1.Decrease in Low Attenuation Area(LAA) of the Lungs on High Resolution Computed Tomography(HRCT) by Long-term Spa Therapy in Patients with Asthma.
Kozo ASHIDA ; Fumihiro MITSUNOBU ; Yasuhiro HOSAKI ; Hiroshi TSUGENO ; Makoto OKAMOTO ; Norikazu NISHIDA ; Takuya NAGATA ; Shingo TAKATA ; Tadashi YOKOI ; Yoshiro TANIZAKI
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2003;66(2):115-122
Characteristics of low attenuation area (LAA) of the lungs on HRCT were studied in 132 patients with asthma, and long-term spa therapy on the LAA of the lungs was observed in 5 patients with asthma, whose me an %LAA was more than 30%.
1. The morphology of LAA of the lungs on HRCT observed in asthma was different from that in pulmonary emphysema. 2. The LAA of the lungs in asthma was closely related to residual volume (RV). 3. The mean %LAA value significantly decreased from 33.5% before spa therapy to 24.5% at 24 months after beginning of the therapy. CT number also significantly increased after long-term spa therapy. 4. %FEV1.0 value significantly improved from 52.1% before spa therapy to 72.1% at 24 months after spa therapy. The RV value also decreased by spa therapy, however, the decrease was not significant. These results suggest that LAA of the lungs in asthma is associated with hyperinflation, and the LAA of the lungs decreases after long-term spa therapy.
2.Long-term Spa Therapy Prevents the Progressive Pathological Changes of the lung in Patients with Pulmonary Emphysema.
Fumihiro MITSUNOBU ; Yasuhiro HOSAKI ; Kozo ASHIDA ; Hiroshi TSUGENO ; Makoto OKAMOTO ; Norikazu NISHIDA ; Takuya NAGATA ; Shingo TAKATA ; Tadashi YOKOI ; Yoshiro TANIZAKI
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2003;66(2):91-98
Clinical effects of spa therapy for patients with pulmonary emphysema (PE) were evaluated by observing changes in %LAA of the lung on HRCT, %RV, %FVC, %FEV 1.0, and %DLco values after the long-term therapy. The subjects in this study 16 patients with PE. The subjects were divided into two groups according to the extent of %LAA<-950 HU of the lung on HRCT: %LAA<50% (N=6) and 50%≤%LAA (N=8). 1. Spa therapy significantly improved %LAA (42.5% at the initial stage to 36.3% 24 months after spa therapy), %RV (202.1% to 156.1%) and %DLco 71.0% to 85.7%), but not %FVC and %FEV 1.0, in patients with PE of %LAA<50%, however, significant. Improvement of these parameters was not observed in patients without spa therapy. 2. Spa therapy did not improve the values of %LAA, %RV, and %DLco, as well as %FVC and %FEV 1.0, in patients with PE of 50%≤%LAA. These parameters tended to decrease in the patients of 50%≤%LAA. These results suggest that spa therapy improves %LAA and parameters related to pulmonary function when they are at early stage of PE, however, the therapy was not remarkably effective for these parameters when they were at advanced stage of PE.
3.Spa Therapy for Patients with Respiratory Disease Admitted at Misasa Medical Center for Last 20 Years.
Fumihiro MITSUNOBU ; Yasuhiro HOSAKI ; Kozo ASHIDA ; Hirofumi TSUGENO ; Makoto OKAMOTO ; Norikazu NISHIDA ; Takuya NAGATA ; Shingo TAKATA ; Tadashi YOKOI ; Yoshiro TANIZAKI
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2003;66(2):99-107
Spa therapy has been performed at our medical center for last 20 years. The changes in number and frequency of patients with respiratory disease were analyzed every 5 year for last 20 years. The total number of patients with respiratory disease who were admitted at our medical center for last 20 years was 1934, of whom the number of patients with asthma was 1226 (63.4%), and the number of those with COPD was 415 (21.5%). The number of patients with asthma treated with spa therapy showed a tendency to increase form 57 for the first 5 years (first stage) to 465 for the last 5 years (forth stage). The number of patients with COPD also increased from 26 for the first 5 years to 227 for the last 5 years. The frequency of SDIA decreased from 68.4% for the first 5 years to 29.0% for the last 5 years. In contrast, the frequency of pulmonary emphysema increased 19.2% at the first stage to 76.7% at the forth stage. The number and frequency of elderly patients with asthma and COPD over the age of 60 tended to increase for last 20 years.
4.Effects of Spa Therapy Combined with Dietary Supplementation with n-3 Fatty Acids on Bronchial Asthma
Makoto OKAMOTO ; Kozo ASHIDA ; Fumihiro MITSUNOBU ; Yasuhiro HOSAKI ; Hirofumi TSUGENO ; Norikazu NISHIDA ; Takuya NAGATA ; Tadashi YOKOI ; Shingo TAKATA ; Yoshiro TANIZAKI
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2003;66(3):171-179
N-3 fatty acids are reportedly effective for asthma. In addition, spa therapy has been reported to be effective for patients with asthma. In the present study, the effects of spa therapy combined with perilla seed oil-rich diet (rich in n-3 fatty acid) were examined on asthma. A total of 14 asthmatic patients had a complex spa therapy and consumed a perilla seed oil-rich diet-rich in α-linolenic acid (α-LNA) for 8 weeks. Generation of leukotriene (LT) C4 by leucocytes, respiratory function were analyzed. The generation of LTC4 by leucocytes decreased significantly for 2, 4 and 8 weeks (P<0.05). Peak expiratory flow (PEF) values increased significantly for 2, 4, 6 and 8 weeks (P<0.05). The values of ventilatory parameters [forced vital capacity (FVC), forced expiratory volume in one second (FEV1), forced expiratory flow after 25% of expired FVC (FEF25), forced expiratory flow after 75% of expired FVC (FEF75), mean expiratory flow during the middle half of the FVC (FEF25-75)] revealed a significant increase after 4 and 8 weeks of the modified diet (P<0.05). The results suggest that spa therapy combined with a perilla seed oil-rich diet are effective in the treatment of asthma in terms of its ability to suppress LTC4 generation by leucocytes, and in inducing an improvement of pulmonary function.
5.Five-year Observation of the Effects of Spa Therapy for Patients with Pulmonary Emphysema, Evaluated by %Low Attenuation Area (%LAA) of the Lungs on High-resolution CT, %DLco and %Residual Volume (RV)
Fumihiro MITSUNOBU ; Yasuhiro HOSAKI ; Kozo ASHIDA ; Naofuni IWAGAKI ; Takuya NAGATA ; Makoto FUJII ; Shingo TAKATA ; Masanori Hamada ; Yoshiro TANIZAKI
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2004;67(3):148-154
The effects of long-term spa therapy were studied in 10 patients with pulmonary emphysema: five patients had long-term spa therapy for 5 years (group A), and another 5 patients had not spa therapy for the same 5 years (group B). There were no significant differences in %FVC, %FEV 1.0, %LAA of the lung on HRCT, %DLco and %RV between the two groups. 1. The LAA of the lung on HRCT slightly, but did not significantly increase in patients with spa therapy for 5 years. In patients without spa therapy, the %LAA of the lung significantly increased after 4-(61.1%) (p<0.01) and 5-year observation (65.5%) (p<0.001) compared with the initial value (52.2%). 2. The %DLco and %RV values slightly decreased in patients with spa therapy, but the decrease in the two parameters was not significant. 3. The %DLco significantly decreased (67.2% to 49.0%), and the %RV also significantly increased (175.4% to 230.6%) after 5-year observation in patients without spa therapy. The results obtained here suggest that spa therapy for pulmonary emphysema should start as early as possible when the diagnosis of the disease is decided, and the therapy should be continued as long as possible.
6.Improvement of Hyperinflation of the Lungs by Spa Therapy in Patients with Asthma
Fumihiro MITSUNOBU ; Yasuhiro HOSAKI ; Kozo ASHIDA ; Naofumi IWAGAKI ; Takuya NAGATA ; Makoto FUJII ; Shingo TAKATA ; Masanori HAMADA ; Yoshiro TANIZAKI
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2004;67(4):195-201
Effects of spa therapy on % low attenuation area (LAA)<-950 HU of the lungs on HRCT at full inspiration, CT number, a ratio of expiratory LAA to inspiratory LAA (exp LAA/ins LAA), residual volume (RV) and diffusing capacity for carbon monoxide (DLco) in asthma were compared between never-smokers and ex-smokers of asthmatics.
1. The % LAA of the lungs on HRCT in asthma significantly decreased after spa therapy both in never-smokers and ex-smokers of asthmatics. CT number also significantly increased in the two groups. 2. The exp LAA/ins LAA significantly decreased after spa therapy in never-smokers, but not in ex-smokers. 3. The %RV also significantly decreased by spa therapy in never-smokers, but not in ex-smokers. 4. The DLco value did not significantly change by spa therapy both in nevers-mokers and ex-smokers. 5. The values of %FVC and %FEV 1.0 tended to increased in the two groups, but the increase was not significant. The value of FEV 1.0% significantly increased after spa therapy in never-smokers, but not in ex-smokers. The results suggest that hyperinflation and destruction of terminal airspaces are stronger in ex-smokers than in never-smokers, and that spa therapy is more effective in never-smokers than in ex-smokers.
7.Effects of Spa Therapy for Asthmatics with a Long History of Cigarette Smoking, Evaluated by Bronchial Hyperresponsiveness and Generation of Leukotrienes by Leucocytes
Fumihiro MITSUNOBU ; Yasuhiro HOSAKI ; Kozo ASHIDA ; Naofumi IWAGAKI ; Takuya NAGATA ; Makoto FUJII ; Shingo TAKATA ; Masanori HAMADA ; Yoshiro TANIZAKI
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2005;68(2):83-91
The effects of spa therapy for asthmatics with a long history of cigarette smoking were studied, compared with the effects for those without smoking history. 1. Of 22 patients with smoking history, 15 (68.2%) had definite efficacy of spa therapy (4 had marked efficacy, and 11 had moderate efficacy), and the residual 7 had slight or no efficacy. In contrast, of 36 patients without smoking history, 29 (80.6%) had definite efficacy. The effects of spa therapy for asthmatics were significantly higher in never-smokers than in ex-smokers.
2. A significant increase in the production of IgE antibodies, bronchial hyperresponsiveness and the generation of leukotrienes B4 (LTB4) and C4 (LTC4) by leucocytes was observed in ex-smokers compared with never-smokers. 3. The frequency of patients with a positive BAST against inhalant allergens was larger in subjects with slight or no efficacy than in those with marked or moderate efficacy in never-smokers, but not in ex-smokers. 4. Bronchial hyperresponsiveness was significantly increased in patients with slight or no efficacy than in those with marked or moderate efficacy both in ex-smokers and never-smoker. 5. The generation of LTB4 was more increased in subjects with slight or no efficacy than in those with efficacy both in ex-smokers and never-smokers, however, the differences were not significant. 5. The generation of LTC4 tended to be more increased in subjects with slight or no efficacy than in those with efficacy in never-smokers, but not in ex-smokers, although these were not significant. The results suggest that an increase in the production of IgE antibodies, bronchial hyperresponsiveness, and the generation of LTB4 and LTC4, which might be influenced by cigarette smoking, affect the effects of spa therapy for patients with asthma.
9.A Case of Decreased Swallowing Function Due to Cardiac Myxoma
Sumiyo AKAZAWA ; Seiko MIURA ; Yasuhiro NAGAYOSHI ; Junya FUKUSHIMA ; Takahiro NISHINO ; Hiroji NAGATA ; Taigo NAGAYAMA ; Kazuaki NISHIKI ; Taishi FUJII ; Daisuke SAKAMOTO ; Tetsuya MINAMI ; Taketsugu TSUCHIYA ; Hidetaka URAMOTO ; Shigeru KUDOH ; Tamaki TAKANO ; Takaki MIWA ; Michihiko KITAYAMA ; Shigeru SKAMOTO
An Official Journal of the Japan Primary Care Association 2022;45(1):31-35
The case was a 77-year-old man. He had dizziness and dysphagia for 2 years, and underwent detailed screening at the internal medicine department for general malaise and bloody sputum. He was hospitalized for aspiration pneumonia due to dysphagia of unknown origin. This time, he visited a local doctor with palpitations and shortness of breath. Echocardiography indicated a left atrial tumor involving the mitral valve and arrhythmia. Emergency surgery was performed to remove the left atrial myxoma and close the patch at our hospital's cardiovascular surgery department. After the excision, swallowing function was restored, and the patient was diagnosed with postoperative Ortner's syndrome. We report a case where echocardiography was considered important as a detailed investigation of the cause of swallowing dysfunction and dizziness.
10.Associations between thyroid-stimulating hormone and hypertension according to thyroid cyst status in the general population: a cross-sectional study.
Yuji SHIMIZU ; Yuko NABESHIMA-KIMURA ; Shin-Ya KAWASHIRI ; Yuko NOGUCHI ; Yasuhiro NAGATA ; Takahiro MAEDA ; Naomi HAYASHIDA
Environmental Health and Preventive Medicine 2020;25(1):69-69
BACKGROUND:
The absence of thyroid cysts may indicate latent thyroid damage, as demonstrated in our previous study. However, the association between the absence of thyroid cysts and latent functional damage of the thyroid is unknown. At low thyroid hormone productivity, which may be associated with latent functional damage of the thyroid, the association between thyroid-stimulating hormone (TSH) and hypertension might be enhanced. Therefore, we evaluated the association between TSH level and hypertension stratified by thyroid cyst status.
METHODS:
We conducted a cross-sectional study of 1724 euthyroid Japanese individuals aged 40-74 years who participated in an annual health checkup in 2014.
RESULTS:
In the study population, 564 and 686 participants had thyroid cysts and hypertension, respectively. A significant positive association was observed between TSH and hypertension in subjects without a thyroid cyst but not in subjects with thyroid cysts. There was a significant positive association between hypertension and TSH in subjects without a thyroid cyst (odds ratio [OR] 1.27; 95% confidence intervals [CI] 1.01, 1.61) but not in subjects with thyroid cysts (OR 0.79; CI 0.57, 1.09) in the model fully adjusted for known confounding factors. The correlation between the TSH and free triiodothyronine (fee T3) levels (simple correlation coefficient [r] = - 0.13, p < 0.01) was stronger in the subjects without thyroid cysts than in those with thyroid cysts (r = - 0.03, p = 0.525).
CONCLUSIONS
TSH is positively associated with hypertension only in individuals without thyroid cysts. The correlation between the TSH and free T3 levels was stronger in the subjects without thyroid cysts than in those with thyroid cysts. Therefore, the absence of thyroid cysts could be related to the association between TSH level and hypertension, possibly by indicating that the subjects without thyroid cysts had limited thyroid hormone reserves. Therefore, the absence of thyroid cysts could indicate the latent functional damage of the thyroid.
Aged
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Cross-Sectional Studies
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Cysts/etiology*
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Female
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Humans
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Hypertension/metabolism*
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Japan
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Male
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Middle Aged
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Thyroid Diseases/etiology*
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Thyroid Gland/pathology*
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Thyrotropin/metabolism*