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Toshiki Furukawa,
Takashi Hasegawa, Kazuo Suzuki,
Toshiyuki Koya,
Takuro Sakagami,
Akira Youkou,
Hiroshi Kagamu,
Masaaki Arakawa,
Fumitake Gejyo,
Ichiei Narita,
Eiichi Suzuki
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ABSTRACT: Although the association between asthma control and body mass index (BMI) has been thoroughly investigated, most of this work has focused on the influence on asthma incidence or the effect of obesity on asthma control. To date, there have been no published studies on the influence of underweight on asthma control.
The aim of this study was to investigate the influence of underweight, as defined by the Japan Society for the Study of Obesity (JASSO), on asthma control in Japanese asthmatic patients. Using data from questionnaire surveys administered by the Niigata Asthma Treatment Study Group, we compared asthma control, as measured by the Asthma Control Test (ACT), between a normal weight group (18.5kg/m2 =< BMI < 25kg/m2) and an underweight group (BMI < 18.5kg/m2).
Of the asthmatic patients who completed the 2008 and 2010 surveys, 1464 and 1260 cases were classified as being in the normal weight group, and 174 and 155 cases were classified as being in the underweight group. The ACT score (median, [interquartile range]) in the underweight group in 2008 (22, [19-24]) and 2010 (23, [19-25]) was significantly lower than that in the normal group in 2008 (23, [20-25]) and in 2010 (24, [21-25]).
This study is the first, large-scale investigation of the influence of underweight on asthma control, and we have confirmed an adverse influence in a clinical setting. A potential mechanism for this interaction was unknown. Further investigation will be required.
Allergology International 07/2012; 61(3):489-96.
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Mayumi Sasagawa,
Takashi Hasegawa,
Jun-ichiro J Kazama,
Toshiyuki Koya,
Takuro Sakagami, Kazuo Suzuki,
Katsuhito Hara,
Hideo Satoh,
Katsuya Fujimori,
Fumitoshi Yoshimine,
Kazuhiro Satoh,
Ichiei Narita,
Masaaki Arakawa,
Fumitake Gejyo,
Eiichi Suzuki
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ABSTRACT: BACKGROUND: The effect of inhaled corticosteroid (ICS) on the bone status of asthmatic patients is still uncertain, because it can differ by race and because there have been few cases in Japan. In this study, the bone status of ICS users with asthma was evaluated in an actual clinical setting in Japan. METHODS: In 7 participating hospitals, ICS users with asthma and control subjects were age- and gender-matched and recruited into this study. To assess bone status, ultrasound measurements of each individual's calcaneus were made using an AOS-100. The ratio of the osteo sono-assessment index (OSI) to the average OSI corrected for age and gender was denoted as %OSI and used for quantitative assessment. The second %OSI measurement was performed 6 months after the first %OSI one. During the study period, individual treatment remained unchanged. Results: There were no significant differences in the 1st and 2nd %OSI between the ICS users and control subjects. However, the 2nd %OSI significantly decreased compared with 1st %OSI in female ICS users, although there were no significant changes in the male and female control subjects and male ICS users. Conclusions: The 6 month management of asthma in the actual clinical setting, including regular ICS use, might have a harmful influence on the bone status of female asthmatic patients. It may be necessary to manage and treat female patients for potent corticosteroid-induced osteoporosis, although further analyses of bone status in asthma patient ICS users will be required.
Allergology International 06/2011; 60(4):459-65.
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ABSTRACT: BACKGROUND Despite the use of inhaled corticosteroid (ICS) becoming increasingly widespread, many problems related to asthma management still need to be addressed. One of them, obesity, has been reported to exert a harmful influence on asthma control. However, there have been few reports focusing not only on both obesity and its influence on Japanese asthma patients but also on the Japanese definition of obesity, as defined by the Japan Society for the Study of Obesity (JASSO). AIMS & METHODS The aim of this study was to confirm the influence of obesity, as defined by the JASSO, on asthma management in Japanese asthmatic patients. Using data from the Niigata Asthma Treatment Study Group 2008 questionnaire survey, differences between the "normal" group (18.5 kg/m(2) ≤ BMI <25 kg/m(2)) and the "obese" group (25 kg/m(2) ≤ BMI) were analyzed. RESULTS There was a significantly lower step 1 rate (19.4% v.s. 26.8%) and a higher proportion of patients using inhaled salmeterol (43.6% v.s. 35.8%) and leukotriene receptor antagonist (49.8% v.s. 40.8%) in the obese group relative to the normal group, although there were no significant differences in indicators of asthma control, including asthma control test scores. CONCLUSION This study investigated influences of JASSO-defined obesity on asthma severity and management in a clinical setting in Japan. It is possible that there are strong interactions between asthma and obesity, such as obesity causing decreased ICS therapy efficacy and leukotriene (LT)-related inflammation, although further investigation is necessary.
Internal Medicine 01/2011; 50(18):1911-6. · 0.94 Impact Factor
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ABSTRACT: Perimenstrual asthma (PMA) has been documented in 30% to 40% of asthmatic women; the characteristics of PMA have also been well described. However, there have been few epidemiological investigations of PMA in practice. In this study, we analyzed PMA based on a questionnaire survey carried out in Japan and compared the results with those of studies reported previously.
For 8 weeks from September through October 2004, a questionnaire survey was administered to patients with bronchial asthma and their attending physicians. The questionnaire surveyed asthma control, asthma-related emergencies and satisfaction in daily life. The attending physicians were questioned about patient profiles and medications. All female patients who were menstruating during the survey period and who were known to have asthma exacerbation related to menstruation were allocated to the PMA group; those who were not were allocated to the non-PMA group.
The rate of PMA in female patients who were menstruating during the survey period was 11.3% in this study. Characteristic features of the PMA group (n = 54) included more severe disease, worsened disease control and more aggressive patient management, including increased oral corticosteroid use compared with the non-PMA group. The rates of emergency episodes in the PMA group were higher than in the non-PMA group. There was a significant increase in aspirin intolerant asthma (AIA, 25.5%) in the PMA group compared with the non-PMA group (8.4%).
Attention should be paid to the lack of knowledge regarding PMA in patients with asthma in actual clinical settings. The low rate of PMA reported in this study may be due to the study method using self-reports of PMA by patients without sufficient knowledge, and may not be an accurate representation of the actual incidence of the disease. The clinical similarity of PMA to AIA in this study may also provide a new insight into the mechanism of PMA.
Allergology International 10/2007; 56(3):249-55.
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Allergology International 07/2007; 56(2):179.
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Kazuo Suzuki,
Junta Tanaka,
Yuhsuke Ogaw,
Akio Kasai,
Yasuhiko Ohno,
Kunio Sakail,
Hideaki Nakayama,
Hiroki Tsukada,
Fumitake Gejyo,
Kazuhiko Hanzawa,
Eiichi Suzuki
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ABSTRACT: We encountered 2 cases of pulmonary thromboembolism developed during refuge for Niigata Chuetsu earthquake in 2004. Case 1 was a 76-year-old woman who moved to the back seat of a car for refuge since the earthquake struck on October 23rd, 2004. When she emerged from the car on the morning of October 25th, she felt sudden dyspnea and lost consciousness. On arrival at the hospital, she had low blood pressure and hypoxemia, hypocapnia, and metabolic acidosis. Based on her clinical history and her symptoms, pulmonary thromboembolism was suspected and heparinization was begun immediately. In our hospital, the chest CT angiography proved the diagnosis. She was transferred to a university hospital for further treatment. Case 2 was a 79-year-old woman. She spent only one night in a car. Fifteen days after the earthquake, chest tightness and dyspnea occurred. Although her symptoms were improved and disappeared, she came to our hospital. Chest CT images confirmed pulmonary thromboembolism, and treatment with heparin was begun. We think this pulmonary thromboembolism was related to the knee-bending position she had assumed in the car and decreased activity during refuge. This is a clinical condition which could happen during disasters in the future. We should recognize the likelihood of pulmonary thromboembolisms in the disasters in the future.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 05/2007; 45(4):324-8.
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ABSTRACT: A 76-year-old man with autosomal dominant polycystic kidney disease (ADPKD) was admitted complaining of severe edema of bilateral lower extremities. Computed tomography (CT) of his abdomen revealed an enlarged hepatic cyst with intra-cystic hemorrhage, and massive thrombosis in the inferior vena cava (IVC). The extrinsic mechanical stress on the IVC seemed to induce thrombosis within the IVC, and the thrombosis was likely the cause of severe edema in lower extremities. In this report, we present a rare case of IVC thrombosis due to an enlarged cyst in ADPKD successful treated with anticoagulant therapy.
Internal Medicine 04/2004; 43(3):209-12. · 0.94 Impact Factor
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Kazuo Suzuki,
Shinichi Kinebuchi,
Kentaro Sugiyama,
Hiroshi Satoh,
Masuo Tango,
Hirochi Moriyama,
Masaki Terada,
Hidemi Ooi,
Takashi Hasegawa,
Kenichi Igarashi,
Makoto Satoh,
Eiichi Suzuki,
Fumitake Gejyo
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ABSTRACT: A 65-year-old woman who had complained of non-productive cough since May 1998 visited our hospital on November 5, 2000. She had been treated at another hospital with Kampo (Chinese herbal medicine), including Moku-boui-to, Bakumon-do-to, and Saiko-keishi-kankyo-to for chronic non-productive cough. Chest radiographs and CT films showed the reticular shadows that had been present in 1998, in both lower lung fields, and also demonstrated new reticular shadows in the right upper lung field and left lingular segment. Laboratory data revealed hypoxemia and pulmonary function tests revealed restrictive ventilatory disturbance, so she was admitted to our hospital on November 9, 2000. After the cessation of Kampo treatment, her symptoms disappeared, and the hypoxemia, restrictive disturbance, and reticular shadows in the chest radiograph gradually improved. Video-assisted lung biopsy specimens showed thickened alveolar walls with lymphocyte and eosinophil infiltration. A leukocyte migration test was positive for Moku-boui-to, Bakumon-do-to, and weakly positive for Saiko-keishi-kankyo-to. Although no challenge test for Kampo was performed, we diagnosed this case as interstitial pneumonia exacerbated Kampo-induced pneumonitis based on these clinical, laboratory and histological findings.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 08/2002; 40(7):605-11.
