The present paper deals with the metabolic functions of the cases which had been undergone total or subtotal gastrectomy for their gastric cancer. The serum K, Ca, Cl and the blood sugar level at the hungry time were within the limits of normal in all the cases after the total or subtotal gastrectomy. By means of the Sakaguchi's test meal, the result of the measurement of the blood sugar level showed a steep curve directly after the operation, and it showed a tendency of flattening with the lapse of time. It was considered that there might be a tendency of accommodation and turning to normal states due to the digestion and resorption of carbonic hydrates.

抄録全体を表示

In order to follow up the carbohydrate metabolism in liver during surgical operation, arterial and hepatic venous blood sugar level, hepatic venous arterial difference in blood sugar level, and hepatic sugar output were measured by the hepatic venous catheter method in 105 cases under various anesthetics, and in 43 cases under various operations. Besides 17 cases were subjected to the glucose tolerance test during operation. Results were as follows:
1) Under pentothal nitrous oxide and ether anesthesia, the arterial and hepatic venous blood sugar level remained within the range of 70∼150mg/dl in the majority of the cases, showing only a slight effect of anesthesia. When hypoxia occurred, however, levels rose very perceptibly, the hepatic venous arterial difference and hepatic sugar output also rose.
2) The arterial sugar level rose remarkedly during surgical operation and kept on slight rising just after operation. The rise of the hepatic venous blood sugar level was also very perceptible during operation and tended to decrease at the postoperative period, so that the hepatic venous arterial difference diminished after operation, revealing the progress of gradual consumption of liver glycogen during surgical operation.
3) The hepatic sugar output at the post-operative period was found to be very low in the cases with liver disturbances, or occurence of shock or hypoxia, suggesting a remarkable consumption of liver glycogen, meanwhile, in the cases of artificial hypotension induced with C₆ the rise in the blood sugar level was slight.
4) Following the glucose tolerance test during operation, the return to the initial blood sugar level from hyperglycaemia after glucose injection was prolonged, and the hepatic sugar intake rate stood at 37.1%, suggesting that the liver glycogenolysis was intensified, but glycogenesis was disturbed by operation.

抄録全体を表示

The present paper deals with the 106 cases of pulmonary resection during the period from June 1954 through October 1955, with the policy to observe the expansibility of the residual lung portion by avoiding post-operative thoracoplasty. In order to analyse the factors responsible for incomplete expansibility, the clinical findings and the degree of post-operative expansion of lung were examined.
On the basis of the results of the study, the author is to recommend the complete hemostasis during operation, aspiration of the intra-pleural fluid, separation of adhesion and decortication, removal of passage disturbance of the bronchus, removal of the post-operative inhibition of respiratory movements of the operated side and positive application of pressure on the lung. Clinical care to assist the expansion of the residual lung is also discussed.

抄録全体を表示

In order to study the detergent process of pulmonary cavity-walls in tuberculosis, the author examined 236 cavities obtained from 60 autopsy cases and 10 resection cases. Results were as follows:
1) Healing process of cavity-walls were found only in chemotherapeutically treated cases, i. e., in 12 of 15 cases treated with more than 1 year, in 7 of 16 cases with more than 6 months and in 2 of 23 cases. with less than 6 months of continued chemotherapy.
2) Fifty nine healed or healing cavities were found by the macroscopical and histological observations. Twenty four of these cavities showed complete or incomplete disappearance of necrotic layer. In the necrotic layer of 35 cavities, there were elimination, marked thinning or penetration of capillaries, mesenchymal cells and polymorphonuclear leucocytes with intense phagocytosis. The resorption of casious substances were demonstrated in the remaining or thinning necrotic layers. There were no tubercle bacilli in these areas.
3) Although it is believed that the opening of drainage bronchi is important for the healing mechanism of cavity, they were not seen in 7 of the 59 cavities.
4) Detergent of cavity-walls depended mainly upon elimination of necrotic layer, and resorption and organization of caseous substances.
5) In detergent process of cavity-walls, unspecific young granulation tissue played a very important role, thereby specific granulation tissue showed atrophy, and sometimes disappearance.
6) In most cases, the elimination of necrotic layer was found in the inner parts of the unspecific granulation tissue, which showed sparseness, bleeding, edema or epithelial regeneration.
7) It seems that the penetrating of capillaries, mesenchymal cells and polymorphonuclear leucocytes has definite significance for the resorption of caseous substances.

抄録全体を表示

The present paper deals with the review of 24 cases of heterotaxy discovered in 51, 071 (0.47 per 1, 000) by the surveys of group examination of tuberculosis conducted on the Social Insurance insured persons and school children, during the period from 1953 through 1957.
The number of true cases was 16 (13 males, and 3 females), and of which cases showed complete heterotaxy, and 4 cases were incomplete heterotaxy (dextro-cardia). Statistical analysis was also conducted on these cases.

抄録全体を表示