著者

中山 久代 今村 俊一 野沢 出 橋本 かおり 村上 嘉彦

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 (ISSN:00326313)

巻号頁・発行日

vol.89, no.11, pp.1407-1413, 1996-11-01 (Released:2011-11-04)

参考文献数

15

被引用文献数

1

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The effectiveness of midodrine administration for the treatment of dizziness in patients with orthostatic dysregulation (OD) was investigated. Midodrine (4mg/day) was administered for 8 weeks to 42 patients with dizziness who were confirmed to have orthostatic dysregulation based on a questionnaire. The patients were subdivided into 3 groups on the basis of blood pressure and Schellong test results. Twenty patients had low systolic pressure, less than 100mmHg at rest in the supine position, twelve patients had orthostatic hypotension, and the other ten patients were diagnosed to have orthostatic dysregulation without low systolic pressure or orthostatic hypotension.The effects of the drug were evaluated objectively on the basis of improvement in the Schellong test results, and subjectively on the basis of the patient's perception of symptoms as described in the OD questionnaire results at 4 and 8 weeks after midodrine administration. In general, the symptoms tended to decrease after treatment in most of the patients. In patients with hypotension or orthostatic hypotension, in particular, excellent improvement was achieved. Improvement occurred not only in the patients symptoms, but also in low blood pressure at bed rest and Schellong test results. These observations suggest that administration of midodrine was efficacious in the treatment of dizziness in patients with orthostatic dysregulation as a probable consequence of poor cir culatory function due to autonomic imbalance.

著者

野沢 出 中山 久代 霜村 真一 橋本 かおり 今村 俊一 久松 建一 村上 嘉彦

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.52, no.4, pp.577-583, 1993 (Released:2009-06-05)

参考文献数

22

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We carried out a questionnaire. survey on orthostatic dysregulation (abbreviated OD) in 63 young female subjects aged 18-19 years. Ten of them were judged to have confirmed OD, 8 had suspected OD, and the remaining 45 were regarded as normal. Schellong test results showed some difference in three items between the confirmed OD group and normal subjects, but the positive rate of the Schellong test in itself was not significantly different among these three groups. It was our impression that a more detailed analysis of this test is needed to increase its diagnostic validity in determining OD.The Cornell Medical Index-Health Questionnaire (abbreviated CMI) which was modified for the Japanese population with emotional disturbances by Fukamachi was given to these subjects to obtain information about their underlying psychological and emotional status. According to Fukamachi's classification Type III or IV patterns, suggestive of suspicious (III) or probable (IV) neurosis were found in 5 (11.1%) of the normal subjects, in 3 (30.3%) of the subjects with confirmed OD, and in 4 (50.0%) of those with suspected OD. These data suggest a correlation between OD and emotional and/or psychogenic disturbances.Subjects with OD and patients with vertigo or dizziness who visited our clinic were noted to have similar results on CMI. This does not, however, necessarily mean that some subjects with OD are abnormal or sick, since the CMI itself is intended only as an adjunct to, and not as a substitute for, medical interviews and physical examinations.

著者

桐山 裕二 金沢 健雅 濱島 吉男 阿部 篤朗 橋本 かおり 藤原 寛樹 秋山 篤子 山井 庸介 清水 豊 本村 一郎 一和多 俊男 平岡 仁志 長尾 光修

出版者

特定非営利活動法人 日本呼吸器内視鏡学会

雑誌

気管支学 (ISSN:02872137)

巻号頁・発行日

vol.21, no.5, pp.338-343, 1999

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症例は21歳, 男性。20歳時よりうつ病, 心身症で某医にて加療歴あり。深夜に泥酔状態で帰宅し, 酸素スプレーと誤って家庭用殺虫剤を吸入した。翌朝になって発熱, 咳嗽, 血痰, 呼吸困難が出現し近医で胸部異常影を指摘され, 当科紹介入院。入院時の胸部X線では両側S^6主体の肺胞性浸潤影が認められ, 発症経過からリポイド肺炎が考えられたため, パルス療法と抗生剤による治療を施行した。全経過中に胸水貯留像や結節状陰影など多彩なX線像を呈したが, ステロイド療法継続により線維化像をみることなく改善した。本症例では組織診断は得られなかったが, 気管支洗浄液のガスクロマトグラフ質量分析の結果において, 誤って吸入したとされる殺虫剤成分に含まれるケロシンと同一成分が気管支洗浄液中に検出されたことより外因性リポイド肺炎が強く疑われた。