Use of danazol in myoma

子宮筋腫14症例に対しダナソールを400mg/dayを月経5日目より16週間経口投与した。平均年齢は45.4才で,ダナゾール投与により超音波計測では筋腫核の体積は投与前を100%とすると75%へと縮小した。投与後に赤血球,ヘモグロビンは有意に増加し,s-GOTは平均22.5U/ℓが平均28.8U/ℓ,s-GPTも平均19.4U/ℓが平均34.9U/ℓと有意な上昇が認められたが投与後速やかに正常範囲に戻った｡投与により過多月経は92.9%,月経痛80%,腰痛は75%に改善が認められた｡投与によりQCT法による骨塩量は平均10.4%の上昇がみられたが,4例には骨塩量の平均5.5%低下がみられた｡筋腫核の縮小率は投与前を100%とすると骨塩量低下群では平均51.7%になり,骨塩量増加群では平均84.4%になり,有意に骨塩量低下群に縮小率が高かった｡Danazol was administered in 14 cases of myoma for 16 weeks. Mean age was 45.5 y.o. Danazol treatment gived sufficient symptomatic improvement. Uitrasound measurement of uterine myomas following danazol treatment decreased to 25.0% prior to treatment. Bone mineral density measured by QCT increased 214mg/cm(3) to 237mg/cm(3) after danazol treatment. Response in size of decresed bone mineral density group was greater than that of increased bone mineral density group. (p<0.05

Pelvimetry with smaller radiation field by CC･DR system- An examination on applying to lateral radiography of the pelvis (Guthmann) ―

100万画素CCDカメラを用いたI.I.-DR装置(CC･DRシステム)をX線骨盤計測に適用するため,被曝線量をはじめとするいくつかの点を検討した｡照射野内の被曝線量は従来の高感度Screen-Film システムであるG12/HRSと同等以下に抑えることが可能であった｡また,CC･DRシステムの9インチ円形照射野は一般的に用いられている大角フィルム面積の1/3であり,胎位の95%を占めるといわれている頭位の撮影においては胎児の生殖腺はもちろん, 赤色骨髄を多く含む脊椎への被曝を大幅に低減できた｡また,新たに開発された距離計測ソフトウェアーの正確度は良好で,通常lmm以下の誤差で測定が可能であることを確認した。その他,装置に標準装備されている自動露出機構の特性についても報告し,最後に撮影時の留意点についても検討した｡To apply CC･DR system (image intensifier digital radiography system including one million pixel CCD camera)to X-ray pelvimetry, We examined exposure dose of X-ray, radiation field, and accuracy of X-ray pelvimetry by the system. The hazards of radiation by CC･DR system were less than those of radiation by G12/HRS which is high sensitive screen-film system. 9 inch round radiation field by CC・DR system was one third of the area of 14×14 inch film. In cephalic presentation which occurs in about 95% of pregnancies, the damages of radiation by CC･DR system to fetal gonads and spinal bones including bone marrow much were less than those by usual X-ray examination. The accuracy of a distance measuring software devised newly for pelvimetry was reliable, and we could measure diameters with less than 1 mm deviations. Also we report the characteristics of automatic exposure controller annexed to this TV system and enumerate points to which we pay attention on taking a radiograph. Furthermore, It is expected that CC･DR system was useful to apply to superio-interior pelviography (Martius)

気管支喘息の臨床分類とその細胞性および液性因子の特徴

Characteristics of each asthma type classified by clinical symptoms and　findings were studied in 72 patients with bronchial asthma. 1. Ventilatory function tests showed that the values of % MMF, % V(50) and % V(25) were significantly lower in patients with bronchiolar obstruction (type II) compared to the values of those with simple bronchoconstriction type (type Ia) and those with bronchoconstriction + hypersecretion (type Ib). 2. The proportion of neutrophils in bronchoalveolar lavage (BAL) fluid was significantly higher in type II than in type Ia and type Ib. Several　patients with type Ib showed higher proportion of BAL eosinophils. 3. The release of LTC(4) from leucocytes was significantly lower in type II compared with type Ia and type Ib. There was no significant difference in the release of histamine and LTB(4) among the three asthma types.気管支喘息72例を対象に,その臨床病態の特徴を,気道炎症性の細胞および化学伝達物質の観察により検討した｡1.気道反応の特徴を換気機能の面から検討すると,II細気管支閉塞型において,MMF,V(50)やV(25)などの小ないし細気管支領域の換気障害を示すパラメーターの値は,Ia型,Ib型に比べ 有意の低下を示した｡2.気道細胞反応では,II型において,他の臨床病型に比べ,BAL液中好中球の出現頻度の有意の増加が観察された(Ia, p<0.001 ; Ib, p<0.01)｡好酸球の出現頻度は,Ib過分泌型において著しい増加傾向を示す症例が見られたが,その平均出現頻度には3病型間に有意の差は見られなかった｡3.好中球からのメジェー夕ー遊離では,ヒスタミン遊離は,Ia単純性気管支撃縮型において最も高い値が示されたが,推計学的には3病型間に有意の差は見られなかった｡ロイコトリエンC(4)では,Ia型においてII型に比べ有意に高い遊離が観察された(p<0.05)｡ロイコトリエンB(4)遊離には,3病型間に差は見られなかった

Changes of bone mineral densities in women and prevention and treatment of osteoporosis

当科では3年ほど前よりQCT法を用いて骨塩量測定を行い,骨粗鬆症の管理治療を行っている｡264名の測定値について分析をしたところ,40歳頃から60歳にかけて急速に低下すること,肥満度が増すにつれ骨塩量も増加する傾向がみられた｡また,閉経前に卵巣を両側摘出した場合ホルモン補充療法を行っているが,卵巣を温存した場合と差がでなかった｡治療に結合型エストロゲンを用いた群の12カ月後の骨塩量の増加率は,任用しなかった群にくらべ有意の差があった｡Bone mineral density (BMD) was measured in 264 females by QCT. BMD was rapidly decreased between 40's and 60's. There was a tendency for BMD increase in proportion to obesity. HRT was made without bilateral ovaries at operation, then there were no differencis between removal of ovaries and preserve of ovaries. The increase rate of BMD treated by conjugated-estrogens was higher than that of no treated BMD (p<0.05)

老年者気管支喘息における気道炎症細胞.喘息重症度と関連した気道細胞反応の特徴

Cellular composition of bronchoalveolar lavage (BAL) fluid was examined in 11 elderly asthmatics over the age of 70, and the results were compared with those of 11 younger asthmatics under the age of 50. In the subjects with mild asthma, the proportion of BAL cells in the elderly subjects was 86.2% macrophages, 11.0% lymphocytes, 1.9% neutrophils, 0.9% eosinophils and 0.08% basophilic cells. The proportion of neutrophils and eosinophils in the BAL fluid was slightly higher in younger subjects with mild asthma compared with that in elderly subjects, although no significant difference was found between the two groups. In subjects with severe asthma, the proportions of lymphocytes, neutrophils, eosinophils and basophilic cells were more increased in both younger and older patients compared to those with mild asthma, and a significant increase in the number of BAL eosinophils was found in younger subjects with severe asthma compared to those with mild asthma (p < 0.05). However, no significant difference was present in the proportion of BAL cells between younger and older patients with severe asthma. The results reveal that BAL cells are more increased in subjects with suvere asthma than in those with mild asthma in both younger and older subjects, and show the possibility that this increase is more predominant in neutrophils in older subjects and in eosinophils in younger subjects.70才以上の老年者気管支喘息11例(平均年齢71.4才)を対象に,重症度と気道細胞反応との関連について検討を加えた｡なお,対照として50才以下の喘息症例11例(平均年齢33.5才)を選んだ｡1.老年者の軽症型喘息における気管支肺胞洗浄(BAL)液中の出現細胞の頻度は,マクロファージが86.2%,リンパ球が11.0%,好中球が1.9%,好酸球が0.9%,好塩基性細胞が0.08%であった｡BAL液中の好中球,好酸球の頻度は若青年症例でやや高い傾向が見られたが,両群間に有意の差は見られなかった｡重症例では,老年症例,若青年症例とも,軽症例に比べリンパ球,好中球,好酸球などのBAL細胞の出現頻度が増加しており,特に好酸球では若青年症例の重症例で軽症例に比べ有意に高い頻度が観察された｡これらの結果は, リンパ球,好中球,好酸球などのBAL細胞は,軽症例に比べ重症例で増加してくること,そして,その増加は老年症例では好中球,若青年症例では好酸球の増加が特徴的であることを示唆しているものと考えられた

気管支肺胞洗浄液中に一過性の好中球増多をきたしたアトピー型喘息

Clinical course of one asthma patient (64 years old, female), who had an increased proportion of neutrophils in bronchoalveolar lavage (BAL) fluid, was observed in relation to the proportion of BAL cells and ventilatory function. The patient had large asthma attacks two times during her clinical course for 15 months observed. 1. An increased proportion of BAL neutrophils and suppression of ventilatory function were found after her first large asthma attacks. The increased proportion of BAL neutrophils continued for more than 5 months. A reduction in the proportion of BAL neutrophils was found 3 months after her second large asthma attack, accompanied by improvement of clinical symptoms and ventilatory function. The numbers of total cells and neutrophils in BAL fluid were also reduced. Transient increase in number of BAL lymphocytes was found 13 months after the first large attack when the number of BAL neutrophils was markedly decreased. The number of BAL eosinophils did not change during her clinical course.経過中に気管支肺胞洗浄(BAL)液中に一過性の好中球増多が観察されたアトピー型喘息症例について,若干の臨床的観察を加えた｡症例は,64才の女性で,臨床症状,および血清IgE高値,ハウスダストに対するIgE抗体陽性などから,アトピー型喘息と診断された｡なお,経過観察し得た15ヵ月の間に2回の大発作が観察された｡1.第1回の大発作後,BAL液中好中球増多と換気機能の低下が観察された｡そして,このBAL液中好中球頻度は明らかな改善が見られた｡BAL液中の総細胞数および好中球の絶対数も徐々に減少傾向を示し,好中球頻度と同様,第2回目の大発作3ヵ月後には著明な減少が観察された｡同時にこの時期には,BAL液中リンパ球の増加も見られた｡しかし,BAL液中好酸球数は15ヵ月の経過観察中ほとんど変化は見られなかった

Study on the relatjonship between the bone mineral density mesured by QCT and the osteoporosis therapy.

当院通院あるいは入院中の女性患者54例を対象に骨塩量を経時的に3回測定し検討を行った。54例の骨塩量の平均は3回とも有意差はなく,年次骨塩変化量は-3.1±14.6mg/cm(3)/yearであった｡平均骨塩量の年齢別比較では40才台,50才台,60才台の順に有意な減少がみられ,60才台と70才以上との間には差は認めなかった｡また50才台及び70才以上の年代で1年当たりの骨塩量の減少が大きい傾向が窺われた｡身長と骨塩量との間に有意の正の相関を認めたが,体重との間には有意の相関を認めなかった｡血清中Ca,P及びALPと骨塩量との検討ではいずれも有意の相関を認めなかった｡骨塩変化量減少群と増加群との比較では,平均骨塩量及び背景因子の間に差を認めなかった｡女性,特にステロイド療法を必要とする患者については閉経の時期にあたる40～50才台より積極的に骨粗髭症対策を考える必要性があると考えられた｡また運動療法については温泉プール療法自体を再検討するとともに,骨粗髭症に特異的な運動療法の確立が必要と思われた｡Bone mineral densities (BMD) were　mesured 3 times in 54 females aged 40 to 84 years old to evaluate about relationship between BMD and osteoporosis therapy or patient background factors. BMD decreased 3.1±14.6mg/cm(3) per year, and BMD values were more decreased in subjects with the age of 50's and over 70's than in those with the age of 40's and 60's. In patients with bronchial asthma or rheumatoid arthritis, treated with corticosteroids (predonisolone : 3-7.5mg/day), BMD were sigfnificantly more decreased than in patients without corticosteroid therapy. There was a significant positive correlation between BMD and body height, but no correlation between BMD and body weight, serum Ca, P, or alkaline phosphatase. No differences in background factors were found between subjects with increased BMD and those with decreased BMD. These results indicate that female patients with corticosteroids need active treatments for the prophylaxis of osteoporosis at the age of 40's or 50's