ミチバ
More プロフィール

Search

Calendar

<<　2012/02　>>
日 月 火 水 木 金 土
1 2 3 4
5 6 7 8 9 10 11
12 13 14 15 16 17 18
19 20 21 22 23 24 25
26 27 28 29

トップページ

Doctors Blog

ブログの購読

新着コメント

新着トラックバック

< セミ・リアルタイム中継：高齢者住宅．その... | メイン | 金属（加工）労働者は、間質性肺炎のリスク... >
2008.11.19 22:00 |  診療  |  その他（医療関連）  |  ミチバ  | 推薦数 : 2

職業性肺疾患、慢性過敏性肺炎、特発性肺線維症の鑑別を

・慢性過敏性肺炎（ＨＰ）と特発性肺線維症（ＩＰＦ）についての以下のような総説がありました。（総説なので抄録はありません）

慢性過敏性肺炎と特発性肺線維症の類似性

吉澤靖之(東京医科歯科大学 大学院医歯学総合研究科統合呼吸器病学)

アレルギー(0021-4884)57巻2号 Page95-101(2008.02)

 

・この論文の「はじめに」に「・・・特発性とは原因がないというより現在は不明であるとするのが正しく、特発性は仮の診断名に冠する単語である。」とあり、「おわりに」で、「ＩＰＦと診断する前に職業歴および生活歴（住宅環境も含めて）を詳細に聴取すること」とかかれています。私自身特発性間質性肺炎ということばは極力使いません。特発性といってしまえば、それで原因を追究する努力がストップするおそれがあるからです。

・この論文の中で、「慢性過敏性肺炎の原因抗原」という表があり、職業・環境医学的に大切だと思いましたので、以下に引用します。

 

疾患名発生状況抗原
夏型過敏性肺炎住居Trichosporon asahii, T. mucoides
塗装工肺自動車塗装イソシアネート
住居関連過敏性肺炎住居

Candida albicans, Aspergillus niger,

Cephalosporium acremonium,

Penicillium corylophilum

鳥飼病

 

 

 

 

羽毛ふとん肺

鳥飼育

自宅庭への鳥飛来

鶏糞肥料使用

剥製

間接曝露

羽毛布団使用

鳥排泄物

〃

〃

羽毛

隣人の鳩、公園・神社･駅の野鳥、野鳩の群棲

羽毛

加湿器肺加湿器使用Aspergillus flavus? Phoma herbarum?

農夫肺

 

 

 

 

酪農作業

 

 

 

トラクター運転

Saccharopolyspora retivirgula,

Thermoactinomyces vulgaris,

Absidia corymbifera, Eurotium amstelodami,

Wsllemia sebi

Rhizopus属

機械工肺

(machine operator lung)

自動車工場

(metal working fluids)

合成水溶性機械洗浄液中

Acinetobacter lwoffii? Pseudomonas fluorescens?

小麦粉肺菓子製造小麦粉

コーヒー作業者肺

(coffee worker's lung)

コーヒー豆を炒る作業

(coffee roast factory)

コーヒー豆塵埃(coffee-bean dust)

 

温室栽培者肺

ラン栽培（温室）

きゅうり栽培（温室）

不明（木材チップの真菌）

不明

きのこ栽培者肺

椎茸栽培

エノキダケ栽培

椎茸胞子

エノキダケ胞子（？）

固定リンク | コメント (1) | トラックバック (110)

トラックバック

この記事のトラックバック URL

http://blog.m3.com/OEM/20081119/2/trackback

トラックバック一覧

Blogs ou should be reading
[...]Here is a Great Blog You Might Find Interesting that we Encourage You[...]… [続きを読む]
posted from brooksglycerin8 2011.11.11 03:03
Recommeneded websites…
Here are some of the sites we recommend for our visitors [続きを読む]
posted from antenna geoselector 2011.11.19 23:18
Recommeneded websites…
[...]Here are some of the sites we recommend for our visitors[...]…… [続きを読む]
posted from jwoww tanning lotion 2011.11.23 02:58
Cool sites
[...]we came across a cool site that you might enjoy. Take a look if you want[...]… [続きを読む]
posted from Cheap Fires 2011.11.23 07:42
The best website……
[...]here are some links to sites that we link to because we think they are worth visiting[...]…… [続きを読む]
posted from jwoww tanning lotion 2011.11.23 17:10
Online Article…
[...]The information mentioned in the article are some of the best available [...]... [続きを読む]
posted from best adjustable dumbells 2011.11.26 00:02
free iphone games ipad download android apps
I’m impressed, I have to say. Really hardly ever do I encounter a blog that’s each educative and ent... [続きを読む]
posted from android apps download 2011.11.26 22:56
Visitor recommendations
[...]one of our visitors recently recommended the following website[...]… [続きを読む]
posted from britax frontier 85 reviews 2011.11.27 09:46
Recommeneded websites
[...]Here are some of the sites we recommend for our visitors[...]… [続きを読む]
posted from outdoor play 2011.11.27 21:41
Cool sites
[...]we came across a cool site that you might enjoy. Take a look if you want[...]… [続きを読む]
posted from best elliptical machines 2011.11.28 01:58
Links
[...]Sites of interest we have a link to[...]… [続きを読む]
posted from Baby Flip Flops 2011.11.28 07:01
Recent Blogroll Additions…
[...]usually posts some very interesting stuff like this. If you’re new to this site[...]… [続きを読む]
posted from teeter hang ups ep-550 inversion table 2011.11.28 17:42
Blogs ou should be reading
[...]Here is a Great Blog You Might Find Interesting that we Encourage You[...]… [続きを読む]
posted from bov800xl 2011.11.28 22:26
Links
[...]Sites of interest we have a link to[...]… [続きを読む]
posted from business portraits 2011.11.29 07:02
Links
[...]Sites of interest we have a link to[...]… [続きを読む]
posted from Facebookpasswordhack 2011.11.29 18:17
Read was interesting, stay in touch…
[...]please visit the sites we follow, including this one, as it represents our picks from the web[.... [続きを読む]
posted from Reputation Defender Experts 2011.11.30 08:52
Related…
[...]just beneath, are numerous totally not related sites to ours, however, they are surely worth go... [続きを読む]
posted from video game reviews 2011.11.30 09:21
Blogs ou should be reading
[...]Here is a Great Blog You Might Find Interesting that we Encourage You[...]… [続きを読む]
posted from garmin for running 2011.11.30 18:33
Superb website
[...]always a big fan of linking to bloggers that I love but don’t get a lot of link love from[...]…... [続きを読む]
posted from natural sleep herbs 2011.11.30 23:26
Websites worth visiting
[...]here are some links to sites that we link to because we think they are worth visiting[...]… [続きを読む]
posted from after a heart attack 2011.12.01 06:51
Websites you should visit
[...]below you’ll find the link to some sites that we think you should visit[...]… [続きを読む]
posted from S8100 2011.12.01 07:19
Read was interesting, stay in touch…
[...]please visit the sites we follow, including this one, as it represents our picks from the web[.... [続きを読む]
posted from Herbal Incense 2011.12.01 19:10
Related…
[...]just beneath, are numerous totally not related sites to ours, however, they are surely worth go... [続きを読む]
posted from costa rica surf camp 2011.12.06 23:54
Superb website…
[...]always a big fan of linking to bloggers that I love but don’t get a lot of link love from[...]…... [続きを読む]
posted from White Bean Chicken Chili Recipe 2011.12.08 14:48
Related…
[...]just beneath, are numerous totally not related sites to ours, however, they are surely worth go... [続きを読む]
posted from furgoneta 2011.12.08 22:23
Related…
[...]just beneath, are numerous totally not related sites to ours, however, they are surely worth go... [続きを読む]
posted from website hosting 2011.12.09 05:57
Links…
[...]Sites of interest we have a link to[...]…… [続きを読む]
posted from Chicken Drumsticks and mushroom recipes 2011.12.09 14:18
Blogs ou should be reading
[...]Here is a Great Blog You Might Find Interesting that we Encourage You[...]… [続きを読む]
posted from help tinnitus 2011.12.10 01:05
Wow
[...]below you’ll obtain the link to some internet sites that we think you must visit[...] [続きを読む]
posted from septic tank 2011.12.10 17:45
Related…
[...]just beneath, are numerous totally not related sites to ours, however, they are surely worth go... [続きを読む]
posted from promotional products 2011.12.10 21:14
Websites you should visit
[...]below you’ll find the link to some sites that we think you should visit[...]… [続きを読む]
posted from Resistor color coding 2011.12.11 09:35
Wow
[...]below you’ll find the link to some websites that we consider you must visit[...] [続きを読む]
posted from septic portland 2011.12.12 13:03
Links…
[...]Sites of interest we have a link to[...]…… [続きを読む]
posted from Spinach Stuffed Chicken 2011.12.12 14:52
Check this out
[...] that is the end of this article. Here you’ll find some sites that we think you’ll appreciate, ... [続きを読む]
posted from low cost web design 2011.12.13 00:40
Cool sites
[...]we came across a cool site that you might enjoy. Take a look if you want[...]… [続きを読む]
posted from writing software 2011.12.13 02:35
Awesome website
[...]the time to read or visit the content or sites we have linked to below the[...]… [続きを読む]
posted from burlington coat factory 2011.12.13 07:07
Websites worth visiting
[...]here are some links to sites that we link to because we think they are worth visiting[...]… [続きを読む]
posted from internet Marketing 2011.12.13 21:17
Blogs ou should be reading
[...]Here is a Great Blog You Might Find Interesting that we Encourage You[...]… [続きを読む]
posted from Best Home Surveillance Equipment 2011.12.14 07:15
Sites we Like…
[...] Every once in a while we choose blogs that we read. Listed below are the latest sites that we ... [続きを読む]
posted from white boots 2011.12.14 19:00
Awesome website
[...]the time to read or visit the content or sites we have linked to below the[...]… [続きを読む]
posted from creative valentines day gifts 2011.12.14 21:27
Sites we Like…
[...] Every once in a while we choose blogs that we read. Listed below are the latest sites that we ... [続きを読む]
posted from ray ban 2011.12.15 07:31
Visitor recommendations
[...]one of our visitors recently recommended the following website[...]… [続きを読む]
posted from sell phones 2011.12.15 20:06
Visitor recommendations
[...]one of our visitors recently recommended the following website[...]… [続きを読む]
posted from shoulder press barbell 2011.12.18 23:48
Recommeneded websites
[...]Here are some of the sites we recommend for our visitors[...]… [続きを読む]
posted from Selbstcoaching 2011.12.19 03:33
Sites we Like…
[...] Every once in a while we choose blogs that we read. Listed below are the latest sites that we ... [続きを読む]
posted from Cheap Calls Worldwide 2011.12.19 06:58
Blogs ou should be reading
[...]Here is a Great Blog You Might Find Interesting that we Encourage You[...]… [続きを読む]
posted from business funding leads 2011.12.19 09:14
replacement windows
[...]below you’ll locate the link to some web-sites that we believe you ought to visit[...] [続きを読む]
posted from window replacement colorado springs 2011.12.20 04:03
Great website…
[...]here are some hyper-links to sites that we link to as we feel they are really worth browsing[..... [続きを読む]
posted from Chicken Recipes For Dinner 2011.12.23 17:59
Thank
[...]below you’ll come across the link to some web sites that we believe you'll want to visit[...] [続きを読む]
posted from text marketing 2011.12.25 12:45
Sources…
[...]check below, are some totally unrelated websites to ours, however, they are most trustworthy so... [続きを読む]
posted from Chicken Recipes For Dinner 2011.12.30 12:22
Great website…
[...]here are some hyper-links to sites that we link to as we feel they are really worth browsing[..... [続きを読む]
posted from Chicken Recipes For Dinner 2011.12.31 01:10
Related…
[...]just beneath, are numerous totally not related sites to ours, however, they are surely worth go... [続きを読む]
posted from Obi Quack 2012.01.01 19:51
Sites we Like…
[...]Every once in a while we choose blogs that we read. Listed below are the latest sites that we c... [続きを読む]
posted from pool safety fence tampa 2012.01.03 20:46
Great website
[...]we like to honor many other internet sites on the web, even if they aren’t linked to us, by lin... [続きを読む]
posted from Download Themeforest Templates For FREE 2012.01.04 11:13
Superb website
[...]always a big fan of linking to bloggers that I love but don’t get a lot of link love from[...] [続きを読む]
posted from hearing loss 2012.01.07 13:18
Links
[...]Sites of interest we have a link to[...]… [続きを読む]
posted from tax refund 2012.01.17 22:05
Read was interesting, stay in touch…
[...]please visit the sites we follow, including this one, as it represents our picks from the web[.... [続きを読む]
posted from SEO 2012.01.18 18:38
Superb website
[...]always a big fan of linking to bloggers that I love but don’t get a lot of link love from[...]…... [続きを読む]
posted from Stress asthma treatment 2012.01.18 20:41
Websites you should visit
[...]below you’ll find the link to some sites that we think you should visit[...]… [続きを読む]
posted from bowflex selecttech 552 2012.01.19 17:58
Awesome website
[...]the time to read or visit the content or sites we have linked to below the[...]… [続きを読む]
posted from adjustable dumbbell sets 2012.01.19 20:10
Sites we Like…
[...] Every once in a while we choose blogs that we read. Listed below are the latest sites that we ... [続きを読む]
posted from Bread maker reviews 2012.01.19 21:44
Great
[...]that will be the end of this article. Here you’ll come across some web sites that we think you ... [続きを読む]
posted from stock market news 2012.01.20 11:02
Check this out
[...] that is the end of this article. Here you’ll find some sites that we think you’ll appreciate, ... [続きを読む]
posted from car rental costa rica 2012.01.20 18:45
Visitor recommendations
[...]one of our visitors recently recommended the following website[...]… [続きを読む]
posted from Comunicados de prensa 2012.01.20 21:50
Awesome website
[...]the time to read or visit the content or sites we have linked to below the[...]… [続きを読む]
posted from como conquistar a una mujer 2012.01.21 21:51
Sites we Like…
[...] Every once in a while we choose blogs that we read. Listed below are the latest sites that we ... [続きを読む]
posted from Best Projector Reviews 2012.01.22 00:14
Great website
[...]we like to honor many other internet sites on the web, even if they aren’t linked to us, by lin... [続きを読む]
posted from Printing A5 Flyers 2012.01.23 21:07
Visitor recommendations
[...]one of our visitors recently recommended the following website[...]… [続きを読む]
posted from Naples NY Real Estate 2012.01.24 03:07
Sites we Like…
[...] Every once in a while we choose blogs that we read. Listed below are the latest sites that we ... [続きを読む]
posted from Dominical 2012.01.24 16:13
Visitor recommendations
[...]one of our visitors recently recommended the following website[...]… [続きを読む]
posted from forex bonus account 2012.01.24 17:50
Recent Blogroll Additions…
[...]usually posts some very interesting stuff like this. If you’re new to this site[...]… [続きを読む]
posted from Costa Rica news 2012.01.24 18:51
Check this out
[...] that is the end of this article. Here you’ll find some sites that we think you’ll appreciate, ... [続きを読む]
posted from Costa Rica Homes For Sale 2012.01.25 19:41
Blogs you should be reading
[...]Here is a Great Blog You Might Find Interesting that we Encourage You[...]… [続きを読む]
posted from Costa Rica Houses For Sale 2012.01.26 02:56
Great website
[...]we like to honor many other internet sites on the web, even if they aren’t linked to us, by lin... [続きを読む]
posted from Costa Rica SEO 2012.01.26 08:46
Recommeneded websites
[...]Here are some of the sites we recommend for our visitors[...]… [続きを読む]
posted from Online gallery 2012.01.27 04:59
Websites you should visit
[...]below you’ll find the link to some sites that we think you should visit[...]… [続きを読む]
posted from Luxury Home For Sale 2012.01.27 15:38
Links
[...]Sites of interest we have a link to[...]… [続きを読む]
posted from properties in Costa Rica 2012.01.27 17:08
Online Article…
[...]The information mentioned in the article are some of the best available [...]... [続きを読む]
posted from best treadmill review 2012.01.27 19:21
Visitor recommendations
[...]one of our visitors recently recommended the following website[...]… [続きを読む]
posted from binaural beat 2012.01.27 20:12
Websites you should visit
[...]below you’ll find the link to some sites that we think you should visit[...]… [続きを読む]
posted from binaural music 2012.01.27 20:56
Great website
[...]we like to honor many other internet sites on the web, even if they aren’t linked to us, by lin... [続きを読む]
posted from first page google 2012.01.27 22:58
Visitor recommendations
[...]one of our visitors recently recommended the following website[...]… [続きを読む]
posted from Panasonic Bread Machine 2012.01.29 02:25
Recommeneded websites
[...]Here are some of the sites we recommend for our visitors[...]… [続きを読む]
posted from Dyson DC24 2012.01.29 03:33
Websites you should visit
[...]below you’ll find the link to some sites that we think you should visit[...]… [続きを読む]
posted from Bowflex SelectTech 552 Dumbbells 2012.01.29 04:26
Blogs ou should be reading
[...]Here is a Great Blog You Might Find Interesting that we Encourage You[...]… [続きを読む]
posted from bushnell medalist rangefinder 2012.01.29 05:15
Blogs ou should be reading
[...]Here is a Great Blog You Might Find Interesting that we Encourage You[...]… [続きを読む]
posted from Amazon Marketplace 2012.01.29 21:59
Superb website
[...]always a big fan of linking to bloggers that I love but don’t get a lot of link love from[...]…... [続きを読む]
posted from amazon associates 2012.01.29 22:34
Recent Blogroll Additions…
[...]usually posts some very interesting stuff like this. If you’re new to this site[...]… [続きを読む]
posted from how to make fast money 2012.01.30 16:44
Great website
[...]we like to honor many other internet sites on the web, even if they aren’t linked to us, by lin... [続きを読む]
posted from resume 2012.01.31 01:26
android free apps ipad games download iphone
[...]Spot on with this write-up, I truly assume this web site needs much more consideration. I’ll in... [続きを読む]
posted from best free iphone apps 2012.02.01 01:55
Great website
[...]we like to honor many other internet sites on the web, even if they aren’t linked to us, by lin... [続きを読む]
posted from resume templates 2012.02.01 15:14
Awesome website
[...]the time to read or visit the content or sites we have linked to below the[...]… [続きを読む]
posted from exercise bikes reviews 2012.02.07 04:07
Websites worth visiting
[...]here are some links to sites that we link to because we think they are worth visiting[...]… [続きを読む]
posted from SEO Link Monster bonus 2012.02.07 06:57
Sites we Like…
[...] Every once in a while we choose blogs that we read. Listed below are the latest sites that we ... [続きを読む]
posted from SEO Link Monster review 2012.02.07 07:07
Online Article…
[...]The information mentioned in the article are some of the best available [...]... [続きを読む]
posted from physic reading 2012.02.07 07:31
Recent Blogroll Additions…
[...]usually posts some very interesting stuff like this. If you’re new to this site[...]… [続きを読む]
posted from indoor exercise bike 2012.02.07 16:42
Check this out
[...] that is the end of this article. Here you’ll find some sites that we think you’ll appreciate, ... [続きを読む]
posted from vibrating exercise machine 2012.02.07 17:05
Blogs ou should be reading
[...]Here is a Great Blog You Might Find Interesting that we Encourage You[...]… [続きを読む]
posted from pontoon boat review 2012.02.07 18:59
Cool sites
[...]we came across a cool site that you might enjoy. Take a look if you want[...]… [続きを読む]
posted from free scrapebox list 2012.02.07 23:12
Superb website
[...]always a big fan of linking to bloggers that I love but don’t get a lot of link love from[...]…... [続きを読む]
posted from Free walmart gift card 2012.02.08 00:15
Cool sites
[...]we came across a cool site that you might enjoy. Take a look if you want[...]… [続きを読む]
posted from Idol Tan review 2012.02.08 04:19
Awesome website
[...]the time to read or visit the content or sites we have linked to below the[...]… [続きを読む]
posted from oily skin remedies 2012.02.08 06:55
Related…
[...]just beneath, are numerous totally not related sites to ours, however, they are surely worth go... [続きを読む]
posted from Lego Mindstorms NXT 2.0 review 2012.02.08 08:02
Related…
[...]just beneath, are numerous totally not related sites to ours, however, they are surely worth go... [続きを読む]
posted from free investment guide 2012.02.08 18:41
Sites we Like…
[...] Every once in a while we choose blogs that we read. Listed below are the latest sites that we ... [続きを読む]
posted from Indian Rishtas 2012.02.08 21:52
Links
[...]Sites of interest we have a link to[...]… [続きを読む]
posted from horizon treadmill 2012.02.09 07:42
Related…
[...]just beneath, are numerous totally not related sites to ours, however, they are surely worth go... [続きを読む]
posted from convertible car seat reviews 2012.02.09 23:22
Related…
[...]just beneath, are numerous totally not related sites to ours, however, they are surely worth go... [続きを読む]
posted from free scrapebox lists 2012.02.10 05:45
[...]we came across a cool site that you might enjoy. Take a look if you want[...]…
[...]please visit the sites we follow, including this one, as it represents our picks from the web[.... [続きを読む]
posted from Chat Webcam 2012.02.11 19:36
Websites you should visit
[...]below you’ll find the link to some sites that we think you should visit[...]… [続きを読む]
posted from The magic of making up 2012.02.14 08:13

コメント

コメント一覧

機械工肺と温室栽培者肺は知りませんでした。

石綿肺以上に重要な問題ですよね。

石綿肺や特発性間質性肺炎は基本的には根本的治療がありませんが、慢性過敏性肺臓炎は抗原暴露から隔離するのが基本的最重要な治療なわけですから。

そういうことを知らないで、だらだらステロイドを使っているとステロイドの副作用で困ることになりますよね。

何度「肺線維症をみたら少なくとも問診で慢性過敏性肺臓炎と石綿肺と薬剤性肺障害だけはすぐに除外するように」と何度勉強会で力説しても、CTの所見に書いても、ちゃんと問診しているのかしてないのか主治医からのフィードバックはほとんどありません.....

急性ないし亜急性過敏性肺臓炎、急性肺水腫、好酸球性肺炎のときはそれなりに情報が得られるのですが。

>Paul Carpenterさま、コメントありがとうございます。
臨床、病理、放射線等各専門科でのやりとり重要ですね。私、恥ずかしながら、放射線科のDr.より、情報が足りないと放射線の所見用紙に書かれて反省し、わりとしっかりコメントかいております。
written by Paul Carpenter / 2008.11.20 08:41

コメントを書く

ニックネーム*
メールアドレス*
URL
内容*
※「利用規約」をお読みのうえ、適切な投稿をお願いします。