start-ver=1.4 cd-journal=joma no-vol=70 cd-vols= no-issue= article-no= start-page=1 end-page=8 dt-received= dt-revised= dt-accepted= dt-pub-year=1999 dt-pub=199912 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Spa therapy for patients with asthma. A study on 437 patients with asthma admitted for last 5 years. kn-title=気管支喘息に対する温泉療法.最近5年間(1994年-1998年)の入院症例437例を対象に en-subtitle= kn-subtitle= en-abstract=The parients with asthma who were admitted at our hospital for last 5 years (1994-1998) were examined in relation to age and areas where patients came. 1. Of 664 patients with respiratory disease admitted for last 5 years, 437 patients (65.8% ) had asthma. The frequency of asthma in all patients with respiratory disease was the highest (74.4% ) in 1995, and decreased in 1997 and 1998 (60.7% ). 2. The number of patients with asthma from distant areas (outside Tottori prefecture) was constantly larger than the number of those inside Tottori prefecture in each year. The number of patients from Okayama, Osaka, Hyogo, Hiroshima, Yamaguchi, and Ehime was larger than the number from other distant areas. 3. Regarding the distribution of age of these patients, the number of patients over the age of 60 was more frequently observed, regardless of the area where patients came. Larger number of patients over the age of 70 (35.1% ) was found in those inside Tottori prefecture, while the number of patients between the ages of 60 and 69 (37.7% ) was larger in those from distant areas. kn-abstract=1994年1月より1998年12月までの5年間に当院へ入院した呼吸器疾患のなかで気管支喘息を対象に,年齢,地域分布などの経年変化について検討を加えた。1.最近5年間に当院へ入院した呼吸器疾患患者は664例で,このうち,気管支喘息は437例(65.8% )であった。呼吸器疾患のなかで気管支喘息に占める割合の経年変化では,1995年度が最も高く(74.4% ),1997,1998年度にはやや低下(ともに60.7% )の傾向が見られた。2.入院患者の地域分布では,鳥取県内からの入院患者に比べ,遠隔地(鳥取県外)からの入院患者が比較的多く,いずれの年度においても50% 以上(平均57.3% )であった。また,岡山,大阪,兵庫,広島,山口,愛媛県などからの入院症例が多い傾向か見られた。3.年齢別検討では,いずれの地域においても,高齢者の入院症例か多く,鳥取県内では70才以上の症例の頻度(平均35.1% )が,また遠隔地(鳥取県外)では60-69才の症例の頻度(平均37.7% )が高い傾向か見られた。 en-copyright= kn-copyright= en-aut-name=TanizakiYoshiro en-aut-sei=Tanizaki en-aut-mei=Yoshiro kn-aut-name=谷崎勝朗 kn-aut-sei=谷崎 kn-aut-mei=勝朗 aut-affil-num=1 ORCID= en-aut-name=MitsunobuFumihiro en-aut-sei=Mitsunobu en-aut-mei=Fumihiro kn-aut-name=光延文裕 kn-aut-sei=光延 kn-aut-mei=文裕 aut-affil-num=2 ORCID= en-aut-name=MifuneTakashi en-aut-sei=Mifune en-aut-mei=Takashi kn-aut-name=御舩尚志 kn-aut-sei=御舩 kn-aut-mei=尚志 aut-affil-num=3 ORCID= en-aut-name=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=保崎泰弘 kn-aut-sei=保崎 kn-aut-mei=泰弘 aut-affil-num=4 ORCID= en-aut-name=AshidaKozo en-aut-sei=Ashida en-aut-mei=Kozo kn-aut-name=芦田耕三 kn-aut-sei=芦田 kn-aut-mei=耕三 aut-affil-num=5 ORCID= en-aut-name=TsugenoHirofumi en-aut-sei=Tsugeno en-aut-mei=Hirofumi kn-aut-name=柘野浩史 kn-aut-sei=柘野 kn-aut-mei=浩史 aut-affil-num=6 ORCID= en-aut-name=OkamotoMakoto en-aut-sei=Okamoto en-aut-mei=Makoto kn-aut-name=岡本誠 kn-aut-sei=岡本 kn-aut-mei=誠 aut-affil-num=7 ORCID= en-aut-name=HaradaSeishi en-aut-sei=Harada en-aut-mei=Seishi kn-aut-name=原田誠之 kn-aut-sei=原田 kn-aut-mei=誠之 aut-affil-num=8 ORCID= en-aut-name=TakataShingo en-aut-sei=Takata en-aut-mei=Shingo kn-aut-name=高田真吾 kn-aut-sei=高田 kn-aut-mei=真吾 aut-affil-num=9 ORCID= en-aut-name=OchiKoji en-aut-sei=Ochi en-aut-mei=Koji kn-aut-name=越智浩二 kn-aut-sei=越智 kn-aut-mei=浩二 aut-affil-num=10 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=2 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=3 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=4 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=5 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=6 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=7 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=8 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=9 en-affil= kn-affil=岡山大学医学部附属病院三朝分院内科 affil-num=10 en-affil= kn-affil=岡山大学医学部臨床検査医学 en-keyword=気管支喘息 (asthma) kn-keyword=気管支喘息 (asthma) en-keyword=温泉療法 (spa therapy) kn-keyword=温泉療法 (spa therapy) en-keyword=高齢患者 (aged patients) kn-keyword=高齢患者 (aged patients) en-keyword=遠隔地 (distant area) kn-keyword=遠隔地 (distant area) END start-ver=1.4 cd-journal=joma no-vol=70 cd-vols= no-issue= article-no= start-page=9 end-page=16 dt-received= dt-revised= dt-accepted= dt-pub-year=1999 dt-pub=199912 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=T型アレルギー反応および副腎皮質ホルモンは気管支喘息における末梢血白血球のロイコトリエンB4およびC4産生に影響をおよぼす kn-title=IgE-mediated allergy enhances and glucocorticoids inhibit the generation of leukotrienes B4 and C4 by peripheral leucocytes in patients with asthma en-subtitle= kn-subtitle= en-abstract=気管支喘息71例および健康人23名を対象に、Ca ionophore A23187刺激時の末梢血白血球のロイコトリエンB4 (LTB4)およびC4(LTC4)の産生能について検討を加えた。なお、71例中ステロイド依存性重症難治性喘息(SDIA)は22例であった。1.アトピー性、16非SDIA症例におけるLTB4、LTC4産生は、健康人と比べ有意に高い値を示したが、非アトピー性喘息では健康人との間に有意の差は見られなかった。また、アトピー性喘息では、SDIA症例において非SDIA症例に比べ、LTB4、LTC4産生が有意に抑制されていた。2.非SDIA症例では、アトピー性、非アトピー性を問わず、LTC4産生は、非発作時に比べ発作時に有意に亢進した状態であった。しかし、LTB4産生には、非発作時、発作時との間に有意の差は見られなかった。3.SDIA症例では、LTB4、LTC4産生と発作との有意の関連は見られなかった。以上の結果より、IgE にmediateされるアレルギー反応や喘息発作はLTB4、LTC4産生に促進的に、また副腎皮質ホルモンは抑制的に作用することが示唆された。 kn-abstract=The generation. of leukotrienes 84 (LT84) and C4 (LTC4) by leucocytes stimulated with Ca ionophore A23187 was examined in 71 patients with asthma (42 with atopic and 29 with nonatopic asthma) and 23 healthy controls. Of these patients,22 had SDIA (steroid-dependent intractable asthma). 1. The generation of LT84 and LTC4 by leucocytes was significantly more enhanced in patients with atopic, non-SOIA asthma than in healthy subjects, but not in patients with nonatopic asthma. The generation of LT84 and LTC4 in atopic asthma was significantly more decreased in patients with SOIA than in those with non-SOIA. 2. The LTC4 generation was significantly larger in attack stage than in attack-free stage of patients with atopic and nonatopic asthma when they had not SOIA. However, no significant difference was found in LT84 generation between attack and nonattack stages in these patients. 3. In patients with SOIA, no significant differences were observed in the generation of LT84 and LTC4 between attack and nonattack stages. The results suggest that IgE-mediated allergy and asthma attacks enhance and glucocorticoids inhibit the generation of LT84 and LTC4 by leucocytes. en-copyright= kn-copyright= en-aut-name=TanizakiYoshiro en-aut-sei=Tanizaki en-aut-mei=Yoshiro kn-aut-name=谷崎勝朗 kn-aut-sei=谷崎 kn-aut-mei=勝朗 aut-affil-num=1 ORCID= en-aut-name=MitsunobuFumihiro en-aut-sei=Mitsunobu en-aut-mei=Fumihiro kn-aut-name=光延文裕 kn-aut-sei=光延 kn-aut-mei=文裕 aut-affil-num=2 ORCID= en-aut-name=MifuneTakashi en-aut-sei=Mifune en-aut-mei=Takashi kn-aut-name=御舩尚志 kn-aut-sei=御舩 kn-aut-mei=尚志 aut-affil-num=3 ORCID= en-aut-name=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=保崎泰弘 kn-aut-sei=保崎 kn-aut-mei=泰弘 aut-affil-num=4 ORCID= en-aut-name=AshidaKozo en-aut-sei=Ashida en-aut-mei=Kozo kn-aut-name=芦田耕三 kn-aut-sei=芦田 kn-aut-mei=耕三 aut-affil-num=5 ORCID= en-aut-name=TsugenoHirofumi en-aut-sei=Tsugeno en-aut-mei=Hirofumi kn-aut-name=柘野浩史 kn-aut-sei=柘野 kn-aut-mei=浩史 aut-affil-num=6 ORCID= en-aut-name=OkamotoMakoto en-aut-sei=Okamoto en-aut-mei=Makoto kn-aut-name=岡本誠 kn-aut-sei=岡本 kn-aut-mei=誠 aut-affil-num=7 ORCID= en-aut-name=HaradaSeishi en-aut-sei=Harada en-aut-mei=Seishi kn-aut-name=原田誠之 kn-aut-sei=原田 kn-aut-mei=誠之 aut-affil-num=8 ORCID= en-aut-name=TakataShingo en-aut-sei=Takata en-aut-mei=Shingo kn-aut-name=高田真吾 kn-aut-sei=高田 kn-aut-mei=真吾 aut-affil-num=9 ORCID= en-aut-name=OchiKoji en-aut-sei=Ochi en-aut-mei=Koji kn-aut-name=越智浩二 kn-aut-sei=越智 kn-aut-mei=浩二 aut-affil-num=10 ORCID= en-aut-name=KoideNorio en-aut-sei=Koide en-aut-mei=Norio kn-aut-name=小出典男 kn-aut-sei=小出 kn-aut-mei=典男 aut-affil-num=11 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部附属病院三朝分院 affil-num=2 en-affil= kn-affil=岡山大学医学部附属病院三朝分院 affil-num=3 en-affil= kn-affil=岡山大学医学部附属病院三朝分院 affil-num=4 en-affil= kn-affil=岡山大学医学部附属病院三朝分院 affil-num=5 en-affil= kn-affil=岡山大学医学部附属病院三朝分院 affil-num=6 en-affil= kn-affil=岡山大学医学部附属病院三朝分院 affil-num=7 en-affil= kn-affil=岡山大学医学部附属病院三朝分院 affil-num=8 en-affil= kn-affil=岡山大学医学部附属病院三朝分院 affil-num=9 en-affil= kn-affil=岡山大学医学部附属病院三朝分院 affil-num=10 en-affil= kn-affil=医学部臨床検査医学 affil-num=11 en-affil= kn-affil=医学部臨床検査医学 en-keyword=bronchial asthma kn-keyword=bronchial asthma en-keyword=LT84 kn-keyword=LT84 en-keyword=LTC4 kn-keyword=LTC4 en-keyword=IgE-mediated allergy kn-keyword=IgE-mediated allergy en-keyword=glucocorticoids kn-keyword=glucocorticoids END start-ver=1.4 cd-journal=joma no-vol=70 cd-vols= no-issue= article-no= start-page=17 end-page=27 dt-received= dt-revised= dt-accepted= dt-pub-year=1999 dt-pub=199912 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=気管支喘息における胸部HRCT所見の臨床[光延文裕1]的意義 kn-title=Evaluation of low attenliation area (LAA) of the lungs in patients with reversible airway obstruction by high resolution computed tomography (HRCT). en-subtitle= kn-subtitle= en-abstract=【目的】気管支喘息症例において胸部HRCTを用いて% LAA(Lowattenuationarea)を評価し,臨床病態との関連を検討する。 【対象と方法】気管支喘息症例81例ならびに健常者22例を対象とした。大動脈弓部,下葉分岐部,横隔膜上3cmの3スライスを撮影し,胸部CT値の演算によりCT値が-950HU以下の% LAA,さらに3スライス中の最大% LAAと3スライスの平均CT値を算出した。その値と年齢,発症年齢,罹病期間,性別,喫煙歴,重症度,病型,肺機能との関連を検討した。【結果】1.最大% LAAは平均CT値と強い相関を示した(r=-0.916,p<0.0001)。2.最大% LAAは喫煙喘息患者において非喫煙喘息患者,喫煙ならびに非喫煙健常者に比較して喫煙者において有意に高値を示した。% LAAは喫煙者,非喫煙者ともに重症例において有意に高値を示した。3.最大% LAAは肺機能では1秒率(r=-0.611,p<0.0001),全肺気量(r=-0.391,p<0.0001)と有意な相関を示した。4.最大% LAAは喘息の重症度とは有意の竿間を示したが,病型とは関連は見られなかった。 【考案】喘息患者におけるHRCTによる最大% LAAは喫煙,重症度,肺機能と関連を示しており,気管支喘息の臨床病態を反映する可能性が示唆された。 kn-abstract=The significance of the low attenuation area (LAA) of the lungs on high resolution computed tomography (HRCT) has not been determined in patients with asthma. We examined the relationship between the percentage of lung area with CT numbers lower than -950HU (% LAA) and the mean CT number in 81 patients with reversible airway obstruction (asthma) and in 22 healthy subjects, as well as the relationship between maximal % LAA and various parameters of pulmonary function, smoking history, disease severity and allergic type in the asthmatic subjects. The mean CT number was obtained by scans at three anatomic levels, and maximal % LAA was the % LAA which had the largest value of those measured at the three anatomic levels of the lung. We found that: 1. The mean CT number was closely related to the maximal % LAA of the lungs in all subjects studied (r= -0.916, p