JaLCDOI 10.18926/15093
Title Alternative 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
FullText URL 067_085_091.pdf
Author Mitsunobu, Fumihiro| Mifune, Takashi| Hosaki, Yasuhiro| Ashida, Kozo| Yokota, Satoshi| Tsugeno, Hirofumi| Takeuchi, Kazuaki| Nawa, Yuichiro| Tanizaki, Yoshiro| Ochi, Koji| Harada, Hideo|
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.
Keywords complex spa therapy (複合温泉療法) clinical asthma type (臨床病型) ventilatory function (換気機能) bronchial hyperresponsiveness (気道過敏性) adrenocortical glands (副腎皮質)
Publication Title 岡大三朝分院研究報告
Published Date 1996-11
Volume volume67
Start Page 85
End Page 91
ISSN 0918-7839
language English
File Version publisher
NAID 120002307192
JaLCDOI 10.18926/15096
Title Alternative 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
FullText URL 067_099_106.pdf
Author Hosaki, Yasuhiro| Mifune, Takashi| Mitsunobu, Fumihiro| Ashida, Kozo| Yokota, Satoshi| Tsugeno, Hirofumi| Takeuchi, Kazuaki| Nawa, Yuichiro| Tanizaki, Yoshiro| Ochi, Koji| Harada, Hideo|
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 Ⅱ. bronchiolar obstruction correlate with airway inflammation. The increased proportion BAL neutrophils is characteristic of type Ⅱ 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 Ⅱ 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.
Keywords Spa therapy (温泉療法) Airway inflammation (気道炎症反応) BAL eosinophilia (BAL好酸球増多) BAL neutrophilia (BAL好中球増多) Bronchial asthma (気管支喘息)
Publication Title 岡大三朝分院研究報告
Published Date 1996-11
Volume volume67
Start Page 99
End Page 106
ISSN 0918-7839
language English
File Version publisher
NAID 120002307894
JaLCDOI 10.18926/15094
Title Alternative 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
FullText URL 067_092_098.pdf
Author Mifune, Takashi| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Yokota, Satoshi| Tsugeno, Hirofumi| Takeuchi, Kazuaki| Nawa, Yuichiro| Tanizaki, Yoshiro| Saito, Katsuyoshi|
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.
Keywords Bronchial asthma (気管支喘息) Spa therapy (温泉療法) Endocrine-autonomic nerve system (内分泌・自律神経系) Psychological disorders (心的要素)
Publication Title 岡大三朝分院研究報告
Published Date 1996-11
Volume volume67
Start Page 92
End Page 98
ISSN 0918-7839
language English
File Version publisher
NAID 120002307879
JaLCDOI 10.18926/14962
Title Alternative ステロイド依存性重症難治性気管支喘息症例における胃粘膜病変の検討
FullText URL 069_063_067.pdf
Author Mifune, Takashi| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Harada, Seishi| Okamoto, Makoto| Yumoto, Eiichirou| Takata, Shingo| Tanizaki, Yoshiro|
Abstract Recently, we experienced two asthmatic patients with advanced gastric cancer. The two patients had steroid-dependent intractable asthma (SDIA) who had been on administration of corticosteroids for more than 2 years. To determine the influence of pathophysiology of SDIA on stomach mucous lesion, gastroscopic examinations and immunological examinations were performed in eight patients with SDIA, compared with 25 patient with non-SDIA. In patients with SDIA, gastric cancer, its precursor condition and immunosuppressive state were observed. These results suggest that the immunosuppressive state in SDIA induced by the long-term administration of corticosteroids may lead to the risk of gastric cancer development.
Keywords ステロイド依存性重症難治性 (steroid-dependent intractable asthma (SDIA)) 胃癌 (gastric cancer) 免疫抑制 (immunosuppression) リンパ球 (lymphocytes) IgG
Publication Title 岡大三朝分院研究報告
Published Date 1998-12
Volume volume69
Start Page 63
End Page 67
ISSN 0918-7839
language English
File Version publisher
NAID 120002308665
JaLCDOI 10.18926/14960
Title Alternative n-3系脂肪散を強化した食事療法が有効と考えられた肺気腫の一例
FullText URL 069_049_056.pdf
Author Tsugeno, Hirofumi| Ashida, Kozo| Mitsunobu, Fumihiro| Mifune, Takashi| Okamoto, Makoto| Hosaki, Yasuhiro| Tanizaki, Yoshiro| Tsuji, Takao|
Abstract An effective treatment for the advanced stages of chronic obstructive pulmonary disease (COPD) has not been established yet. We report our recent experience of one patient with pulmonary emphysema treated by dietary supplementation of n-3 fatty acid for two months. He presented improvements in clinical symptoms and pulmonary function, and suppression of leukotriene B(4) generation by peripheral leukocytes. We consequently suppose that dietary treatment with n-3 fatty acids (perilla seed oil) may offer benefits for the treatment of pulmonary emphysema by competitively inhiabiting the conversion of arachidonicacid to leukotrienes and prostanoids.
Keywords pulmonary emphysema n-3 fatty acid leukotriene diet therapy
Publication Title 岡大三朝分院研究報告
Published Date 1998-12
Volume volume69
Start Page 49
End Page 56
ISSN 0918-7839
language English
File Version publisher
NAID 120002308253
JaLCDOI 10.18926/14900
Title Alternative Fluticasone 投与にもかかわらず症状が軽快ぜすn-3系不飽和脂肪酸強化食による食事療法及びモンテルカストが著効した気管支喘息の1例
FullText URL 076_053_059.pdf
Author Takata, Shingo| Ashida, Kozo| Hosaki, Yasuhiro| Hamada, Masanori| Iwagaki, Naofumi| Kikuchi, Hiroshi| Mitsunobu, Fumihiro|
Abstract A 25-year-old woman had the chief complaint of recurrent episodes of dyspnea and wheeze. Asthma had been diagnosed at infant years and sometimes experienced asthma attacks. She graduated senior high school and entered technical school in Tokyo. She received fluticasone (400μg daily) but exacerbation continued after she became an office clerk. She returned Kurashiki in October 2001 but had wheeze and asthma exacerbations. She was admitted to our hospital for evaluation and treatment of bronchial asthma on August 2, 2002. After admission, her symptoms subsided within some days. She was treated with montelukast and perilla seed oil-rich supplementation . The number of eosinophils decreased, decrease was observed in leukotriene (LT) B4 generation and in LTC4 generation, and pulmonary function improved following montelukast and perilla seed oil-rich supplementation for 4 weeks. The patient had no exacerbation under treatment and was discharged from the hospital on September 2, 2002. For some patients with persistent asthma, inhaled corticosteroids may fail to achieve adequate control possibly because corticosteroids do not completely inhibit the synthesis and release of cysteinyl leukotrienes (cysLTs) in the lung. Montelukast blocks the interaction of cysLTs with their receptor and resulting downstream events and perilla seed oil-rich diet suppresses LT generation. Combination therapy with montelukast and perilla seed oil-rich diet is more effective than montelukast or perilla seed oil-rich diet alone because of additive effects of montelukast with perilla seed oil-rich diet. We suggest that montelukast and perilla seed oil-rich supplementation are effective options when bronchial asthma patients receive inhaled corticosteroid but exacerbation continues.
Keywords モンテルカスト (montelukast) 気管支喘息 (bronchial asthma) ロイコトリエンC4 (leukotriene C4) エゴマ油食 (perilla seed oil-rich supplementation) フルチカゾン (fluticasone)
Publication Title 岡大三朝医療センター研究報告
Published Date 2008-03-01
Volume volume76
Start Page 53
End Page 59
ISSN 1348-1258
language English
File Version publisher
NAID 120002308179
JaLCDOI 10.18926/14912
FullText URL 071_073_075.pdf
Author Ashida, Kozo| Tsugeno, Hirofumi| Hosaki, Yasuhiro| Mitsunobu, Fumihiro| Mifune, Takashi| Nishida, Norikazu| Okamoto, Makoto| Takata, Shingo| Tanizaki, Yoshiro| Tsuji, Takao|
Abstract 症例は80才,女性。76才時[平成7年11月]より肝機能異常[アルカリフォスファターゼ高値]を認め,肝機能異常出現1年7ケ月後,血清学的検索で原発性胆汁性肝硬変症が疑われたが,無治療にて外来で経過を観察を行った。アルカリフォスファターゼ値は漸増傾向を示し,トランスアミナーゼ値の異常も伴ってきたため,平成12年11月精査目的で入院。組織検査等で無症候性原発性胆汁性肝硬変症[PBC]と診断した。PBCは中年・女性に好発する疾患で,高齢【特に後期高齢者]での発症は極めて稀である。4年間の自然経過も含め,興味深いと考えられたので報告する。
Keywords 原発性胆汁性肝硬変症 (primary biliary cirrhosis) 高齢 (elderly) 自然経過 (natural course)
Publication Title 岡大三朝分院研究報告
Published Date 2001-02-01
Volume volume71
Start Page 73
End Page 75
ISSN 0918-7839
language Japanese
File Version publisher
NAID 120002308230
JaLCDOI 10.18926/14893
Title Alternative Clinical research for hospitalized patients with community-acquired pneumonia from 2002 to 2007
FullText URL 076_012_017.pdf
Author Takata, Shingo| Hosaki, Yasuhiro| Ashida, Kozo| Hamada, Masanori| Iwagaki, Naofumi| Kikuchi, Hiroshi| Mitsunobu, Fumihiro|
Abstract 当院に入院した市中肺炎症例の臨床像を明らかにし, 日本呼吸器学会2007年成人市中肺炎診療ガイドラインによる市中肺炎の重症度分類の妥当性を検討した。2002年4月から2007年3月までの過去5年間に当院に入院した, 30歳から95歳までの市中肺炎109名142例 (男性72名102例, 女性37名40例) を対象に, その臨床像を検討した。平均年齢は74.8歳で,65歳未満26例, 65歳以上75歳未満の前期高齢者30例, 75歳以上の後期高齢者86例であった。 肺炎重症度は軽症21例, 中等症99例, 重症17例, 超重症5例であった。抗菌薬の選択に関して軽症では21例中18例, 中等症では99例中92例, 重症では17例中16例がガイドラインに準じていたが, 超重症では全例でガイドラインに準じていなかった。平均入院日数は軽症28.4日,中等症39.9日, 重症48.5日, 超重症45.2日であった。死亡例は, 軽症では無く, 中等症群7例, 重症群4例, 超重症群3例の計14例で, 死亡例の平均年齢は81.8歳であった。重症度が悪化するにつれ, 高齢, BUN高値, 低酸素血症, 意識障害, 低血圧の頻度は増加傾向にあった。79例で慢性呼吸器疾患を合併し, 慢性呼吸器疾患合併群では有意に呼吸器関連死亡が多かった。日本呼吸器学会2007年成人市中肺炎診療ガイドラインは, 本邦の肺炎の重症度別症 例解析に適していると考えられた。
Keywords 日本呼吸器学会2007年成人市中肺炎診療ガイドライン (the Guideline for communityacquired pneumonia edited by the Japanese Respiratory Society) 市中肺炎 (community-acquired pneumonia) 呼吸器関連死亡 (respiratory system-related death) 高齢者 (elderly) 慢性呼吸器疾患 (chronic pulmonary disease)
Publication Title 岡大三朝医療センター研究報告
Published Date 2008-03-01
Volume volume76
Start Page 12
End Page 17
ISSN 1348-1258
language Japanese
File Version publisher
NAID 120002308574
JaLCDOI 10.18926/14834
Title Alternative HRCT上の肺のLow Attenuation Areaおよび肺機能により評価された高齢者善喘息の特徴
FullText URL 72_009_015.pdf
Author Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Nishida, Norikazu| Takata, Shingo| Yokoi, Tadashi| Nakai, Mutsuo| Tanizaki, Yoshiro|
Abstract The clinical significance of low attenuation area <-950 HU of the lungs on high - resolution computed tomography (HRCT) was evaluated in 80 patients with asthma in relation to patient age, CT number, pulmonary function including % residusal volume (% RV) and % DLco, and generation of leukotrienes B4 and C4 by leucocytes. 1. The % LAA (<- 950 HU) of the lungs showed a tendency to increase significantly with aging; the % LAA was significantly larger in elderly patients over the age of 60 years than in those under the age of 49 years. The CT number was also significantlyincreased with aging. 2. The values of % FVC, % FEV1.0, and FEV1.0% were significantly decreased in elderly patients over age 70 compared with the values in those under age 49. 3. The value of % residual volume (% RV) tended to increase significantly with aging; the value in patients over the age of 70 years was significantly larger in those between the ages of 50 and 59 (p
Keywords low attenuation area of the lung CT number residual volume DLco aging
Publication Title 岡大三朝分院研究報告
Published Date 2002-02-01
Volume volume72
Start Page 9
End Page 15
ISSN 0918-7839
language English
File Version publisher
NAID 120002308131