カンジダ特異的IgG(4)抗体と気管支喘息

Serum levels of Candida-specific IgG(4) antibodies were examined in 66 patients with bronchial asthma, relating to patient age and asthma severity. 1. The levels of Candida-specific IgG(4) antibodies were the highest in patients with 60+years of age, compared to the levels in cases with 0-39 and 40-59 years of age. 2. In cases with 40-59 years of age, the levels of Candida-specific IgG(4) were significantly higher in cases with long-term steroid therapy (severe intractable asthma) than in cases without steroid regimen. The results suggest that increased levels of Candida-specific IgG(4) were observed in relation to patient age and asthma severity.66例の気管支喘息症例を対象に，血清中カンジダ特異的lgG(4)抗体を測定し，その血中レベルと年齢および喘息の重症度との関連について検討を加えた。1．血清カンジダ特異的IgG(4)値は，0～39才，40～59才の年齢層にくらべ，60才以上の年齢層において高く，年齢によりその値が変動することが 示唆された。2．40～59才の年齢層では，血清カンジダ特異的IgG(4)は，ステロイド非使用例にくらべ，ステロイド依存性重症難治性喘息症例で有意の高値を示し，この年齢層では，カンジダ特異的IgG(4)抗体がその発症病態に関連している可能性が示唆された。以上，カンジダ特異的IgG(4)抗体の上昇は，高年齢層の症例（60才以上）では全般的に，また40～59才の年齢層で重症型喘息症例において観察されることが明らかにされた

Thermological study on the coldness women - Second report. The relationship between the change of atmospheric temperature and body surface temperature in women with complaints of coldness in limbs

季節毎の婦人の冷え性患者における全身の皮膚表面温度分布について，サーモグラフィを用いて検討した。その結果以下のことが判明した。1）冷え性は外気温が1カ月の最高気温が20℃，最低気温が10℃，平均気温で15℃以下になると発症しやすくなる。2）外気温が前記の条件において，中間温環境下でサーモグラフィ上，軀幹部の最高温度と四肢部の最低温度の差が8℃以上ある症例では99％の確率で冷えを訴えることが明かとなった。From January to December in 1990, whole body temperature was measured in 79 women by using a thermotracer 6T66, and was compared to the change of atmospheric temperature.The difference between the highest temperature of the body and the lowest temperature of the limbs was more than 8℃ in women with complaints of coldness of limbs. This difference was observed in 88% of the women complaining coldness when the average atmospheric temperature in a month was more than 15℃

Thermological study on the coldness in women

サーモグラフィを用いた冷え症の診断基準を作ることを目的として，冷え症患者（30名）の体表面温度分布を体表面を11カ所に分けて中間温環境下でサーモトレーサ6T66を1用いて測定し，対称群（11名）と比較した。同時にCMI調査と，患者の日常生活に関するアンケート調査を実施した。その結果1．冷え症群では四肢末端部，ことに手掌・足背・足底において最低温度が低く，局所の最高・最低温度間の温度較差が大きい傾向を示した。軀幹部では最高温度，最低温度，温度較差すべて両群間に大きな差はみられなかった。2．冷え症群の手掌，足背，足底の温度分布パターンは末端部ほど温度が低いという特徴的なパターンを多く示した。3．CMI調査では，冷え症群の中等症と軽症例の一部に強い神経症的傾向を認めたが，重症例では神経症的傾向は軽度であった。4．アンケート調査では脂っこいものよりあっさりしたものを好きであるとか，顔にのぼせを感じることがある，甘いものが好きであるという例が冷え症群に多かった。以上の結果からサーモグラフィを用いて中間温環境下で四肢末端の温度鈴布を測定することにより，冷え症を客観的に診断する可能性を得た。Whole body surface temparature was measured in 41 women with a thermtracer 6T66. Except palm, sole and instep, there were no differences in surface temperature of other parts of the body among these cases. Surface temperature of palm, sole and instep were lower than other parts of the body and showed 4 characteristic distribution patterns on thermography. Thermography at palm, sole and instep is useful for the objective approach of the patients who complain of coldness in some part of their bodies

臨床所見および検査成績からのスコアーによる喘息分類の特徴

Twenty six patients with bronchial asthma was classified by clinical symptoms and singns (clinical diagnosis), and the classification by clinical diagnosis was compared with the classification by a score calculated from clinical findings and examinations (score diagnosis). 1. Of 12 subjects with type Ia classified by clinical diagnosis, 8 cases with 0 to 49 ml/day of expectoration were evaluated as type Ia by score diagnosis. While four type Ia cases with 50 to 99ml/day of expectoration were calssified as type Ib by score diagnosis. The increased incidence of eosinophils in bronchoalveolar lavage fluid (BALF) of these four cases was similar to the incidence in type Ib cases with hypersecretion. 2. All of 6 subjects with type Ib by clinical diagnosis were estimated as type Ib by score diagnosis. 3. Of 8 cases with type II by clinical diagnosis, 7 cases were assessed as type II by score diagnosis. One case with type II by clinical diagnosis and with the score of 10 points was evaluated as questionable type II by score diagnosis.気管支喘息36例を対象に,臨床病態による喘息の分類（臨床診断）を試み,この分類と臨床所見および臨床検査より求めたスコアーによる分類（スコアー分類）との比較検討を行った｡1.臨床分類でIa.単純性気管支攣縮型と診断された12症例のうち,1日喀痰量0-49mlの8症例は,スコアー分類では同様にIa.型と分類された｡一方,1日喀痰量50-99mlの4症例はスコアー分類ではIb.型（気管支攣縮+過分泌型）と分類された｡これら4症例のBALF中好酸球増多はIb.型に類似した病態であった｡2.臨床診断によりIb.型に分類された6症例はいずれもスコアー診断でもIb.型と分類された｡3.臨床診断によりII.型（細気管支閉塞型）と分類された8症例のうち,7症例はスコアー診断でもII.型と分類されたが,1症例はスコアー10でII.型の診断基準に合わず,questionable II.型と診断された

Relationship between bone mineral densities of second metacarpal bone and lumber spine

QCTおよびDIP法による測定値の相関性について検討し,DIP法による腰椎骨塩量の推定および,スクリーニングへの適用について考察した｡QCT値とΣGS/DやMClとの相関関係の検討では.対象のQCT値が低値か高値かによって相関関係がかなり異なることが明らかになった｡すなわち,QCT値が低い領域は,QCT値と,ΣGS/DやMCIに明らかな正の相関関係が認められたが,一方, QCT値が高い領域では,相関関係は認められなかった｡また,ΣGS/D=2.8mmAI以上,またはMCI=0.48以上の症例においては腰椎圧迫骨折の危険は小さく,ΣGS/D=1.8mmAI以下,またはMCI=0.24以下の症例においては腰椎圧迫骨折の危険が大きい可能性が示唆された。To compare bone mineral density between second metacarpal bone and lumber spine,　two measuring methods, digital image processing　method (DIP) for second metacarpal bone and quantitative computed tomography (QCT) for lumber spine were employed in this study. The bone mineral density was evaluated in 89 females and the results were compared between the two methods. A correlation between the bone mineral densities by QCT and ΣGS/D was found in subjects showing low mineral density by QCT, but not in those with high mineral density. These results reveal that DIP is useful to observe bone mineral density and if ΣGS/D and MCI are enough high, almost he hasn't risk of fracture of lumber spine

Character, Habit and Taste of woman with coldeness in their bodies

冷え性の発現は寒冷刺激に対する血管運動性体温調節と密接に関係しているが,患者の性格･生活習慣･食事の嗜好等にも関わっていると考えられる｡そこで今回は冷え性婦人100名を対象にCMl調査と35項目にのぼるアンケート調査を行った｡その結果,冷え性の増悪因子として,日頃の運動不足･神経症的性格傾向･過労･食べ物の嗜好がクローズアップされ,この面での生活指導が冷え性の治療を行っていく上で,薬物的な治療と並んで重要であることか示唆された。The character, habit and taste were studied about by means of a questionnaire survey and Cornell Medical Index in 100 women who felt cold in their part of bodies. More than 30% of the women showed the neurotic personality, They had a tendency to dislike the greasy foods, and frequently had sweet foods. More than 50% of them ordinally complained of shoulder stiffness and generalfatigue. The women who played sports weekly were less than 20%. The neurotic porsonality, the tendency to dislike the greasy foods and the lack of exercise were seemed to be the feature of their character, taste, and habit. Thus, improvement of their personality and life style may have a good effect on the coldness in women

Maternity swimming at Misasa Hospital of Okayama University Medical School. -Third report. The physiological changes before and after the maternity swimming-

第一報において妊婦水泳に関する妊婦の認識について報告し，第二報において妊婦水泳の現状とその適応について報告したが，その後も症例は順調に増加しており，現在までの参加人数は49名に達した。今回は妊婦水泳が母体と胎児の循環器系にどのような影響を与えるかを調べるために，妊婦水泳の前後におけるnon stress test（NST）と母体の血圧と脈拍数の変化を分析した。対象は妊娠5カ月以降の21名の正常妊婦とした。1．母体の脈拍数は水泳後に増加するものが約80％と明らかに多かったが，血圧は水泳前後で大きな差はみられなかった。2．NSTでは，水泳後に胎児基準心拍数の増加するものが妊娠中期で55.2％，後期で62.3％と多かった。胎児心拍数のlong term variability（LTV）は水泳後に減少するものが妊娠後期で 48.4％を占めた。3.胎動回数は水泳前後でほぼ一定であった。腹緊回数が水泳後に増加した例が妊娠後期で42.4％を占めた。これらの結果のうち，水泳後の胎児基準心拍数の増加とLTVの減少について生理学的見地より若干の考察を加えた。The physiological changes before and after the maternity swimming were retrospectivelly analyzed in 151 records. Following findings were observed after maternity swimming: 1. An increase in maternal pulse rate was observed in 116 cases (76.8%) out of all the cases. 2. Maternal blood pressure increased in 81 cases (53.6%) and decreased in 60 cases (39.7%). 3. An Increase In baseline of fetal heart rate was found in 92 cases (60.9%). 4. Long term variability (LTV) decreased in 67 case s (44.3%) and increased in 21 cases (13.9%). 5. The number of cases with increased fetal movement was almost similar to the number of cases with decreased movement. 6. The rate of uterine contraction increased in 66 cases (43.7%), but there were no cases to need any treatment. The conclusion was as follows: 1. No dangerous changes were observed in non stress test (NST), maternal pulse rate and maternal blood pressure. 2. The increase of baseline of fetal heart rate and the decrease of LTV were characteristic changes of NST after the maternity swimming

ステロイド依存性重症難治性喘息に対する複合温泉療法の作用機序

Effects of complex spa therapy, which comprises swimming training in a hot spring pool, inhalation of iodine salt solution and fango therapy, were analyzed in patients with steroid-dependent intractable asthma (SDIA) by comparison between the subjects with and without efficacy of the therapy. 1. The complex spa therapy was effective in the patients with lower levels of FEV(1.0%) and % PEFR. 2. The complex spa therapy was not always effective in the patients with a low value of % V(25), which represents depressed airflow in the small airways. 3. The efficacy of the complex spa therapy was found in the patients showing a low value of % V(25) accompanied by BAL neutrophilia, but not found in those without increased proportion (more than 10% ) of neutrophils in BAL fluid. The results reveal that the complex spa therapy is effective in patients with SDIA showing low values of FEV(1.0%) and % PEFR, and in those with a low value of % V(25) and BAL neutrophilia.ステロイド依存性重症難治性喘息を対象に,温泉プール水泳訓練,ヨードゾル吸入療法.鉱泥湿布療法からなる複合温泉療法の臨床効果の解析を行った。1.複合温泉療法は,FEV(1.0%)および% PEFR値の低い症例により有効であった｡2.複合温泉療法は､細気管支領域の換気障害を示すと考えられる% V(25)値が低い症例に対して,必ずしも有効ではなかった｡3.複合温泉療法の効果は,BAL液中好中球増多(10%以上)が見られ､かつ% V(25)値が低い症例により有効であったが､同様に% V(25)値が低くても,BAL液中に好中球増多 が見られない症例に対しては,有効ではなかった｡以上の結果より,複合温泉療法はFEV(1.0%)や% PEFR値の低く,またBAL液中好中球増多が見られ,かつ% V(25)値が低いようなステロイド依存性重症難治性喘息に対して有効性が高いことが示唆された

老令者の気管支喘息,各臨床病型における換気機能の特徴

Ventilatory function was examined in 20 elderly patients with bronchial asthma in relation to clinical asthma types, and the results were compared with those of younger asthmatics. 1. Ventilatory parameters such as FEV(1.0%), % PEFR, % MMF, % V(50) and % V(25), which repressent obstructive ventilatory dysfunction, were in general lower in older asthmatics than in the youger cases. 2. The values of % V(50) and % V(25), representing ventilatory dysfunction in small airways, were significantly lower in the older subjects with type Ib and II compared to the younger cases with same types. 3. Markedly decreased values in ventilatory parameters, particularly in % MMF, % V(50) and　% V(25) were observed in both older and younger subjects with type II. The results suggest that ventilatory function decreases with aging and the decrease is related to the pathophysiological changes in the airways.60才以上の老年気管支喘息20例(平均年令;66.7才)を対象に,その換気機能について,臨床病態別に59才以下の症例(平均年令;44.9才)との比較検討を行った｡1.FFV(1.0%), % PEFR, % MMF, % V50, % V25などの閉塞性換気障害を表すパラメーターは,59才以下の症例に比べ老年症例で全般的に低い傾向が見られた｡2.小ないし細気管支領域の換気榛能を反映すると考えられる% V(50)および% V(25)は,Ib型およびII型喘息を示す老年症例において,59才以下の症例に比べ,有意に低い値を示した｡3.II型喘息症例では,59才以下および老年症例のいずれにおいても, %　MMF, % V(50)および% V(25)は他の臨床病型にくらべ著明に低い値を示した｡これらの結果は,気管支喘息における換気機能は,加令とともに低下傾向を示すこと,そしてその低下は臨床病態と関連していることを示しているものと考えられた

The efficacy of maternity swimming to reduce mother's weight

第1報において妊婦水泳に関する妊婦の認識について報告し (1) ,第2報において妊婦水泳の現状とその適応について報告した (2) ｡その後,第3報において妊婦水泳が母児の循環系におぼす影響について報告し (3) ,第4報にて出産後1年間の児の予後調査を行った (4) 。今回は,妊婦水泳による体重減少効果について検討を行った。その結果,妊婦水泳前後で平均460gの体重減少がみられた｡また水泳を10回以上行った妊婦において,水泳を行っている期間の体重増加が水泳を行っていない期間の体重増加に比べて有意に少なかった｡これより,妊婦水泳には一定の減量効果があり,肥満妊婦の治療にも応用できると考えられた。The efficacy of awimming to reduce mother's weight were studided retrospectively in 107 women. Each time they swum for a hour. They were given a chance of swimming at only one time in a week. Most of them reduced their weight after the swimming. The average of the weight loss was 460 gram after each time of swimming. In women who had a chance of swimming at ten times or more, the mother's weight gain in a week when they had a chance of swimming, was statistically (p<0.01) less than the weight in a week when they didn't swim. Thus, the maternity swimming was thought to have the efficacy to reduce mother's weight. If the maternlty swimming is clinically applied for the treatment of obese pregnant women, their weight will reduce efficiently