著者

石原 享介 中井 準 坂本 広子 李 英徹 岩崎 博信 梅田 文一 恒田 時雄 瀬尾 憲正

出版者

The Japanese Respiratory Society

雑誌

日本胸部疾患学会雑誌 (ISSN:03011542)

巻号頁・発行日

vol.20, no.6, pp.688-693, 1982-06-25 (Released:2010-02-23)

参考文献数

18

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A 31-year-old housewife with a history of recurrent eczema and otitis media was admitted in March 1981, because of progressive dyspnea. On admission she was semicomatotic, febrile and cyanotic. Inspiratory crackles were heard all over the lung. Eczema was present on the scalp. Chest X-ray showed bilateral consolidation. Arterial blood gas analysis showed marked hypoxemia. She was immediately placed on CPPV, large doses of antibiotics and hydrocortisone. During 10 days stay in ICU, her condition improved gradually.Her chest X-ray two weeks after admission showed residual scattered fine nodular densities with a partially confluent area. Because she had been using an ultrasonic humidifier in her home for four months before admission, an attempt to provocate the condition using her own humidifier was made. Four hours after humidifing besides her bed for one hour, a fever of 37.8°, leukocytosis and a decrease of vital capacity developed. Chest X-ray 22 hours after provocation showed new scattered fine densities. Microscopic examination of lung tissues obtained by transbronchial lung biopsy showed infiltration of lymphocytes with a few neutrophiles and eosinophiles to the alveolar wall.Candida albicans was cultured from water in the humidifier and precipitating antibody to this organism was detected in her serum. However inhalation provocation test using this organism was not performed.

著者

岡崎 美樹 冨岡 洋海 長谷 川幹 片上 信之 坂本 廣子 石原 享介 岩崎 博信 梅田 文一 中井 準 岡田 行功 庄村 東洋

出版者

JAPANESE SOCIETY FOR TUBERCULOSIS

雑誌

結核 (ISSN:00229776)

巻号頁・発行日

vol.65, no.4, pp.293-297, 1990

被引用文献数

11

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A case of 22-year-old female with mediastinal tuberculous lymphadenitis and pericostal tuberculosis was reported.Her complaint was right chest pain and subcutaneous mass on the right chest wall.Chest contrast CT showed right paratracheal lymph node swelling with central low density area and surrounding rim enhancement, which has been reported as typical characteristics of mediastinal tuberculous lymphadenit is.Pigeon-egg sized subcutaneous mass with fluctuation was palpable on the right sternal border and the smear of its content showed acid-fast bacilli.In spite of two months therapy with antituberculous drugs, both masses were unchanged in size.The lesions resected surgically, were both encapsulated abscesses containing yellowish pus, and microscopic examination of these specimen disclosed the finding of tuberculosis.Mycobacterium tuberculosis was cultured from contents of both masses.After nine months of anti-tuberculous therapy, no sign of recurrence is observed until now.Both masses were discontinuous and the possibility of lymphangitic spread of organism was speculated as its etiology.

著者

足立 満 森川 昭廣 石原 享介

出版者

一般社団法人 日本アレルギー学会

雑誌

アレルギー (ISSN:00214884)

巻号頁・発行日

vol.51, no.5, pp.411-420, 2002

参考文献数

10

被引用文献数

25

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本邦における喘息患者の実態を調査するために,2000年9月から12月にかけて全国に無作為に電話によるインタビューを行った.協力世帯は38,132世帯,このうち喘息患者は1,326世帯で確認され,最終的に成人401名,小児402名の喘息患者を解析対象とした.この1ヵ月間の喘息の症状は成人,小児ともに日中で半数以上,夜間で4割で認められた.この1年間の通院は成人で4割,小児で6割が経験した.日常生活・社会活動上で何らかの制約を感じたのは成人で7割,小児で6割に及んだ.肺機能検査を受けたことが無い患者は成人で半数,小児で8割に上った.喘息の病態を「気道炎症」と回答した患者は成人で6%,小児の保護者で7%,吸入ステロイド薬使用頻度は成人で12%,小児で5%と低くかった.重症の患者では客観的重症度と白己評価の重症度に大きなギャップが認められ,自分を実際よりも軽症と判断している場合が多かった.本調査より,有効な治療法が存在するにもかかわらず,本邦の喘息管理はガイドラインの目標に遥かに及んでいないことが判明した.全ての臨床医への正しい知識の普及,さらに喘息に対する社会認識を高めるためより一層の社会への教育,啓蒙の重要性が示唆された.