| 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 | 10.18926/14835 |
|---|---|
| Title Alternative | 気管支喘息における気管支肺胞洗浄液中の細胞成分に対する加齢および副腎皮質ホルモンの影響 |
| FullText URL | 72_016_022.pdf |
| Author | Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Nishida, Norikazu| Takata, Shingo| Yokoi, Tadashi| Tanizaki, Yoshiro| |
| Abstract | Effects of aging and glucocorticoid therapy on bronchoalveolar lavage (BAL) cells, particularly lymphocytes, neutrophils and eosinophils, were examined in 81 patients with asthma. 1. The proportion of BAL lymphocytes tended to increase with aging in asthmatics under age 69 years, and the proportion was significantly higher in patients with asthma between the ages of 60 and 69 than in those under age 39 and between the ages of 40 and 49. 2. The proportions of BAL neutrophils and eosinophils were not related to aging. 3. The proportion of BAL lymphocytes was higher in patients without glucocorticoid therapy than in those with steroid-dependent intractable asthma (SOIA) in those under age 69 years. In patients between the ages of 50 and 59, the proportion of BAL lymphocytes was significantly higher in patients without glucocorticoids than in those with SOIA. 4. The proportion of BAL neutrophils was higher in patients without glucocorticoid therapy than in those with SOIA, and the difference was significant in patients between the ages of 60 and 69. 5. The proportion of BAL eosinophils was not related to glucocorticoid therapy. These results suggest that the proportion of BAL lymphocytes and neutrophils is affected by aging and glucocorticoid therapy, but not BAL eosinophils. |
| Keywords | aging asthma glucocorticoid therapy BAL cells |
| Publication Title | 岡大三朝分院研究報告 |
| Published Date | 2002-02-01 |
| Volume | volume72 |
| Start Page | 16 |
| End Page | 22 |
| ISSN | 0918-7839 |
| language | English |
| File Version | publisher |
| NAID | 120002308605 |
| JaLCDOI | 10.18926/14788 |
|---|---|
| Title Alternative | 肺気腫と喘息のHRCT上のlow attenuation are（LAA）の性質の差。喫煙との関連を含めて |
| FullText URL | 74_035_041.pdf |
| Author | Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Iwagaki, Naofumi| Nagata, Takuya| Fujii, Makoto| Takata, Shingo| Yokoi, Tadashi| Hamada, Masanori| Tanizaki, Yoshiro| |
| Abstract | The low attenuation area (LAA) of the lungs on high resolution computed tomography (HRCT) was evaluated in 20 asthmatics (10 ex-smokers and 10 never-smokers) and 10 patients with pulmonary emphysema (all ex-smokers) by ventilatory function, lung volume, DLco, and a ratio of expiratory LAA/inspiratory LAA. 1 . The % LAA of the lungs on HRCT was significantly larger in patients with pulmonary emphysema(PE) than in those with asthma, but there was not significant difference in % LAA between ex-smokers and never-smokers of asthmatics. 2. A ratio of expiratory Winspiratory LAA was significantly higher in patients with PE than in those with asthma , and the ratio was significantly higher in ex-smokers of asthmatics than in never-smokers (p<0.05). 3 . The difference in % residual volume and % DLco was significant between asthma and PE , and between ex - smokers and never-smokers of asthmatics (% RV : p<0.05, DLco : p<0.05) . 4 . The difference in the values of % FVC, % FEV(1) .O, and FEV1.0% was significant between asthma and PE, but not significant between ex-smokers and never- smokers of asthmatics. The results suggest that the difference in a ratio of expiratory W inspiratory LAA, % RV and % DLco was significant between ex - smokers and never - smokers of asthmatics , and cigarette smoking induces more irreversible changes of the lungs. |
| Keywords | low attenuation area asthma pulmonary emphysema cigarette smoking |
| Publication Title | 岡大三朝医療センター研究報告 |
| Published Date | 2004-02-01 |
| Volume | volume74 |
| Start Page | 35 |
| End Page | 41 |
| ISSN | 1348-1258 |
| language | Japanese |
| File Version | publisher |
| NAID | 120002308507 |
| 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 | 10.18926/14751 |
|---|---|
| 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 | 10.18926/14783 |
|---|---|
| FullText URL | 74_011_017.pdf |
| Author | Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Iwagaki, Naofumi| Nagata, Takuya| Fujii, Makoto| Takata, Shingo| Yokoi, Tadashi| Hamada, Masanori| Tanizaki, Yoshiro| |
| Abstract | Clinical effects of long-term spa therapy for 4 years were estimated in 8 patients of pulmonary emphysema (4 with spa therapy and 4 without spa therapy) by pulmonary function and morphological changes of peripheral airspaces of the lung on
high - resolution computed tomography (HRCT).
1 . The values of % FVC, % FEV1.0, and FEV 1.0% did not significantly change for 4year observation both in patients with spa therapy and those without spa therapy.
2. The OLco value significantly decreased from 69.9% at the initial level to 48.8% after 4-year observation in patients without spa therapy (p |
| Keywords | spa therapy (温泉療法) pulmonary emphysema (,肺気腫) % RV % DLco % low attenuation area of the lung |
| Publication Title | 岡大三朝医療センター研究報告 |
| Published Date | 2004-02-01 |
| Volume | volume74 |
| Start Page | 11 |
| End Page | 17 |
| ISSN | 1348-1258 |
| language | English |
| File Version | publisher |
| NAID | 120002308395 |
| JaLCDOI | 10.18926/14784 |
|---|---|
| Title Alternative | 長期間の喫煙は高齢者気管支喘息における気道過敏性と関連した白血球LTB4産生を亢進させる |
| FullText URL | 74_018_025.pdf |
| Author | Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Iwagaki, Naofumi| Nagata, Takuya| Fujii, Makoto| Takata, Shingo| Yokoi, Tadashi| Hamada, Masanori| Tanizaki, Yoshiro| |
| Abstract | Abstract : Influence of cigarette smoking on leukotriene 84 (LTB4) generation by leucocytes associated with bronchial hyperresponsiveness was examined in 110 patients with asthma. l. The frequency of positive RAST score for inhalant allergens and LTB4 generation by leucocytes were significantly larger in previous and current smokers than in nonsmokers. 2. In nonsmokers, bronchial hyperresponsiveness was significantly higher in asthmatics under the age of 49 years compared with that in patients between 50 and 59 years, between 60 and 69 years, and those over age 70 years. In contrast, no significant differences were present between bronchial hyperresponsiveness and patient age in previous and current smokers. 3. In patients over age 60, bronchial hyperresponsiveness was significantly higher in previous and current smokers than in nonsmokers. In these patients, LTB4 generation was significantly more increased in previous and current smokers than in nonsmokers. 4. A significant correlation was observed in asthmatics of nonsmokers between LTB4 generation and bronchial hyperresponsiveness . 5. LTC4 generation was significantly higher in previous and current smokers than in nonsmokers in patients under age 49 years. These results show that in patients over age 60 years, cigarette smoking induces an increase in the generation of LTB4, leading to an increase in bronchial hyperresponsiveness . |
| Keywords | cigarette smoking asthma LTB4 generation LTC4 generation bronchial hyperresponsiveness |
| Publication Title | 岡大三朝医療センター研究報告 |
| Published Date | 2004-02-01 |
| Volume | volume74 |
| Start Page | 18 |
| End Page | 25 |
| ISSN | 1348-1258 |
| language | Japanese |
| File Version | publisher |
| NAID | 120002308359 |
| 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 | 10.18926/14787 |
|---|---|
| FullText URL | 74_026_034.pdf |
| Author | Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Iwagaki, Naofumi| Nagata, Takuya| Fujii, Makoto| Takata, Shingo| Yokoi, Tadashi| Hamada, Masanori| Tanizaki, Yoshiro| |
| Abstract | To determine the characteristics of the elderly in high - resolution computed tomography (HRCT) lung densitometry, mean lung density (MLD) and relative area of the lungs showing attenuation values less than -950 HU (RA(950)) on HRCT were evaluated in nonsmoking control subjects (n = 80) and patients with asthma (n = 80) in relation to their age and pulmonary function. MLD was significantly decreased, and RAW was significantly increased with increasing age in both asthmatics and controls. The MLD values were significantly lower in asthmatics compared with controls in subjects aged between 60 and 69 years and over age 70. RAgsov alues were significantly higher in asthmatics compared with controls in subjects aged between 50 and 59 years, between 60 and 69, and over 70. % FEV(1) and FEV(1) / FVC were significantly decreased in elderly asthmatic patients over 70 years of age compared with the values in those under 49. Percent residual volume (% RV) was significantly larger in patients over 70 years of age than in those between 50 and 59, and under 49 years. RAW was significantly larger in patients with steroid-dependent intractable asthma (SDIA) between 50 and 59 years of age, and between 60 and 69 compared with RA 950 in those without SDIA. However, RAW did not differ significantly between SDIA and non-SDIA in patients over age 70. The results suggested that in % LAA of the lungs on HRCT was significantly increased in the elderly subjects with and without asthma, and it was significantly higher in the elderly asthmatics than the elderly controls. |
| Keywords | aging (加齢) high-resolution computed tomography (高分解能CT) low attenuation area (低吸収域) mean lung density (平均CT値) pulmonary function (肺機能) |
| Publication Title | 岡大三朝医療センター研究報告 |
| Published Date | 2004-02-01 |
| Volume | volume74 |
| Start Page | 26 |
| End Page | 34 |
| ISSN | 1348-1258 |
| language | English |
| File Version | publisher |
| NAID | 120002308286 |
| JaLCDOI | 10.18926/14774 |
|---|---|
| Title Alternative | A case of Parkinson's disease associated with bromocriptine - induced leukopenia and throm-bocytopenia |
| FullText URL | 73_084_087.pdf |
| Author | Takata, Shingo| Mifune, Takashi| Mitsunobu, Fumihiro| Okamoto, Makoto| Nishida, Norikazu| Tsugeno, Hirofumi| Ashida, Kozo| Hosaki, Yasuhiro| Yokoi, Tadashi| Tanizaki, Yoshiro| Niiya, Kenji| Tanimoto, Mitsune| |
| Abstract | 症例は67歳,女性｡以前からパーキンソン病にて加療されていたが,リハビリテーション目的で当院入院した.入院時白血球数,血小板数正常であったが,bromocriptine投与開始後白血球減少,血小板減少を認めた.薬剤性白血球減少症及び血小板減少症を疑い, bromocriptine投与中止するとともにfilgrastim投与により,白血球減少,血小板減少は改善した。誘発試験施行し白血球減少を認めた｡Bromocriptineによる白血球減少症,血小板減少症の報告は少なく,我々の検索しえた範円内では本症例を含めて2例のみであった。Bromocriptineには安全性や神経保護作用に関して多くのデータの蓄積があるが,安全性に十分な注意が必要であると考えられた｡ |
| Keywords | パーキンソン病 (Parkinson's disease) ブロモクリプチン (Bromocriptine) 白球血減少症 (Leukopenia) 血小板減少症 (Thrombocytopenia) フィルグラスチム (Filgrastim) |
| 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 | 84 |
| End Page | 87 |
| ISSN | 1348-1258 |
| language | Japanese |
| File Version | publisher |
| NAID | 120002308217 |
| 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 |
| 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 | 10.18926/14766 |
|---|---|
| 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 | 10.18926/14810 |
|---|---|
| Title Alternative | 6種類の血中膵酵素値に及ぼす加齢および性の影響 |
| FullText URL | 74_057_061.pdf |
| Author | Seno, Toshinobu| Ochi, Koji| Mizushima, Takaaki| Shinji, Toshiyuki| Koide, Norio| |
| Abstract | The serum levels of some pancreatic enzymes have been reported to be affected by age and gender. Currently, serum total amylase, pancreatic isoamylase (P-amylase) , lipase , trypsin (ogen) , pancreatic phospholipase A(2) (PLA(2)) , and elastase I are utilized in diagnosing pancreatic diseases. We here compared age and gender-related alterations of these six pancreatic enzymes in healthy subjects to delineate different properties among the enzymes. Subjects were 155 males and 172 females between ages 20 and 79 years who were apparently healthy, and were stratified by age and sex. PLA(2) and elastase I were assayed by RIA, trypsin (ogen) by EIA and others by activity. The pancreatic enzymes, except PLA(2), were significantly elevated with age, although they declined in males in the 260 age group. There were significant sex differences in total amylase and P-amylase. Total amylase was significantly higher in females than in males in the 260 age group, P-amylase in the 40-49 age group. Age should be considered in the valuation of serum enzymes except PLA(2), sex difference should be considered in the valuation of amylase (total and P-amylase). |
| Keywords | pancreatic enzyme amylase phospholipase A(2) aging gender |
| Publication Title | 岡大三朝医療センター研究報告 |
| Published Date | 2004-02-01 |
| Volume | volume74 |
| Start Page | 57 |
| End Page | 61 |
| ISSN | 1348-1258 |
| language | English |
| File Version | publisher |
| NAID | 120002308272 |
| 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 | 10.18926/14893 |
|---|---|
| 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 |
