コキュウ キノウ ケンサ ニ オケル ヒマン ノ エイキョウ

肥満が呼吸機能に及ぼす影響に関しては,既に多くの報告がなされているが一定の見解が得られていないのが現状である.今回,われわれは喫煙歴がなく呼吸器疾患を有さない患者を対象とし,男女別にそれぞれ非肥満者群がBody Mass Index (以下BMI) を25未満とし,肥満者群がBMIを25以上として2群に分け,各検査値に対する肥満の影響を基準値との比率 (%) で比較検討した.今回の検討では,特に%予備呼気量 (%Expiratory Reserve Volume;以下%ERV) と%最大呼気口腔内圧(%Maximal mouth Expiratory Pressure;以下%MEP) で男女とも肥満の影響が認められた.%ERVは,非肥満者群に比べ肥満者群が男女ともに有意な低値となった.一方,%MEPでは非肥満者群に比べ肥満者群が男女ともに有意な高値となった.呼吸機能検査の基準値を求める予測式は,体重 (肥満) が考慮されていないため,判読の際には肥満の影響を考慮する必要性が示唆された.Backgrounds:Recently, the number of people with obesity is increasing. It is known that obesity affects respiratory systems including functions of diaphragm. However, the influence of obesity on respiratory function test is not clearly elucidated.Patients and Methods:Subjects who received pulmonary function tests in Department of Laboratory Medicine Dokkyo Medical University Koshigaya Hospital between November 2007 and June in 2008 were enrolled in this study. Smokers and Subjects with respiratory diseases were excluded. Enrolled subjects were divided into 2 groups, obesity group( Body Mass Index( BMI)≧25) and non-obesity( BMI<25) group, and pulmonary function test results were compared.Results:%Expiratory Reserve Volume (ERV) in obesity groups was significantly lower than that in non-obesity group. %Maximal mouth Expiratory Pressure (MEP) in obesity groups was significantly higher than that in non-obesity group. No significant differences were detected between 2 groups in %Vital Capacity, %Forced Expiratory Volume 1.0 % and V50/V25.Conclusion:A body weight value is not included in the predicting formula for calculation of standard value of each pulmonary function data. Therefore, the influence of obesity required to be considered when the pulmonary function test is carried out for patients with obesity

ドッキョウ イカ ダイガク コシガヤ ビョウイン ニオケル, フクブ チョウ オンパ ケンサ ニヨル タンノウ リュウキセイ ビョウヘン ノ ケントウ

腹部超音波検査が施行された3572 例を対象として胆嚢隆起性病変の検討を行った.胆嚢隆起性病変は3572例中791例( 22.1%) に認められ,重複検査例を除いた773例の平均年齢は59.6±13.6歳であり,男性370 例,女性403 例であった.胆嚢隆起性病変の最大径の平均は4.7±5.8 mm で,単発が256 例 (33.1%),多発が517例( 66.9%) であった.773例中,10 mm 以上の病変を有する症例は44 例( 5.6%) であった.これら44例の最終診断は,胆嚢良性ポリープ19例( 43.2%),胆嚢腺筋症2 例( 4.6%),胆泥貯留2 例( 4.6%),胆嚢結石2例( 4.6%) 切除可能胆嚢癌6例( 13.6%),切除不能胆嚢癌6 例( 13.6%),その他の癌2 例( 4.6%),不明5例( 11.3%) であり,胆嚢癌の半数が切除不能であった.今後,超音波検査を用いて切除可能な胆嚢癌をより多く拾い上げるためには,人間ドック等による,より幅広いスクリーニングが必要であると考えられた.The present study investigated the presence and characteristicsof elevated gallbladder lesions in 3572 patients whounderwent abdominal ultrasonography in our hospital betweenApril 2011 and March 2012. Elevated gallbladder lesionswere present in 791 patients (22.1 %). After excludingpatients who underwent repeat examination, 44 of theremaining 773 patients (5.6 %) had lesions &#8805; 10 mm. Finaldiagnoses in these 44 patients were as follows:benign gallbladderpolyp, n=19 (43.2 %);gallbladder adenomyosis,n=2 (4.6 %);biliary sludge accumulation, n=2 (4.6 %);gallbladder stone, n=2( 4.6%);resectable gallbladder cancer,n=6( 13.6%);non-resectable gallbladder cancer, n=6(13.6%);other cancers, n=2( 4.6%);and unknown, n=5(11.3 %). Wider screening during routine medical examinationssuch as annual health checks is required to enable increasedidentification of gallbladder cancer at an early stagewhen resection is still possible