| JaLCDOI | 10.18926/14753 |
|---|---|
| Title Alternative | 高齢者喘息における HRCT 上の肺の low attenuation area (LAA) に及ぼす長期間喫煙の影響．肺気腫症例との比較． |
| FullText URL | 73_019_024.pdf |
| Author | Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Nishida, Norikazu| Nagata, Takuya| Takata, Shingo| Yokoi, Tadashi| Tanizaki, Yoshiro| |
| Abstract | The influence of cigarette smoking on the pathophysiology in elderly patients with asthma. Forty asthmatics over the age of 70 years (20 ex-smokers and 20 never-smokers), and 20 patients with pulmonary emphysema over age 70 (all ever-smokers) were studied to determine the influence of cigarette smoke on the low attenuation area (LAA) <-950 HU (RA950) of the lungs on high resolution CT (HRCT) scans, and the ratio of expiratory LAA to inspiratory LAA of the lungs in relation to pulmonary function. The LAA value was significantly higher in patients with pulmonary emphysema compared with ever-smokers of asthmatics. The LAA ratio was significantly higher in ever-smokers than in never-smokers of asthmatics, and the ratio was less than 0.5 in all never-smokers, and the ratio was more than 0.5 in 10 of 20 ever-smokers of asthmatics and in all patients with pulmonary emphysema. The % RV (residual volume) was significaltly larger and % DLco (diffusing capacity for carbon monoxide) was significantly lower in subjects with the ratio more than 0.5 than in those with the ratio less than 0.5. These results suggest that cigarette smoke influences LAA of the lungs in relation to % RV value and % DLco value. |
| Keywords | cigarette smoking high resolution CT % RV % DLco elderly asthmatics |
| Publication Title | 岡大三朝医療センター研究報告 |
| Published Date | 2003-02-01 |
| Volume | volume73 |
| Start Page | 19 |
| End Page | 24 |
| ISSN | 1348-1258 |
| language | English |
| File Version | publisher |
| NAID | 120002308216 |
| JaLCDOI | 10.18926/14752 |
|---|---|
| Title Alternative | アルルギー性鼻炎を合併したアトピー性喘息患者におけるロイコトリエン産生能と気道過敏性 |
| FullText URL | 075_037_044.pdf |
| Author | Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Iwagaki, Naofumi| Fujii, Makoto| Takata, Shingo| Hamada, Masanori| Tanizaki, Yoshiro| |
| Abstract | Rhinitis frequently precedes asthma, and treating allergic rhinitis has benefi-cial effects on asthma, suggesting upper airway disease ia a risk factor for asthma. The aim of the present study was to investigate the influence of allergic rhinitis on se-rum IgE level, leukotriene generation by peripheral leukocytes, and bronchial hyperresponsiveness (BHR) to methacholine in patients with atopic asthma. Seventy-one asthmatic subjects (mean age, 59.5±12.5, years ; 37 women, 34 men) were recruited, and 48 asthmatics had allergic rhinitis and 23 asthmatics did not have allergic rhinitis. The log10 (Dmin) was significantly lower for those with allergic rhinitis than those with-out allergic rhinitis (P<0.05), implying that those with allergic rhinitis developed BHR to a greater degree than those without allergic rhinitis. LTC4 generation from periph-eral leukocytes was significantly greater for atopic astmatics with allergic rhinitis than those without allergic rhinitis (p<0.05). In contrast, the amount of LTB4 produced from peripheral leukocytes did not significantly differ between asthmatic patients with and without allergic rhinitis. These results suggest that the presence of allergic rhinitis enhances BHR by enhancing LTC4 production. while the presence of allergic rhinitis did not affect LTB4 production in patients with atopic asthma. |
| Keywords | asthma (気管支喘息) allergic rhinitis (アレルギー性鼻炎) leukotriene generation (ロイコトリエン産性能) bronchial hyperresponsiveness (気道過敏性) |
| Publication Title | 岡大三朝医療センター研究報告 |
| Published Date | 2004-12-01 |
| Volume | volume75 |
| Start Page | 37 |
| End Page | 44 |
| ISSN | 1348-1258 |
| language | English |
| File Version | publisher |
| NAID | 120002308204 |
| JaLCDOI | 10.18926/14751 |
|---|---|
| Title Alternative | 気管支喘息における長期間喫煙による病態的変化の若年者と高齢者の比較 |
| FullText URL | 075_027_036.pdf |
| Author | Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Hamada, Masanori| Iwagaki, Naofumi| Fujii, Makoto| Takata, Shingo| Tanizaki, Yoshiro| |
| Abstract | Influence of long-term clgarette smoking on the paphophysiological changes of the disease was compared between younger and older patients with asthma. 1. The frequency of positive RAST score against inhalant allergens was significantly higher in ex-smokers than in never-smokers in older patients with astham, but not in younger subjects. 2. Ventilatory parameters such as % FVC and FEV 1.0% were not sig-nificantly different between ex-smokers and never-smokers either in younger or older patients, although a significant difference in these values was observed between younger and older subjects. 3. The % DLco was significantly lower in ex-smokers than in never-smokers both in yonger and older patients. 4. The parameters associated with hyperinflation asuch as % RV and % LAA of the lungs on HRCT were significantly higher in older patients than in younger subjects, and also significantly larger in ex-smokers than in never-smokers in older patients, but % RV was not different between ex-smokers and never-smokers in young subjects. 5. Bronchial hyperresponsiveness (BH) was significantly more increased in ex-smokers than in never-smokers in older patients, but not in younger subjects. There was a significant difference in BH be-tween younger and older patients. 6. LTB4 generation was significantly larger in ex-smokers than in never-smokers in older patients, and LTC4 generation was more in-creased in ex-smokers both in younger and older subjects. The results show that significant differences between ex-smokers and never-smokers were observed in % DLco, LTC4 generation and % LAA both in younger and older subjects, and in IgE an-tibodies production, % RV, BH and LTB4 generation only in older subjects. In contrast, the values of % FVC and FEV1.0% were not different between ex-smokers and never-smok-ers either in younger or older subjects. A significant difference between younger and older subjects was found in all other parameters except % DLco and LTC4 generation. |
| Keywords | cigarette smoking % RV % LAA of he lungs on HRCT asthma bronchial hyperresponsiveness |
| Publication Title | 岡大三朝医療センター研究報告 |
| Published Date | 2004-12-01 |
| Volume | volume75 |
| Start Page | 27 |
| End Page | 36 |
| ISSN | 1348-1258 |
| language | English |
| File Version | publisher |
| NAID | 120002308352 |
| JaLCDOI | 10.18926/14750 |
|---|---|
| Title Alternative | 気管支喘息の low attenuation are (LAA) に対する長期喫煙の影響-4年間の経過観察- |
| FullText URL | 73_010_018.pdf |
| Author | Mitsunobu, Fumihiro| Ashida, Kozo| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Okamoto, Makoto| Nishida, Norikazu| Nagata, Takuya| Takata, Shingo| Yokoi, Tadashi| Nakai, Mutsuo| Tanizaki, Yoshiro| Tanimoto, Mitsune| |
| Abstract | Background-The influence of cigarette smoking on the pathogenesis of asthma in the elderly remains controversial. This study attempts to estimate longitudinal changes in HRCT (high resolution computed tomography) parameters and pulmonary function parameters obtained for ex-smokers and never-smokers in asthmatics during 4-yr follow-up period. Methods-Fourteen asthmatics (6 ex-smokers and 8 never-smokers) were studied to determine the influence of aging and cigarette smoking on pulmonary function, and mean lung density (MLD) and the relative area of the lung showing attenuation values less than -950 HU (RA950) on HRCT scans. Results-The values of FVC and FEV1, were significantly more decreased in asthmatics without a smoking history during 4-yr follow-up period. The values of FVC, FEV1, FEV1/FVC and DLco/VA were significantly decreased and RV/TLC were significantly increased in asthmatics with a smoking history over 4 years, and annual decline in FEV1 ex-smokers was larger than that in never-smokers. In the upper lung field, inspiratory MLD was observed to shift in a negative direction and inspiratory RA950 was found to increase during 4-yr observation period in ex-smokers, but not in never-smokers. In the middle lung field, inspiratory RA950 was significantly enhanced in both two groups. Although expiratory MLD, expiratory RA950 and exp RA950/ins RA950 were observed to change significantly during the observation period in ex-smokers, no changes were observed in never-smokers. Conclusion-These results suggest that aging augments airspace enlargement predominantly in the middle lung field, while long term cigarette smoking further worsens emphysematous alterations in the upper lung field. |
| Keywords | lung density high resolution computed tomography asthma |
| Publication Title | 岡大三朝医療センター研究報告 |
| Published Date | 2003-02-01 |
| Volume | volume73 |
| Start Page | 10 |
| End Page | 18 |
| ISSN | 1348-1258 |
| language | English |
| File Version | publisher |
| NAID | 120002308656 |
| JaLCDOI | 10.18926/14749 |
|---|---|
| Title Alternative | 高齢者気管支喘息における喫煙による気道過敏性の亢進と温泉療法の臨床効果 |
| FullText URL | 075_018_026.pdf |
| Author | Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Iwagaki, Naofumi| Fujii, Makoto| Takata, Shingo| Hamada, Masanori| Tanizaki, Yoshiro| |
| Abstract | Clinical effects of spa therapy were examined in 60 elderly asthmatics in comparison between ex-smokers with a long history of cigarette smoking more than 20 years and never-smokers. Spa therapy wse effective in 47 of the 60 subjects (78.4%) with asthma. Ragarding in influence of cigarette smoking, the therapy was effective in 16 of the 24 astmatics (66.7%) with a long history of cigarette smoking. In con-trast, the therapy was effective in 31 of the 36 asthmatics (86.1%) withput smoking history. The spa efficacy was significantly larger in asthmatics without smoking history than those with (P<0.05). There was no significant correlation between spa efficacy and IgE-mediated reactions. Bronchial hyperresponsiveness was significantly higher in subjects with slight or no efficacy of spa therapy than in those with marked and mod-erate efficacy both in ex-smokers and never-smokers as well as in total subjects. The generation of leukotriene B4 (LTB4) by leucocytes was significantly increased in sub-jects with slight or no efficacy of spa therapy than in those with marked and moderate efficacy in total subjects and in those with smoking history, but not in those without smoking history. The generation of leukotriene C4 (LTC4) by leucocytes was not sig-nificantly correlated with spa efficacy in total subjects, and also either in ex-smokers or never-smokers. The results demonstrate that clinical effects of spa therapy are in-fluenced by long-term cigarette smoking, which increases bronchial hyperrespon-siveness and the generation of LTB4 by leucocytes. |
| Keywords | cigarette smoking spa therapy elderly asthmatics bronchial hyperresponsiveness |
| Publication Title | 岡大三朝医療センター研究報告 |
| Published Date | 2004-12-01 |
| Volume | volume75 |
| Start Page | 18 |
| End Page | 26 |
| ISSN | 1348-1258 |
| language | English |
| File Version | publisher |
| NAID | 120002308545 |
| JaLCDOI | 10.18926/14748 |
|---|---|
| Title Alternative | 気管支喘息に対する年間薬剤費の重症度別検討 |
| FullText URL | 075_012_017.pdf |
| Author | Tanizaki, Yoshiro| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Hamada, Masanori| Iwagaki, Naofumi| Fujii, Makoto| Takata, Shingo| |
| Abstract | Costs of drugs used for the treatment for 1 year were examined in 32 pa-tients with asthma in relation to disease severity. Asthma severity was classified as : 1) intermiitent; 2) mild persistent; 3) moderate persistent; 4) severe persistent. 1. The total cost of drugs used for each patient for 1 year was the highest (￥263,710) in patients of stage 4 (severe persistent) and the lowest (￥74,670) in those of stage 1 (intermittent). The costs of bronchodilators and antiallergics were predominant at all stages, and their cost increased significantly with increasing severity. 2. The costs of drugs such as antiallergics and bronchodilators were predominant, and the costs of drugs such as inhaled corticosteroids and mucolytics were considerably high in pa-tients of all stages. 3. The costs of bronchodilators, inhaled corticosteroids, and antiallergics were the largest in patients of stage 4. The results suggested that the costs of durgs used for the asthma treatment tended to increase as the disease sever-ity became stronger from stage 1 to stage 4, and the maln drugs related to the in-crease in total costs were bronchodilators, antiallergics, and inhaled corticosteroids. |
| Keywords | asthma disease severity costs bronchodilators corticostreroids antiallergics |
| Publication Title | 岡大三朝医療センター研究報告 |
| Published Date | 2004-12-01 |
| Volume | volume75 |
| Start Page | 12 |
| End Page | 17 |
| ISSN | 1348-1258 |
| language | English |
| File Version | publisher |
| NAID | 120002308112 |
| JaLCDOI | 10.18926/14747 |
|---|---|
| Title Alternative | Spa therapy for patients with respiratory disease. Analysis of 2129 patients admitted at Misasa Medical Center for last 21 years from 1982 to 2002 |
| FullText URL | 73_001_009.pdf |
| Author | Tanizaki, Yoshiro| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Nishida, Norikazu| Tsugeno, Hirofumi| Nagata, Takuya| Yokoi, Tadashi| Takata, Shingo| |
| Abstract | 1982年から2002年までの21年間の当医療センターで入院加療した2129例を対象に5年間毎にその年次推移を検討した．2129例のうちわけは，気管支喘息1311例（61.5％），COPD467例（21.9％），その他351例であった．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例と初期と比べ8.1倍の増加が見られた．また，そのなかのSDIA （steroid-dependent intractable asthma）の頻度は初期の68.4％から第4期では28.9％にまで低下する傾向を示した．2. COPD症例は，初期の5年間（1982-1986年）では平均5.2例/年から第4期には45.4例へと8.7倍の増加が見られた．また，そのなかの肺気腫が占める割合いは初期の19.2％から第4期では78.5％と明らかな増加傾向を示した．なお，昨年度の1年間では，第4期の5年間（1997-2001年）とほぼ同様の傾向を示したが，全般的な傾向としては気管支喘息症例がやや減少し，一方肺気腫症例が増加する傾向が見られた．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％だあったが，第4期では68.0％，そして昨年度は85.4％と，年々その頻度は高くなっていく傾向が見られた．すなわち，最近21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，そしてその年令は年々高くなる傾向にあることが示された． |
| Keywords | 喘息 COPD 温泉療法 高齢者 |
| Publication Title | 岡大三朝医療センター研究報告 |
| Published Date | 2003-02-01 |
| Volume | volume73 |
| Start Page | 1 |
| End Page | 9 |
| ISSN | 1348-1258 |
| language | Japanese |
| File Version | publisher |
| NAID | 120002308396 |
| JaLCDOI | 10.18926/14746 |
|---|---|
| Title Alternative | Spa therapy for patients with respiratory disease. Analysis of 2485 patients admitted at Misasa Medical Center for last 23 years from 1982 to 2004 |
| FullText URL | 075_001_011.pdf |
| Author | Tanizaki, Yoshiro| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Hamada, Masanori| Iwagaki, Naofumi| Fujii, Makoto| Takata, Shingo| |
| Abstract | 1982年から2004年までの23年間に三朝医療センターで入院加療した呼吸器疾患患者は2485例であった. これらの症例を対象に5年間毎にその年次推移を検討した. 2485例のうちわけは, 気管支喘息1489例(59.9%), COPD551例(22.2%), その他445例であった. 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91.8例と初期と比べ8.1倍の増加が見られた. また, 第5期(最近の3年間)では87.7例/年であった. そのなかのステロイド依存症重症難治性喘息(SDIA : steroid-de-pendent intractable asthma)の占める割合は初期の68.4% から第4期では28.9％, 第5期の3年間では22.0% にまで低下する傾向を示した. 2. COPD症例は, 初期の5年間(1982-1986年)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45.3例/年へと同様に8.7倍の増加が見られた. また, そのなか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87.4%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%, 阻止いて第5期では87.6% と, 年々その頻度は高くなっていく傾向が見られた. すなわち, 最近23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, そしてその年令は年々高くなる傾向にあること, そして, 以前とは異なり必ずしも重症難治性の症例ばかりでなく, むしろ比較的軽症例の入院が増加しつつあることなどが, 最近の傾向として注目される. |
| Keywords | 喘息 COPD 温泉療法 高齢者 |
| Publication Title | 岡大三朝医療センター研究報告 |
| Published Date | 2004-12-01 |
| Volume | volume75 |
| Start Page | 1 |
| End Page | 11 |
| ISSN | 1348-1258 |
| language | Japanese |
| File Version | publisher |
| NAID | 120002308531 |
| Author | 芦田 耕三| |
|---|---|
| Published Date | 1997-03-25 |
| Publication Title | |
| Content Type | Thesis or Dissertation |
