| JaLCDOI | 10.18926/14892 |
|---|---|
| Title Alternative | Spa therapy for patients with respiratory disease.Analysis of 2762 patients admitted at Misasa Medical Center for last 25 years from 1982 to 2006 |
| FullText URL | 076_001_011.pdf |
| Author | Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Iwagaki, Naofumi| Takata, Shingo| Kikuchi, Hiroshi| Hamada, Masanori| |
| Abstract | 1982年から2006年までの25年間に当医療センターで入院加療した2762例を対象に５年毎にその年次推移を検討した｡その内訳は,気管支喘息1578例(57.1％),COPD652例(23.6％),その他532例(19.3％) 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93.0例／年と初期と比べ8.1倍の増加がみられた｡また, 第５期 (2002－2006年) では70.4例／年と6.2倍であった｡その内のステロイド依存性重症難治性喘息(SDIA；steroid-dependent intractable asthma)の頻度は初期の68.4％から第４期では29.0％,第５期24.1％にまで低下する傾向を示した｡２.COPD症例は, 第１期では平均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47.4例／年へと9.1倍の増加がみられた｡また, その中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78.9％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％, そして第5期では85.1％と, 年々その頻度は高くなっていく傾向が見られた｡ 即ち, 最近25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, そしてその年齢は年々高くなる傾向にあることが示唆された｡ |
| Keywords | 気管支喘息 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 | 2008-03-01 |
| Volume | volume76 |
| Start Page | 1 |
| End Page | 11 |
| ISSN | 1348-1258 |
| language | Japanese |
| File Version | publisher |
| NAID | 120002308278 |
| 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 | 10.18926/14901 |
|---|---|
| Title Alternative | IgG4-related disease |
| FullText URL | 076_060_065.pdf |
| Author | Hiramatsu, Kazuhisa| Asano, Motoi| Matsushita, Koki| Miyoshi, Tomoko| Nakamura, Sukio| Mizushima, Takaaki| Koide, Norio| Kataoka, Hitomi| Ochi, Koji| Mitsunobu, Fumihiro| |
| Abstract | IgG4関連疾患は21世紀になって提唱された新しい疾患である｡組織学的にはIgG4陽性形質細胞やリンパ球浸潤が涙腺, 唾液腺, 後腹膜, 膵臓, 胆管などで起こり, 臨床的にはMikulicz病, 後腹膜線維症, 自己免疫膵炎, 糖尿病, 原発性硬化性胆管炎類似の胆管病変などを呈する全身性疾患であり, ステロイド治療に対する良好な反応性を認める｡その診断基準は確立されておらず, われわれは, ①血清IgG4の高値, ②本疾患に特徴的な臓器の障害(唾液腺,涙腺, 膵臓, 後腹膜), ③組織学的にIgG4陽性形質細胞とリンパ球の浸潤の確認, の３項目のうち２項目以上認めれば, IgG4関連疾患とするという診断基準を提言する｡ |
| Keywords | IgG4関連疾患 (IgG4-related disease) 自己免疫膵炎 (autoimmune pancreatitis) Mikulicz病 (Mikulicz's disease) 後腹膜線維症 (retroperitoneal fibrosis) |
| 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 | 60 |
| End Page | 65 |
| ISSN | 1348-1258 |
| language | Japanese |
| File Version | publisher |
| NAID | 120002308383 |
| JaLCDOI | 10.18926/14895 |
|---|---|
| Title Alternative | 慢性閉塞性肺疾患患者における温泉療法の６分間歩行に対する効果 |
| FullText URL | 076_024_030.pdf |
| Author | Takata, Shingo| Ashida, Kozo| Hosaki, Yasuhiro| Hamada, Masanori| Iwagaki, Naofumi| Kikuchi, Hiroshi| Mitsunobu, Fumihiro| |
| Abstract | Our previous studies have shown that subjective symptoms and ventilatory function are improved by spa therapy in patients with chronic obstructive pulmonary disease (COPD). In the present study, we investigated the effects of spa therapy on six-minute walk distance in patients with COPD . Subjects were 10 patients with chronic obstructive pulmonary disease (9 males and 1 female) admitted to our hospital to undergo pulmonary rehabilitation. All patients had complex spa therapy (swimming training in a hot spring pool, inhalation of iodine salt solution, and fango therapy) for 4 weeks. Ventilatory function, six-minute walk distance, oxygen saturation and Borg scale were measured. Vital capacity, forced expiratory volume in one second, sixminute walk distance and oxygen saturation increased, but not significantly. Significant decreases were observed for Borg scale. We found that spa therapy improved ventilatory dysfunction and six-minute walk distance in patients with COPD. The results demonstrated that spa therapy may lead to better disease control and exercise tolerance in patients with COPD. |
| Keywords | Chronic obstructive pulmonary disease (慢性閉塞性肺疾患) Spa therapy (温泉療法) Six-minute walk test (６分間歩行試験) Borg scale (ボルグスケール) Ventilatory function (呼吸機能) |
| 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 | 24 |
| End Page | 30 |
| ISSN | 1348-1258 |
| language | English |
| File Version | publisher |
| NAID | 120002308319 |
| JaLCDOI | 10.18926/14897 |
|---|---|
| Title Alternative | A case of generalized measles-like erythema induced by ketoprofen |
| FullText URL | 076_035_040.pdf |
| Author | Takata, Shingo| Ashida, Kozo| Hosaki, Yasuhiro| Hamada, Masanori| Iwagaki, Naofumi| Kikuchi, Hiroshi| Mitsunobu, Fumihiro| |
| Abstract | 症例は74歳男性｡慢性Ｃ型肝炎にて当院外来通院中であった｡肝細胞癌を指摘され1998年7月腹部血管造影, 経皮エタノール注入療法施行した｡以後当院外来加療中であったが, 腹部超音波上肝Ｓ５に低エコー域を認め, 1999年10月27日精査加療目的で入院となった｡入院 後肝Ｓ６にも低エコー域を認めた｡超音波ガイド下経皮的針生検施行し, Ｓ５では中から低分化の腺癌に加え, 部分的に扁平上皮癌が認められ, 腺扁平上皮癌と診断された｡Ｓ６では中分化, 一部高分化の肝細胞癌を認めた｡転移性肝癌の可能性を考え全身検査を行なったが,他臓器に原発病巣は発見されず, 肝細胞癌に肝原発扁平上皮癌を合併したと考えた｡経皮的エタノール注入療法施行し12月28日退院となった｡その後も外来にて加療されていたが, 2000年３月肝Ｓ４を中心に再発し, ９月９日死亡した｡肝細胞癌に合併した肝原発腺扁平上皮癌は稀であり, 若干の文献的考察を加えて報告する｡ |
| Keywords | ケトプロフェン (ketoprofen) 喘息発作 (asthma attack) 麻疹様紅斑 (measles-like erythema) リンパ球刺激試験 (lymphocyte stimulating test) 接触性皮膚炎 (contact dermatitis) |
| 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 | 35 |
| End Page | 40 |
| ISSN | 1348-1258 |
| language | Japanese |
| File Version | publisher |
| NAID | 120002308527 |
| JaLCDOI | 10.18926/14894 |
|---|---|
| Title Alternative | Examination about the effectiveness of thermal therapy on exercise tolerance and pulmonary function for patients with chronic obstructive pulmonary disease |
| FullText URL | 076_018_023.pdf |
| Author | Kikuchi, Hiroshi| Hosaki, Yasuhiro| Ashida, Kozo| Hamada, Masanori| Iwagaki, Naofumi| Takata, Shingo| Mitsunobu, Fumihiro| |
| Abstract | 我々は現在まで, 慢性閉塞性肺疾患(COPD；chronic obstructive pulmonary disease)患者に対する複合温泉療法(温泉プール運動浴, 鉱泥湿布療法, ヨード吸入) の有効性を報告してきた｡今回, 温熱療法の有効性を明らかにすることを目的として, 温熱療法を 従来の治療に併用し, 運動耐容能および肺機能に対する効果を検討した｡Ａ群７例(68～79歳・男性６例, 女性１例) およびＢ群７例(63～81歳・全例男性), 計14例のCOPD患者を対象とした｡Ａ群については, 薬物・肺理学療法の他に, 温熱療法を週５回で４週間施行した｡ 温熱療法として, 乾式遠赤外線式サウナを用いた60℃, 15分間のサウナ浴(座位) を施行した後, 臥位で30分間全身を毛布で包んで安静保温した｡Ｂ群は, 薬物・肺理学療法のみ４週 続けた｡治療前後で肺機能および６分間歩行試験を施行し比較検討した｡両群とも, 治療開始４週後には６分間歩行での歩行距離, 酸素飽和度(ＳpO2), 修正Borg scaleにて改善を認め, 肺機能においても肺活量(VC；vital capacity), 一秒量(FEV1.0；forced expiratory volume in one second) は上昇した｡両群間の比較では, ６分間歩行試験で上記３項目の改善率はいずれもＡ群はＢ群を凌駕し, Ａ群が優位に運動耐容能の向上を認めた｡Ａ群で修正 Borg scaleの治療４週間後の改善率は有意差(p＜0.01) を認めた｡また肺機能では, ４週間後でVC上昇率はほぼ不変であったがFEV1.0ではＡ群が優位に上昇した｡以上の結果より温熱療法がCOPD治療に有効である可能性が示唆された｡ |
| Keywords | COPD (Chronic obstructive pulmonary disease) 複合温泉療法 (Complex spa therapy) 温熱療法 (Thermal therapy) 肺理学療法 (Lung physiotherapy) 修正Borg scale (6 minute- walk test, Pulmonary function test) |
| 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 | 18 |
| End Page | 23 |
| ISSN | 1348-1258 |
| language | Japanese |
| File Version | publisher |
| NAID | 120002308391 |
| JaLCDOI | 10.18926/14899 |
|---|---|
| Title Alternative | Considering peak inspiratory flow in selection of inhalation device |
| FullText URL | 076_049_052.pdf |
| Author | Konuma, Toshimitsu| Kawasaki, Yoichi| Katsube, Risa| Nawa, Hideki| Mitsunobu, Fumihiro| |
| Abstract | 気管支喘息や慢性閉塞性肺疾患の治療において､適切に吸入薬を使用することが重要である｡本症例は60歳代女性で､労作時呼吸困難を訴え入院となった｡点滴による治療､内服薬服用と同時に吸入薬の使用開始となったが､呼吸機能検査値が低値であり､製薬企業供与の吸入チェック器具により吸入できていないことが判明した｡そこで､吸入薬を変更し吸入できていることを確認した｡吸気流量が十分得られない場合は積極的にチェック器具により確認を行い､アドヒアランスの改善に努めることが重要である｡ |
| Keywords | 気管支喘息 アドヒアランス向上 吸気流量 ピークフロー |
| 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 | 49 |
| End Page | 52 |
| ISSN | 1348-1258 |
| language | Japanese |
| File Version | publisher |
| NAID | 120002308027 |
| 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 | 10.18926/14896 |
|---|---|
| Title Alternative | Spa therapy for patient with postherpetic neuralgia：A case report |
| FullText URL | 076_031_034.pdf |
| Author | Hamada, Masanori| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Ashida, Kozo| Iwagaki, Naofumi| Takata, Shingo| Kikuchi, Hiroshi| |
| Abstract | 帯状疱疹後神経痛に対して, 温泉療法を行い, 良好な結果が得られた症例について報告する｡72才, 女性. 右下肢の皮疹にて帯状疱疹を発症した｡皮疹が治癒した後も疼痛が強かった｡発症半年後, 温泉を利用したリハビリテーション目的にて, 当院に入院した｡右下肢にはアロディニアがあり､温度覚過敏があった｡微温浴を中心とした温熱療法と右下肢の自動介助運動を中心とした運動療法を行った. 温泉療法により疼痛軽減し､杖歩行が可能となった｡温泉療法は副作用も少なく帯状疱疹後神経痛の治療の選択肢の一つになると考える｡ |
| Keywords | Chronic obstructive pulmonary disease (慢性閉塞性肺疾患) Spa therapy (温泉療法) Six-minute walk test (６分間歩行試験) Borg scale (ボルグスケール) Ventilatory function (呼吸機能) |
| 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 | 31 |
| End Page | 34 |
| ISSN | 1348-1258 |
| language | Japanese |
| File Version | publisher |
| NAID | 120002308313 |
| Author | 三朝医療センター| |
|---|---|
| Published Date | 2008-03-01 |
| Publication Title | 岡大三朝医療センター研究報告 |
| Volume | volume76 |
| Content Type | Others |
| JaLCDOI | 10.18926/14898 |
|---|---|
| Title Alternative | A case of primary adenosquamous carcinoma of the liver with hepatocellular carcinoma |
| FullText URL | 076_041_048.pdf |
| Author | Takata, Shingo| Ashida, Kozo| Hosaki, Yasuhiro| Hamada, Masanori| Iwagaki, Naofumi| Kikuchi, Hiroshi| Mitsunobu, Fumihiro| |
| Abstract | 症例は74歳男性｡慢性Ｃ型肝炎にて当院外来通院中であった｡肝細胞癌を指摘され1998年7月腹部血管造影, 経皮エタノール注入療法施行した｡以後当院外来加療中であったが, 腹部超音波上肝Ｓ５に低エコー域を認め, 1999年10月27日精査加療目的で入院となった｡入院 後肝Ｓ６にも低エコー域を認めた｡超音波ガイド下経皮的針生検施行し, Ｓ５では中から低分化の腺癌に加え, 部分的に扁平上皮癌が認められ, 腺扁平上皮癌と診断された｡Ｓ６では中分化, 一部高分化の肝細胞癌を認めた｡転移性肝癌の可能性を考え全身検査を行なったが,他臓器に原発病巣は発見されず, 肝細胞癌に肝原発扁平上皮癌を合併したと考えた｡経皮的エタノール注入療法施行し12月28日退院となった｡その後も外来にて加療されていたが, 2000年３月肝Ｓ４を中心に再発し, ９月９日死亡した｡肝細胞癌に合併した肝原発腺扁平上皮癌は稀であり, 若干の文献的考察を加えて報告する｡ |
| Keywords | 肝腺扁平上皮癌 (adenosquamous carcinoma of the liver) 肝細胞癌 (hepatocellular carcinoma) 経皮的エタノール注入療法 (percutaneous ethanol injection) |
| 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 | 41 |
| End Page | 48 |
| ISSN | 1348-1258 |
| language | Japanese |
| File Version | publisher |
| NAID | 120002308284 |
| 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 | 10.18926/14751 |
|---|---|
| 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 |
| Author | Nishimura, Nobuko| |
|---|---|
| Published Date | 2004-12-01 |
| Publication Title | 岡大三朝医療センター研究報告 |
| Volume | volume75 |
| Content Type | Others |
| 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 | 10.18926/14756 |
|---|---|
| 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 |
| Author | 三朝医療センター| |
|---|---|
| Published Date | 2004-12-01 |
| Publication Title | 岡大三朝医療センター研究報告 |
| Volume | volume75 |
| Content Type | Others |
| 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 | 10.18926/14754 |
|---|---|
| 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 | 10.18926/14748 |
|---|---|
| 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 |
