Clincal evaluation of spa effects for patients with respiratory disease and chronic pain disease

1998年1月より12月までの1年間に,温泉療法-主として温泉プール水泳ないし歩行訓練及び鉱泥湿布治療-を受けた158例の入院症例(呼吸器疾患78例,疼痛性疾患64例,その他16例)について退院時に臨床効果を5段階で評価してもらいそれぞれの入院期間との比較検討を行った｡対象症例の年齢は70才代が最も多く,次いで60才代,50才代,80才代であった｡地域分布では,鳥取県外の入院症例が72.2%を占め,県外である遠隔地としては,岡山県,兵庫県,広島県,大阪府,東京都,神奈川県からの入院が多く見られた｡臨床効果は,"非常に良くなった"と,"かなり良くなった"を有効と判定し,その有効率は呼 吸器疾患では78.2%であった｡一方,疼痛性疾患では,その有効率は50.0%であったが,"少し良くなった"症例を含めると,95.3%,その他の症例は68.8%であった｡入院期間別に検討すると,呼吸器疾患では入院1ケ月で72.7%,2ケ月では81.8%,3ケ月以上では76.5%であった｡一方,疼痛性疾患では,入院1ケ月で21.1%,2ケ月で60.0%,3ケ月で64.0%であり,呼吸器疾患と比べ,効果出現までの期間がやヽ長く,入院期間が長くなるほど,その効果は高くなる傾向が見られた｡Clinical evaluation of spatherapy, mainly swimming and walk training in a hot spring pool and fango therapy, was performed in 158 patients (78 with respiratory disease, 64 with chronic pain disease, and 16 with other diseases) who were admitted at our hospital to receive spa therapy from January to December in 1998. The number of patients over the age of 70 was largest, and the number of patients outside Tottori prefecture (72.2%) was larger than the number inside Tottori prefecture. Spa efficacy was assessed by 5 steps according to improvement of clinical symptoms; efficacy-marked, moderate,and slight, no efficacy, and worse. Spa therapy was evaluated as effective when their symptoms were markedly or moderately improved. The spa efficacy was 72.2% at 1 month, 81.8% at 2 months, and 76.5% at 3 months after spa therapy in patients with respiratory disease. In contrast, the, efficacy was 21.1% at 1 month, 60.0% at 2 months,and 64.0% at 3 months after the therapy in patients with chronic pain disease. The efficacy was higher as the term of admission was longer in patients with chronic pain disease

Analysis of Factors Regarding Spa Therapy in Patients with Rheumatoid Arthritis

1998年4月より9月までの6ヶ月間に当院へ入院し温泉療法をうけた慢性関節リウマチ患者6例を対象に,温泉治療経験の有無,年齢,機能障害度(クラス),罹患年数の4項目が温泉療法効果に及ぼす影響につき検討した｡温泉治療経験の有無では治療経験を有する患者においてMHAQ(modified health assessment questionnaile),患者による疼痛評価,患者による全般活動性評価に有意な改善が見られ,年齢(75才以上,75才未満)では,75才未満においてMHAQに有意な改善傾向が見られた｡機能障害度(クラス3以上,クラス2以下),罹患年数(15年以上,15年未満)においては有意差は見られなかった｡温泉の永続効果を保つためには,年1～2回の入院を繰り返すことが効果的であることが示唆された｡In patients with rheumatoid arthritis (RA) who received spa therapy (ST) on admission, we examined factors for treatment response. This study included 6 RA patients and the following 4 parameters were investigated: presence or absence of previous ST, age, duration of RA, and grade of the functional disorder. Treatment response was evaluated according to the American College of Rheumatology core set measures. With respect to the presence or absence of previous ST, modified health assessment questionnaire (MHAQ), pain scale and patient global assessments in the group with previous ST were significantly improved compared to those in the group without previous ST. With respect to age, MHAQ in the group consisting of patients less than 75 years old was significantly improved compared to that in the group consisting of patients 75 years old or older. With respect to the grade of the functional disorder (class 2 or lower vs. class 3 or higher) and the duration of RA (less than 15 years vs. 15 years or more), there were no significant differences. These results suggest that repeated therapy is more effective in ST and treatment response may be relatively poor in elderly patients with RA aged over 75 years

Evaiuation of spa therapy by questionnaire. Characteristics of patients from distant areas.

1999年4月～12月の9ケ月間の遠隔地からの入院患者80名（痔痛性疾患47例，呼吸器疾患33例）を対象に，岡大三朝分院に来院した動機，入院前の状態，温泉療法の効果，薬剤の変化，退院決定の動機等について退院前にアンケート調査を行い検討を加えた。対象症例の年齢は60才以上の高齢者力て多く，入院期間は1ケ月～2ケ月末満が多い傾向であった。入院前の状態では，今までの治療に不満，限界を感じて来院している症例が71例（88．7％）を占めていた。地域別では広島，大阪，京都，兵庫からの来院か多く，その他18都府県に及んでいた。アンケート結果では，疾患別による若干の傾向と，温泉療法に対する評価として症状の改善が見られ，また，使用薬剤の減量の可能性が示唆された。Clinical evaluation of spa therapy was examined in 80 patients with respiratory disease and with joint pain including lumber pain, who came from distant areas (outside Tottori prefecture) and were admitted at Misasa Hospital by questionnaire in relation to a motive of admission, effects of spa therapy, dose of medication, a motive of discharge. In many of these patients, the age was over 60 years and duration of their admission was from two to three months. Seventy-one- (88.7%) of the 80 patients were admitted at our hospital because they were not satisfactory for the treatment of asthma which they had before. The number of patients from Hiroshima, Osaka, Kyoto, and Hyogo, prefectures was larger than the number from other distant areas. The results of the questionnaire suggest that improvement of symptoms and reduction of drugs used are ecpected by spa therapy

The effects of perilla seed oil ointment for atopic dermatitis

近年アトピー性皮膚炎が増加しており,工ゴマ油を使った食事療法がアレルギー抑制に有用であることが報告されている｡そこで今回,エゴマ油を外用剤として使用するため,亜鉛華単軟膏を基剤とした工コマ軟膏を作製し,アトピー性皮膚炎患者3例を対象にその臨床応用を試みた｡その結果,掻痒感の軽減に効果がみられ,また皮膚症状では,丘疹.表皮剥離,苔癬化,落屑などの所見が改善される傾向が見られた｡The perilla seed oil contains rich α-linolenic acid (α-LNA), parent n-3 fatty acid. The dietary intake of n-3 fatty acid, such as perilla seed oil, has been reported to have some clinical effects in patients with allergic disease. In this report, we prepared the perilla seed oil ointment for atopic dermatitis and the effects of the ointment was evaluated in three patients with atopic dermatitis. This ointment suppressed skin itch, and improved papules, excoriation, lichenification and desquamation of the skin. These results suggest that the perilla seed oil ointment has some effectiveness including suppression of inflammatory changes of the skin in patients with atopic dermatitis

Identification of kaonashi Mutants Showing Abnormal Pollen Exine Structure in Arabidopsis thaliana

Exine, the outermost architecture of pollen walls, protects male gametes from the environment by virtue of its chemical and physical stability. Although much effort has been devoted to revealing the mechanism of exine construction, still little is known about it. To identify the genes involved in exine formation, we screened for Arabidopsis mutants with pollen grains exhibiting abnormal exine structure using scanning electron microscopy. We isolated 12 mutants, kaonashi1 (kns1) to kns12, and classified them into four types. The type 1 mutants showed a collapsed exine structure resembling a mutant of the callose synthase gene, suggesting that the type 1 genes are involved in callose wall synthesis. The type 2 mutant showed remarkably thin exine structure, presumably due to defective primexine thickening. The type 3 mutants showed defective tectum formation, and thus type 3 genes are required for primordial tectum formation or biosynthesis and deposition of sporopollenin. The type 4 mutants showed densely distributed baculae, suggesting type 4 genes determine the position of probacula formation. All identified kns mutants were recessive, suggesting that these KNS genes are expressed in sporophytic cells. Unlike previously known exine-defective mutants, most of the kns mutants showed normal fertility. Map-based cloning revealed that KNS2, one of the type 4 genes, encodes sucrose phosphate synthase. This enzyme might be required for synthesis of primexine or callose wall, which are both important for probacula positioning. Analysis of kns mutants will provide new knowledge to help understand the mechanism of biosynthesis of exine components and the construction of exine architecture

Predictors of dying at home for patients receiving nursing services in Japan: A retrospective study comparing cancer and non-cancer deaths

<p>Abstract</p> <p>Background</p> <p>The combined effects of the patient's and the family's preferences for death at home have in determining the actual site of death has not been fully investigated. We explored this issue on patients who had been receiving end-of-life care from Visiting Nurse Stations (VNS). In Japan, it has been the government's policy to promote end-of-life care at home by expanding the use of VNS services.</p> <p>Methods</p> <p>A retrospective national survey of a random sample of 2,000 out of the 5,224 VNS was made in January 2005. Questionnaires were mailed to VNS asking the respondents to fill in the questionnaire for each patient who had died either at home or at the hospital from July to December of 2004. Logistic regression analysis was respectively carried out to examine the factors related to dying at home for cancer and non-cancer patients.</p> <p>Results</p> <p>We obtained valid responses from 1,016 VNS (50.8%). The total number of patients who had died in the selected period was 4,175 (cancer: 1,664; non-cancer: 2,511). Compared to cancer patients, non-cancer patients were older and had more impairment in activities of daily living (ADL) and cognitive performance, and a longer duration of care. The factor having the greatest impact for dying at home was that of both the patient and the family expressing such preferences [cancer: OR (95% CI) = 57.00 (38.79-83.76); non-cancer: OR (95% CI) = 12.33 (9.51-15.99)]. The Odds ratio was greater compared with cases in which only the family had expressed such a preference and in which only the patient had expressed such a preference. ADL or cognitive impairment and the fact that their physician was based at a clinic, and not at a hospital, had modest effects on dying at home.</p> <p>Conclusions</p> <p>Dying at home was more likely when both the patient and the family had expressed such preferences, than when the patient alone or the family alone had done so, in both cancer and non-cancer patients. Health care professionals should try to elicit the patient's and family's preferences on where they would wish to die, following which they should then take appropriate measures to achieve this outcome.</p