start-ver=1.4 cd-journal=joma no-vol=9 cd-vols= no-issue= article-no= start-page=9 end-page=15 dt-received= dt-revised= dt-accepted= dt-pub-year=2013 dt-pub=20131212 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Effect of repeated Waon therapy on exercise tolerance and pulmonary function in patients with chronic obstructive pulmonary disease: a pilot controlled clinical trial en-subtitle= kn-subtitle= en-abstract= kn-abstract=Purpose: Controlled clinical trials evaluating the efficacy of repeated Waon therapy for patients with chronic obstructive pulmonary disease (COPD) have yet to be conducted. The purpose of the present study was to evaluate whether repeated Waon therapy exhibits an adjuvant effect on conventional therapy for COPD patients. Patients and methods: This prospective trial comprised 20 consecutive COPD patients who satisfied the criteria of the Global initiative for chronic Obstructive Lung Disease (GOLD) guidelines, stages 1?4. They were assigned to either a Waon or control group. The patients in the Waon group received both repeated Waon therapy and conventional therapy, including medications, such as long-acting inhaled β2 agonists, long-acting anticholinergics and xanthine derivatives, and pulmonary rehabilitation. The Waon therapy consisted of sitting in a 60°C sauna room for 15 minutes, followed by 30 minutes of being warmed with blankets once a day, 5 days a week, for a total of 20 times. The patients in the control group received only conventional therapy. Pulmonary function and the 6-minute walk test were assessed before and at 4 weeks after the program. Results: The change in vital capacity (0.30 ± 0.4 L) and in peak expiratory flow (0.48 ± 0.79 L/s) in the Waon group was larger than the change in the vital capacity (0.02 ± 0.21 L) (P=0.077) and peak expiratory flow (?0.11 ± 0.72 L/s) (P=0.095) in the control group. The change in forced expiratory flow after 50% of expired forced vital capacity in the Waon group, 0.08 (0.01?0.212 L/s), was larger than that in the control group, ?0.01 (?0.075?0.04 L/s) (P=0.019). Significant differences were not observed in the change in any parameters in the 6-minute walk test. Data are presented as means ± standard deviation or median (25th?75th percentile). Conclusion: The addition of repeated Waon therapy to conventional therapy for COPD patients can possibly improve airway obstruction. en-copyright= kn-copyright= en-aut-name=KikuchiHiroshi en-aut-sei=Kikuchi en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=ShiozawaNobuyoshi en-aut-sei=Shiozawa en-aut-mei=Nobuyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TakataShingo en-aut-sei=Takata en-aut-mei=Shingo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=AshidaKozo en-aut-sei=Ashida en-aut-mei=Kozo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MitsunobuFumihiro en-aut-sei=Mitsunobu en-aut-mei=Fumihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil= kn-affil=Okayama Univ Hosp, Misasa Med Ctr, Div Med affil-num=2 en-affil= kn-affil=Okayama Univ Hosp, Misasa Med Ctr, Div Med affil-num=3 en-affil= kn-affil=Okayama Univ Hosp, Misasa Med Ctr, Div Med affil-num=4 en-affil= kn-affil=Okayama Univ Hosp, Misasa Med Ctr, Div Med affil-num=5 en-affil= kn-affil=Okayama Univ Hosp, Misasa Med Ctr, Div Med en-keyword=modified Borg scale kn-keyword=modified Borg scale en-keyword=airway obstruction kn-keyword=airway obstruction en-keyword=6-minute walk test kn-keyword=6-minute walk test en-keyword=quality of life kn-keyword=quality of life END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue= article-no= start-page=99 end-page=106 dt-received= dt-revised= dt-accepted= dt-pub-year=1996 dt-pub=199611 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=気管支喘息に対する複合温泉療法の作用機序 3.気道炎症反応との関連 kn-title=Action mechanisms of complex spa therapy on bronchial asthma. 3. Relationship to airway inflammation en-subtitle= kn-subtitle= en-abstract=気道炎症反応の程度や特徴が,気管支肺胞洗浄液(BAL)中の細胞成分によって評価された｡Ia.単純性気管支攣縮型,Ib.気管支攣縮+過分泌型,U.細気管支閉塞型などの各臨床病型は気道炎症反応と関連している｡BAL液中好中球増多は,U型喘息の特徴的所見であり,また好酸球増多はIb型喘息でしばしば観察される｡気道過敏性もまた気道炎症反応と関連している｡温泉療法の作用機序としては,温泉療法にIgEにmediateされるアレルギー反応(液性因子相)を抑制する作用がないことから,気道炎症反応(細胞性因子相)の抑制が推測されている｡実際,温泉療法は,気道炎症反応が軽度なIa型喘息に比べ,Ib型やU型などの明らかに気道炎症反応をともなう病型に対してより有効である｡気道過敏性もまた温泉療法により改善される｡これらの 結果から,温泉療法は,気道を清浄化し,気道粘膜を正常化することによって,気道炎症反応を抑制していくものと考えられる｡ kn-abstract=The degree and characteristic of airway inflammation were evaluated by the proportions of bronchoalveolar lavage (BAL) cells. Clinical asthma types such as Ia. simple bronchoconstriction, Ib. bronchoconstriction + hypersecretion, and U. bronchiolar obstruction correlate with airway inflammation. The increased proportion BAL　neutrophils is characteristic of type U asthma, and increase in BAL eosinophil count is often observed in type Ib asthma. Bronchial hyperresponsiveness also correlates with airway inflammation. Action of spa therapy has been speculated to be related to airway inflammation, since the therapy has no action inhibiting IgE-mediated allergic reaction. In fact, spa therapy is more effective in patients with type Ib and type U than in those with type Ia showing slight degree of airway inflammation. Bronchial hyperresponsiveness is also improved by spa therapy. From a point of view, the direct action of spa therapy may be to clean airways and improve damaged mucous membrane of the airways, leading to suppression of airway inflammation. en-copyright= kn-copyright= 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=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=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=YokotaSatoshi en-aut-sei=Yokota en-aut-mei=Satoshi kn-aut-name=横田聡 kn-aut-sei=横田 kn-aut-mei=聡 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=TakeuchiKazuaki en-aut-sei=Takeuchi en-aut-mei=Kazuaki kn-aut-name=竹内一昭 kn-aut-sei=竹内 kn-aut-mei=一昭 aut-affil-num=7 ORCID= en-aut-name=NawaYuichiro en-aut-sei=Nawa en-aut-mei=Yuichiro kn-aut-name=名和由一郎 kn-aut-sei=名和 kn-aut-mei=由一郎 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= 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=HaradaHideo en-aut-sei=Harada en-aut-mei=Hideo kn-aut-name=原田英雄 kn-aut-sei=原田 kn-aut-mei=英雄 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=岡山大学医学部臨床検査医学 affil-num=11 en-affil= kn-affil=岡山大学医学部臨床検査医学 en-keyword=Spa therapy (温泉療法) kn-keyword=Spa therapy (温泉療法) en-keyword=Airway inflammation (気道炎症反応) kn-keyword=Airway inflammation (気道炎症反応) en-keyword=BAL eosinophilia (BAL好酸球増多) kn-keyword=BAL eosinophilia (BAL好酸球増多) en-keyword=BAL neutrophilia (BAL好中球増多) kn-keyword=BAL neutrophilia (BAL好中球増多) en-keyword=Bronchial asthma (気管支喘息) kn-keyword=Bronchial asthma (気管支喘息) END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue= article-no= start-page=92 end-page=98 dt-received= dt-revised= dt-accepted= dt-pub-year=1996 dt-pub=199611 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=気管支喘息に対する複合温泉療法の作用機序 2.内分泌･自律神経系および心因的要素に対する効果 kn-title=Action mechanisms of complex spa therapy on bronchial asthma. 2. Effects on endocrine-autonomic nerve system and psychological factors en-subtitle= kn-subtitle= en-abstract=内分泌･自律神経系および心因的要素に対する温泉療法の効果が,気管支喘息を対象に検討された｡内分泌系では,血中コーチゾ-ルおよびACTH値が,温泉療法後に上昇することが示された｡また,自律神経系では,血中アドレナリンおよびノルアドレナリン濃度が温泉療法により減少することが示され,特に,血中アドレナリンは温泉療法前後の濃度に有意の差が見られた｡しかしながら,血中サブスタンスPおよびブラジキニン濃度には,温泉療法による有意の変動は見られなかった｡心因的要素に対する温泉療法の作用を検討するため,CMI,SDS,CAIおよびSDの4種類の心身医学的検査が行われた｡その結果,いずれの心身医学的検査においても,温泉療法により疾患に不利に働く心因的要素が改善する傾向が見られた｡これらの結果より,温泉療法が内分泌･自律神経系に対して有用な作用を有し,また,疾患に不利な心因的要素を改善させる作用を有していることがある程度示唆された｡ kn-abstract=Actions of spa therapy on endocrine-autonomic nerve system and psychological factors were analyzed in patients with bronchial asthma. In endocrine function, serum levels of cortisol and ACTH tended to increase after spa therapy. In autonomic nerve system, decrease in concentrations of serum adrenalin and noradrenalin was observed after spa therapy, and the difference between the initial levels before spa therapy and the levels after the therapy was significant in serum levels of adrenalin. However, serum levels of substance P and Bradykinin were not affected by spa therapy. To evaluate the action of spa therapy on mental condition in patients with asthma, four kinds of psychological tests, CMI, SDS, CAl and SD, were carried out. Improvement of mental disorders in patients with asthma is observed after spa therapy in all psychological tests. These results suggest that spa therapy acts effectively on endocrine-autonomic nerve system and improve psychological conditions. 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=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=YokotaSatoshi en-aut-sei=Yokota en-aut-mei=Satoshi kn-aut-name=横田聡 kn-aut-sei=横田 kn-aut-mei=聡 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=TakeuchiKazuaki en-aut-sei=Takeuchi en-aut-mei=Kazuaki kn-aut-name=竹内一昭 kn-aut-sei=竹内 kn-aut-mei=一昭 aut-affil-num=7 ORCID= en-aut-name=NawaYuichiro en-aut-sei=Nawa en-aut-mei=Yuichiro kn-aut-name=名和由一郎 kn-aut-sei=名和 kn-aut-mei=由一郎 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= en-aut-name=SaitoKatsuyoshi en-aut-sei=Saito en-aut-mei=Katsuyoshi kn-aut-name=斎藤勝剛 kn-aut-sei=斎藤 kn-aut-mei=勝剛 aut-affil-num=10 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=土肥病院内科 en-keyword=Bronchial asthma (気管支喘息) kn-keyword=Bronchial asthma (気管支喘息) en-keyword=Spa therapy (温泉療法) kn-keyword=Spa therapy (温泉療法) en-keyword=Endocrine-autonomic nerve system (内分泌・自律神経系) kn-keyword=Endocrine-autonomic nerve system (内分泌・自律神経系) en-keyword=Psychological disorders (心的要素) kn-keyword=Psychological disorders (心的要素) END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue= article-no= start-page=85 end-page=91 dt-received= dt-revised= dt-accepted= dt-pub-year=1996 dt-pub=199611 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=気管支喘息に対する複合温泉療法の作用機序 1.温泉療法の評価方法との関連 kn-title=Action mechanisms of complex spa therapy on bronchial asthma. 1. Relationship to evaluation of spa therapy en-subtitle= kn-subtitle= en-abstract=複合温泉療法(温泉プール水泳訓練,ヨードゾル吸入,鉱泥湿布療法)の作用機序が,年齢,臨床病型,気道炎症反応との関連のもとに検討された｡温泉療法の作用機序は,2種類の臨床効果,すなわち,直接効果と間接効果により観察された｡自,他覚症状の改善,換気機能の改善,そして,気道過敏性の改善などが,温泉療法の直接効果として,また,副腎皮質機能の改善が間接効果とし て観察された｡温泉療法の臨床効果は,40才以上の症例においてより有効であり,また,臨床病型別では､Ia型に比べ,Ib型およびU型においてより有効であった｡Ib型やU型の気管支喘息では,温泉療法の作用機序と気道炎症反応との間に密接な関連が認められた｡ kn-abstract=Action mechanisms of complex spa therapy (swimming training in a hot spring pool, inhalation with iodine salt solution, and fango therapy) were studied in relation to patient age, clinical asthma type, and airway inflammation. Actions of spa therapy were observed by two clinical effects : direct and indirect effects. Improvement of subjective symptoms, ventilatory function, and bronchial hyperresponsiveness was observed as direct effects of spa therapy, and improvement of suppressed function of adrenocortical glands as indirect effects of the therapy. The clinical effects of spa therapy were higher in patients over the age of 40. Regarding clinical asthma type, the effects were larger in patients with type Ib and type II asthma than in those with type Ia. The efficacy of spa therapy was closely related with airway inflammation in patients with type Ib and type II 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=YokotaSatoshi en-aut-sei=Yokota en-aut-mei=Satoshi kn-aut-name=横田聡 kn-aut-sei=横田 kn-aut-mei=聡 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=TakeuchiKazuaki en-aut-sei=Takeuchi en-aut-mei=Kazuaki kn-aut-name=竹内一昭 kn-aut-sei=竹内 kn-aut-mei=一昭 aut-affil-num=7 ORCID= en-aut-name=NawaYuichiro en-aut-sei=Nawa en-aut-mei=Yuichiro kn-aut-name=名和由一郎 kn-aut-sei=名和 kn-aut-mei=由一郎 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= 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=HaradaHideo en-aut-sei=Harada en-aut-mei=Hideo kn-aut-name=原田英雄 kn-aut-sei=原田 kn-aut-mei=英雄 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=岡山大学医学部臨床検査医学 affil-num=11 en-affil= kn-affil=岡山大学医学部臨床検査医学 en-keyword=complex spa therapy (複合温泉療法) kn-keyword=complex spa therapy (複合温泉療法) en-keyword=clinical asthma type (臨床病型) kn-keyword=clinical asthma type (臨床病型) en-keyword=ventilatory function (換気機能) kn-keyword=ventilatory function (換気機能) en-keyword=bronchial hyperresponsiveness (気道過敏性) kn-keyword=bronchial hyperresponsiveness (気道過敏性) en-keyword=adrenocortical glands (副腎皮質) kn-keyword=adrenocortical glands (副腎皮質) END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue= article-no= start-page=107 end-page=114 dt-received= dt-revised= dt-accepted= dt-pub-year=1996 dt-pub=199611 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Spa therapy and drug therapy in patients with bronchial asthma kn-title=気管支喘息における温泉療法と薬物療法 en-subtitle= kn-subtitle= en-abstract=Bronchial asthma can be classified into three fundamental clinical types : Ia. simple bronchoconstriction type, Ib. bronchoconstriction + hypersecretion type and U. bronchiolar obstruction type, by clinical pathophysiology. While. bronchial asthma is divided into two types : atopic and nonatopic, by the onset mechanisms of the disease. Spa therapy accompanied with drug therapy should be carried out according to the clinical pathophysiology and the onset mechanisms of the disease. In drug therapy for bronchial asthma, actions of drugs such as bronchodilating and anti-inflammatory actions are more important. While spa therapy is more effective in asthma patients with hypersecretion and bronchiolar obstruction compared to those with simple bronchoconstriction type. In atopic asthma, histamine and leukotrienes are more active in the onset mechanisms of the disease. In contrast, in nonatopic asthma, lrukotrienes are more important. Anti-allergic drugs should be applied for the treatment of asthma on the bases of these findings. kn-abstract=気管支喘息は,その臨床病態より,Ia.単純性気管支攣縮型,Ib.気管支痙攣縮+過分泌型,U.細気管支閉塞型の3つの基本病型に分けることができる｡また,発症病態からは,アトピー型と非アトピー型に分けられる｡気管支喘息に対する温泉療法や薬物療法の際には,これらの臨床病態や発症病態を十分把握した上で最も適切な治療法を選ぶ必要がある｡気管支喘息に対する薬物療法では,気管支拡張薬,去痰薬,抗アレルギー薬,副腎皮質ホルモンなどがその主たるものであるが,特に薬物療法では気管支拡張作用と抗炎症作用が重要である｡一方,温泉療法では,気道の浄化作用や気管支粘膜の正常化作用などが得られ,臨床病型では,過分泌型や細気管支閉塞型に対してより効果的である｡また,発症病態からすれば,アトピー型ではヒスタミンとロイコトリエンが,非アトピー型ではロイコトリエンがより優勢な化学伝達物質であり,このような発症病態を十分把握した上で,適切な抗アレルギー薬を選ぶ必要が ある｡ 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=保崎泰弘 kn-aut-sei=保崎 kn-aut-mei=泰弘 aut-affil-num=4 ORCID= en-aut-name=AshidaKouzou en-aut-sei=Ashida en-aut-mei=Kouzou 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=YokotaSatoshi en-aut-sei=Yokota en-aut-mei=Satoshi kn-aut-name=横田聡 kn-aut-sei=横田 kn-aut-mei=聡 aut-affil-num=6 ORCID= en-aut-name=TakeuchiKazuaki en-aut-sei=Takeuchi en-aut-mei=Kazuaki kn-aut-name=竹内一昭 kn-aut-sei=竹内 kn-aut-mei=一昭 aut-affil-num=7 ORCID= en-aut-name=NawaYuichiro en-aut-sei=Nawa en-aut-mei=Yuichiro kn-aut-name=名和由一郎 kn-aut-sei=名和 kn-aut-mei=由一郎 aut-affil-num=8 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 en-keyword=気管支喘息 (bronchial asthma) kn-keyword=気管支喘息 (bronchial asthma) en-keyword=臨床病型 (clinicaI classification) kn-keyword=臨床病型 (clinicaI classification) en-keyword=アトピー型 (atopic asthma) kn-keyword=アトピー型 (atopic asthma) en-keyword=温泉療法 (spa therapy) kn-keyword=温泉療法 (spa therapy) en-keyword=薬物療法 (drug therapy) kn-keyword=薬物療法 (drug therapy) END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue= article-no= start-page=79 end-page=84 dt-received= dt-revised= dt-accepted= dt-pub-year=1996 dt-pub=199611 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=U型喘息(細気管支閉塞型)と気管支肺胞洗浄液の好中球数 kn-title=Type U (bronchiolar obstruction) asthma and number of neutrophils in bronchoalveolar lavage (BAL) fluid en-subtitle= kn-subtitle= en-abstract=気管支喘息は,その臨床症状より,Ia型(Ia-1およびIa-2),Ib型およびU型の3つの病型に分けることができる(臨床分類)｡また,同時に臨床所見および検査により分類することができる(スコアー分類)｡いずれの分類においても,BAL液中の好中球の著増および高度な% V25値の低下がU細気管支閉塞型の特徴的所見である｡しかしながら,BAL液中の好中球の増加をともなわないU型喘息が存在することが明らかにされている｡これらの症例では,BAL液 中好中球増加をともなう症例に比べ平均年齢が高い｡しかし,FEVl.0% 値､BAL液中リンパ球頻度や血清IgG値などは､好中球増加をともなう症例ほどの低下傾向は見られない｡これらの結果はBAL液中好中球増加をともなうU型z喘息の発症機序には､液性および細胞性免疫能の低下が､また､BAL液中好中球増加をともなわないU型喘息では､加齢がある程度関連していることを示 している。 kn-abstract=Bronchial asthma is classified into three types ; type Ia (Ia-1 and Ia-2), type Ib, and type U, by clinical symptoms (clinical diagnosis). Asthma is also classified by clinical findings and examinations (score diagnosis). Both classification systems show that markedly increased proportion of BAL neutrophils and marked decrease in % V25 value are characteristic of type U, bronchiolar　obstruction, asthma. However, there are some type U asthma patients without BAL neutrophilia. In these patients, age is higher compared to those with BAL enutrophlia. Decrease in FEV1.0% value and decrease in the proportion of BAL lympocytes and serum IgG level, are not so remarkable as decrease in those with BAL neutrophilia. It has been suggested that type U asthma with BAL neutrophilia correlates with suppression of humoral and cellular immunity, and same type of astma without BAL neutrophilia is in part caused by aging. 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=保崎泰弘 kn-aut-sei=保崎 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=YokotaSatoshi en-aut-sei=Yokota en-aut-mei=Satoshi kn-aut-name=横田聡 kn-aut-sei=横田 kn-aut-mei=聡 aut-affil-num=6 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=7 ORCID= en-aut-name=TakeuchiKazuaki en-aut-sei=Takeuchi en-aut-mei=Kazuaki kn-aut-name=竹内一昭 kn-aut-sei=竹内 kn-aut-mei=一昭 aut-affil-num=8 ORCID= en-aut-name=NawaYuichiro en-aut-sei=Nawa en-aut-mei=Yuichiro kn-aut-name=名和由一郎 kn-aut-sei=名和 kn-aut-mei=由一郎 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=HaradaHideo en-aut-sei=Harada en-aut-mei=Hideo kn-aut-name=原田英雄 kn-aut-sei=原田 kn-aut-mei=英雄 aut-affil-num=11 ORCID= en-aut-name=IkedaSatoru en-aut-sei=Ikeda en-aut-mei=Satoru kn-aut-name=池田敏 kn-aut-sei=池田 kn-aut-mei=敏 aut-affil-num=12 ORCID= en-aut-name=TaketaKazuhisa en-aut-sei=Taketa en-aut-mei=Kazuhisa kn-aut-name=武田和久 kn-aut-sei=武田 kn-aut-mei=和久 aut-affil-num=13 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=岡山大学医学部臨床検査医学 affil-num=11 en-affil= kn-affil=岡山大学医学部臨床検査医学 affil-num=12 en-affil= kn-affil=岡山大学医学部公衆衛生学 affil-num=13 en-affil= kn-affil=岡山大学医学部公衆衛生学 en-keyword=Asthma classification (喘息分類) kn-keyword=Asthma classification (喘息分類) en-keyword=BAL lymphocytes (BALリンパ球) kn-keyword=BAL lymphocytes (BALリンパ球) en-keyword=BAL neutrophils (BAL好中球) kn-keyword=BAL neutrophils (BAL好中球) en-keyword=% V25 value kn-keyword=% V25 value en-keyword=U型喘息 kn-keyword=U型喘息 END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue= article-no= start-page=63 end-page=70 dt-received= dt-revised= dt-accepted= dt-pub-year=1996 dt-pub=199611 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=サーモグラフィーによる体表面温度の測定 kn-title=Evaluation of Body Surface Temperature by Thermography en-subtitle= kn-subtitle= en-abstract=健常人並びに糖尿病患者を対象にして下肢の体表面温度を測定した｡測定にはサーモグラフィーを用い,得られた画像の数値化にはコンピュータを用いた画像処理システムを利用した｡健常人を用いた実験では,20℃の水を用いた冷水負荷を5分間行うことにより,冷水負荷後,下肢の体表面温度は時間とともに上昇して30分後に良好な回復を得ることができた｡画像処理により28℃以上の体表面温度を呈した下肢の面積を負荷前と比較したところ,回復率は,2名の健常人についてみるとそれぞれ83%,88%であった｡27℃で画像処理を行った場合には回復率は93%となり過大評価される可能性があった｡また,29℃で画像処理を行ったところに,逆に,64%となり過少評価される可能性があり,28℃が最も良い条件であった｡この様な条件下で,糖尿病患者7名について同様に測定を行ったところ,1名は健常人と同じく99%の良好な回復率を呈した｡しかし,他の1名は56%であり,残りの,5名は6%以下であった｡この様に,糖尿病患者では,下肢の体表面温度の冷水負荷後の回復率に顕著な差を認めた｡この差は,糖尿病患者における,末梢循環障害の程度を反映しているものと考えられた｡この様にコンピュータを用いた画像処理システムの応用によりサーモグラフィーの画像は数値化することが出来,測定結果はより客観的に据えることが可能となった｡画像処理されたサーモグラフィーは下肢の循環障害を持つ患者の末梢血流量の評価に有用な測定方法であると考えられた。 kn-abstract=Body Surface Temperature was observed by thermography. The surface temperature of a healthy person's lower limbs, after being cooled in a water bath, increased in parallel with time. Patients with Diabetes Mellitus had different patterns in the rate of increase of the surface temperature. After cold loading, one patient had a 99% recovery ratio of surface temperature, the same level as healthy volunteers (83%, and 88%), as calculated by a picture processing program with the computerized thermotracer. However, the recovery ratio of other patients was poorer, ranging from 56% to under 6% recovery. This measurement of elevation of body temperature is useful for the estimation of peripheral blood flow in patients with lower limbcirculation failure. en-copyright= kn-copyright= 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=1 ORCID= en-aut-name=NawaYuichiro en-aut-sei=Nawa en-aut-mei=Yuichiro kn-aut-name=名和由一郎 kn-aut-sei=名和 kn-aut-mei=由一郎 aut-affil-num=2 ORCID= en-aut-name=TakeuchiKazuaki en-aut-sei=Takeuchi en-aut-mei=Kazuaki kn-aut-name=竹内一昭 kn-aut-sei=竹内 kn-aut-mei=一昭 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=YokotaSatoshi en-aut-sei=Yokota en-aut-mei=Satoshi kn-aut-name=横田聡 kn-aut-sei=横田 kn-aut-mei=聡 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=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=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=HaradaHideo en-aut-sei=Harada en-aut-mei=Hideo kn-aut-name=原田英雄 kn-aut-sei=原田 kn-aut-mei=英雄 aut-affil-num=11 ORCID= en-aut-name=IkedaSatoru en-aut-sei=Ikeda en-aut-mei=Satoru kn-aut-name=池田敏 kn-aut-sei=池田 kn-aut-mei=敏 aut-affil-num=12 ORCID= en-aut-name=TaketaKazuhisa en-aut-sei=Taketa en-aut-mei=Kazuhisa kn-aut-name=武田和久 kn-aut-sei=武田 kn-aut-mei=和久 aut-affil-num=13 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=岡山大学医学部臨床検査医学 affil-num=11 en-affil= kn-affil=岡山大学医学部臨床検査医学 affil-num=12 en-affil= kn-affil=岡山大学医学部公衆衛生学 affil-num=13 en-affil= kn-affil=岡山大学医学部公衆衛生学 en-keyword=Thermography (サーモグラフィー) kn-keyword=Thermography (サーモグラフィー) en-keyword=Diabetes Mellitus (糖尿病) kn-keyword=Diabetes Mellitus (糖尿病) en-keyword=Peripheral Circulation (末梢循環) kn-keyword=Peripheral Circulation (末梢循環) en-keyword=Cold Loading (冷水負荷) kn-keyword=Cold Loading (冷水負荷) END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue= article-no= start-page=57 end-page=62 dt-received= dt-revised= dt-accepted= dt-pub-year=1996 dt-pub=199611 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=気管支喘息症例に対する鼻腔内ステロイド療法 kn-title=Intranasal glucocorticoid therapy in asthmatic patients with mucosal abnormalities of sinonasal cavity en-subtitle= kn-subtitle= en-abstract=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｡ kn-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 100m? 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. 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=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=YokotaSatoshi en-aut-sei=Yokota en-aut-mei=Satoshi kn-aut-name=横田聡 kn-aut-sei=横田 kn-aut-mei=聡 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=TakeuchiKazuaki en-aut-sei=Takeuchi en-aut-mei=Kazuaki kn-aut-name=竹内一昭 kn-aut-sei=竹内 kn-aut-mei=一昭 aut-affil-num=7 ORCID= en-aut-name=NawaYuichiro en-aut-sei=Nawa en-aut-mei=Yuichiro kn-aut-name=名和由一郎 kn-aut-sei=名和 kn-aut-mei=由一郎 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= 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=HaradaHideo en-aut-sei=Harada en-aut-mei=Hideo kn-aut-name=原田英雄 kn-aut-sei=原田 kn-aut-mei=英雄 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=岡山大学医学部臨床検査医学 affil-num=11 en-affil= kn-affil=岡山大学医学部臨床検査医学 en-keyword=bronchial asthma (気管支喘息) kn-keyword=bronchial asthma (気管支喘息) en-keyword=rhinitis (鼻炎) kn-keyword=rhinitis (鼻炎) en-keyword=intranasal steroid therapy (鼻腔内吸入ステロイド療法) kn-keyword=intranasal steroid therapy (鼻腔内吸入ステロイド療法) en-keyword=expectoration (喀痰排出) kn-keyword=expectoration (喀痰排出) en-keyword=peak expiratory flow (ピークフロー) kn-keyword=peak expiratory flow (ピークフロー) END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue= article-no= start-page=50 end-page=56 dt-received= dt-revised= dt-accepted= dt-pub-year=1996 dt-pub=199611 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=中高年発症型喘息患者におけるIgE系アレルギー反応の加令による変化 kn-title=Age-related changes of IgE-mediated allergic reaction in patients with late onset asthma. en-subtitle= kn-subtitle= en-abstract=発症年令が40才以上の中高年発症型喘息患者におけるIgE系アレルギー反応の加令による変化について検討を加えた｡1.発症年令が40から49才と60才以上の患者では,50から59才の患者に比して血清IgE値が300IU/m?以上の高値を示す頻度が高い傾向が見られた。2.ダニ,ゴキブリに対するRAST陽性率は発症年令が50から59才の患者に比して,40から49才と60才以上の患者で高値を示した｡一方,カンジダに対するRAST陽性率は,発症年令が40から49才と60才以上の患者に比して,50から59才の患者で高値を示した｡3.発症年令が50から59才の患者では,他の発症年令の患者に比べて,重症例が多く,軽症例が少ない傾向が見られた｡以上の結果から,発症年令が50から59才の患者のIgE系アレルギー反応は若年発症型喘息患者と異なり,発症年令が40から49才と60才以上の患者のIgE系アレルギー反応は若年発症型喘息患者と 類似することが示唆された｡ kn-abstract=Age-related changes in IgE-mediated allergic reaction were examined in patients with late onset asthma, whose asthma occured over the age at onset of 40. 1. The number of patients with a high serum IgE level over 3001U/m? was larger in those between the ages at onset of 40 and 49 and over age at onset 60 than in those between the ages at onset 50 and 59. 2. A positive RAST score to Hdm and cockroach allergens was more frequently found in patients between 40 and 49 and over age 60 at onset compared to those between 50 and 59 at onset. In contrast, the number of patients with a positive RAST to Candida was larger in those between 50 and 59 at onset than in those of between 40 and 49 and over 60 at onset. 3. Severe asthma was more frequently and slight asthma was less frequently observed in patients between 50 and 59 at onset than in those of the other age at onset groups. These results suggest that IgE-mediated allergic reaction in patients between the ages at onset of 50 and 59 is different from that in those with early onset asthma, and that the reaction in patients between the ages at onset 40 and 49 and over 60 resembles to the reaction in those with early onset 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=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=YokotaSatoshi en-aut-sei=Yokota en-aut-mei=Satoshi kn-aut-name=横田聡 kn-aut-sei=横田 kn-aut-mei=聡 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= 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=8 ORCID= en-aut-name=HaradaHideo en-aut-sei=Harada en-aut-mei=Hideo kn-aut-name=原田英雄 kn-aut-sei=原田 kn-aut-mei=英雄 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=岡山大学医学部臨床検査医学 affil-num=9 en-affil= kn-affil=岡山大学医学部臨床検査医学 en-keyword=IgE kn-keyword=IgE en-keyword=RAST kn-keyword=RAST en-keyword=吸入抗原 (inhalant Allergen) kn-keyword=吸入抗原 (inhalant Allergen) en-keyword=気管支喘息 (Bronchial asthma) kn-keyword=気管支喘息 (Bronchial asthma) en-keyword=加令 (aging) kn-keyword=加令 (aging) END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue= article-no= start-page=43 end-page=49 dt-received= dt-revised= dt-accepted= dt-pub-year=1996 dt-pub=199611 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=温泉療法による気管支喘息患者の心理的障害の改善 kn-title=Improvement of psychological disorders by spa therapy in patients with asthma en-subtitle= kn-subtitle= en-abstract=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｡@CMI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｡ASDS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｡BCAI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｡ kn-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. en-copyright= kn-copyright= en-aut-name=YokotaSatoshi en-aut-sei=Yokota en-aut-mei=Satoshi kn-aut-name=横田聡 kn-aut-sei=横田 kn-aut-mei=聡 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=保崎泰弘 kn-aut-sei=保崎 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=TakeuchiKazuaki en-aut-sei=Takeuchi en-aut-mei=Kazuaki kn-aut-name=竹内一昭 kn-aut-sei=竹内 kn-aut-mei=一昭 aut-affil-num=7 ORCID= en-aut-name=NawaYuichiro en-aut-sei=Nawa en-aut-mei=Yuichiro kn-aut-name=名和由一郎 kn-aut-sei=名和 kn-aut-mei=由一郎 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= en-aut-name=TadaShinya en-aut-sei=Tada en-aut-mei=Shinya kn-aut-name=多田慎也 kn-aut-sei=多田 kn-aut-mei=慎也 aut-affil-num=10 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=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=岡山大学医学部第二内科 affil-num=11 en-affil= kn-affil=岡山大学医学部第二内科 en-keyword=気管支喘息 (Bronchial asthma) kn-keyword=気管支喘息 (Bronchial asthma) en-keyword=温泉療法 (Spa therapy) kn-keyword=温泉療法 (Spa therapy) en-keyword=心理テスト（CMI, SDS, CAI) (CMI test, SDS test, CAI test) kn-keyword=心理テスト（CMI, SDS, CAI) (CMI test, SDS test, CAI test) END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue= article-no= start-page=35 end-page=42 dt-received= dt-revised= dt-accepted= dt-pub-year=1996 dt-pub=199611 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=気管支喘息におけるエゴマ油と白血球のロイコトリエンB4,C4合成 kn-title=Dietary supplementation with n-3 fatty acids in bronchial asthma correlated with the generation of LTB4 and LTC4 en-subtitle= kn-subtitle= en-abstract=近年,ロイコトリエンと遅発型気管支反応(LAR)との密接な関連が注目されている｡本論文では,アラキドン酸(AA)代謝を通してロイコトリエン合成に関与すると推定される,αリノレン酸を多く含むエゴマ油による食事療法の臨床効果を,気管支喘息を対象に検討した｡臨床症状および換気機能は,2週間のエゴマ油投与で明らかな改善差傾向を示した｡Ca ionophore A23187刺激時の白血球のLTB4およびLTC4産生は,エゴマ油投与により,投与前に比べ有意の減少を示した(p<0.05)｡血中脂肪酸に関しては,イエイコサペンタエン酸(EPA),ドコサヘキサエン酸(DHA)およびAA濃度は,エゴマ油投与により増加傾向を示し,同時にEPA/AA比も増加する傾向が見られた｡以上の結果より,エゴマ油による食事療法は,治療上有用であると考えられた｡ kn-abstract=In recent years, it has been noted that there is a close correlation between leukotrienes and late asthmatic reaction (LAR). In this study, effects of dietary supplementation with perilla seed oil rich in alpha-linolenic acid, which is speculated to affect the generation of leukotrienes through metabolism of arachidonic acid (AA), were evaluated in 6 patients with asthma. The symptoms and ventilatory function were improved after 2-week dietary supplementation with perilla seed oil. The generation of LTB4 and LTC4 by peripheral leucocytes stimulated with Ca ionophore A23187 was significantly suppressed by the dietary supplementation (LTB4 and LTC4 ; p<0.05). Regarding the composition of fatty acids in serum phospholipids, the concentrations of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and AA tended to increase after the supplementation, accompanied with an increase in the ratio of EPA to AA. These results suggest that dietary supplementation with perilla seed oil brings beneficial effects in the treatment of asthma. 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=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=保崎泰弘 kn-aut-sei=保崎 kn-aut-mei=泰弘 aut-affil-num=4 ORCID= en-aut-name=YokotaSatoshi en-aut-sei=Yokota en-aut-mei=Satoshi kn-aut-name=横田聡 kn-aut-sei=横田 kn-aut-mei=聡 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=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= en-aut-name=YamamotoJunko en-aut-sei=Yamamoto en-aut-mei=Junko kn-aut-name=山本純子 kn-aut-sei=山本 kn-aut-mei=純子 aut-affil-num=8 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=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=中国短期大学食物栄養科 affil-num=9 en-affil= kn-affil=岡山大学医学部第一内科 en-keyword=n-3系脂肪酸 (n-3 fatty acids) kn-keyword=n-3系脂肪酸 (n-3 fatty acids) en-keyword=気管支喘息 (bronchial asthma) kn-keyword=気管支喘息 (bronchial asthma) en-keyword=アラキドン酸 (arachidonic acid) kn-keyword=アラキドン酸 (arachidonic acid) en-keyword=LTB4 kn-keyword=LTB4 en-keyword=LTC4 kn-keyword=LTC4 END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue= article-no= start-page=28 end-page=34 dt-received= dt-revised= dt-accepted= dt-pub-year=1996 dt-pub=199611 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Ia型(単純気管支れん縮型)喘息における気道過敏性について…年齢および気管支肺胞洗浄液中の細胞成分との関連について kn-title=Bronchial hyperresponsiveness in type Ia (simple bronchoconstriction) asthma Relationship to patient age and the proportions of bronchoalveolar cells en-subtitle= kn-subtitle= en-abstract=気管支喘息患者Ia型(単純気管支れん縮型)39人(Ia-1型25人,Ia-2型14人)の気道過敏性を年齢,呼吸機能検査,気管支肺胞洗浄液(BAL)中の細胞成分と関連で検討を行った｡1.BAL液中の好酸球の比率はIa-1型に比べIa-2型で優位に高値であった｡2.メサコリンに対しての過敏性はIa-1型とIa-2型とで差を認めなかった｡3.気道過敏性はどちらの病型においても年齢にともなって減弱する傾向にあったが,一秒率及びBAL液中の好中球,リンパ球の比率とは相関しなかった｡4.メサコリンに対しての気道過敏性はIa-1型,Ia-2型ともにBAL液中の好酸球の比率が増加するにしたがって亢進した｡以上より単純気管支れん縮型(Ia型)の気管支喘息患者の気道過敏性はその年齢,BAL液中の好酸球の比率に相関することが示唆された｡ kn-abstract=Bronchial hyperresponsiveness was examined in relation to age, ventilatory function, and the proportion of bronchoalveolar lavage (BAL) cells in 39 patients with type Ia asthma (simple bronchoconstriction) (25 with type Ia-1 and 14 with type Ia-2), classified by clinical symptoms. 1. The proportion of BAL eosinophils was significantly higher in type Ia-2 than that in type Ia-1 asthma patients. 2. Bronchial reactivity to methacholine was not different between type Ia-1 and type Ia-2 asthma patients. 3. Bronchial hyperreactivity tended to decrease as patient age was higher in both types of asthma. Neither ventilatory function (FEV1.0%) nor the proportions of BAL lymphocytes and neutrophils was not correlated with bronchial hyperresponsiveness in both types of asthma. 4. Bronchial reactivity to methacholine more dereased with the increase in the proportion of BAL eosinophils in both type Ia-1 and Ia-2 asthma patients. The results show that bronchial hyperresponsiveness in patients with type Ia asthma is correlated to patients age and the proportion of BAL eosinophils. 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=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=保崎泰弘 kn-aut-sei=保崎 kn-aut-mei=泰弘 aut-affil-num=4 ORCID= en-aut-name=YokotaSatoshi en-aut-sei=Yokota en-aut-mei=Satoshi kn-aut-name=横田聡 kn-aut-sei=横田 kn-aut-mei=聡 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=TakeuchiKazuaki en-aut-sei=Takeuchi en-aut-mei=Kazuaki kn-aut-name=竹内一昭 kn-aut-sei=竹内 kn-aut-mei=一昭 aut-affil-num=7 ORCID= en-aut-name=NawaYuichiro en-aut-sei=Nawa en-aut-mei=Yuichiro kn-aut-name=名和由一郎 kn-aut-sei=名和 kn-aut-mei=由一郎 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= 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=HaradaHideo en-aut-sei=Harada en-aut-mei=Hideo kn-aut-name=原田英雄 kn-aut-sei=原田 kn-aut-mei=英雄 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=岡山大学医学部臨床検査医学 affil-num=11 en-affil= kn-affil=岡山大学医学部臨床検査医学 en-keyword=Bronchial hyperresponsiveness kn-keyword=Bronchial hyperresponsiveness en-keyword=Type Ia asthma kn-keyword=Type Ia asthma en-keyword=Patient age kn-keyword=Patient age en-keyword=BAL eosinophiIs kn-keyword=BAL eosinophiIs END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue= article-no= start-page=21 end-page=27 dt-received= dt-revised= dt-accepted= dt-pub-year=1996 dt-pub=199611 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=アトピー型および非アトピー型気管支喘息の発作発症機序の差異について･･･ロイコトリエンC4の役割について kn-title=Difference in the onset mechansisms of attacks between atopic and nonatopic asthma. A role of leukotriene C4 en-subtitle= kn-subtitle= en-abstract=気管支喘息患者14人(アトピー型,非アトピー型各7人)につき気管支肺胞洗浄(BAL)液及び気管支肺胞洗浄細胞と末梢血白血球をカルシウムイオノファA23187で刺激し,主要な気管支収縮メディエーターであるヒスタミンとロイコトリエンC4(LTC4)の濃度を測定した｡1.BAL中細胞の比率では好塩基球のみ非アトピー型に比べアトピー型で優位に高い値であった｡(p<0.05) 2.BAL液のヒスタミンの濃度はアトピー型で有意に高い値であったが,ロイコトリエンC4はアトピー型,非アトピー型で有意な差を認めなかった｡3.BAL細胞からのカルシウムイオノファA23187刺激によるロイコトリエンC4産生はアトピー型に比べ非アトピー型で高い値であったが,有意差は認めなかった｡一方,同刺激によるヒスタミン遊離は非アトピー型よりアトピー型で有意 に高値であった｡(p<0.001)｡以上の結果よりアトピ-型の気管支喘息の発症機序にはヒスタミン,ロイコトリエンC4の両者が,非アトピー型に於いてはロイコトリエンC4のみが主として関与していること可能性が示唆された｡ kn-abstract=Concentrations of main bronchoconstricting chemical mediators, histamine and leukotriene C4 (LTC4), were measured in bronchoalveolar lavage (BAL) fluid, and when cells (peripheral leukocytes and BAL cells) were stimulated by Ca ionophore A23187, in 7 atopic and 7 nonatopic asthma patients. 1. The proportion of basophilic cells was significantly larger in atopic than in nonatopic asthma (p<0.05), however no significant difference was present in the other BAL cells between the two asthma types. 2. Concentration of histamine in BAL fluid was significantly higher in atopic than that in nonatopic asthma, however, difference in that of LTC4 was not found between them. 4. The release of LTC 4 from BAL cells was higher in nonatopic than that in atopic asthma, but this was not significant. In contrast, the release of histamine was significantly higher in atopic compared to that in nonatopic asthma (p<0.001) when the cells were stimulated by Ca ionophore A23187. These results suggest that both histamine and LTC4 participate in the onset mechanism of atopic asthma, and only LTC4 in that of nonatopic asthma. 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=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=保崎泰弘 kn-aut-sei=保崎 kn-aut-mei=泰弘 aut-affil-num=4 ORCID= en-aut-name=YokotaSatoshi en-aut-sei=Yokota en-aut-mei=Satoshi kn-aut-name=横田聡 kn-aut-sei=横田 kn-aut-mei=聡 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=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 en-keyword=Histamine kn-keyword=Histamine en-keyword=LTC4 kn-keyword=LTC4 en-keyword=atopic kn-keyword=atopic en-keyword=nonatopic kn-keyword=nonatopic en-keyword=BAL cells kn-keyword=BAL cells END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue= article-no= start-page=14 end-page=20 dt-received= dt-revised= dt-accepted= dt-pub-year=1996 dt-pub=199611 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=U型(細気管支閉塞)喘息と閉塞性細気管支炎における細気管支領域の炎症反応の差 kn-title=Difference in small airway inflammation between type U (bronchiolar obstruction) asthma and obstructive bronchiolitis en-subtitle= kn-subtitle= en-abstract=U型喘息と閉塞性細気管支炎の臨床的特徴について,換気機能および気道炎症反応を中心に検討を加えた｡1.年齢,および発症年齢とも閉塞性細気管支炎に比べU型喘息において高い傾向が見られた｡IgE系反応はU型喘息では観察されたが,閉塞性細気管支炎では見られなかった｡2.換気機能では,測定された全ての換気パラメーターにおいて,その値は閉塞性細気管支炎に比べU型喘息でより低い値を示し,FEV1.0%,% MMFおよび% V50では有意の差が見られた｡3.BAL液中好中球頻度は,U型喘息(55.7%),閉塞性細気管支炎(74.4%)いずれにおいても高い値を示したが,両者間に有意の差は見られなかった｡4.一方,BAL液中の絶対数では,U型喘息に比べ,閉塞性細気管支炎において,総細胞数,マクロファージおよび好中球数が有意の高値を示した｡5.また,lm?あたりの細胞数の比較でも,閉塞性細気管支炎で好中球数が著明な高値を示した｡これらの結果より,この2疾患では気道内好中球増多は同様に見られるものの,その気道炎症の程度は明らかに閉塞性細気管支炎でより高度であることが示された｡ kn-abstract=Ventilatory function and inflammatory cells in airways were compared between patients with type U (bronchiolar obstruction) asthma and those with obstructive bronchiolitis. 1. Age and age at onset were higher in patients with type U asthma than in those with obstructive bronchiolitis. IgE-mediated allergic reaction was observed in patients with type U asthma, but not in those with obstructive bronchiolitis. 2. In ventilatory function tests, all ventilatory parameters examined were lower in patients with type U asthma compared to those with obstructive bronchiolitis, and the differences were significant in FEV1.0% (p<0.001), % MMF (p<0.02), and V50 (p<0.01). 3. The proportion of BAL neutrophils was very high in type U asthma (55.7%) and obstructive bronchiolitis (74.4%), however, this was not significant. 4. Absolute numbers/BAL fluid of total cells, BAL macrophages and BAL neutrophils were significantly higher in patients with obstructive bronchiolitis than in those with type U asthma. 5. The results on absolute number/m? of BAL cells demonstrated that number of BAL neutrophils markedly larger in patients with obstructive bronchiolitis compared to those with type U asthma. These results show that high proportion of BAL neutrophils was observed in the two respiratory diseases, however, the degree of inflammation in airways was markedly greater in obstructive bronchiolitis. 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=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=YokotaSatoshi en-aut-sei=Yokota en-aut-mei=Satoshi kn-aut-name=横田聡 kn-aut-sei=横田 kn-aut-mei=聡 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=TakeuchiKazuaki en-aut-sei=Takeuchi en-aut-mei=Kazuaki kn-aut-name=竹内一昭 kn-aut-sei=竹内 kn-aut-mei=一昭 aut-affil-num=7 ORCID= en-aut-name=NawaYuichiro en-aut-sei=Nawa en-aut-mei=Yuichiro kn-aut-name=名和由一郎 kn-aut-sei=名和 kn-aut-mei=由一郎 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= en-aut-name=TadaShinya en-aut-sei=Tada en-aut-mei=Shinya kn-aut-name=多田慎也 kn-aut-sei=多田 kn-aut-mei=慎也 aut-affil-num=10 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=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=岡山大学医学部第二内科 affil-num=11 en-affil= kn-affil=岡山大学医学部第二内科 en-keyword=U型喘息 (Type Uasthma) kn-keyword=U型喘息 (Type Uasthma) en-keyword=閉塞性細気管支炎 (Obstructive bronchiolitis) kn-keyword=閉塞性細気管支炎 (Obstructive bronchiolitis) en-keyword=換気機能 (Ventilatory function) kn-keyword=換気機能 (Ventilatory function) en-keyword=BAL好中球 (BAL neutrophiIs) kn-keyword=BAL好中球 (BAL neutrophiIs) en-keyword=IgE系反応 (IgE-mediated allergy) kn-keyword=IgE系反応 (IgE-mediated allergy) END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue= article-no= start-page=8 end-page=13 dt-received= dt-revised= dt-accepted= dt-pub-year=1996 dt-pub=199611 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=肺活量(FVC)低値を示す気管支喘息の臨床的特徴 kn-title=Clinical features of asthma patients with a low % FVC. In relation to clinical asthma type and disease severity. en-subtitle= kn-subtitle= en-abstract=% 肺活量が75%以下の低値を示す気管支喘息について,その臨床的特徴を,臨床病型や重症度との関連のもとに検討した｡1.% 肺活量と年齢との間には関連は見られなかった｡2.% 肺活量と臨床病型との問には有意の関連が見られ,U型喘息(細気管支閉塞型)における% 肺活量は,Ia-1型やIa-2型などの単純性気管支攣縮型に比べ,有意に低い値を示した｡3.% 肺活量はまた喘息の重症度と有意の関連を示した｡これらの症例では,喘息の重症度が増すにつれて,% 肺活量は減少する傾向が見られた｡4.これら症例の低値を示す% 肺活量は,治療(複合温泉療法)により改善される傾向が見られた｡以上の結果より,これらの症例(% 肺活量が75%以下)では,% 肺活量と喘息の重症度との間にある程度の関連があることが明らかになった｡ kn-abstract=Clinical features of asthma patients with a low % FVC (<75%) were studied in relation to clinical asthma type and disease severity. 1. The value of % FVC was not related to patient age. 2. A significant association between % FVC value and clinical asthma type was found. The value of % FVC was significantly lower in subjects with type U asthma (bronchiolar obstruction) than in those with type Ia-1 and type Ia-2 (simple bronchoconstriction) (p<0.001). 3. % FVC value significantly correlated with disease severity. The value in the subjects tended to decrease as their asthma conditions were more severe. 4. The % FVC value in the subjects was improved after treatment (complex spa therapy). These results demonstrate that a significant correlation is present between low % FVC and disease severity in asthma patients with a low % FVC. 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=YokotaSatoshi en-aut-sei=Yokota en-aut-mei=Satoshi kn-aut-name=横田聡 kn-aut-sei=横田 kn-aut-mei=聡 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=TakeuchiKazuaki en-aut-sei=Takeuchi en-aut-mei=Kazuaki kn-aut-name=竹内一昭 kn-aut-sei=竹内 kn-aut-mei=一昭 aut-affil-num=7 ORCID= en-aut-name=NawaYuichiro en-aut-sei=Nawa en-aut-mei=Yuichiro kn-aut-name=名和由一郎 kn-aut-sei=名和 kn-aut-mei=由一郎 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= 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=HaradaHideo en-aut-sei=Harada en-aut-mei=Hideo kn-aut-name=原田英雄 kn-aut-sei=原田 kn-aut-mei=英雄 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=岡山大学医学部臨床検査医学 affil-num=11 en-affil= kn-affil=岡山大学医学部臨床検査医学 en-keyword=% FVC低値 (Low % FVC) kn-keyword=% FVC低値 (Low % FVC) en-keyword=気管支喘息 (Bronchial asthma) kn-keyword=気管支喘息 (Bronchial asthma) en-keyword=臨床病型 (Clinical asthma type) kn-keyword=臨床病型 (Clinical asthma type) en-keyword=重症度 (asthma severity) kn-keyword=重症度 (asthma severity) en-keyword=温泉療法 (Spa therapy) kn-keyword=温泉療法 (Spa therapy) END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue= article-no= start-page=1 end-page=7 dt-received= dt-revised= dt-accepted= dt-pub-year=1996 dt-pub=199611 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=BAL液中好中球増加をともなわないU型喘息について kn-title=Clinical features of type U asthma (bronchiolar obstruction) without bronchoalveolar neutrophilia en-subtitle= kn-subtitle= en-abstract=細気管支閉塞型(U型)喘息の臨床的特徴が,BAL液中の好中球頻度との関連のもとに検討された｡対象13例のうち,7例がBAL液中好中球増加(平均好中球頻度;53.5%)をともなう症例(BALn(+))で,残りの6例はBAL液中好中球増加 をともなわない(3.5%)症例(BALn(-))であった｡1.平均年齢は,BALn(+)症例(55.0才)に比べ,BALn(-)症例(66.0才)でより高い傾向が見られた｡2.メサコリンに対する気道過敏性は,BALn(+)症例に比べBALn(-)症例でやや高い傾向が見られたが,両者間に有意の差は見られなかった｡3.FEV1.0%値は,BALn(-)症例に比べBALn(+)症例で有意に低い値を示した(P<0.05)｡4.BAL液中リンパ球頻度はBALn(+)症例でBALn(-)症例に比べ有意に低い値を示した(P<0.001)｡5.血清IgG,IgAおよびIgM値には両者間に有意の差は見られなかったが,IgG値はBALn(+)症例でより低い傾向が見られた｡これらの結果より,U型喘息にはBAL液中好中球増加を示す症例と示さない症例の2種類があること,そして前者は免疫能の低下と,そして後者は加齢とある程度の関連があることが示唆された｡ kn-abstract=Clinical features of asthma patients with bronchiolar obstruction (type U asthma) were studied in relation to the proportion of neutrophils in bronchoalveolar lavage (BAL) fluid. Of 13 subjects studied, 7 were accompanied with BAL neutrophilia (53.5%) (BALn(+)) and 6 were without BAL neutrophilia (3.5%) (BALn(-)). 1. The mean age was higher in BALn(-) (66.0 years) than in BALn(+) patients (55.0 years). 2. Bronchial reactivity to methacholine was slightly higher in BALn(-) patients than in those with BALn(+). 3. The value of FEV1.0% was significantly lower in BALn(+) patints than in those with BALn(-) (p<0.01). 4. The proportion of BAL lymphocytes was signicantly more decreased in BALn(+) patients compared to the proportion in those with BALn(-) (p<0.001). 5. the values of serum IgG, IgA, and IgM were not significantly different between BALn(+) and BALn(-) patients, however, the value of IgG was more decreased in BALn(+) patients than in those with BALn(-). These results suggest that two kinds of type U asthma ; one is with BAL neutrophilia related to suppressed immunity, and another is without BAL neutrophilia in part due to aging. 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=保崎泰弘 kn-aut-sei=保崎 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=YokotaSatoshi en-aut-sei=Yokota en-aut-mei=Satoshi kn-aut-name=横田聡 kn-aut-sei=横田 kn-aut-mei=聡 aut-affil-num=6 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=7 ORCID= en-aut-name=TakeuchiKazuaki en-aut-sei=Takeuchi en-aut-mei=Kazuaki kn-aut-name=竹内一昭 kn-aut-sei=竹内 kn-aut-mei=一昭 aut-affil-num=8 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=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=岡山大学医学部第一内科 en-keyword=気管支喘息 (Bronchial asthma) kn-keyword=気管支喘息 (Bronchial asthma) en-keyword=細気管支閉塞 (Bronchiolar obstruction) kn-keyword=細気管支閉塞 (Bronchiolar obstruction) en-keyword=BAL好中球 (BAL neutrophilia) kn-keyword=BAL好中球 (BAL neutrophilia) en-keyword=免疫能低下 (Suppressed immunity) kn-keyword=免疫能低下 (Suppressed immunity) en-keyword=加齢 (Aging) kn-keyword=加齢 (Aging) END start-ver=1.4 cd-journal=joma no-vol=68 cd-vols= no-issue= article-no= start-page=107 end-page=114 dt-received= dt-revised= dt-accepted= dt-pub-year=1997 dt-pub=199712 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Three cases of rheumatoid arthritis with biliary tract cancer kn-title=慢性関節リウマチに胆道系悪性腫瘍を合併した3例 en-subtitle= kn-subtitle= en-abstract=The relationships between rheumatoid arthritis and malignant disease have been a focus of controversy for many years. Many studies of patients with rheumatoid arthritis have found no increases in overall cancer rates. Although significant elevations in rates of lymphoma, myeloma and malignant disease in patients treated with immunosuppressive drugs have been reported, it has been considered that gastrointestinal and biliary tract cancer in patients with rheumatoid arthritis is rare. We recently experienced three cases of rheumatoid arthritis with biliary tract cancer. They were gall bladder, cancer, bile duct cancer and cancer of papilla of Vater. Patients with rheumatoid arthritis should be carefully monitored for malignant disease. kn-abstract=一般的に,慢性関節リウマチには悪性腫瘍の合併は少ないと言われている｡特に,消化器系あるいは胆道系悪性腫瘍を合併したという報告は極めて少ない｡我々は慢性関節リウマチの経過中,胆道系悪性腫瘍を合併した3例を経験した｡3症例はそれぞれ胆嚢癌,肝内胆管癌,乳頭部癌を合併していた｡非常に稀な症例であり,文献的考案を含め報告する｡ en-copyright= kn-copyright= 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=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=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=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=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=5 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=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=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= 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 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=胆道系悪性腫瘍 (biliary tract cancer) kn-keyword=胆道系悪性腫瘍 (biliary tract cancer) en-keyword=胆嚢癌 (gall bladder cancer) kn-keyword=胆嚢癌 (gall bladder cancer) en-keyword=胆管癌 (bile duct cancer) kn-keyword=胆管癌 (bile duct cancer) en-keyword=乳頭部癌 (cancer of papilla of Vater) kn-keyword=乳頭部癌 (cancer of papilla of Vater) END start-ver=1.4 cd-journal=joma no-vol=68 cd-vols= no-issue= article-no= start-page=99 end-page=106 dt-received= dt-revised= dt-accepted= dt-pub-year=1997 dt-pub=199712 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Diet therapy with α-linolenic acid-enriched perilla seed oil on pulmonary emphysema. kn-title=n-3系脂肪酸を強化した食事療法が有効と考えられた肺気腫の一例 en-subtitle= kn-subtitle= en-abstract=An effective treatment of advanced stages of chronic obstructive pulmonary disease (COPD) has not been estadlished yet. We report out recent experience of one patient with pulmonary emphysema treated with dietary supplementation with n-3 fatty acid for two months. He presented improvements in clinical symptoms and pulmonary function, and suppression in generation of leukotriene B(4) (LTB(4) )by peripheral leukocytes. Weconsequently suppose that dietary treatment with n-3 fatty acids (perilla seed oil) may be beneficial for the treatment of pulmonary emphysema by inhibiting the conversion of arachidonic acid (AA) to leukotrienes (LTs) and prostanoids competitively. kn-abstract=症例は67歳,男性｡主訴は労作時呼吸困難｡【第一回目入院】平成7年9月から12月まで入院し,薬物療法,複合温泉療法を行なった｡自覚症状はやや改善がみられたが,呼吸機能検査所見の改善は得られなかった｡【第二回目入院】平成8年8月から12月まで入院｡n-3系脂肪酸強化食事療法も併用した｡自覚症状および,呼吸機能検査上,FVC,FEV(1.0),PEFなどに改善を認めた｡n-3系脂肪酸はアラキドン酸代謝を通してロイコトリエン合成に関与すると推定されるが,経過中に白血球のLTB(4)産生能の減少を認めた。この症例は肺気腫に対するn-3系脂肪酸強化食事療法の有用性が示唆され,病態を考える上でも興味深いと考えられたので報告する。 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=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=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=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=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=5 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=6 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=7 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=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=岡山大学医学部第一内科 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=肺気腫 (pulmonary emphysema) kn-keyword=肺気腫 (pulmonary emphysema) en-keyword=n-3系脂肪酸 (n-3 fatty acid) kn-keyword=n-3系脂肪酸 (n-3 fatty acid) en-keyword=食事療法 (diet therapy) kn-keyword=食事療法 (diet therapy) en-keyword=ロイコトリエン合成 (leukotriene) kn-keyword=ロイコトリエン合成 (leukotriene) END start-ver=1.4 cd-journal=joma no-vol=68 cd-vols= no-issue= article-no= start-page=80 end-page=93 dt-received= dt-revised= dt-accepted= dt-pub-year=1997 dt-pub=199712 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=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 kn-title=Rehabilitation for patients with respiratory disease. Spa efficacy in relation to pathophysiological characteristics of bronchial asthma. en-subtitle= kn-subtitle= en-abstract=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｡ kn-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. 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=保崎泰弘 kn-aut-sei=保崎 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=IwagakiNaofumi en-aut-sei=Iwagaki en-aut-mei=Naofumi kn-aut-name=岩垣尚志 kn-aut-sei=岩垣 kn-aut-mei=尚志 aut-affil-num=8 ORCID= en-aut-name=YamamotoKazuhiko en-aut-sei=Yamamoto en-aut-mei=Kazuhiko kn-aut-name=山本和彦 kn-aut-sei=山本 kn-aut-mei=和彦 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=気管支喘息 (Bronchial asthma) kn-keyword=気管支喘息 (Bronchial asthma) en-keyword=リハビリテーション (rehabilitation) kn-keyword=リハビリテーション (rehabilitation) en-keyword=複合温泉療法 (complex spa therapy) kn-keyword=複合温泉療法 (complex spa therapy) en-keyword=換気機能 (ventilatory function) kn-keyword=換気機能 (ventilatory function) en-keyword=副腎皮質 (adrenocortical glands) kn-keyword=副腎皮質 (adrenocortical glands) END start-ver=1.4 cd-journal=joma no-vol=68 cd-vols= no-issue= article-no= start-page=51 end-page=58 dt-received= dt-revised= dt-accepted= dt-pub-year=1997 dt-pub=199712 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Clinical effect of spa therapy on lumbargo kn-title=腰痛症に対する温泉療法の効果 en-subtitle= kn-subtitle= en-abstract=Clinical effect of spa therapy was evaluated in 12 patients with lumbargo by a scoring system based on the standard judgement of therapy for lumbargo by Japanese Society of Orthopedics. The score for each category of subjective symptoms, objective symptoms, daily life activity, and disorder of urinary bladder, and total score calculated from each score were compared before and after spa therapy. A significant improvement of subjective symptoms, daily life activity, and total score was observed after spa therapy. However objective symptom was not significantly improved. The effects of spa therapy was larger in patients under age of 65, and in those who had long-term spa therapy more than 80 days during their admission. The results suggest that spa therapy IS effective for patients with lumbargo. kn-abstract=腰痛症患者12例を対象に温泉療法の臨床効果について検討した｡臨床効果の判定は,日本整形外科学会の腰痛治療成績判定基準に基づき,自覚症状,他覚症状,及び日常生活動作などの項目を中心に,治療前後で比較検討した｡その結果,自覚症状,日常生活動作,総計では,治療前に比べ治療後に有意の改善がみられた｡また改善指数や改善率での検討でも温泉療法の有効性が示唆された｡年齢別(60才以上と60才未満),入院期間(80日以上と80日未満)別の 検討では,65才未満の症例,80日以上の入院の症例において,改善指数,改善率が,有意差はみられなかったもののより高い傾向がみられた｡ 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=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=YamamotoKazuhiko en-aut-sei=Yamamoto en-aut-mei=Kazuhiko kn-aut-name=山本和彦 kn-aut-sei=山本 kn-aut-mei=和彦 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=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=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=6 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=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=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=TadaShinya en-aut-sei=Tada en-aut-mei=Shinya kn-aut-name=多田慎也 kn-aut-sei=多田 kn-aut-mei=慎也 aut-affil-num=10 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=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=岡山大学医学部第二内科 affil-num=11 en-affil= kn-affil=岡山大学医学部第二内科 en-keyword=腰痛症 (lumbargo) kn-keyword=腰痛症 (lumbargo) en-keyword=温泉療法 (spa therapy) kn-keyword=温泉療法 (spa therapy) en-keyword=腰痛治療判定基準 (scoring system based on the standard judgement of therapy for lumbargo) kn-keyword=腰痛治療判定基準 (scoring system based on the standard judgement of therapy for lumbargo) END start-ver=1.4 cd-journal=joma no-vol=68 cd-vols= no-issue= article-no= start-page=45 end-page=50 dt-received= dt-revised= dt-accepted= dt-pub-year=1997 dt-pub=199712 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=気管支喘息患者における腰椎海綿骨骨塩量と脊椎圧迫骨折の臨床的特徴 kn-title=Determinants of trabecular bone mineral density of the lumber spines and vertebral fracture in patients with bronchial asthma en-subtitle= kn-subtitle= en-abstract=対象は気管支喘息75症例｡このうち44例はステロイド依存性難治症例であった｡35症例については,0.5年から4年間(平均:2.6±1.3年間)の経時的観察もおこなわれた｡これらの症例の骨塩量に影響を及ぼす因子について検討をおこなった｡高齢者,女性に有意な低骨塩量を認めた｡重回帰分析にて年齢,性別,経口副腎ステロイド投与総量などの項目に骨塩量と有意な関連が認められた｡また,35症例中5例に脊椎圧迫骨折が発生し,いずれも骨塩量が低く,高齢者,女性,長期ステロイド内服例であった｡これらのことから気管支喘息患者においては,女性,高齢者,長期ステロイド内服例に骨塩量減少や脊椎圧迫骨折のリスクが高いと考えられた｡また,ステロイド続発性骨粗鬆症の発生には,ステロイドの現在の一日内服量よりもこれまでの総積算内服量が重要と考えられた｡ kn-abstract=Clinical risk factors associated with the development of osteoporosis and vertebral fractures were evaluated in patients with asthma in relation to sex, age, and dose of glucocorticoids (GC). In 75 asthmatic patients including 44 steroid-dependent asthma, the bone mineral density (BMD) of the lumber spines was measured by quantitative computed tomography (QCT). Thirty five patients of them were followed up with radiographs over a period of 0.5 to 4 years (average: 2.6±1.3 years). The BMD was significantly lower in older (p