en-subtitle= kn-subtitle= en-abstract=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。 kn-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. en-copyright= kn-copyright= en-aut-name=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=保ア泰弘 kn-aut-sei=保ア kn-aut-mei=泰弘 aut-affil-num=1 ORCID= en-aut-name=MitsunobuFumihiro en-aut-sei=Mitsunobu en-aut-mei=Fumihiro kn-aut-name=光延文裕 kn-aut-sei=光延 kn-aut-mei=文裕 aut-affil-num=2 ORCID= en-aut-name=MifuneTakashi en-aut-sei=Mifune en-aut-mei=Takashi kn-aut-name=御舩尚志 kn-aut-sei=御舩 kn-aut-mei=尚志 aut-affil-num=3 ORCID= en-aut-name=AshidaKozo en-aut-sei=Ashida en-aut-mei=Kozo kn-aut-name=芦田耕三 kn-aut-sei=芦田 kn-aut-mei=耕三 aut-affil-num=4 ORCID= en-aut-name=TsugenoHirofumi en-aut-sei=Tsugeno en-aut-mei=Hirofumi kn-aut-name=柘野浩史 kn-aut-sei=柘野 kn-aut-mei=浩史 aut-affil-num=5 ORCID= en-aut-name=OkamotoMakoto en-aut-sei=Okamoto en-aut-mei=Makoto kn-aut-name=岡本誠 kn-aut-sei=岡本 kn-aut-mei=誠 aut-affil-num=6 ORCID= en-aut-name=TakataShingo en-aut-sei=Takata en-aut-mei=Shingo kn-aut-name=高田真吾 kn-aut-sei=高田 kn-aut-mei=真吾 aut-affil-num=7 ORCID= en-aut-name=YokoiTadashi en-aut-sei=Yokoi en-aut-mei=Tadashi kn-aut-name=横井正 kn-aut-sei=横井 kn-aut-mei=正 aut-affil-num=8 ORCID= en-aut-name=TanizakiYoshiro en-aut-sei=Tanizaki en-aut-mei=Yoshiro kn-aut-name=谷崎勝朗 kn-aut-sei=谷崎 kn-aut-mei=勝朗 aut-affil-num=9 ORCID= en-aut-name=OchiKoji en-aut-sei=Ochi en-aut-mei=Koji kn-aut-name=越智浩二 kn-aut-sei=越智 kn-aut-mei=浩二 aut-affil-num=10 ORCID= en-aut-name=TsujiTakao en-aut-sei=Tsuji en-aut-mei=Takao kn-aut-name=辻孝夫 kn-aut-sei=辻 kn-aut-mei=孝夫 aut-affil-num=11 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=2 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=3 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=4 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=5 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=6 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=7 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=8 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=9 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=10 en-affil= kn-affil=医学部臨床検査医学 affil-num=11 en-affil= kn-affil=医学部第一内科 en-keyword=Laser-Doppler blood flowmetry (レーザードプラー血流計) kn-keyword=Laser-Doppler blood flowmetry (レーザードプラー血流計) en-keyword=cold loading (冷水負荷) kn-keyword=cold loading (冷水負荷) en-keyword=peripheral circulation (末梢循環) kn-keyword=peripheral circulation (末梢循環) en-keyword=blood flow (血流量) kn-keyword=blood flow (血流量) en-keyword=blood velocity (血流速度) kn-keyword=blood velocity (血流速度) END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue= article-no= start-page=50 end-page=58 dt-received= dt-revised= dt-accepted= dt-pub-year=2001 dt-pub=20010201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=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 kn-title=Effects of dietary supplementation with n−3 fatty acidson bronchial asthma associated with changes in lipids.−Comparison with n−6 fatty acids− en-subtitle= kn-subtitle= en-abstract=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。 kn-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. en-copyright= kn-copyright= en-aut-name=OkamotoMakoto en-aut-sei=Okamoto en-aut-mei=Makoto kn-aut-name=岡本誠 kn-aut-sei=岡本 kn-aut-mei=誠 aut-affil-num=1 ORCID= en-aut-name=MitsunobuFumihiro en-aut-sei=Mitsunobu en-aut-mei=Fumihiro kn-aut-name=光延文裕 kn-aut-sei=光延 kn-aut-mei=文裕 aut-affil-num=2 ORCID= en-aut-name=AshidaKozo en-aut-sei=Ashida en-aut-mei=Kozo kn-aut-name=芦田耕三 kn-aut-sei=芦田 kn-aut-mei=耕三 aut-affil-num=3 ORCID= en-aut-name=MifuneTakashi en-aut-sei=Mifune en-aut-mei=Takashi kn-aut-name=御舩尚志 kn-aut-sei=御舩 kn-aut-mei=尚志 aut-affil-num=4 ORCID= en-aut-name=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=保ア泰弘 kn-aut-sei=保ア kn-aut-mei=泰弘 aut-affil-num=5 ORCID= en-aut-name=TsugenoHirofumi en-aut-sei=Tsugeno en-aut-mei=Hirofumi kn-aut-name=柘野浩史 kn-aut-sei=柘野 kn-aut-mei=浩史 aut-affil-num=6 ORCID= en-aut-name=TakataShingo en-aut-sei=Takata en-aut-mei=Shingo kn-aut-name=高田真吾 kn-aut-sei=高田 kn-aut-mei=真吾 aut-affil-num=7 ORCID= en-aut-name=TanizakiYoshiro en-aut-sei=Tanizaki en-aut-mei=Yoshiro kn-aut-name=谷崎勝朗 kn-aut-sei=谷崎 kn-aut-mei=勝朗 aut-affil-num=8 ORCID= en-aut-name=HaradaMine en-aut-sei=Harada en-aut-mei=Mine kn-aut-name=原田実根 kn-aut-sei=原田 kn-aut-mei=実根 aut-affil-num=9 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=2 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=3 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=4 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=5 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=6 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=7 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=8 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=9 en-affil= kn-affil=岡山大学第二内科 en-keyword=perilla seed oil (エゴマ抽) kn-keyword=perilla seed oil (エゴマ抽) en-keyword=a -1inolenic acid (α−リノレン酸) kn-keyword=a -1inolenic acid (α−リノレン酸) en-keyword=leukotriene C4 (ロイコトリエンC4) kn-keyword=leukotriene C4 (ロイコトリエンC4) en-keyword=respiratory function (呼吸機能) kn-keyword=respiratory function (呼吸機能) en-keyword=脂質代謝 kn-keyword=脂質代謝 END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue= article-no= start-page=59 end-page=67 dt-received= dt-revised= dt-accepted= dt-pub-year=2001 dt-pub=20010201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=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 kn-title=Glucocorticoid-induced cortical bone porosity in postmenopausal patients with asthma en-subtitle= kn-subtitle= en-abstract=【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]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。 kn-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. en-copyright= kn-copyright= en-aut-name=TsugenoHirofumi en-aut-sei=Tsugeno en-aut-mei=Hirofumi kn-aut-name=柘野浩史 kn-aut-sei=柘野 kn-aut-mei=浩史 aut-affil-num=1 ORCID= en-aut-name=GotoBunrei en-aut-sei=Goto en-aut-mei=Bunrei kn-aut-name=後藤文禮 kn-aut-sei=後藤 kn-aut-mei=文禮 aut-affil-num=2 ORCID= en-aut-name=NakaiMutsuro en-aut-sei=Nakai en-aut-mei=Mutsuro kn-aut-name=中井睦郎 kn-aut-sei=中井 kn-aut-mei=睦郎 aut-affil-num=3 ORCID= en-aut-name=OkamotoMakoto en-aut-sei=Okamoto en-aut-mei=Makoto kn-aut-name=岡本誠 kn-aut-sei=岡本 kn-aut-mei=誠 aut-affil-num=4 ORCID= en-aut-name=TakataSingo en-aut-sei=Takata en-aut-mei=Singo kn-aut-name=高田真吾 kn-aut-sei=高田 kn-aut-mei=真吾 aut-affil-num=5 ORCID= en-aut-name=MifuneTakashi en-aut-sei=Mifune en-aut-mei=Takashi kn-aut-name=御舩尚志 kn-aut-sei=御舩 kn-aut-mei=尚志 aut-affil-num=6 ORCID= en-aut-name=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=保ア泰弘 kn-aut-sei=保ア kn-aut-mei=泰弘 aut-affil-num=7 ORCID= en-aut-name=MitsunobuFumihiro en-aut-sei=Mitsunobu en-aut-mei=Fumihiro kn-aut-name=光延文裕 kn-aut-sei=光延 kn-aut-mei=文裕 aut-affil-num=8 ORCID= en-aut-name=AshidaKozo en-aut-sei=Ashida en-aut-mei=Kozo kn-aut-name=芦田耕三 kn-aut-sei=芦田 kn-aut-mei=耕三 aut-affil-num=9 ORCID= en-aut-name=AkiyamaTsuneo en-aut-sei=Akiyama en-aut-mei=Tsuneo kn-aut-name=穐山恒雄 kn-aut-sei=穐山 kn-aut-mei=恒雄 aut-affil-num=10 ORCID= en-aut-name=TsujiTakao en-aut-sei=Tsuji en-aut-mei=Takao kn-aut-name=辻孝夫 kn-aut-sei=辻 kn-aut-mei=孝夫 aut-affil-num=11 ORCID= en-aut-name=TanizakiYoshiro en-aut-sei=Tanizaki en-aut-mei=Yoshiro kn-aut-name=谷崎勝朗 kn-aut-sei=谷崎 kn-aut-mei=勝朗 aut-affil-num=12 ORCID= affil-num=1 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=2 en-affil= kn-affil=カルシウム研究所 affil-num=3 en-affil= kn-affil=岡山大学三朝分院放射線室 affil-num=4 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=5 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=6 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=7 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=8 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=9 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=10 en-affil= kn-affil=岡山大学三朝分院放射線室 affil-num=11 en-affil= kn-affil=岡山大学第一内科 affil-num=12 en-affil= kn-affil=岡山大学三朝分院内科 en-keyword=glucocorticoid kn-keyword=glucocorticoid en-keyword=cortical bone kn-keyword=cortical bone en-keyword=pQCT kn-keyword=pQCT en-keyword=osteoporosis kn-keyword=osteoporosis END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue= article-no= start-page=68 end-page=72 dt-received= dt-revised= dt-accepted= dt-pub-year=2001 dt-pub=20010201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=A case of systemic lupus erythematosus (SLE) associated with disseminated intravascular coagulation (DIC) kn-title=播種性血管内凝固症候群(DIC)を合併した全身性エリテマトーデス(SLE)の1例 en-subtitle= kn-subtitle= en-abstract=A case of disseminated intravascular coagulation (DIC) in a patient with systemic lupus erythematosus (SLE) was described. A 73-year-old female was diagnosed as having rheumatoid arthritis when she was 64 years old. In Jan, 1999, the patient was admitted to our hospital with the complaint of loss of appetite. She was suspected of DIC because of thrombocytopenia, increased fibrin degradation product and prolonged prothrombin test. Abnormality in coagulation system is recognized in collagen disease. In this case coagulation system was activated and DIC occurred. In this case rheumatoid factor was positive. But she was suspected of complicating other collagen disease because she was poor in typical characteristics of rheumatoid arthritis, such as morning stiffness. SLE was diagnosed on the basis of renal injury, thrombocytopenia, positive anti-Sm antibody and positive antinuclaer antibody in this case. kn-abstract=播種性血管内凝固症候群(DIC)を合併した全身性エリテマトーデス(SLE)を経験したので報告する。症例は73歳女性。64歳時慢性関節リウマチ(RA)と診断された。1999年1月食欲低下を訴え当科受診した。血小板減少、FDP高値、PT上昇等よりDIC発症を疑った。膠原病では凝固系の異常を認めるが、本症例では凝固系が完進しDICを来したと考えられた。 本症例はリウマチ因子陽性であったが、朝のこわばり等典型的なRAの所見に乏しく他の膠原病の合併を疑い、腎障害、血小板減少、抗Sm抗体、抗核抗体陽性よりSLEと診断した。 en-copyright= kn-copyright= en-aut-name=TakataSingo en-aut-sei=Takata en-aut-mei=Singo kn-aut-name=高田真吾 kn-aut-sei=高田 kn-aut-mei=真吾 aut-affil-num=1 ORCID= en-aut-name=OkamotoMakoto en-aut-sei=Okamoto en-aut-mei=Makoto kn-aut-name=岡本誠 kn-aut-sei=岡本 kn-aut-mei=誠 aut-affil-num=2 ORCID= en-aut-name=TsugenoHirofumi en-aut-sei=Tsugeno en-aut-mei=Hirofumi kn-aut-name=柘野浩史 kn-aut-sei=柘野 kn-aut-mei=浩史 aut-affil-num=3 ORCID= en-aut-name=HaradaSeishi en-aut-sei=Harada en-aut-mei=Seishi kn-aut-name=原田誠之 kn-aut-sei=原田 kn-aut-mei=誠之 aut-affil-num=4 ORCID= en-aut-name=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=保ア泰弘 kn-aut-sei=保ア kn-aut-mei=泰弘 aut-affil-num=5 ORCID= en-aut-name=MifuneTakashi en-aut-sei=Mifune en-aut-mei=Takashi kn-aut-name=御舩尚志 kn-aut-sei=御舩 kn-aut-mei=尚志 aut-affil-num=6 ORCID= en-aut-name=MitsunobuFumihiro en-aut-sei=Mitsunobu en-aut-mei=Fumihiro kn-aut-name=光延文裕 kn-aut-sei=光延 kn-aut-mei=文裕 aut-affil-num=7 ORCID= en-aut-name=TanizakiYoshiro en-aut-sei=Tanizaki en-aut-mei=Yoshiro kn-aut-name=谷崎勝朗 kn-aut-sei=谷崎 kn-aut-mei=勝朗 aut-affil-num=8 ORCID= en-aut-name=NiiyaKenji en-aut-sei=Niiya en-aut-mei=Kenji kn-aut-name=新谷憲治 kn-aut-sei=新谷 kn-aut-mei=憲治 aut-affil-num=9 ORCID= en-aut-name=HaradaMine en-aut-sei=Harada en-aut-mei=Mine kn-aut-name=原田実根 kn-aut-sei=原田 kn-aut-mei=実根 aut-affil-num=10 ORCID= affil-num=1 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=2 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=3 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=4 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=5 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=6 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=7 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=8 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=9 en-affil= kn-affil=岡山大学医学部第二内科 affil-num=10 en-affil= kn-affil=岡山大学医学部第二内科 en-keyword=慢性関節リウマチ (Rheumatoid arthritis) kn-keyword=慢性関節リウマチ (Rheumatoid arthritis) en-keyword=全身性エリテマトーデス (Systemic lupus erythematosus) kn-keyword=全身性エリテマトーデス (Systemic lupus erythematosus) en-keyword=播種性血管内凝固症候群 (Disseminated intravascular coagulation syndrome) kn-keyword=播種性血管内凝固症候群 (Disseminated intravascular coagulation syndrome) END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue= article-no= start-page=96 end-page=100 dt-received= dt-revised= dt-accepted= dt-pub-year=2001 dt-pub=20010201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=平成11年度看護部教育・研修・活動状況 en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name= en-aut-sei= en-aut-mei= kn-aut-name=中村寿美江 kn-aut-sei=中村 kn-aut-mei=寿美江 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=看護部 en-keyword=看護部 kn-keyword=看護部 en-keyword=研修会 kn-keyword=研修会 en-keyword=活動 kn-keyword=活動 END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue= article-no= start-page=73 end-page=75 dt-received= dt-revised= dt-accepted= dt-pub-year=2001 dt-pub=20010201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=4年間無治療にて経過を観察した高齢発症原発性胆汁性肝硬変症の一例 en-subtitle= kn-subtitle= en-abstract= kn-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。 en-copyright= kn-copyright= en-aut-name=AshidaKozo en-aut-sei=Ashida en-aut-mei=Kozo kn-aut-name=芦田耕三 kn-aut-sei=芦田 kn-aut-mei=耕三 aut-affil-num=1 ORCID= en-aut-name=TsugenoHirofumi en-aut-sei=Tsugeno en-aut-mei=Hirofumi kn-aut-name=柘野浩史 kn-aut-sei=柘野 kn-aut-mei=浩史 aut-affil-num=2 ORCID= en-aut-name=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=保ア泰弘 kn-aut-sei=保ア kn-aut-mei=泰弘 aut-affil-num=3 ORCID= en-aut-name=MitsunobuFumihiro en-aut-sei=Mitsunobu en-aut-mei=Fumihiro kn-aut-name=光延文裕 kn-aut-sei=光延 kn-aut-mei=文裕 aut-affil-num=4 ORCID= en-aut-name=MifuneTakashi en-aut-sei=Mifune en-aut-mei=Takashi kn-aut-name=御舩尚志 kn-aut-sei=御舩 kn-aut-mei=尚志 aut-affil-num=5 ORCID= en-aut-name=NishidaNorikazu en-aut-sei=Nishida en-aut-mei=Norikazu kn-aut-name=西田典数 kn-aut-sei=西田 kn-aut-mei=典数 aut-affil-num=6 ORCID= en-aut-name=OkamotoMakoto en-aut-sei=Okamoto en-aut-mei=Makoto kn-aut-name=岡本誠 kn-aut-sei=岡本 kn-aut-mei=誠 aut-affil-num=7 ORCID= en-aut-name=TakataShingo en-aut-sei=Takata en-aut-mei=Shingo kn-aut-name=高田真吾 kn-aut-sei=高田 kn-aut-mei=真吾 aut-affil-num=8 ORCID= en-aut-name=TanizakiYoshiro en-aut-sei=Tanizaki en-aut-mei=Yoshiro kn-aut-name=谷崎勝朗 kn-aut-sei=谷崎 kn-aut-mei=勝朗 aut-affil-num=9 ORCID= en-aut-name=TsujiTakao en-aut-sei=Tsuji en-aut-mei=Takao kn-aut-name=辻孝夫 kn-aut-sei=辻 kn-aut-mei=孝夫 aut-affil-num=10 ORCID= affil-num=1 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=2 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=3 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=4 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=5 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=6 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=7 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=8 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=9 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=10 en-affil= kn-affil=岡山大学医学部第一内科 en-keyword=原発性胆汁性肝硬変症 (primary biliary cirrhosis) kn-keyword=原発性胆汁性肝硬変症 (primary biliary cirrhosis) en-keyword=高齢 (elderly) kn-keyword=高齢 (elderly) en-keyword=自然経過 (natural course) kn-keyword=自然経過 (natural course) END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue= article-no= start-page=76 end-page=83 dt-received= dt-revised= dt-accepted= dt-pub-year=2001 dt-pub=20010201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=マトリックスメタロプロテアーゼと膵疾患 kn-title=Matrix metalloproteinases (MMPs) and pancreatic diseases en-subtitle= kn-subtitle= en-abstract=マトリックスメタロブロテアーゼ(MMP)は,コラーゲン分解能を有し,種々の疾患との関連性が示唆されている。とりわけ,癌の浸潤,転移には密接な関係があるとされている。また,MMP阻害剤を癌の治療に用いる試みもなされている。本稿ではMMPと膵疾患の関連性,MMP阻害剤の膵癌への応用の可能性について総説する。 kn-abstract=Matrix metalloproteinases (MMPs) is a family of collagenolytic enzymesand are associated with many pathological conditions. Especially, MMPs have a strong relation with tumor progression and invasion. In this review, we focused on association of MMPs and pancreatic diseases, and a potential treatment of MMPs inhibitors for pancreatic cancer. en-copyright= kn-copyright= en-aut-name=YokoyamaMotohiro en-aut-sei=Yokoyama en-aut-mei=Motohiro kn-aut-name=横山元浩 kn-aut-sei=横山 kn-aut-mei=元浩 aut-affil-num=1 ORCID= en-aut-name=OchiKoji en-aut-sei=Ochi en-aut-mei=Koji kn-aut-name=越智浩二 kn-aut-sei=越智 kn-aut-mei=浩二 aut-affil-num=2 ORCID= en-aut-name=MizushimaTakaaki en-aut-sei=Mizushima en-aut-mei=Takaaki kn-aut-name=水島孝明 kn-aut-sei=水島 kn-aut-mei=孝明 aut-affil-num=3 ORCID= en-aut-name=IchimuraMitsuko en-aut-sei=Ichimura en-aut-mei=Mitsuko kn-aut-name=一村光子 kn-aut-sei=一村 kn-aut-mei=光子 aut-affil-num=4 ORCID= en-aut-name=TsurumiTetsuya en-aut-sei=Tsurumi en-aut-mei=Tetsuya kn-aut-name=鶴見哲也 kn-aut-sei=鶴見 kn-aut-mei=哲也 aut-affil-num=5 ORCID= en-aut-name=MitsunobuFumihiro en-aut-sei=Mitsunobu en-aut-mei=Fumihiro kn-aut-name=光延文裕 kn-aut-sei=光延 kn-aut-mei=文裕 aut-affil-num=6 ORCID= en-aut-name=TanizakiYoshiro en-aut-sei=Tanizaki en-aut-mei=Yoshiro kn-aut-name=谷崎勝朗 kn-aut-sei=谷崎 kn-aut-mei=勝朗 aut-affil-num=7 ORCID= affil-num=1 en-affil= kn-affil=岡山大学臨床検査医学 affil-num=2 en-affil= kn-affil=岡山大学臨床検査医学 affil-num=3 en-affil= kn-affil=岡山大学臨床検査医学 affil-num=4 en-affil= kn-affil=岡山大学保険学科 affil-num=5 en-affil= kn-affil=岡山赤十字病院 affil-num=6 en-affil= kn-affil=岡山大学三朝分院内科 affil-num=7 en-affil= kn-affil=岡山大学三朝分院内科 en-keyword=matrix metalloproteinase(MMP) kn-keyword=matrix metalloproteinase(MMP) en-keyword=tissue inhibitor of metalloproteinase(TIMP) kn-keyword=tissue inhibitor of metalloproteinase(TIMP) en-keyword=pancreatic cancer (膵癌) kn-keyword=pancreatic cancer (膵癌) en-keyword=chronic pancreatitis (慢性膵炎) kn-keyword=chronic pancreatitis (慢性膵炎) END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue= article-no= start-page=84 end-page=88 dt-received= dt-revised= dt-accepted= dt-pub-year=2001 dt-pub=20010201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Evaiuation of spa therapy by questionnaire. Characteristics of patients from distant areas. kn-title=アンケート調査による温泉療法の評価 −遠隔地からの入院患者を対象に− en-subtitle= kn-subtitle= en-abstract=Clinical evaluation of spa therapy was examined in 80 patients with respiratory disease and with joint pain including lumber pain, who came from distant areas (outside Tottori prefecture) and were admitted at Misasa Hospital by questionnaire in relation to a motive of admission, effects of spa therapy, dose of medication, a motive of discharge. In many of these patients, the age was over 60 years and duration of their admission was from two to three months. Seventy-one- (88.7%) of the 80 patients were admitted at our hospital because they were not satisfactory for the treatment of asthma which they had before. The number of patients from Hiroshima, Osaka, Kyoto, and Hyogo, prefectures was larger than the number from other distant areas. The results of the questionnaire suggest that improvement of symptoms and reduction of drugs used are ecpected by spa therapy. kn-abstract=1999年4月〜12月の9ケ月間の遠隔地からの入院患者80名(痔痛性疾患47例,呼吸器疾患33例)を対象に,岡大三朝分院に来院した動機,入院前の状態,温泉療法の効果,薬剤の変化,退院決定の動機等について退院前にアンケート調査を行い検討を加えた。対象症例の年齢は60才以上の高齢者力て多く,入院期間は1ケ月〜2ケ月末満が多い傾向であった。入院前の状態では,今までの治療に不満,限界を感じて来院している症例が71例(88.7%)を占めていた。地域別では広島,大阪,京都,兵庫からの来院か多く,その他18都府県に及んでいた。アンケート結果では,疾患別による若干の傾向と,温泉療法に対する評価として症状の改善が見られ,また,使用薬剤の減量の可能性が示唆された。 en-copyright= kn-copyright= en-aut-name=NishimuraNobuko en-aut-sei=Nishimura en-aut-mei=Nobuko kn-aut-name=西村伸子 kn-aut-sei=西村 kn-aut-mei=伸子 aut-affil-num=1 ORCID= en-aut-name=TerasakiKayo en-aut-sei=Terasaki en-aut-mei=Kayo kn-aut-name=寺崎佳代 kn-aut-sei=寺崎 kn-aut-mei=佳代 aut-affil-num=2 ORCID= en-aut-name=YamamotoSadae en-aut-sei=Yamamoto en-aut-mei=Sadae kn-aut-name=山本貞枝 kn-aut-sei=山本 kn-aut-mei=貞枝 aut-affil-num=3 ORCID= en-aut-name=YoshioKeiko en-aut-sei=Yoshio en-aut-mei=Keiko kn-aut-name=吉尾慶子 kn-aut-sei=吉尾 kn-aut-mei=慶子 aut-affil-num=4 ORCID= en-aut-name=NakamuraSumie en-aut-sei=Nakamura en-aut-mei=Sumie kn-aut-name=中村寿美江 kn-aut-sei=中村 kn-aut-mei=寿美江 aut-affil-num=5 ORCID= en-aut-name=TanizakiYoshiro en-aut-sei=Tanizaki en-aut-mei=Yoshiro kn-aut-name=谷崎勝朗 kn-aut-sei=谷崎 kn-aut-mei=勝朗 aut-affil-num=6 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部附属病院二勤分院看護部 affil-num=2 en-affil= kn-affil=岡山大学医学部附属病院二勤分院看護部 affil-num=3 en-affil= kn-affil=岡山大学医学部附属病院二勤分院看護部 affil-num=4 en-affil= kn-affil=岡山大学医学部附属病院二勤分院看護部 affil-num=5 en-affil= kn-affil=岡山大学医学部附属病院二勤分院看護部 affil-num=6 en-affil= kn-affil=岡山大学三朝分院内科 en-keyword=遠隔地 (distant area) kn-keyword=遠隔地 (distant area) en-keyword=温泉療法 (spa therapy) kn-keyword=温泉療法 (spa therapy) en-keyword=アンケート (questionaire) kn-keyword=アンケート (questionaire) en-keyword=呼吸器疾患 (respiratory disease) kn-keyword=呼吸器疾患 (respiratory disease) en-keyword=疼痛性疾患 (pain disease) kn-keyword=疼痛性疾患 (pain disease) END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue= article-no= start-page=89 end-page=93 dt-received= dt-revised= dt-accepted= dt-pub-year=2001 dt-pub=20010201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=通院患者の温泉プール訓練についての満足度と期待度 en-subtitle= kn-subtitle= en-abstract= kn-abstract=通院患者の温泉プール利用者95名を対象にアンケート調査し,主に訓練に対する満足度と期待度について調査した。 結果は有効回答85名,対象者の年齢65歳以上58名(68%)65歳末満27名(32%),疾患別では呼吸器疾患39名(45.9%)療病性疾患29名(34.1%)その他の疾患17名(20%)であった。 t検定の結果有意差(P<0.05)があったのは,療病性疾患群では呼吸器疾患群に比べ期待度が高い,訓練が頻回な群で期待度が高い,指導あり群で満足度が高い,であった。年齢別での効果では65歳末満と65歳以上の比較で有意差はなかったが,高齢者(65歳以上)において高い傾向が見られた。温泉プール訓練は高齢者に効果的な訓練と考えられ,より効果を高めるための課題として訓練指導を充実する必要がある。 en-copyright= kn-copyright= en-aut-name= en-aut-sei= en-aut-mei= kn-aut-name=石田美枝子 kn-aut-sei=石田 kn-aut-mei=美枝子 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部附属病院三朝分院 en-keyword=温泉プール訓練 kn-keyword=温泉プール訓練 en-keyword=外来通院患者 kn-keyword=外来通院患者 en-keyword=満足度 kn-keyword=満足度 en-keyword=期待度 kn-keyword=期待度 END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue= article-no= start-page=94 end-page=95 dt-received= dt-revised= dt-accepted= dt-pub-year=2001 dt-pub=20010201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=運動器疾患入院状況 en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name=NakamuraSumie en-aut-sei=Nakamura en-aut-mei=Sumie kn-aut-name=中村寿美江 kn-aut-sei=中村 kn-aut-mei=寿美江 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=看護部 en-keyword=看護部 kn-keyword=看護部 en-keyword=入院状況 kn-keyword=入院状況 en-keyword=運動器疾患 kn-keyword=運動器疾患 END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue= article-no= start-page=123 end-page=127 dt-received= dt-revised= dt-accepted= dt-pub-year=2001 dt-pub=20010201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=業績集 en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name= en-aut-sei= en-aut-mei= kn-aut-name=三朝医療センター kn-aut-sei=三朝医療センター kn-aut-mei= aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil= END