Muisti ja Arki : Ajankohtaista tietoa muistisairauksista, niiden ennaltaehkäisemisestä sekä arjesta muistisairauden kanssa

Suomen väestön ikärakenne muuttuu nopeasti lähivuosikymmeninä. Tilastokeskuksen ennusteiden mukaan yli 75-vuotiaiden määrä kaksinkertaistuisi vuoteen 2030 mennessä, joten muistisairauksien esiintyvyys tulee myös lisääntymään ikääntyvien määrän kasvaessa. Opinnäytetyömme idea sai alkunsa SenioriKaste-hankkeelta, joka toivoi ensitietopäivän järjestämistä Keski-Pohjanmaan alueella muistisairauksiin sairastuneille sekä heidän läheisilleen. Opinnäytetyömme tarkoituksena oli järjestää muistisairauksia käsittelevä tilaisuus muistisairauteen sairastuneille sekä heidän läheisilleen. Tilaisuus oli myös avoin kaikille asiasta kiinnostuneille. Opinnäytetyömme tavoitteena oli välittää muistisairauteen sairastuneille ja heidän läheisilleen ajankohtaista tietoa muistisairauksista sekä keinoista, joiden avulla kotona pärjääminen onnistuu mahdollisimman pitkään. Kartoitimme yhteistyökumppaneidemme kautta aiheen tärkeyttä ja tarvetta. Heidän asiakkailtaan saadun palautteen perusteella varmistuimme tilaisuuden järjestämisen tärkeydestä ja tiedon tarpeellisuudesta. Opinnäytetyömme toteutui toiminnallisena projektityönä yhteistyössä toimeksiantajan SenioriKaste-hankkeen kanssa Kokkolassa 4.6.2015. Tilaisuudessa luennoitiin muistisairauksien ennaltaehkäisemisestä, yleisimmistä muistisairauksista, muistisairauksien varhaisesta tunnistamisesta sekä niiden tuomista haasteista ja vaikutuksista ihmisen jokapäiväiseen elämään. Tilaisuuteen osallistui yhteensä 140 henkilöä. Osallistujilta kerättiin kirjallinen palaute. Palautekyselyistä tehtiin yhteenveto ja kehittämisehdotukset kirjattiin myös opinnäytetyöhön. Tilaisuus vastasi yleisesti osallistujien odotuksia kiitettävästi. Projekti toteutettiin parityöskentelynä, jossa onnistuimme kiitettävästi.The age structure of Finnish population is changing rapidly within the next few decades. Statistics prognosis is that the number of over 75 years old people will be doubled by 2030, so the occurrence of memory disorders will increase with aging people. The idea for this study got its start from Senior Initiation project that wished a public lecture to be organized in Central Ostrobothnia for patients with memory disorder and their families. The purpose of our study was to organize a memory disorder event for the aforementioned groups. The occasion was open for anyone who was interested in it. The aim of this study was to provide current information to memory disorder patients and their loved ones about memory disorders and ways to cope with it at home as long as possible. Through our co-operation partners we surveyed the importance and need of the topic. Based on the feedback from their clients we were convinced of the importance of the event and the need for information. Our thesis was completed as a functional project work together with our client Senior Initiation project in Kokkola 4th of June 2015. The prevention of memory disorders, most common memory disorders, their early recognition and the challenges and effects they bring to people’s everyday lives were discussed during this event. The total of 140 people took part in the event. A written feedback was collected from all participants. A summary was made from the feedback survey, and all development proposals were registered also in this thesis. The event corresponded in general to the participants’ expectations very well. The project was implemented as pair work, in which we succeeded commendably

気管支喘息における気管支肺胞洗浄液中の細胞成分に対する加齢および副腎皮質ホルモンの影響

Effects of aging and glucocorticoid therapy on bronchoalveolar lavage (BAL) cells, particularly lymphocytes, neutrophils and eosinophils, were examined in 81 patients with asthma. 1. The proportion of BAL lymphocytes tended to increase with aging in asthmatics under age 69 years, and the proportion was significantly higher in patients with asthma between the ages of 60 and 69 than in those under age 39 and between the ages of 40 and 49. 2. The proportions of BAL neutrophils and eosinophils were not related to aging. 3. The proportion of BAL lymphocytes was higher in patients without glucocorticoid therapy than in those with steroid-dependent intractable asthma (SOIA) in those under age 69 years. In patients between the ages of 50 and 59, the proportion of BAL lymphocytes was significantly higher in patients without glucocorticoids than in those with SOIA. 4. The proportion of BAL neutrophils was higher in patients without glucocorticoid therapy than in those with SOIA, and the difference was significant in patients between the ages of 60 and 69. 5. The proportion of BAL eosinophils was not related to glucocorticoid therapy. These results suggest that the proportion of BAL lymphocytes and neutrophils is affected by aging and glucocorticoid therapy, but not BAL eosinophils.気管支喘息81例を対象に,気管支肺胞洗浄(BAL)液中の細胞成分,特にリンパ球,好中球および好酸球に対する加齢および副腎皮質ホルモ ンの影響について検討を加えた｡ 1.BAL液中のリンパ球頻度は,69才以下の症例では加齢とともに増加する傾向を示し,60-69才の年齢層では,39才以下および40-49才の年齢層の症例に比べ有意に高い値を示した｡　 2.BAL液中の好中球および好酸球頻度と加齢との間には関連が見られなかった｡　 3.BAL液中のリンパ球頻度は,69才以下の症例では,ステロイド依存性重症難治性喘息(SDIA)に比べ,ステロイド非使用例で有意に高い値を示し,50-59才の年齢層ではその差は有意であった｡　 4.BAL液中好中球頻度は,ステロイド非使用例に比べSDIA症例において高い値を示し,60-69才の年齢層ではその差は有意であった｡　 5.BAL液中好酸球頻度は,ステロイド使用の有無との関連は見られなかった｡これらの結果は,BAL液中リンパ球および好中球頻度は加齢や副腎皮質ホルモン投与の影響を受けるが,BAL液中好酸球額度には影響しないことを示唆している

Heat stable cell growth inhibiting factor isolated from rat liver microsomes.

A heat stable cell growth inhibiting factor was isolated from rat liver microsomes by hot salt extraction, ethanol fractionation and the hot phenol method. The factor was contained in the RNA fraction (designated as mhRNA). mhRNA inhibited the growth of mouse fibroblast (L-929) cells at a relatively low concentration (55 microgram/ml of culture medium). The molecular weight of mhRNA was about 27,000 and the base composition was guanine and cytosine rich.</p

The generation of leukobienes B4 (LTB4) and C4 (LTC4) and bronchial hyperresponsiveness in patients with asthma and spa therapy

Changes in the generation of leukotrienes B4 (LTB4) and C4 (LTC4) by leucocytes after spa therapy were examined in 30 patients with asthma. 1. The efficacy of spa therapy was marked in 8 (26.7%), and moderate in 16 (53.3%) of 30 patients with asthma, and slight or no efficacy of the therapy was observed in the residual 6 patients (20.0%). 2. Bronchial reactivity to methacholine was the highest in patients with slight or no efficacy of spa therapy, however. there were no significant differences among the three groups classified by clinical efficacy. 3. The generation of LTC4 was significantly higher in patients with slight or no efficacy compared with the generation in those with marked (p<O. 01) and moderate efficacy (p<O. 001). However, there were no signifcant differences in the generation of LTB4 among them. 4. The generation of LTC4 signifcantly decreased in patients with marked and moderate efficacy after spa therapy. but not in those with slight or no efficacy. The generation of LTB4 was not significantly different before and after spa therapy among patients with marked, moderate, and slight or no efficacy. These results show that the efficacy of spa therapy for patients with asthma is closely related to the generation of LTC4 by leucocytes.気管支喘息30例を対象に,温泉療法によるロイコトリエンB4 (LTB4),C4 (LTC4)産生の変動および気道過敏性と臨床効果との関連について検討を加えた｡　 1.温泉療法の臨床効果は,著効8例(26.7%),有効16例(53.3%),やや有 効あるいは無効6例(20.0%)であった｡　 2.メサコリンに対する気道過敏性は,やや有効あるいは無効例で高い傾向が見られたが,著効,有効例と比べ有意の差は見られなかった。 3.LTC4産生はやや有効あるいは無効例において著効例(P<0.01)や有効例(P<0.001)に比べ有意に高い値が示された｡しかし,LTB4産生では臨床効果との関連は見られなかった｡　 4.著効例および有効例では,温泉療法後にLTB4産生の有意の低下 傾向が見られたが,無効例では有意の変動は見られなかった.また,LTB4産生に関しては温泉療法の臨床効果にかかわらず有意の変動は見られなかった｡これらの結果より,気管支喘息に対する温泉療法の臨床効果は,LTC4産生とある程度関連していることを示唆しているものと考えられる

Airflow, the volume and transfer factor of lungs in elderly asthmatics with long-term cigarette smoking

The influence of cigarette smoke on pulmonary function, airflow, lung volume, and transfer factor in patients with asthma was examined in 40 subjects over the age of 70 years (20 ever-smokers and 20 never-smokers), and 20 patients with pulmonary emphysema over age 70 (all ex-smokers). The ventilatory parameters showing airflow limitation (% FEV(1) and FEV(1)%) were not significantly different between ever-smokers and never-smokers of elderly asthmatics. In contrast, % FEV(1) and FEV(1) % values were significantly lower in patients with pulmonary emphysema than in those with asthma with or without a history of smoking. The % RV value was significantly larger and % DLco value was significantly more decreased in ever-smokers compared with neversmokers of the elderly asthmatics. However, there were no significant differences in % RV and % DLco values between asthmatics with a history of smoking and patients with pulmonary emphysema. The results show that cigarette smoke inflluences % RV and % DLco, but not % FEV(1) and FEV(1) %, suggesting airflow limitation of large and moderate size airways.高齢者気管支喘息40例(20年以上の喫煙者20例,非喫煙者20例)および肺気腫(全症例喫煙者)20例を対象に,長期間喫煙の肺機能,airflow,lung volume およびlung transfer factor,に及ぼす影響について検討した｡まずFVC値は,喘息の喫煙例,非喫煙例,および肺気腫症例の間に有意の差は見られなかった｡% FEV(1)およびFEV(1)/FVC値は,喫煙例,非喫煙例いずれの喘息症例も肺気腫と比 べ有意に高い値を示したが,喘息の喫煙例と非喫煙例の間には有意差は見られなかった｡一方,% RVおよびDLco値は,喘息の非喫煙例に比べ,喫煙例および肺気腫症例で有意に低い値を示した｡ これらの結果は,長期間の喫煙は% FEV(1)やFEV(1)/FVCにはあまり影響しないこと, しかし,% RVや% DLcOにはかなり影響することを示している

高齢者気管支喘息の病態におよぼす加齢および喫煙の影響について

高齢者喘息の病態に対する加齢および喫煙の影響について,若干の検討を加えた｡高齢者喘息,特に70才以上の喘息では,HRCT上の1950HU以下の肺のlow attenuation area(LAA)は,苦青年者喘息と比べ有意に増加していた.また,同時にこの年齢層では残気量の有意の増加,拡散能の有意の低下が見られた.% LAAと% 1秒量との間には,喘息の非喫煙例,喫煙例,肺気腫(全例喫煙例),いずれにおいても相関が見られた｡しかし,% LAAと拡散能との間には,喘息の喫煙例および肺気腫では相関が見られたが,非喫煙例では有意の相関は見られなかった｡これは,喫煙の拡散能におよぽす影響が大きいことを示唆しているものと考えられた｡Influences of aging and cigarette smoking on the pathophysiology in elderly patients wish asthma were examined in 152 patients with asthma and 14 patients with pulmonary emphysema. The low attenuation area (LAA) <-950 HU of the lungs on high-resolution computed tomography (HRCT) was significantly larger in patients over age 70 years than in those under age 49 years. A significant increase in residual volume (RV) of the lungs and significant decrease in the value of DLco were observed in these patients over age 70 compared to the values in those under age 49. A significant correlation between % LAA and % FEV1.0 was found in patients with asthma (in both smoker and nonsmoker) and with pulmonary emphysema. However, any correlation between % LAA and the value of DLco was not observed in nonsmoking patients with asthma, suggesting that the influence of smoking on DLco is remarkably larger than the influence of aging

’あくび’と胸痛を訴えた気管支喘息の1症例

We present a case of a patient with asthma who developed yawning associated with anterior chest pain. She was admitted due to severe anterior chest pain, wheezing and dyspnea. Although the frequency of the symptoms decreased, she began to experience frequent episodes of yawning at night accompanied by tears. While she experienced yawning, although PEF (peak expiratory flow) decreased, no asthmatic symptoms, such as wheezing or dyspnea were observed. The yawning was improved markedly by bronchodilators and a leukotriene receptor antagonist, and moderately improved by corticosteroids. We speculated that yawning is a clinical manifestation of asthma that responds to treatment.64歳の女性｡1993年2月に高度の前胸部痛,職場,呼吸困難を主訴として入院した｡入院後,前胸部痛,喘鳴,呼吸困難は徐々に軽快傾向であったが,夜間流涙を伴う`あくびが頻回に出現するようになった｡`あくび'が出現する時には,喘息症状(喘鳴,呼吸困難)は伴わないが,ピークフローに低下を認めた｡`あくび'に対する治療としては,気管支拡張剤,ロイコトリエン受容体結抗剤は著効,副腎皮質ステロイド剤は中等度 有効であった｡`あくび'は治療に反応する喘息の-症状であることが示唆された

高齢者喘息のIgEにmediateされるアレルギー反応におよぽす喫煙の影響

The influence of cigarette smoking on the pathophysiology of asthma in the elderly remains controversial. In this study, the inluence of cigarette smoking on IgE - mediated allergy including the generation of leukotrienes B4 (LTB4) and C4 (LTC4) was examined in forty asthmatics over the age of 70 years (20 ex-smokers and 20 never-smokers), and 20 patients with pulmonary emphysema over age 70 (all ex - smokers). The frequency of patients with serum IgE more than 200 IU/ml was significantly larger in smoking asthmatics than in non - smoking asthmatics. The incidence of patients with positive RAST score for inhalant allergens, was also significantly higher in patients with a history of smoking than in those without a smoking history. There were no significant differences in the frequency of patients with positive RAST and those with serum IgE more than 200 IU/ml between non-smoking asthmatics and patients with pulmonary emphysema. The generation of leukotriene B4 (LTB4) by leukocytes was significantly more increased in ex-smokers than in never-smokers in the elderly asthmatics. The results suggest the possibility that cigarette smoking enhances IgE - mediated allergy in elderly patients with asthma.高齢者喘息の病態に対する喫煙の影響については,なお不明な点が多い｡本研究では,70歳以上の気管支喘息40例(喫煙歴20年以上の症例20例,非喫煙症例20例)および70歳以上の肺気腫20例(全例喫煙者)を対象に,IgE-mediatedallergy(LTB4,LTC4の産生を含む)に対する喫煙の影響について検討した｡血清IgE値が200IU/ml以 上を示す症例の頻度は,喘息の喫煙例で非喫煙例や肺気腫症例と比べ有意に高い値を示した｡吸入抗原に対する特異的IgE抗体が陽性を示す症例の頻度は,喘息の喫煙例で非喫煙例や肺気腫に比べ有意に高い値を示した｡しかし,血清IgEが200IU/ml以上の症例の頻度およびRAST陽性例の頻度は,喘息の非喫煙例と肺気腫例の間には有意 の差は見られなかった｡LTB4の産生は,喘息の喫煙例で,非喫煙例と比べ有意の亢進が見られた｡また,肺気腫例では,喘息の非喫煙例に比べ,有意に高い産生が見られた｡しかし,LTC4の産生には喘息の喫煙例,非喫煙例,肺気腫例の間に有意の差は見られなかった

高齢者喘息における HRCT 上の肺の low attenuation area (LAA) に及ぼす長期間喫煙の影響．肺気腫症例との比較．

The influence of cigarette smoking on the pathophysiology in elderly patients with asthma. Forty asthmatics over the age of 70 years (20 ex-smokers and 20 never-smokers), and 20 patients with pulmonary emphysema over age 70 (all ever-smokers) were studied to determine the influence of cigarette smoke on the low attenuation area (LAA) <-950 HU (RA950) of the lungs on high resolution CT (HRCT) scans, and the ratio of expiratory LAA to inspiratory LAA of the lungs in relation to pulmonary function. The LAA value was significantly higher in patients with pulmonary emphysema compared with ever-smokers of asthmatics. The LAA ratio was significantly higher in ever-smokers than in never-smokers of asthmatics, and the ratio was less than 0.5 in all never-smokers, and the ratio was more than 0.5 in 10 of 20 ever-smokers of asthmatics and in all patients with pulmonary emphysema. The % RV (residual volume) was significaltly larger and % DLco (diffusing capacity for carbon monoxide) was significantly lower in subjects with the ratio more than 0.5 than in those with the ratio less than 0.5. These results suggest that cigarette smoke influences LAA of the lungs in relation to % RV value and % DLco value.70歳以上の気管支喘息40例(20例喫煙者,20例非喫煙者)および肺気腫20例を対象に,長期間喫煙のHRCT上の-950 HU以下の肺のlow atenuation area(LAA)に及ぼす影響について検討した。 HRCT上の肺の% LAAは,喘息の喫煙例で非喫煙例に比べ有意に高い値を示した｡また,この% LAAは,肺気腫症例で喘息の喫煙例に比べさらに高い値を示した｡LAA比(呼気時LAA/吸気時LAA)は,職息症例では喫煙例で非喫煙例比べ有意に高い値を示したが,肺気腫症例ではさらに高い値を示した｡LAA比0.5以上を示す症例は,喘息の非喫煙例では見られず,喫煙例で20例中10例,肺気腫症例では全例に見られた｡そして,喘息喫煙例でLAA比が0.5以上を示す症例は,0.5以下の症例に比べ,% RVは有意に高く,また% DLcoは有意に低い値を示した｡しかし,% RV,% DLco値いずれも喘息のLAA比0.5以上の症例と肺気腫の間には有意差は見られず,喘息における喫煙の影響の高いことが示唆された