Effects of Spa Therapy on Patients with Pulmonary Emphysema: Relationship to disease severity evaluated by low attenuation area of the lung on high resolution computed tomography

「INTRODUCTION」 Chronic obstructive pulmonary disease (COPD) is characterized by airways narrowing caused by bronchoconstriction, hypersecretion, edema of mucous membrane, and bronchiolar obstruction. Our previous studies have demonstrated that spa therapy is effective in patients with COPD, such as bronchial asthma1-5) and obstructive bronchiolitis6). In these patients, improvement of subjective and objective symptoms7,8), ventilatory function9,10), and an incraese in serum cortisol levels11,12) have been observed after spa therapy. However, Any trials to improve subjective symptoms and ventilatory function by spa therapy have not been successful in patients with pulmonary emphysema. In recent years, it has been suggested that computed tomography (CT) scanning is a sensitive technique of detecting emphysematous lesions in patients with COPD. Regarding pulmonary emphysema, it is generally agreed that the relative lung area with low attenuation values ＜-950 Housefield Unit (HU) on high resolution computed tomography (HRCT) scans at full inspiration is a sensitive imaging method to measure the extent of emphysema13,14).