start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue= article-no= start-page=66 end-page=70 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=20080301 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 start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue= article-no= start-page=60 end-page=65 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=20080301 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=IgG4-related disease kn-title=IgG4関連疾患 en-subtitle= kn-subtitle= en-abstract=IgG4-related disease is a new concept which was established in 21st century. Histologically, infiltrations of IgG4-positive plasma cells and lymphocytes occur in the lacrimal gland, salivary gland , retroperitoneum , pancreas , and biliary tract. IgG4-related disease is a systematic disease presenting symptoms such as Mikulicz's disease, retroperitoneal fibrosis, autoimmune pancreatitis, diabetes and sclerotic cholangitis, and oral steroid therapy is effective. In this paper, we propose diagnostic criteria for IgG4-related disease that have not been established yet. If two (or more) of three following features are fulfilled, IgG4-related disease is diagnosed ； elevated levels of serum IgG4, involvement of organs which is characteristic in IgG4-related disease (salivary gland, lacrimal gland, pancreas and retroperitonium) ,histological findings with IgG4-positive plasma cells and lymphocytes. kn-abstract=IgG4関連疾患は21世紀になって提唱された新しい疾患である｡組織学的にはIgG4陽性形質細胞やリンパ球浸潤が涙腺, 唾液腺, 後腹膜, 膵臓, 胆管などで起こり, 臨床的にはMikulicz病, 後腹膜線維症, 自己免疫膵炎, 糖尿病, 原発性硬化性胆管炎類似の胆管病変などを呈する全身性疾患であり, ステロイド治療に対する良好な反応性を認める｡その診断基準は確立されておらず, われわれは, @血清IgG4の高値, A本疾患に特徴的な臓器の障害(唾液腺,涙腺, 膵臓, 後腹膜), B組織学的にIgG4陽性形質細胞とリンパ球の浸潤の確認, の３項目のうち２項目以上認めれば, IgG4関連疾患とするという診断基準を提言する｡ en-copyright= kn-copyright= en-aut-name=HiramatsuKazuhisa en-aut-sei=Hiramatsu en-aut-mei=Kazuhisa kn-aut-name=平松万尚 kn-aut-sei=平松 kn-aut-mei=万尚 aut-affil-num=1 ORCID= en-aut-name=AsanoMotoi en-aut-sei=Asano en-aut-mei=Motoi kn-aut-name=浅野基 kn-aut-sei=浅野 kn-aut-mei=基 aut-affil-num=2 ORCID= en-aut-name=MatsushitaKoki en-aut-sei=Matsushita en-aut-mei=Koki kn-aut-name=松下公紀 kn-aut-sei=松下 kn-aut-mei=公紀 aut-affil-num=3 ORCID= en-aut-name=MiyoshiTomoko en-aut-sei=Miyoshi en-aut-mei=Tomoko kn-aut-name=三好智子 kn-aut-sei=三好 kn-aut-mei=智子 aut-affil-num=4 ORCID= en-aut-name=NakamuraSukio en-aut-sei=Nakamura en-aut-mei=Sukio kn-aut-name=中村好男 kn-aut-sei=中村 kn-aut-mei=好男 aut-affil-num=5 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=6 ORCID= en-aut-name=KoideNorio en-aut-sei=Koide en-aut-mei=Norio kn-aut-name=小出典男 kn-aut-sei=小出 kn-aut-mei=典男 aut-affil-num=7 ORCID= en-aut-name=KataokaHitomi en-aut-sei=Kataoka en-aut-mei=Hitomi kn-aut-name=片岡仁美 kn-aut-sei=片岡 kn-aut-mei=仁美 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= 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=10 ORCID= affil-num=1 en-affil= kn-affil=岡山大学病院総合診療内科 affil-num=2 en-affil= kn-affil=岡山大学病院総合診療内科 affil-num=3 en-affil= kn-affil=岡山大学病院総合診療内科 affil-num=4 en-affil= kn-affil=岡山大学病院総合診療内科 affil-num=5 en-affil= kn-affil=岡山大学病院総合診療内科 affil-num=6 en-affil= kn-affil=岡山大学病院総合診療内科 affil-num=7 en-affil= kn-affil=岡山大学病院総合診療内科 affil-num=8 en-affil= kn-affil=岡山大学医療教育統合開発センター affil-num=9 en-affil= kn-affil=岡山大学医療教育統合開発センター affil-num=10 en-affil= kn-affil=岡山大学病院三朝医療センター en-keyword=IgG4関連疾患 (IgG4-related disease) kn-keyword=IgG4関連疾患 (IgG4-related disease) en-keyword=自己免疫膵炎 (autoimmune pancreatitis) kn-keyword=自己免疫膵炎 (autoimmune pancreatitis) en-keyword=Mikulicz病 (Mikulicz's disease) kn-keyword=Mikulicz病 (Mikulicz's disease) en-keyword=後腹膜線維症 (retroperitoneal fibrosis) kn-keyword=後腹膜線維症 (retroperitoneal fibrosis) END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue= article-no= start-page=53 end-page=59 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=20080301 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Fluticasone 投与にもかかわらず症状が軽快ぜすn-3系不飽和脂肪酸強化食による食事療法及びモンテルカストが著効した気管支喘息の１例 kn-title=A case with persistent asthma symptoms despite fluticasone treatment in which concomitant treatment with montelukast and perilla seed oil-rich supplementation significantly improved asthma control en-subtitle= kn-subtitle= en-abstract=症例は25歳女性, 主訴は呼吸困難, 喘鳴｡乳児期気管支喘息発症し, 以後も喘息発作を認めた｡ 高校卒業後上京し, 就職後fluticasone propionate400μg投与にもかかわらず, 喘息発作が続いていた｡2001年10月倉敷に帰郷後も喘鳴, 発作を認め, 2002年８月２日精査加療目的で当院入院となっ た｡入院後速やかに喘鳴は消退した｡エゴマ油食,montelukast sodium投与開始し, 血中好酸球, 白血球leukotriene B4, leukotriene C4低下, 呼吸機能改善を認めた｡その後喘息発作, 喘鳴などは再発せず, ９月２日退院となった｡吸入ステロイド薬単独治療では症状を十分に管理できない患者が存在する｡その原因としてステロイド薬はロイコトリエンの産生を完全に抑制できないことが挙げられる｡ロイコトリエンによる気道炎症は,montelukastをはじめとするロイコトリエン受容体拮抗薬によって特異的に抑制され, エゴマ油食もロイコトリエン産生を抑制すると報告されている｡本症例ではmontelukastおよびエゴマ油食の相加効果により, 各々の単独投与より良好な結果が得られた｡従って吸入ステロイドで喘息コントロール不良な症例に対してmontelukastおよびエゴマ油食を併用することが望まれる｡ kn-abstract=A 25-year-old woman had the chief complaint of recurrent episodes of dyspnea and wheeze. Asthma had been diagnosed at infant years and sometimes experienced asthma attacks. She graduated senior high school and entered technical school in Tokyo. She received fluticasone (400μg daily) but exacerbation continued after she became an office clerk. She returned Kurashiki in October 2001 but had wheeze and asthma exacerbations. She was admitted to our hospital for evaluation and treatment of bronchial asthma on August 2, 2002. After admission, her symptoms subsided within some days. She was treated with montelukast and perilla seed oil-rich supplementation . The number of eosinophils decreased, decrease was observed in leukotriene (LT) B4 generation and in LTC4 generation, and pulmonary function improved following montelukast and perilla seed oil-rich supplementation for 4 weeks. The patient had no exacerbation under treatment and was discharged from the hospital on September 2, 2002. For some patients with persistent asthma, inhaled corticosteroids may fail to achieve adequate control possibly because corticosteroids do not completely inhibit the synthesis and release of cysteinyl leukotrienes (cysLTs) in the lung. Montelukast blocks the interaction of cysLTs with their receptor and resulting downstream events and perilla seed oil-rich diet suppresses LT generation. Combination therapy with montelukast and perilla seed oil-rich diet is more effective than montelukast or perilla seed oil-rich diet alone because of additive effects of montelukast with perilla seed oil-rich diet. We suggest that montelukast and perilla seed oil-rich supplementation are effective options when bronchial asthma patients receive inhaled corticosteroid but exacerbation continues. en-copyright= kn-copyright= 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=1 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=2 ORCID= en-aut-name=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=保崎泰弘 kn-aut-sei=保崎 kn-aut-mei=泰弘 aut-affil-num=3 ORCID= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name=濱田全紀 kn-aut-sei=濱田 kn-aut-mei=全紀 aut-affil-num=4 ORCID= en-aut-name=IwagakiNaofumi en-aut-sei=Iwagaki en-aut-mei=Naofumi kn-aut-name=岩垣尚史 kn-aut-sei=岩垣 kn-aut-mei=尚史 aut-affil-num=5 ORCID= en-aut-name=KikuchiHiroshi en-aut-sei=Kikuchi en-aut-mei=Hiroshi kn-aut-name=菊池宏 kn-aut-sei=菊池 kn-aut-mei=宏 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= affil-num=1 en-affil= kn-affil=岡山大学病院三朝医療センター内科 affil-num=2 en-affil= kn-affil=岡山大学病院三朝医療センター内科 affil-num=3 en-affil= kn-affil=岡山大学病院三朝医療センター内科 affil-num=4 en-affil= kn-affil=岡山大学病院三朝医療センターリハビリテーション affil-num=5 en-affil= kn-affil=岡山大学病院三朝医療センター内科 affil-num=6 en-affil= kn-affil=岡山大学病院三朝医療センター内科 affil-num=7 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 en-keyword=モンテルカスト (montelukast) kn-keyword=モンテルカスト (montelukast) en-keyword=気管支喘息 (bronchial asthma) kn-keyword=気管支喘息 (bronchial asthma) en-keyword=ロイコトリエンC4 (leukotriene C4) kn-keyword=ロイコトリエンC4 (leukotriene C4) en-keyword=エゴマ油食 (perilla seed oil-rich supplementation) kn-keyword=エゴマ油食 (perilla seed oil-rich supplementation) en-keyword=フルチカゾン (fluticasone) kn-keyword=フルチカゾン (fluticasone) END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue= article-no= start-page=49 end-page=52 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=20080301 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Considering peak inspiratory flow in selection of inhalation device kn-title=吸気流量を考慮することにより吸入器具を変更できた一症例 en-subtitle= kn-subtitle= en-abstract=In the treatment of bronchial asthma and chronic obstructive pulmonary disease, it is important to use inhalation therapy adequately. A 60’s woman was admitted to our hospital due to exertional dyspnea. She was diagnosed as having exacerbation of asthma. Although she was treated with intravenous, oral, and inhalation administration simultaneously after admissi on, her symptom did not improve enough, and her pulmonary function was still low. Application of the inhalation check device supplied by the medicine manufacture company grant demonstrated that she failed to inhale effectively . Therefore the inhaled glucocorticosteroid was changed, and it was confirmed that she was able to inhale successfully. Her successful inhalation resulted in the improvement of her respiratory symptom and pulmonary function. It is suggested that the manipulation is very important factor on inhalation therapy, and it is necessary to strive to improve the adherence for the treatment of bronchial asthma and chronic obstructive pulmonary disease. kn-abstract=気管支喘息や慢性閉塞性肺疾患の治療において､適切に吸入薬を使用することが重要である｡本症例は60歳代女性で､労作時呼吸困難を訴え入院となった｡点滴による治療､内服薬服用と同時に吸入薬の使用開始となったが､呼吸機能検査値が低値であり､製薬企業供与の吸入チェック器具により吸入できていないことが判明した｡そこで､吸入薬を変更し吸入できていることを確認した｡吸気流量が十分得られない場合は積極的にチェック器具により確認を行い､アドヒアランスの改善に努めることが重要である｡ en-copyright= kn-copyright= en-aut-name=KonumaToshimitsu en-aut-sei=Konuma en-aut-mei=Toshimitsu kn-aut-name=小沼利光 kn-aut-sei=小沼 kn-aut-mei=利光 aut-affil-num=1 ORCID= en-aut-name=KawasakiYoichi en-aut-sei=Kawasaki en-aut-mei=Yoichi kn-aut-name=河崎陽一 kn-aut-sei=河崎 kn-aut-mei=陽一 aut-affil-num=2 ORCID= en-aut-name=KatsubeRisa en-aut-sei=Katsube en-aut-mei=Risa kn-aut-name=勝部理早 kn-aut-sei=勝部 kn-aut-mei=理早 aut-affil-num=3 ORCID= en-aut-name=NawaHideki en-aut-sei=Nawa en-aut-mei=Hideki kn-aut-name=名和秀起 kn-aut-sei=名和 kn-aut-mei=秀起 aut-affil-num=4 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=5 ORCID= affil-num=1 en-affil= kn-affil=岡山大学病院三朝医療センター薬剤室 affil-num=2 en-affil= kn-affil=岡山大学病院三朝医療センター薬剤室 affil-num=3 en-affil= kn-affil=岡山大学病院三朝医療センター薬剤室 affil-num=4 en-affil= kn-affil=岡山大学病院三朝医療センター薬剤室 affil-num=5 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 en-keyword=気管支喘息 kn-keyword=気管支喘息 en-keyword=アドヒアランス向上 kn-keyword=アドヒアランス向上 en-keyword=吸気流量 kn-keyword=吸気流量 en-keyword=ピークフロー kn-keyword=ピークフロー END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue= article-no= start-page=41 end-page=48 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=20080301 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=A case of primary adenosquamous carcinoma of the liver with hepatocellular carcinoma kn-title=肝細胞癌の経過中に肝原発腺扁平上皮癌を合併した１例 en-subtitle= kn-subtitle= en-abstract=A rare case of primary adenosquamous carcinoma of the liver with hepatocellular carcinoma in a 74-year-old man is discussed. The patient had been treated for chronic hepatitis type C. He was diagnosed with hepatocellular carcinoma and abdominal angiography and percutaneous ethanol injection was performed in July 1998. After percutaneous ethanol injection , he consulted the doctor in our hospital regularly. Abdominal ultrasonography identified a hypoechoic mass in liver S5 and he was admitted to our hospital on October 27, 1999. After admission, on ultrasonography a hypoechoic mass was depicted in liver S6. A percutaneous liver biopsy was performed and the histopathological examination revealed adenosquamous carcinoma composed of moderately or poorly differenciated adenosquamous carcinoma and squamous cell carcinoma in S5 and moderately or well differenciated hepatocellular carcinoma in S6. He was diagnosed with primary adenosquamous carcinoma of the liver with hepatocellular carcinoma because further examinations showed no primary lesion in other organs. Percutaneous ethanol injection was performed and he was discharged on December 28. Ultrasonography revealed a hypoechoic nodule in S4 in March 2000 and he died on September 9, 2000. kn-abstract=症例は74歳男性｡慢性Ｃ型肝炎にて当院外来通院中であった｡肝細胞癌を指摘され1998年7月腹部血管造影, 経皮エタノール注入療法施行した｡以後当院外来加療中であったが, 腹部超音波上肝Ｓ５に低エコー域を認め, 1999年10月27日精査加療目的で入院となった｡入院 後肝Ｓ６にも低エコー域を認めた｡超音波ガイド下経皮的針生検施行し, Ｓ５では中から低分化の腺癌に加え, 部分的に扁平上皮癌が認められ, 腺扁平上皮癌と診断された｡Ｓ６では中分化, 一部高分化の肝細胞癌を認めた｡転移性肝癌の可能性を考え全身検査を行なったが,他臓器に原発病巣は発見されず, 肝細胞癌に肝原発扁平上皮癌を合併したと考えた｡経皮的エタノール注入療法施行し12月28日退院となった｡その後も外来にて加療されていたが, 2000年３月肝Ｓ４を中心に再発し, ９月９日死亡した｡肝細胞癌に合併した肝原発腺扁平上皮癌は稀であり, 若干の文献的考察を加えて報告する｡ en-copyright= kn-copyright= 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=1 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=2 ORCID= en-aut-name=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=保崎泰弘 kn-aut-sei=保崎 kn-aut-mei=泰弘 aut-affil-num=3 ORCID= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name=濱田全紀 kn-aut-sei=濱田 kn-aut-mei=全紀 aut-affil-num=4 ORCID= en-aut-name=IwagakiNaofumi en-aut-sei=Iwagaki en-aut-mei=Naofumi kn-aut-name=岩垣尚史 kn-aut-sei=岩垣 kn-aut-mei=尚史 aut-affil-num=5 ORCID= en-aut-name=KikuchiHiroshi en-aut-sei=Kikuchi en-aut-mei=Hiroshi kn-aut-name=菊池宏 kn-aut-sei=菊池 kn-aut-mei=宏 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= affil-num=1 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=2 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=3 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=4 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センターリハビリテーション科 affil-num=5 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=6 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター内科 affil-num=7 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 en-keyword=肝腺扁平上皮癌 (adenosquamous carcinoma of the liver) kn-keyword=肝腺扁平上皮癌 (adenosquamous carcinoma of the liver) en-keyword=肝細胞癌 (hepatocellular carcinoma) kn-keyword=肝細胞癌 (hepatocellular carcinoma) en-keyword=経皮的エタノール注入療法 (percutaneous ethanol injection) kn-keyword=経皮的エタノール注入療法 (percutaneous ethanol injection) END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue= article-no= start-page=35 end-page=40 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=20080301 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=A case of generalized measles-like erythema induced by ketoprofen kn-title=ケトプロフェン湿布剤により全身性麻疹様紅斑を来した１例 en-subtitle= kn-subtitle= en-abstract=A 61-year-old man had been treated for bronchial asthma. He applied a ketoprofen adhesive patch for lumbago at evening on March 29, 2004. About 4 hours after applying a patch, he had dyspnea and epigastralgia and vomited , and came to our hospital at 4:50AM on March 30. He was admitted to our hospital for hypoxia, wheeze and measles-like erythema on his whole body. Asthma attack and erythema disappeared after administration of prednisolone, aminophylline and Stronger Neo-Minophagen C. On April 8, he applied a ketoprofen adhesive patch for lumbago at 7:00PM again. He had almost same symptoms as before at 0:40AM on April 9. He was diagnosed as asthma attack and contact dermatitis caused by a ketoprofen adhesive patch. Erythema disappeared after administration of Stronger Neo-Minophagen C, and he was discharged on April 16. A drug lymphocyte stimulating test was positive for ketoprofen on April 22. kn-abstract=症例は74歳男性｡慢性Ｃ型肝炎にて当院外来通院中であった｡肝細胞癌を指摘され1998年7月腹部血管造影, 経皮エタノール注入療法施行した｡以後当院外来加療中であったが, 腹部超音波上肝Ｓ５に低エコー域を認め, 1999年10月27日精査加療目的で入院となった｡入院 後肝Ｓ６にも低エコー域を認めた｡超音波ガイド下経皮的針生検施行し, Ｓ５では中から低分化の腺癌に加え, 部分的に扁平上皮癌が認められ, 腺扁平上皮癌と診断された｡Ｓ６では中分化, 一部高分化の肝細胞癌を認めた｡転移性肝癌の可能性を考え全身検査を行なったが,他臓器に原発病巣は発見されず, 肝細胞癌に肝原発扁平上皮癌を合併したと考えた｡経皮的エタノール注入療法施行し12月28日退院となった｡その後も外来にて加療されていたが, 2000年３月肝Ｓ４を中心に再発し, ９月９日死亡した｡肝細胞癌に合併した肝原発腺扁平上皮癌は稀であり, 若干の文献的考察を加えて報告する｡ en-copyright= kn-copyright= 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=1 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=2 ORCID= en-aut-name=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=保崎泰弘 kn-aut-sei=保崎 kn-aut-mei=泰弘 aut-affil-num=3 ORCID= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name=濱田全紀 kn-aut-sei=濱田 kn-aut-mei=全紀 aut-affil-num=4 ORCID= en-aut-name=IwagakiNaofumi en-aut-sei=Iwagaki en-aut-mei=Naofumi kn-aut-name=岩垣尚史 kn-aut-sei=岩垣 kn-aut-mei=尚史 aut-affil-num=5 ORCID= en-aut-name=KikuchiHiroshi en-aut-sei=Kikuchi en-aut-mei=Hiroshi kn-aut-name=菊池宏 kn-aut-sei=菊池 kn-aut-mei=宏 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= affil-num=1 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=2 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=3 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=4 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センターリハビリテーション科 affil-num=5 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=6 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター内科 affil-num=7 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 en-keyword=ケトプロフェン (ketoprofen) kn-keyword=ケトプロフェン (ketoprofen) en-keyword=喘息発作 (asthma attack) kn-keyword=喘息発作 (asthma attack) en-keyword=麻疹様紅斑 (measles-like erythema) kn-keyword=麻疹様紅斑 (measles-like erythema) en-keyword=リンパ球刺激試験 (lymphocyte stimulating test) kn-keyword=リンパ球刺激試験 (lymphocyte stimulating test) en-keyword=接触性皮膚炎 (contact dermatitis) kn-keyword=接触性皮膚炎 (contact dermatitis) END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue= article-no= start-page=31 end-page=34 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=20080301 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Spa therapy for patient with postherpetic neuralgia：A case report kn-title=帯状疱疹後神経痛に対する温泉を利用したリハビリテーションの経験 en-subtitle= kn-subtitle= en-abstract=We report a case who had a favorable outcome with spa therapy for postherpetic neuralgia. A 72-year-old woman had shingles with rash in the right leg. Pain was severe even after the rash healed. After six months of the onset of shingles, she was admitted to this hospital for rehabilitation with the use of a hot spring. She presented with allodynia in the right leg and thermohyperesthesia . We provided thermotherapy mainly with tepid bath and therapeutic exercise mainly with active-assistive exercise of the right leg. The pain was alleviated with spa therapy, allowing her to walk with a cane. Spa therapy , with fewer adverse effects , appears likely to become one of the treatment choices for postherpetic neuralgia. kn-abstract=帯状疱疹後神経痛に対して, 温泉療法を行い, 良好な結果が得られた症例について報告する｡72才, 女性. 右下肢の皮疹にて帯状疱疹を発症した｡皮疹が治癒した後も疼痛が強かった｡発症半年後, 温泉を利用したリハビリテーション目的にて, 当院に入院した｡右下肢にはアロディニアがあり､温度覚過敏があった｡微温浴を中心とした温熱療法と右下肢の自動介助運動を中心とした運動療法を行った. 温泉療法により疼痛軽減し､杖歩行が可能となった｡温泉療法は副作用も少なく帯状疱疹後神経痛の治療の選択肢の一つになると考える｡ en-copyright= kn-copyright= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name=濱田全紀 kn-aut-sei=濱田 kn-aut-mei=全紀 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=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=保崎泰弘 kn-aut-sei=保崎 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=IwagakiNaofumi en-aut-sei=Iwagaki en-aut-mei=Naofumi kn-aut-name=岩垣尚史 kn-aut-sei=岩垣 kn-aut-mei=尚史 aut-affil-num=5 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=6 ORCID= en-aut-name=KikuchiHiroshi en-aut-sei=Kikuchi en-aut-mei=Hiroshi kn-aut-name=菊池宏 kn-aut-sei=菊池 kn-aut-mei=宏 aut-affil-num=7 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センターリハビリテーション科 affil-num=2 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=3 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=4 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=5 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=6 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=7 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター内科 en-keyword=Chronic obstructive pulmonary disease (慢性閉塞性肺疾患) kn-keyword=Chronic obstructive pulmonary disease (慢性閉塞性肺疾患) en-keyword=Spa therapy (温泉療法) kn-keyword=Spa therapy (温泉療法) en-keyword=Six-minute walk test (６分間歩行試験) kn-keyword=Six-minute walk test (６分間歩行試験) en-keyword=Borg scale (ボルグスケール) kn-keyword=Borg scale (ボルグスケール) en-keyword=Ventilatory function (呼吸機能) kn-keyword=Ventilatory function (呼吸機能) END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue= article-no= start-page=24 end-page=30 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=20080301 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=慢性閉塞性肺疾患患者における温泉療法の６分間歩行に対する効果 kn-title=Effects of spa therapy on the six-minute walk test in patients with chronic obstructive pulmonary disease en-subtitle= kn-subtitle= en-abstract=我々は温泉療法が慢性閉塞性肺疾患患者に対して, 呼吸機能改善効果を有することを報告してきた｡今回我々は慢性閉塞性肺疾患患者を対象に温泉療法の６分間歩行試験に及ぼす影響について検討した｡当院入院中の慢性閉塞性肺疾患患者10例(男性９例, 女性１例) を対象として, 温泉プール水中運動, 鉱泥湿布療法, ヨードゾル吸入療法等による複合温泉療法を4週間施行し, その間の呼吸機能, ６分間歩行試験における歩行距離, 動脈血酸素飽和度, 修正Borgスケールの変化を比較検討した｡呼吸機能検査では, 肺活量, １秒量 等の改善傾向が認められた｡６分間歩行距離, 動脈血酸素飽和度は上昇傾向にあった｡修正Borgスケールは有意に低下傾向した｡温泉療法により呼吸機能の改善が得られ, これにより動脈血酸素 飽和度及び６分間歩行距離が上昇したと考えられた｡温泉療法が慢性閉塞性肺疾患の治療に有用であることが示唆された｡ kn-abstract=Our previous studies have shown that subjective symptoms and ventilatory function are improved by spa therapy in patients with chronic obstructive pulmonary disease (COPD). In the present study, we investigated the effects of spa therapy on six-minute walk distance in patients with COPD . Subjects were 10 patients with chronic obstructive pulmonary disease (9 males and 1 female) admitted to our hospital to undergo pulmonary rehabilitation. All patients had complex spa therapy (swimming training in a hot spring pool, inhalation of iodine salt solution, and fango therapy) for 4 weeks. Ventilatory function, six-minute walk distance, oxygen saturation and Borg scale were measured. Vital capacity, forced expiratory volume in one second, sixminute walk distance and oxygen saturation increased, but not significantly. Significant decreases were observed for Borg scale. We found that spa therapy improved ventilatory dysfunction and six-minute walk distance in patients with COPD. The results demonstrated that spa therapy may lead to better disease control and exercise tolerance in patients with COPD. en-copyright= kn-copyright= 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=1 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=2 ORCID= en-aut-name=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=保崎泰弘 kn-aut-sei=保崎 kn-aut-mei=泰弘 aut-affil-num=3 ORCID= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name=濱田全紀 kn-aut-sei=濱田 kn-aut-mei=全紀 aut-affil-num=4 ORCID= en-aut-name=IwagakiNaofumi en-aut-sei=Iwagaki en-aut-mei=Naofumi kn-aut-name=岩垣尚史 kn-aut-sei=岩垣 kn-aut-mei=尚史 aut-affil-num=5 ORCID= en-aut-name=KikuchiHiroshi en-aut-sei=Kikuchi en-aut-mei=Hiroshi kn-aut-name=菊池宏 kn-aut-sei=菊池 kn-aut-mei=宏 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= affil-num=1 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=2 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=3 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=4 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センターリハビリテーション科 affil-num=5 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=6 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター内科 affil-num=7 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 en-keyword=Chronic obstructive pulmonary disease (慢性閉塞性肺疾患) kn-keyword=Chronic obstructive pulmonary disease (慢性閉塞性肺疾患) en-keyword=Spa therapy (温泉療法) kn-keyword=Spa therapy (温泉療法) en-keyword=Six-minute walk test (６分間歩行試験) kn-keyword=Six-minute walk test (６分間歩行試験) en-keyword=Borg scale (ボルグスケール) kn-keyword=Borg scale (ボルグスケール) en-keyword=Ventilatory function (呼吸機能) kn-keyword=Ventilatory function (呼吸機能) END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue= article-no= start-page=18 end-page=23 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=20080301 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Examination about the effectiveness of thermal therapy on exercise tolerance and pulmonary function for patients with chronic obstructive pulmonary disease kn-title=慢性閉塞性肺疾患患者の運動耐容能・肺機能に対する温熱療法の有効性についての検討　−pilot study− en-subtitle= kn-subtitle= en-abstract=We have reported the effectiveness of the complex spa therapy (swimming training in a hot spring pool, fango therapy, and inhalation of iodine salt solution) for patients with chronic obstructive pulmonary disease (COPD). In present study, we examined the effectiveness of thermal therapy for COPD patients. Fourteen patients with COPD were classified into two groups； group A (６ males and 1 female, 68-81 years) and group B (７ males , 68-81 years) . For group A , we underwent the thermal therapy which warms the whole body in a sitting posture at 60℃ for 15 minutes with dry system farinfrared sauna 5 times a week, in addition to medication therapy and lung physiotherapy. On the other hand, we carried out only medication therapy and lung physiotherapy for group B. All subjects were treated for 4 weeks. The pulmonary function test and 6 minute-walk test were performed before and after these therapies. In the pulmonary function test, vital capacity (VC) and forced expiratory volume in one second (FEV1) after the therapy improved more than those before therapy in both A and B groups. The FEV1 value after 4 weeks tended to increase more in group A compared with group B. However, no changes were observed in the VC value. In 6 minute-walk test, distance value, oxygen saturation value and Borg Scale value improved more than those before therapy in both A and B groups. These three parameters after 4 weeks tended to improve more in group A compared with group B. In particular, the statistically significant difference was observed in Borg Scale value before and after therapy (p<0.01). It is suggested that the thermal therapy could improve pulmonary function and exercise tolerance, and be helpful in the therapy of COPD patients. kn-abstract=我々は現在まで, 慢性閉塞性肺疾患(COPD；chronic obstructive pulmonary disease)患者に対する複合温泉療法(温泉プール運動浴, 鉱泥湿布療法, ヨード吸入) の有効性を報告してきた｡今回, 温熱療法の有効性を明らかにすることを目的として, 温熱療法を 従来の治療に併用し, 運動耐容能および肺機能に対する効果を検討した｡Ａ群７例(68〜79歳・男性６例, 女性１例) およびＢ群７例(63〜81歳・全例男性), 計14例のCOPD患者を対象とした｡Ａ群については, 薬物・肺理学療法の他に, 温熱療法を週５回で４週間施行した｡ 温熱療法として, 乾式遠赤外線式サウナを用いた60℃, 15分間のサウナ浴(座位) を施行した後, 臥位で30分間全身を毛布で包んで安静保温した｡Ｂ群は, 薬物・肺理学療法のみ４週 続けた｡治療前後で肺機能および６分間歩行試験を施行し比較検討した｡両群とも, 治療開始４週後には６分間歩行での歩行距離, 酸素飽和度(ＳpO2), 修正Borg scaleにて改善を認め, 肺機能においても肺活量(VC；vital capacity), 一秒量(FEV1.0；forced expiratory volume in one second) は上昇した｡両群間の比較では, ６分間歩行試験で上記３項目の改善率はいずれもＡ群はＢ群を凌駕し, Ａ群が優位に運動耐容能の向上を認めた｡Ａ群で修正 Borg scaleの治療４週間後の改善率は有意差(p＜0.01) を認めた｡また肺機能では, ４週間後でVC上昇率はほぼ不変であったがFEV1.0ではＡ群が優位に上昇した｡以上の結果より温熱療法がCOPD治療に有効である可能性が示唆された｡ en-copyright= kn-copyright= en-aut-name=KikuchiHiroshi en-aut-sei=Kikuchi en-aut-mei=Hiroshi kn-aut-name=菊池宏 kn-aut-sei=菊池 kn-aut-mei=宏 aut-affil-num=1 ORCID= en-aut-name=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=保崎泰弘 kn-aut-sei=保崎 kn-aut-mei=泰弘 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=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name=濱田全紀 kn-aut-sei=濱田 kn-aut-mei=全紀 aut-affil-num=4 ORCID= en-aut-name=IwagakiNaofumi en-aut-sei=Iwagaki en-aut-mei=Naofumi kn-aut-name=岩垣尚史 kn-aut-sei=岩垣 kn-aut-mei=尚史 aut-affil-num=5 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=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= affil-num=1 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=2 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=3 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=4 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センターリハビリテーション科 affil-num=5 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=6 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター内科 affil-num=7 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 en-keyword=COPD (Chronic obstructive pulmonary disease) kn-keyword=COPD (Chronic obstructive pulmonary disease) en-keyword=複合温泉療法 (Complex spa therapy) kn-keyword=複合温泉療法 (Complex spa therapy) en-keyword=温熱療法 (Thermal therapy) kn-keyword=温熱療法 (Thermal therapy) en-keyword=肺理学療法 (Lung physiotherapy) kn-keyword=肺理学療法 (Lung physiotherapy) en-keyword=修正Borg scale (6 minute- walk test, Pulmonary function test) kn-keyword=修正Borg scale (6 minute- walk test, Pulmonary function test) END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue= article-no= start-page=12 end-page=17 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=20080301 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Clinical research for hospitalized patients with community-acquired pneumonia from 2002 to 2007 kn-title=2002−2007年における当院市中肺炎入院症例の臨床的研究 en-subtitle= kn-subtitle= en-abstract=The purpose of the study was to record clinically relevant medical outcomes in patients with community-acquired pneumonia and evaluate the performance of severity scores with the Guideline for community-acquired pneumonia edited by the Japanese Respiratory Society. During a 5-year period from April 2002 to March 2007, 142 patients with community-acquired pneumonia (40 females and 102 males) between 30 and 95 years of age who were admitted to our hospital were retrospectively included in this study. The mean age of the patients was 74.8 years. Twenty six patients were between 30 and 64 years of age, 30 patients were between 65 and 74 years of age, and 86 patients were between 75 and 95 years of age . The numbers of admission in each of the severity scores were：mild, 21； moderate, 99；severe, 17；and super severe, ５.The adherence to the Guideline for communityacquired pneumonia edited by the Japanese Respiratory Society for the initial antibiotics choice was high in mild, moderate and severe pneumonia (85.7％, 92.9％ and 94.1％) but was low in super severe pneumonia ( ０ ％) . The mean durations of hospitalization in each of the severity scores were：mild, 28.4 days；moderate, 39.9 days；severe, 48.5 days；and super severe, 45.2 days. Fourteen patients died. The numbers of death in each of the severity scores were： mild, ０；moderate, ７；severe, ４；and super severe, ３. The mean age of those who died was 81.8 years. Elderly, elevated blood urea nitrogen level, hypoxia, orientation disturbance, and hypotension were more frequent when the severity scores were elevated. Of the 142 patients with community-acquired pneumonia, 79 had chronic pulmonary disease and more respiratory system-related death. Our study indicated that the Guideline for community-acquired pneumonia edited by the Japanese Respiratory Society is a very useful tool for analyzing cases with community-acquired pneumonia in Japan. kn-abstract=当院に入院した市中肺炎症例の臨床像を明らかにし, 日本呼吸器学会2007年成人市中肺炎診療ガイドラインによる市中肺炎の重症度分類の妥当性を検討した｡2002年４月から2007年３月までの過去５年間に当院に入院した, 30歳から95歳までの市中肺炎109名142例 (男性72名102例, 女性37名40例) を対象に, その臨床像を検討した｡平均年齢は74.8歳で,65歳未満26例, 65歳以上75歳未満の前期高齢者30例, 75歳以上の後期高齢者86例であった｡ 肺炎重症度は軽症21例, 中等症99例, 重症17例, 超重症５例であった｡抗菌薬の選択に関して軽症では21例中18例, 中等症では99例中92例, 重症では17例中16例がガイドラインに準じていたが, 超重症では全例でガイドラインに準じていなかった｡平均入院日数は軽症28.4日,中等症39.9日, 重症48.5日, 超重症45.2日であった｡死亡例は, 軽症では無く, 中等症群７例, 重症群４例, 超重症群３例の計14例で, 死亡例の平均年齢は81.8歳であった｡重症度が悪化するにつれ, 高齢, BUN高値, 低酸素血症, 意識障害, 低血圧の頻度は増加傾向にあった｡79例で慢性呼吸器疾患を合併し, 慢性呼吸器疾患合併群では有意に呼吸器関連死亡が多かった｡日本呼吸器学会2007年成人市中肺炎診療ガイドラインは, 本邦の肺炎の重症度別症 例解析に適していると考えられた｡ en-copyright= kn-copyright= 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=1 ORCID= en-aut-name=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=保崎泰弘 kn-aut-sei=保崎 kn-aut-mei=泰弘 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=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name=濱田全紀 kn-aut-sei=濱田 kn-aut-mei=全紀 aut-affil-num=4 ORCID= en-aut-name=IwagakiNaofumi en-aut-sei=Iwagaki en-aut-mei=Naofumi kn-aut-name=岩垣尚史 kn-aut-sei=岩垣 kn-aut-mei=尚史 aut-affil-num=5 ORCID= en-aut-name=KikuchiHiroshi en-aut-sei=Kikuchi en-aut-mei=Hiroshi kn-aut-name=菊池宏 kn-aut-sei=菊池 kn-aut-mei=宏 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= affil-num=1 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=2 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=3 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=4 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センターリハビリテーション科 affil-num=5 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=6 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター内科 affil-num=7 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 en-keyword=日本呼吸器学会2007年成人市中肺炎診療ガイドライン (the Guideline for communityacquired pneumonia edited by the Japanese Respiratory Society) kn-keyword=日本呼吸器学会2007年成人市中肺炎診療ガイドライン (the Guideline for communityacquired pneumonia edited by the Japanese Respiratory Society) en-keyword=市中肺炎 (community-acquired pneumonia) kn-keyword=市中肺炎 (community-acquired pneumonia) en-keyword=呼吸器関連死亡 (respiratory system-related death) kn-keyword=呼吸器関連死亡 (respiratory system-related death) en-keyword=高齢者 (elderly) kn-keyword=高齢者 (elderly) en-keyword=慢性呼吸器疾患 (chronic pulmonary disease) kn-keyword=慢性呼吸器疾患 (chronic pulmonary disease) END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue= article-no= start-page=1 end-page=11 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=20080301 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Spa therapy for patients with respiratory disease.Analysis of 2762 patients admitted at Misasa Medical Center for last 25 years from 1982 to 2006 kn-title=呼吸器疾患の温泉療法−25年間の入院症例2762例を対象に− en-subtitle= kn-subtitle= en-abstract=Analysis of 2762 patients with respiratory disease admitted at Misasa Medical Center for the last 25 years from 1982 to 2006 was performed every five years. Of all patients with respiratory disease, 2230 (80.7％) patients had asthma and chronic obstructive pulmonary disease (COPD). １. Of 2230 patients showing obstructive ventilatory dysfunction, 1578 (70.8％) patients had asthma. The frequency of asthma in all patients with respiratory disease was 53.8％ for the first 5 years from 1982, 71.7％ for the second 5 years, 73.6％ for the third 5 years, 53.9％ for the fourth 5 years and 42.5％ for the fifth 5 years. ２. The frequency of steroid-dependent intractable asthma (SDIA) in asthmatic patients was 68.4％ for the first 5 years from 1982, 41.3％ for the second 5 years, 33.9％ for the third 5 years, 29.0％ for the fourth 5 years and 24.1％ for the fifth 5 years. The frequency of patients with SDIA showed a tendency to decrease in recent years. The frequency of patients with pulmonary emphysema in those with COPD was 19.2％ for the first 5 years from 1982, 20.0％ for the second 5 years, 40.2％ for the third 5 years, 76.7％ for the fourth 5 years and 78.9％ for the fifth 5 years, and tended to increase. The frequency of patients over age 60 was 30.1％ for the first 5 years, and showed a tendency to increase, and 68.0％ for the fourth 5 years and 85.1％ for the fifth 5 years. ３. The frequency of patients from distant areas outside Tottori prefecture was almost the same as that inside Tottori prefecture. The number of patients from Okayama, Osaka, Hiroshima, Hyogo, Tokyo, Ehime, Yamaguchi, Kyoto, and Kanagawa was larger than the number from the other distant areas. kn-abstract=1982年から2006年までの25年間に当医療センターで入院加療した2762例を対象に５年毎にその年次推移を検討した｡その内訳は,気管支喘息1578例(57.1％),COPD652例(23.6％),その他532例(19.3％) であった｡１. 気管支喘息は, 第１期(1982−1986年) の５年間では 平均11.4例／年であったが, 第４期(1997−2001年) では平均93.0例／年と初期と比べ8.1倍の増加がみられた｡また, 第５期 (2002−2006年) では70.4例／年と6.2倍であった｡その内のステロイド依存性重症難治性喘息(SDIA；steroid-dependent intractable asthma)の頻度は初期の68.4％から第４期では29.0％,第５期24.1％にまで低下する傾向を示した｡２.COPD症例は, 第１期では平均5.2例／年から第４期には45.4例／年へと8.7倍の, また第５期では47.4例／年へと9.1倍の増加がみられた｡また, その中の肺気腫が占める割合は初期の19.2％から第4期では76.7％, 第５期では78.9％と明らかな増加傾向を示した｡３. 気管支喘息およびCOPD症例の年齢別検討では, 60歳以上の症例の頻度は第１期では30.1％であったが, 第４期では68.0％, そして第5期では85.1％と, 年々その頻度は高くなっていく傾向が見られた｡ 即ち, 最近25年間の年次推移からは, 温泉療法を必要とする呼吸器疾患患者が増加しつつあること, そしてその年齢は年々高くなる傾向にあることが示唆された｡ 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=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=保崎泰弘 kn-aut-sei=保崎 kn-aut-mei=泰弘 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=IwagakiNaofumi en-aut-sei=Iwagaki en-aut-mei=Naofumi kn-aut-name=岩垣尚史 kn-aut-sei=岩垣 kn-aut-mei=尚史 aut-affil-num=4 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=5 ORCID= en-aut-name=KikuchiHiroshi en-aut-sei=Kikuchi en-aut-mei=Hiroshi kn-aut-name=菊池宏 kn-aut-sei=菊池 kn-aut-mei=宏 aut-affil-num=6 ORCID= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name=濱田全紀 kn-aut-sei=濱田 kn-aut-mei=全紀 aut-affil-num=7 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=2 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=3 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=4 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=5 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター　内科 affil-num=6 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター内科 affil-num=7 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センターリハビリテーション科 en-keyword=気管支喘息 kn-keyword=気管支喘息 en-keyword=COPD kn-keyword=COPD en-keyword=温泉療法 kn-keyword=温泉療法 en-keyword=高齢者 kn-keyword=高齢者 END