| Author | 芦田 耕三| |
|---|---|
| Published Date | 1997-03-25 |
| Publication Title | |
| Content Type | Thesis or Dissertation |
| 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 |
| 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 | 10.18926/14748 |
|---|---|
| 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 | 10.18926/14749 |
|---|---|
| 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 | 10.18926/14750 |
|---|---|
| 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 | 10.18926/14751 |
|---|---|
| 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 | 10.18926/14752 |
|---|---|
| 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 | 10.18926/14753 |
|---|---|
| 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 | 10.18926/14754 |
|---|---|
| Title Alternative | 温泉療法による気管支喘息に対する年間薬剤費の削減 |
| FullText URL | 075_045_052.pdf |
| Author | Ashida, Kozo| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Hamada, Masanori| Iwagaki, Naofumi| Fujii, Makoto| Takata, Shingo| Tanizaki, Yoshiro| |
| Abstract | Costs of drugs used for the treatment for 1 year were compared before and after spa therapy in 16 patients with asthma in relation to disease severity. Asthma severity was classified as : stage 1 (intermittent), 2 (mild persistent), 3(moderate persistent), and 4(severe persistent). 1. The total cost of drugs used for each pa-tient for 1 year clearty decreased in all groups. The % decrease of the costs of drugs in each group was 27.2% in patients with stage 1, 43.5% in those with stage 2 and 34.1% in those with stage 3-4 (mean 34.5% ). The reduction of the cost of bronchodilators was predominant in patients with stage 3-4, and the decrease in the cost of corticosteroids predominant in those with stage 2. The reduction of costs of antiallertgics, mucolytics, and antibiotics was predominant in patients with stage 2 and stage 3-4. The % reduction in the cost of corticostroids was remarkable in patients with stage 2. The % decrease in the costs of mucolytics and antibiotics was predomi-nant in patients with stage 2 and stage 3-4. The results obtained here suggest that the costs of drugs used for asthmatics could be reduced by long-term spa therapy, and the reduction of the costs was larger as asthma stage became more severe. |
| Keywords | asthma spa therapy 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 | 45 |
| End Page | 52 |
| ISSN | 1348-1258 |
| language | English |
| File Version | publisher |
| NAID | 120002308608 |
| JaLCDOI | 10.18926/14755 |
|---|---|
| Title Alternative | 高齢者喘息における喫煙による気道過敏性の亢進について |
| FullText URL | 73_025_030.pdf |
| Author | Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Nishida, Norikazu| Nagata, Takuya| Takata, Shingo| Yokoi, Tadashi| Tanizaki, Yoshiro| |
| Abstract | Influence of cigarette smoking on the pathogenesis of asthma in the elderly remains controversial. This study was undertaken to clarify the influence of cigarette smoking on IgE-mediated allergy, bronchial hyperresponsiveness, and the generation of leukotrienes B4 (LTB4) and C4 (LTC4) by leukocytes in 48 elderly patients (25 patients with a history of smoking for more than 20 years and 23 never-smokers) with asthma over the age of 70 years. 1. The incidence of positive IgE antibodies for inhalant allergens was significantly higher in asthmatics with a history of smoking than in never-smokers of asthmatics. 2. In bronchial hyperresponsiveness for methacholine, the Cmin was significantly lower in ever-smokers than in never-smokers of elderly asthmatics. 3. The generation of LB4 was significantly increased in patients with a history of smoking compared with those without a smoking history. However, the difference in LTC4 generation was not significant between ever-smokers and never-smokers of asthmatics. These results suggest that cigarette smoking increases bronchial hyperresponsiceness through IgE-mediated allergy and LTB4 generation. |
| Keywords | cigarette smoking IgE - mediated allergy elderly asthmatics bronchial hyperresponsiveness |
| 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 | 25 |
| End Page | 30 |
| ISSN | 1348-1258 |
| language | English |
| File Version | publisher |
| NAID | 120002308038 |
| JaLCDOI | 10.18926/14756 |
|---|---|
| Title Alternative | Clinical study on reduction of costs of drugs for the treatment of asthma in relation to the administration method |
| FullText URL | 075_053_060.pdf |
| Author | Ashida, Kozo| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Hamada, Masanori| Iwagaki, Naofumi| Fujii, Makoto| Takata, Shingo| Tanizaki, Yoshiro| |
| Abstract | 気管支喘息27例を対象に, 1年間の治療に要した薬剤費が, 温泉療法を行うことによりどの程度削減されるかについて若干の検討を加えた. 本論文では, 薬剤費を定期処方, 臨時処方に大別し, さらにそれぞれをない内服薬と注射・吸入薬とに分けて検討した. 1. 1年間の総薬剤費では, 温泉療法を受けた21例では23,936点から療法後は16,580点へと29.6% の削減が可能であった. 一方, 温泉療法を受けなかった6症例では, 同時期の比較で18,341点から19,021点へと明らかな減少傾向は見られなかった. 2. 定期処方の内服薬の薬剤費では, 温泉療法を受けた症例の削減率25.6% に対して, 温泉療法を受けなかった症例の削減率は23.6% であり, 両グループ間に明らかな差は見られなかった. 一方,定期処方の注射･吸入薬の薬剤費は,温泉療法を受けた症例では5,505点から,5,468点へと軽度の減少傾向が見られたが(削減率7.6%),温泉療法を受けなかった症例では,同時期の推移は3,252点から5,645点へとむしろ増加する傾向が見られた｡3.臨時処方の内服薬の薬剤費は,温泉療法を受けた症例では,2,528点から194点へと削減率90.0%と著明な減少傾向が見られたが,温泉療法を受けなかった症例では446点から786点へとむしろ増加する傾向が見られた｡4.盛時処方の注射･吸入では,同様に温泉療法を受けた症例では著明な減少傾向を示したが(削減率70.7%),壁 けなかった症例では減少傾向は見られなかった｡以上の結果より,温泉療法を行うことにより,薬剤費の削減が可能となることが示された｡ |
| Keywords | 温泉療法 喘息 薬剤費 定期処方 臨時処方 |
| 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 | 53 |
| End Page | 60 |
| ISSN | 1348-1258 |
| language | Japanese |
| File Version | publisher |
| NAID | 120002308337 |
| JaLCDOI | 10.18926/14757 |
|---|---|
| Title Alternative | Spa therapy for patients with respiratory disease. Clinical efficacy and action mechanisms of the therapy on asthma |
| FullText URL | 075_061_073.pdf |
| Author | Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Hamada, Masanori| Yamaoka, Kiyonori| Tanizaki, Yoshiro| |
| Abstract | 呼吸器疾患に対する温泉療法は,最近の22年間にわたり行われてきた結果,その有用性は十分明かとなっている｡この22年の間に,温泉療法を受ける対象もかなり変わってきており,例えば気管支喘息では,ステロイド依存性重症難治性喘息の全症例に対する割合は明 らかに低くなってきている｡また,COPDでは最近全症例に対する肺気腫の割合も,また症例数も著明に増加しつつある｡一方,温泉療法を求めて来院される症例数は年ごとに増加する傾向にあり,初期の5年間と比べ,最近の5年間では,気管支喘息では8.2倍,また肺気腫では 34.8倍の増加が観察されている｡呼吸器疾患に対する温泉療法の作用機序としては,直接作用として,自･他覚症状の改善,換気機能の改善,気道過敏性の改善,気道抵抗の低下,肺の過膨脹の改善,過分泌の抑制などが観察される｡一方,間接作用としては,副腎皮質機能の改善,精神的リラックス,抗酸化酵素であるSOD活性の克進などが観察され,これらの間接作用も気管支喘息の病態改善に重要な役割を果しているものと考えられる｡ |
| Keywords | 温泉療法 (spa therapy) 気管支喘息 (asthma) 精神的リラックス (psychological relaxation) SOD活性 (SOD activity) 副腎皮質機能 |
| 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 | 61 |
| End Page | 73 |
| ISSN | 1348-1258 |
| language | Japanese |
| File Version | publisher |
| NAID | 120002308488 |
| JaLCDOI | 10.18926/14758 |
|---|---|
| Title Alternative | 長期間喫煙による気管支唱息,肺気腫の病態的変化 |
| FullText URL | 075_074_087.pdf |
| Author | Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Hamada, Masanori| Iwagaki, Naofumi| Fujii, Makoto| Takata, Shingo| Tanizaki, Yoshiro| |
| Abstract | The influence of long-term cigarette smoking on the pathophysiology of chronic respiratory diseases with obstructive ventilatory dysfunction was discussed in patients with asthma and pulmonary emphysema (PE). 1. In patients with asthma, significant differences in the pathophysiology of the disease were observed between smokers and nonsmokers. A positive RAST score against inhalant allergens, bronchial hyperresponsiveness, and LTB4 generation by leucocytes were significantly more increased in smokers than in nonsmokers. The values of FEV1/FVC and OLco were significantly more decreased, and % RV was significantly more increased in smokers than in nonsmokers. 2. In comparison of asthma with PE, IgE-mediated allergy was significantly more increased in smokers with asthma than in nonsmokers with asthma and in smokers with PE. The values of % FEV1, FEVl %, and % OLco were significantly higher in nonsmokers with asthma than in smokers with PE, however, the % OLco and % RV were not significantly different between smokers with asthma and those with PE. The % LAA of the lungs on HRCT was larger in patients with PE than in smokers and nonsmokers with asthma. The results suggest that cigarette smoking influences the pathophysiology of asthma and PE. |
| Keywords | cigarette smoking (喫煙) pulmonary function (肺機能) hyperinflation (肺の過膨張) asthma (喘息) pulmonary emphysema (肺気腫) |
| 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 | 74 |
| End Page | 87 |
| ISSN | 1348-1258 |
| language | English |
| File Version | publisher |
| NAID | 120002308631 |
| JaLCDOI | 10.18926/14764 |
|---|---|
| Title Alternative | lgEにmediatedされるアレルギ反応― 、肺機能、HRCT上の肺のlow attenuatjonarea (LAA)、およびLTB4,LTC4産生から見た喘息の病態に対する加齢の影響 |
| FullText URL | 73_031_038.pdf |
| Author | Mitsunobu, Fumihiro| Ashida, Kozo| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Nishida, Norikazu| Nagata, Takuya| Yokoi, Tadashi| Takata, Shingo| Tanizaki, Yoshiro| |
| Abstract | The influence of aging on the pathophysiology of asthma in the elderly was examined in 40 patients (20 younger asthmatics under the age of 50 years, mean age 32.5 years and 20 elderly asthmatics over the age of 70 years, mean age 74.3 years), relating to IgE - mediated allergy, pulmonary function, low attenuation area (LAA) of the lungs on HRCT, and the generation of leukotrienes B4 (LTB4) and C4 (LTC4) by leukocytes. The frequency of patients with serum IgE of more than 200 IU/ml, and the incidence of those with a positive RAST score for inhalant allergens were significantly higher in younger patients than in elderly subjects. The values of % FVC, % FEV1 and FEV 1% were significantly larger in younger patients compared with elderly subjects. The % RV was significantly larger in elderly patients than in younger patients, however, the difference in % DLco was not significant between the two age groups. The LAA of the lungs on HRCT and the ratio of expiratory LAA (exp LAA) to inspiratory LAA (ins LAA) were also significantly larger in elderly asthmatics than in younger subjects. The generation of LTB4 and LTC4 was larger in younger patients than in elderly subjects, and LTB4 generation was significantly larger in younger subjects compared with elderly subjects. These results suggest that changes in IgE-mediated allergy, airflow and lung volume accompanied with hyperinflation are often observed in elderly asthmatics. |
| Keywords | IgE-mediated allergy pulmonary function elderly asthmatics HRCT % RV |
| 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 | 31 |
| End Page | 38 |
| ISSN | 1348-1258 |
| language | English |
| File Version | publisher |
| NAID | 120002308601 |
| JaLCDOI | 10.18926/14765 |
|---|---|
| FullText URL | 73_039_043.pdf |
| Author | Hosaki, Yasuhiro| Mitsunobu, Fumihiro| Ashida, Kozo| Tsugeno, Hirofumi| Nishida, Norikazu| Nagata, Takuya| Takata, Shingo| Yokoi, Tadashi| Tanizaki, Yoshiro| Ochi, Koji| Fukuda, Tetsuya| Shiratori, Yasushi| |
| Abstract | 糖尿病や閉塞性動脈硬化症(ASO)の患者に合併する難治性潰瘍や壊疸の予知,予防を目的として高齢者の末梢循環の観察を行った. 下肢に冷え症,しびれ感,神経痛,歩行障害等を有し温泉療法を希望した患者21例(年齢58-78歳,平均年齢71.4歳)について,下肢の末梢循環障害の程度をレーザードプラー血流計を用いて評価した｡測定は20℃冷水負荷後30分後に,末梢皮膚血流量について測定を行った｡ レーザードプラー血流計で得られた結果は左右足趾始起部5カ所,計10カ所の平均値で表した｡7例については1年後に再測定を行った.14例についてはプロスタグランディン製剤(ベラプロスト)を投与し3ケ月後に再測定を行った｡ 1.自然経過群の7例(平均年齢73.0歳)は初回測定時の血流量は1.82±0.98であった｡2回目測定時は1.59±0.40であった｡血流量の低下傾向を認めたが有意差を認めなかった｡ 2.一方,ベラプロスト内服群の14例(平均年齢70.6歳)は初回測定時の血流量は1.27±0.35であった｡2回目測定時には1.62±0.51であった｡血流量の増加を認めた(P<0.0002)。 3.両群について,3ヶ月当たりの変化率で比較したところ自然経過群は3ヶ月当たり-1.7%の低下傾向を示した｡一方,ベラプロスト内服群は+15.4%の増加(p<0.02)を示 した｡ 4.プロスタグランディン製剤の内服中であっても加齢と共に末梢循環血流Iが低下する症例があり温泉療法を含めた集学的治療の必要性が示唆された｡ |
| Keywords | 加齢 (aging) 末梢循環 (Peripheral circulation) 動脈硬化 (arteriosclerosis) レーザードプラー血流計 (Laser-Doppler blood flowmetry) ベラプロスト (beraprost) |
| 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 | 39 |
| End Page | 43 |
| ISSN | 1348-1258 |
| language | Japanese |
| File Version | publisher |
| NAID | 120002308363 |
| JaLCDOI | 10.18926/14766 |
|---|---|
| FullText URL | 73_044_048.pdf |
| Author | Ashida, Kozo| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Nishida, Norikazu| Nagata, Takuya| Yokoi, Tadashi| Takata, Shingo| Tanizaki, Yoshiro| |
| Abstract | The influence of cigarette smoke on pulmonary function, airflow, lung volume, and transfer factor in patients with asthma was examined in 40 subjects over the age of 70 years (20 ever-smokers and 20 never-smokers), and 20 patients with pulmonary emphysema over age 70 (all ex-smokers). The ventilatory parameters showing airflow limitation (% FEV(1) and FEV(1)%) were not significantly different between ever-smokers and never-smokers of elderly asthmatics. In contrast, % FEV(1) and FEV(1) % values were significantly lower in patients with pulmonary emphysema than in those with asthma with or without a history of smoking. The % RV value was significantly larger and % DLco value was significantly more decreased in ever-smokers compared with neversmokers of the elderly asthmatics. However, there were no significant differences in % RV and % DLco values between asthmatics with a history of smoking and patients with pulmonary emphysema. The results show that cigarette smoke inflluences % RV and % DLco, but not % FEV(1) and FEV(1) %, suggesting airflow limitation of large and moderate size airways. |
| Keywords | cigarette smoking FEV(1) % % 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 | 44 |
| End Page | 48 |
| ISSN | 1348-1258 |
| language | English |
| File Version | publisher |
| NAID | 120002308159 |
| JaLCDOI | 10.18926/14767 |
|---|---|
| Title Alternative | 高齢者喘息のIgEにmediateされるアレルギー反応におよぽす喫煙の影響 |
| FullText URL | 73_049_054.pdf |
| Author | Ashida, Kozo| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Nishida, Norikazu| Nagata, Takuya| Takata, Shingo| Yokoi, Tadashi| Tanizaki, Yoshiro| |
| Abstract | The influence of cigarette smoking on the pathophysiology of asthma in the elderly remains controversial. In this study, the inluence of cigarette smoking on IgE - mediated allergy including the generation of leukotrienes B4 (LTB4) and C4 (LTC4) was examined in 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 ex - smokers). The frequency of patients with serum IgE more than 200 IU/ml was significantly larger in smoking asthmatics than in non - smoking asthmatics. The incidence of patients with positive RAST score for inhalant allergens, was also significantly higher in patients with a history of smoking than in those without a smoking history. There were no significant differences in the frequency of patients with positive RAST and those with serum IgE more than 200 IU/ml between non-smoking asthmatics and patients with pulmonary emphysema. The generation of leukotriene B4 (LTB4) by leukocytes was significantly more increased in ex-smokers than in never-smokers in the elderly asthmatics. The results suggest the possibility that cigarette smoking enhances IgE - mediated allergy in elderly patients with asthma. |
| Keywords | cigarette smoking IgE - mediated allergy LTB4 LTC4 generation 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 | 49 |
| End Page | 54 |
| ISSN | 1348-1258 |
| language | English |
| File Version | publisher |
| NAID | 120002308483 |
| JaLCDOI | 10.18926/14768 |
|---|---|
| Title Alternative | 気管支喘息に対する温泉療法とα-リノレン酸強化食の効果 |
| FullText URL | 73_055_063.pdf |
| Author | Okamoto, Makoto| Ashida, Kozo| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Nishida, Norikazu| Nagata, Takuya| Yokoi, Tadashi| Takata, Shingo| Tanizaki, Yoshiro| Tnimoto, Mitsune| |
| Abstract | N-3 fatty acids are reportedly effective for asthma. In addition, spa therapy has been reported to be effective for patients with asthma. In the present study, the effects of spa therapy combined with perilla seed oil- rich diet (rich in n-3 fatty acid)were examined on asthma. A total of 14 asthmatic patients had a complex spa therapy and consumed a perilla seed oil- rich diet - rich in a -linolenic acid (alpha-LNA) for 8 weeks. Generation of leukotriene (LT) C4 by leucocytes, respiratory function were analyzed. The generation of LTC4 by leucocytes decreased significantly for 2, 4 and 8 weeks (P |
| Keywords | bronchial asthma spa therapy perilla seed oil alpha -linolenic acid Leukotriene C4 |
| 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 | 55 |
| End Page | 63 |
| ISSN | 1348-1258 |
| language | English |
| File Version | publisher |
| NAID | 120002308428 |
| JaLCDOI | 10.18926/14769 |
|---|---|
| Title Alternative | The level of plasma BNP continued remarkably high in the elderly presented with old myocardial infarction. |
| FullText URL | 73_064_071.pdf |
| Author | Nishida, Norikazu| Ashida, Kozo| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Tsugeno, Hirofumi| Okamoto, Makoto| Nagata, Takuya| Yokoi, Tadashi| Nakai, Mutsuo| Makino, Hirofumi| Tanizaki, Yoshiro| |
| Abstract | 心不全が比較的良好にコントロールされているのにもかかわらず,高齢の陳旧性心筋梗塞後患者等で脳性ナトリウム利尿ペプチド(BNP)の異常高値が持続する場合がある.今回,また超高齢の心不全患者で同所見を認めたので,考察を含めて報告する. 93歳高齢の陳急性心筋梗塞患者で,BNP1600-1200の著明な高値が持続した.主に心尖部と一部の前側壁の陳旧性心筋梗塞症であったが,利尿薬等による治療によって心不全はコントロールできており,救急入院時を除いては,鬱血性心不全の状態ではなかった.心願超音 波検査でも心内圧の上昇や下大静脈の拡張も認めなかった.利尿薬を増量するとむしろ脱水による腎機能障害の増悪を認めていた. 入院中に狭心痛を認めることがあり,心筋逸脱酔素の軽度の上昇を認めた.BNPの著明な高値持続は,陳旧性心筋梗塞後の心臓機能障害や左室肥大,僧帽弁閉頚不全等による慢性心不全･心負荷のための心筋でのBNP合成･分泌元進の他に,新たな小梗塞(非貫壁性心筋梗塞)や持続する無症候性の心筋虚血による心筋でのBNP合成･分泌亢進,高齢によるBNPクリアランスの低下と分泌の持続的亢進,慢性腎機能障害によるBNPクリアランスの低下,心筋障害後の心筋再構築(リモデリング)の訳節と心筋繊維化抑制の為に合成が元進していると考えられる.更に,いわゆる老人肺･慢性呼吸機能低下による右心系の負荷による心室からの分泌元進,ステロイドホルモン内服による鉱井コルチコイド作用,貧血,低栄養状態等の様々な要因が重なっているものと考えられた. 心臓でBNPの産生･分泌が亢進するのは,心不全に伴う全身の体液量バランスや血行動態等の悪化を改善,調節するためだけではなく,心臓自身のリモデリングの調節･抑制,再構築の調薪のため,さらには心臓･心筋の繊維化や拡張障害の増悪を抑制するための自己防衛 機構としても機能している.心臓は,単に循環系のポンプではなく,利尿ペプチドホルモンを分泌する内分泌器官でもある. 一般的に加齢に伴いBNPは上昇してくる.特に70歳以上の高齢者では顕著になる.考察ではその点についても新たな文献的考察も含めて報告し,高齢者のBNPの捉え方と治療についても述べる. |
| Keywords | bronchial asthma spa therapy perilla seed oil alpha -linolenic acid Leukotriene C4 |
| 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 | 64 |
| End Page | 71 |
| ISSN | 1348-1258 |
| language | Japanese |
| File Version | publisher |
| NAID | 120002308534 |
