start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue= article-no= start-page=109 end-page=114 dt-received= dt-revised= dt-accepted= dt-pub-year=2004 dt-pub=20041201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=業績集 en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name= en-aut-sei= en-aut-mei= kn-aut-name=三朝医療センター kn-aut-sei=三朝医療センター kn-aut-mei= aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil= END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue= article-no= start-page=93 end-page=108 dt-received= dt-revised= dt-accepted= dt-pub-year=2004 dt-pub=20041201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=On climatology in Misasa spa (twenty-sixth report) kn-title=三朝温泉地の気候について(第26報) en-subtitle= kn-subtitle= en-abstract=Climatological data ofthe last 12 months (2003. 1. 1.- 2003. 12. 31) obtained by the climate autorecording system at the Misasa Medical Branch in Misasa Spa, Tottori-ken, Japan are presented. kn-abstract=我々は1956年以降、三朝温泉地の気候について観察を行っている。今回は2003年1月1日から2003年12月末日までの1年間の気象観察資料を報 告する。機器の故障により、欠落部分が多々あることをお断りしておく。 en-copyright= kn-copyright= en-aut-name=MatsubaraFumie en-aut-sei=Matsubara en-aut-mei=Fumie kn-aut-name=松原扶美恵 kn-aut-sei=松原 kn-aut-mei=扶美恵 aut-affil-num=1 ORCID= en-aut-name=InoueTaeko en-aut-sei=Inoue en-aut-mei=Taeko kn-aut-name=井上妙子 kn-aut-sei=井上 kn-aut-mei=妙子 aut-affil-num=2 ORCID= en-aut-name= en-aut-sei= en-aut-mei= kn-aut-name=光延彰子 kn-aut-sei=光延 kn-aut-mei=彰子 aut-affil-num=3 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=4 ORCID= 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=5 ORCID= affil-num=1 en-affil= kn-affil= affil-num=2 en-affil= kn-affil= affil-num=3 en-affil= kn-affil= affil-num=4 en-affil= kn-affil= affil-num=5 en-affil= kn-affil= END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue= article-no= start-page=88 end-page=92 dt-received= dt-revised= dt-accepted= dt-pub-year=2004 dt-pub=20041201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=平成15年度看護部教育・研修・活動状況 en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name=NishimuraNobuko en-aut-sei=Nishimura en-aut-mei=Nobuko kn-aut-name=西村伸子 kn-aut-sei=西村 kn-aut-mei=伸子 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=看護部 END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue= article-no= start-page=74 end-page=87 dt-received= dt-revised= dt-accepted= dt-pub-year=2004 dt-pub=20041201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=長期間喫煙による気管支唱息,肺気腫の病態的変化 kn-title=Cigarette smoking and pathophysiology of asthma and pulmonary emphysema en-subtitle= kn-subtitle= en-abstract=長期間喫煙による気管支喘息および肺気腫の病態的変化について若干の検討を加えた。1.気管支嘱喘息に関しては,喫煙例と非喫煙例との間に以下のような病態的特徴に差が見られた。吸入抗原に対する特異的IgE抗体の陽性率,気道過敏性,白血球のI:TB4産生能はいずれも,喫煙例で非喫煙例に比べ有意の亢進を示した。また,喫煙例では,非喫煙例に比べ,FEV1%や% DLcoは有意の低下,% RVは有意の増加傾向を示した。2.喘息と肺気腫の比較では,IgEにmediateされるア レルギー反応は,喘息の非喫煙例や肺気腫(全て喫煙例)に比べ,喘息の喫煙例で有意の亢進が見られた。% FEVl,FEV1,% DLco値はいずれも喘息の非喫煙例で,肺気腫と比べ有意に高い値を示したが,% DLcoと% RV値には,喘息の喫煙例と肺気腫の間に有意の差は見られなかった。また,肺のHRCT上の% I.AAは,肺気腫において,喘息の喫煙例,非喫煙例いずれよりも有意に高い値を示した。以上の結果より,長期間の喫煙が喘息や肺気腫の病態に影響を与えることが示された。 kn-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. en-copyright= kn-copyright= 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=1 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=2 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=3 ORCID= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name=濱田全紀 kn-aut-sei=濱田 kn-aut-mei=全紀 aut-affil-num=4 ORCID= en-aut-name=IwagakiNaofumi en-aut-sei=Iwagaki en-aut-mei=Naofumi kn-aut-name=岩垣尚史 kn-aut-sei=岩垣 kn-aut-mei=尚史 aut-affil-num=5 ORCID= en-aut-name=FujiiMakoto en-aut-sei=Fujii en-aut-mei=Makoto kn-aut-name=藤井誠 kn-aut-sei=藤井 kn-aut-mei=誠 aut-affil-num=6 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=7 ORCID= 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=8 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=2 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=3 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=4 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター リハビリテーション科 affil-num=5 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=6 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=7 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=8 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 en-keyword=cigarette smoking (喫煙) kn-keyword=cigarette smoking (喫煙) en-keyword=pulmonary function (肺機能) kn-keyword=pulmonary function (肺機能) en-keyword=hyperinflation (肺の過膨張) kn-keyword=hyperinflation (肺の過膨張) en-keyword=asthma (喘息) kn-keyword=asthma (喘息) en-keyword=pulmonary emphysema (肺気腫) kn-keyword=pulmonary emphysema (肺気腫) END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue= article-no= start-page=61 end-page=73 dt-received= dt-revised= dt-accepted= dt-pub-year=2004 dt-pub=20041201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Spa therapy for patients with respiratory disease. Clinical efficacy and action mechanisms of the therapy on asthma kn-title=呼吸器疾患に対する温泉療法 ―その臨床効果と作用機序― en-subtitle= kn-subtitle= en-abstract=Spa therapy which has been performed for patients with respiratory disease, particularly for those with asthma and pulmonary emphysema for last 22 years demonstrates that spa therapy is effective for asthma and pulmonary emphysema. The characteristics of patients with respiratory disease has been changing during last 22 years : the frequency of patients with steroid-dependent intractable asthma (SDIA) tends to decrease inspite of an increase in number of those with asthma who has been admitted at Misasa Medical Center for spa therapy. The frequency and number of patients with pulmonary emphysema has been increasing in recent years. Spa therapy has direct action mechanism for airways such as improvement of subjective and objective symptoms, and improvement of ventilatory function, bronchial hyperresponsiveness, and hyperinflation of the lungs. The therapy has also indirect action mechanism for other organs excluding the airways such as improvement of suppressed function of adrenocortical glands, psychological relaxation, and an increase in SOD activity. These indirect actions of spa therapy play an important role in treatment of the disease. kn-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。 en-copyright= kn-copyright= 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=1 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=2 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=3 ORCID= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name=濱田全紀 kn-aut-sei=濱田 kn-aut-mei=全紀 aut-affil-num=4 ORCID= en-aut-name=YamaokaKiyonori en-aut-sei=Yamaoka en-aut-mei=Kiyonori kn-aut-name=山岡聖典 kn-aut-sei=山岡 kn-aut-mei=聖典 aut-affil-num=5 ORCID= 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=6 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=2 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=3 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=4 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=5 en-affil= kn-affil=2)医学部保健学科医用放射線科 affil-num=6 en-affil= kn-affil=2)医学部保健学科医用放射線科 en-keyword=温泉療法 (spa therapy) kn-keyword=温泉療法 (spa therapy) en-keyword=気管支喘息 (asthma) kn-keyword=気管支喘息 (asthma) en-keyword=精神的リラックス (psychological relaxation) kn-keyword=精神的リラックス (psychological relaxation) en-keyword=SOD活性 (SOD activity) kn-keyword=SOD活性 (SOD activity) en-keyword=副腎皮質機能 kn-keyword=副腎皮質機能 END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue= article-no= start-page=53 end-page=60 dt-received= dt-revised= dt-accepted= dt-pub-year=2004 dt-pub=20041201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Clinical study on reduction of costs of drugs for the treatment of asthma in relation to the administration method kn-title=気管支喘息における温泉療法による薬剤費の削減の臨床的検討ー投与方法による検討 en-subtitle= kn-subtitle= en-abstract=Reduction of costs of drugs for the treatment for 1 year by spa therapy was examined in 27 patients with asthma comparing the costs before and after the therapy and relating to the methods of administration of drugs. 1. The total cost of drugs used for each patient for 1 year clearly decreased in 21 asthmatics with spa therapy (reduction rate 27. 2%), however, no reduction of the costs was observed in 6 patients without the therapy during the same term. 2. The cost of drugs (oral regular administration) clearly decreased both in patients with spa therapy (reduction rate 25.6%) and without the therapy (23.6%). The cost of drugs (regular administration by injection and inhalation) slightly decreased in patients with spa therapy (7.6%) after spa therapy, but not in those without the therapy. 3. The cost of drugs (temporary oral administration) markedly decreased in patients with spa therapy (90.0%), and the cost of drugs (administration by injection and inhalation) also markedly decreased (70.7%) after the therapy, but not in those without the therapy. The results obtained here suggest that spa therapy is beneficial for the treatment of asthma in improving the symptoms of the disease and in reducing the cost of drugs used for the disease. kn-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。 en-copyright= kn-copyright= 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=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=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=3 ORCID= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name=濱田全紀 kn-aut-sei=濱田 kn-aut-mei=全紀 aut-affil-num=4 ORCID= en-aut-name=IwagakiNaofumi en-aut-sei=Iwagaki en-aut-mei=Naofumi kn-aut-name=岩垣尚史 kn-aut-sei=岩垣 kn-aut-mei=尚史 aut-affil-num=5 ORCID= en-aut-name=FujiiMakoto en-aut-sei=Fujii en-aut-mei=Makoto kn-aut-name=藤井誠 kn-aut-sei=藤井 kn-aut-mei=誠 aut-affil-num=6 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=7 ORCID= 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=8 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=2 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=3 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=4 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター リハビリテーション科 affil-num=5 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=6 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科  affil-num=7 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科  affil-num=8 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 en-keyword=温泉療法 kn-keyword=温泉療法 en-keyword=喘息 kn-keyword=喘息 en-keyword=薬剤費 kn-keyword=薬剤費 en-keyword=定期処方 kn-keyword=定期処方 en-keyword=臨時処方 kn-keyword=臨時処方 END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue= article-no= start-page=45 end-page=52 dt-received= dt-revised= dt-accepted= dt-pub-year=2004 dt-pub=20041201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=温泉療法による気管支喘息に対する年間薬剤費の削減 kn-title=Effects of spa therapy on reduction of the costs of the drugs used for the treatment of asthma in the elderly in relation to disease severity en-subtitle= kn-subtitle= en-abstract=気管支喘息16例を対象に,治療のために要した年間薬剤費が温泉療法により削減可能であるのかどうかについて,国際ガイドラインの重症度分類(stageト4)別に若干の検討を加えた。1.年間の総薬剤費は重症度別の全てのグループにおいて明らかに減少した.2.その削減率は,ステージ1で27.2%,ステージ2で43.5%,ステージ3-4で34.1%であり,その平均は34.5%であった。3.気管支拡張剤の薬剤費の減少はステージ3-4で高度であり,副腎皮質ホルモンの薬剤費の減少はステージ2で著明であった。また,抗アレルギー薬,去痩薬,抗生物質などの薬剤費の削減は,ステージ2および3-4で高度であった。4.削減率では,去壊薬,抗生物質の削減率が,2および3-4で著明であった。 以上の結果より,温泉療法により,気管支喘息の治療に必要な薬剤費は削減可能であること,そして,温泉療法による薬剤費の削減は職息の重症度が高い症例でより高度であることが示唆された。 kn-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. en-copyright= kn-copyright= 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=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=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=3 ORCID= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name=濱田全紀 kn-aut-sei=濱田 kn-aut-mei=全紀 aut-affil-num=4 ORCID= en-aut-name=IwagakiNaofumi en-aut-sei=Iwagaki en-aut-mei=Naofumi kn-aut-name=岩垣尚史 kn-aut-sei=岩垣 kn-aut-mei=尚史 aut-affil-num=5 ORCID= en-aut-name=FujiiMakoto en-aut-sei=Fujii en-aut-mei=Makoto kn-aut-name=藤井誠 kn-aut-sei=藤井 kn-aut-mei=誠 aut-affil-num=6 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=7 ORCID= 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=8 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=2 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=3 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=4 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター リハビリテーション科 affil-num=5 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=6 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科  affil-num=7 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科  affil-num=8 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 en-keyword=asthma kn-keyword=asthma en-keyword=spa therapy kn-keyword=spa therapy en-keyword=costs kn-keyword=costs en-keyword=bronchodilators kn-keyword=bronchodilators en-keyword=corticostreroids kn-keyword=corticostreroids en-keyword=antiallergics kn-keyword=antiallergics END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue= article-no= start-page=37 end-page=44 dt-received= dt-revised= dt-accepted= dt-pub-year=2004 dt-pub=20041201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=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 kn-title=Enhanced leukotriene generation adn bronchial hyperresponsiveness in asthmatics with allergic rhinitis en-subtitle= kn-subtitle= en-abstract=アレルギー鼻炎は気管支喘息のリスクファクターの一つであると考えられている。しばしば喘息に先行して発症し,その治療を行うことは喘息の治療に有用であることが報告されている。我々は本検討において,アトピー性瑞息71例(平均年齢59.5±12.5歳,女性37例,男性34例)を対象としアレルギー性鼻炎の有無によって2群に分類し,血清IgE値,末梢白血球のロイコトリエン産生能,メサコリンに対する気道過敏性を測定し,2群間で比較検討した。対象症例中,48例はアレルギー鼻炎を合併し,23例はアレルギー鼻炎を合併していなかった。アレルギー性鼻炎非合併例に比較してアレルギー性鼻炎合併例において,気道過敏性は有意に克進していた(p<0.05)。末梢血白血球のLTC4産生能も同様に,アレルギー性鼻炎非合併例に比較してアレルギー性鼻炎合併例において有意に克進していた(p<0.05)。しかし,末梢血白血球のLTB4産生能は,両群間で有意の差を認めなかった。以上より,アレルギー性鼻炎の存在が末梢血白血球のT:TC4産生克進を介して,気道過敏性の克進に関連している可能性が示唆された。 kn-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. en-copyright= kn-copyright= 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=1 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=2 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=3 ORCID= en-aut-name=IwagakiNaofumi en-aut-sei=Iwagaki en-aut-mei=Naofumi kn-aut-name=岩垣尚史 kn-aut-sei=岩垣 kn-aut-mei=尚史 aut-affil-num=4 ORCID= en-aut-name=FujiiMakoto en-aut-sei=Fujii en-aut-mei=Makoto kn-aut-name=藤井誠 kn-aut-sei=藤井 kn-aut-mei=誠 aut-affil-num=5 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=6 ORCID= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name=濱田全紀 kn-aut-sei=濱田 kn-aut-mei=全紀 aut-affil-num=7 ORCID= 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=8 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=2 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=3 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=4 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=5 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=6 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科  affil-num=7 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター リハビリテーション科 affil-num=8 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 en-keyword=asthma (気管支喘息) kn-keyword=asthma (気管支喘息) en-keyword=allergic rhinitis (アレルギー性鼻炎) kn-keyword=allergic rhinitis (アレルギー性鼻炎) en-keyword=leukotriene generation (ロイコトリエン産性能) kn-keyword=leukotriene generation (ロイコトリエン産性能) en-keyword=bronchial hyperresponsiveness (気道過敏性) kn-keyword=bronchial hyperresponsiveness (気道過敏性) END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue= article-no= start-page=27 end-page=36 dt-received= dt-revised= dt-accepted= dt-pub-year=2004 dt-pub=20041201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=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 kn-title=Comparison of pathophysiological changes of asthma between younger and older patients with asthma in relation to long-term cigarette smoking en-subtitle= kn-subtitle= en-abstract= kn-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. en-copyright= kn-copyright= 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=1 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=2 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=3 ORCID= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name=濱田全紀 kn-aut-sei=濱田 kn-aut-mei=全紀 aut-affil-num=4 ORCID= en-aut-name=IwagakiNaofumi en-aut-sei=Iwagaki en-aut-mei=Naofumi kn-aut-name=岩垣尚史 kn-aut-sei=岩垣 kn-aut-mei=尚史 aut-affil-num=5 ORCID= en-aut-name=FujiiMakoto en-aut-sei=Fujii en-aut-mei=Makoto kn-aut-name=藤井誠 kn-aut-sei=藤井 kn-aut-mei=誠 aut-affil-num=6 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=7 ORCID= 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=8 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=2 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=3 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=4 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター リハビリテーション科 affil-num=5 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=6 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=7 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科  affil-num=8 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 en-keyword=cigarette smoking kn-keyword=cigarette smoking en-keyword=% RV kn-keyword=% RV en-keyword=% LAA of he lungs on HRCT kn-keyword=% LAA of he lungs on HRCT en-keyword=asthma kn-keyword=asthma en-keyword=bronchial hyperresponsiveness kn-keyword=bronchial hyperresponsiveness END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue= article-no= start-page=18 end-page=26 dt-received= dt-revised= dt-accepted= dt-pub-year=2004 dt-pub=20041201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=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 kn-title=Spa therapy and bronchial hyperresponsiveness associated with cigarette smoking in asthmantics in the elderly en-subtitle= kn-subtitle= en-abstract=高齢者哨息60例を対象に,長期的喫煙の温泉療法の効果に及ぼす影響について検討した。温泉療法は60例中47例(78.4%)に有効であった。喫煙の影響については,喫煙歴の有る24例中16例(66.7%)で温泉療法は有効であったが,一方,非喫煙例36例では31例(86.1%)で有効であり,温泉療法の有効性は非喫煙例で有意に高いことが示された。温泉療法の有効性とIgE系反応との間には有意の関連はみられなかった。気道過敏性は喫煙例,非喫煙例いずれにおいても,有効例(著効ないし有効)に比べ無効例(ややで有効ないし無効)において 有意に高い傾向を示したo LTB4産生は喫煙例では,無効例で有効例と比べ有意の元進が見られたが,非喫煙例では関連は見られなかった。これらの結果は,長期間の喫煙が,気道過敏性や白血球のLTB4産生を克進させ,その結果として温泉療法の臨床効果に影響を与える可能性が高いことを示しているものと考えられる。 kn-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. en-copyright= kn-copyright= 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=1 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=2 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=3 ORCID= en-aut-name=IwagakiNaofumi en-aut-sei=Iwagaki en-aut-mei=Naofumi kn-aut-name=岩垣尚史 kn-aut-sei=岩垣 kn-aut-mei=尚史 aut-affil-num=4 ORCID= en-aut-name=FujiiMakoto en-aut-sei=Fujii en-aut-mei=Makoto kn-aut-name=藤井誠 kn-aut-sei=藤井 kn-aut-mei=誠 aut-affil-num=5 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=6 ORCID= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name=濱田全紀 kn-aut-sei=濱田 kn-aut-mei=全紀 aut-affil-num=7 ORCID= 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=8 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=2 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=3 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=4 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=5 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=6 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=7 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター リハビリテーション科 affil-num=8 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 en-keyword=cigarette smoking kn-keyword=cigarette smoking en-keyword=spa therapy kn-keyword=spa therapy en-keyword=elderly asthmatics kn-keyword=elderly asthmatics en-keyword=bronchial hyperresponsiveness kn-keyword=bronchial hyperresponsiveness END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue= article-no= start-page=12 end-page=17 dt-received= dt-revised= dt-accepted= dt-pub-year=2004 dt-pub=20041201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=気管支喘息に対する年間薬剤費の重症度別検討 kn-title=Costs of drugd used for the treatment of asthma in relation to disease severity en-subtitle= kn-subtitle= en-abstract=気管支喘息32例を対象に,治療のために要した年間薬剤費を,国際ガイドラインの重症度分類(stage1-4)により検討した。1.年間の総薬 剤費はstage4の症例で最も高く(平均?284,370)、-万,stage1(平均?74,670)で最も低い値を示した。2.個々の薬剤費の検討では,抗アレルギー薬,気管支拡張薬などの薬剤費が高く,次で副腎皮質ホルモン(主として吸入薬),去疾薬の順であった。3.気管支拡張薬,副腎皮質ホルモン,抗アレルギー薬などの薬剤費は,いずれもstage4で最も高い値を示した。気管支晴息に対する薬剤費は,疾患が重症になるにつれて高くなる傾向を示した。また,その主たる薬剤は気管支拡張薬,抗アレルギー薬,吸入用副腎皮質ホルモンなどであった kn-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. 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=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=3 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=4 ORCID= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name=濱田全紀 kn-aut-sei=濱田 kn-aut-mei=全紀 aut-affil-num=5 ORCID= en-aut-name=IwagakiNaofumi en-aut-sei=Iwagaki en-aut-mei=Naofumi kn-aut-name=岩垣尚史 kn-aut-sei=岩垣 kn-aut-mei=尚史 aut-affil-num=6 ORCID= en-aut-name=FujiiMakoto en-aut-sei=Fujii en-aut-mei=Makoto kn-aut-name=藤井誠 kn-aut-sei=藤井 kn-aut-mei=誠 aut-affil-num=7 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=8 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=2 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=3 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=4 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=5 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター リハビリテーション科 affil-num=6 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=7 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=8 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 en-keyword=asthma kn-keyword=asthma en-keyword=disease severity kn-keyword=disease severity en-keyword=costs kn-keyword=costs en-keyword=bronchodilators kn-keyword=bronchodilators en-keyword=corticostreroids kn-keyword=corticostreroids en-keyword=antiallergics kn-keyword=antiallergics END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue= article-no= start-page=1 end-page=11 dt-received= dt-revised= dt-accepted= dt-pub-year=2004 dt-pub=20041201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Spa therapy for patients with respiratory disease. Analysis of 2485 patients admitted at Misasa Medical Center for last 23 years from 1982 to 2004 kn-title=呼吸器疾患の温泉療法ー1982年から2004年までの23年間の入院症例2485例を対象にー en-subtitle= kn-subtitle= en-abstract=Analysis of 2485 patients with respiratory disease admitted at Misasa Medical Center for last 23 years from 1982 to 2004 was performed every five years. Of all patients with respiratory disease, 2040 (82.1%) patients had asthma and chronic obstructive pulmonary disease (COPD). 1. Of 2040 patients showing obstructive ventilatory dysfunction, 1489 (73.0%) patients had asthma. The frequency of asthma in all patients with respiratory disease was 53.8% for the first 5 years from 1982 to1986, 71. 7% for the second 5 years, 73.6% for the third 5 years, 53.9% for the fourth 5 years and 47.8% for the last three years. 2. The frequency of steroid-dependent intractable asthma (SDIA) was from 22.0% to 41. 3% except the frequency (68.4%) for the first 5 years. The frequency of patients with SDIA showed a tendency to decrease in recent years. The frequency of patients with pulmonary emphysema in those with COPD was very low (19.2% for the first 5 years) tended to increase and 78. 5% for the fourth 5 years and 87.5% for the last three years. The frequency of patients over age 60 was 31. 0% for the first 5 years, and showed a tendency to in crease, and 68.0% for the fourth 5 years and 84.2% for the last three years. 3. The frequency of patients from distant areas outside Totton prefecture was larger compared to the frequency inside Totton prefecture. The number of patients from Okayama, Osaka, Hyogo, Tokyo, Ehime, Yamaguchi, and Kyoto was larger than the number from other distant areas. kn-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. 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=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=3 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=4 ORCID= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name=濱田全紀 kn-aut-sei=濱田 kn-aut-mei=全紀 aut-affil-num=5 ORCID= en-aut-name=IwagakiNaofumi en-aut-sei=Iwagaki en-aut-mei=Naofumi kn-aut-name=岩垣尚史 kn-aut-sei=岩垣 kn-aut-mei=尚史 aut-affil-num=6 ORCID= en-aut-name=FujiiMakoto en-aut-sei=Fujii en-aut-mei=Makoto kn-aut-name=藤井誠 kn-aut-sei=藤井 kn-aut-mei=誠 aut-affil-num=7 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=8 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=2 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=3 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=4 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=5 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター リハビリテーション科 affil-num=6 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=7 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 affil-num=8 en-affil= kn-affil=岡山大学医学部・歯学部附属病院三朝医療センター 内科 en-keyword=喘息 kn-keyword=喘息 en-keyword=COPD kn-keyword=COPD en-keyword=温泉療法 kn-keyword=温泉療法 en-keyword=高齢者 kn-keyword=高齢者 END