昭和医学会雑誌
Online ISSN : 2185-0976
Print ISSN : 0037-4342
ISSN-L : 0037-4342
28 巻, 9 号
選択された号の論文の6件中1~6を表示しています
  • 鈴木 快輔, 松石 正治, 木嶋 健, 大関 武彦, 中村 寿
    1968 年 28 巻 9 号 p. 541-551
    発行日: 1968/09/28
    公開日: 2010/09/09
    ジャーナル フリー
  • 岡部 伸弥
    1968 年 28 巻 9 号 p. 552-575
    発行日: 1968/09/28
    公開日: 2010/09/09
    ジャーナル フリー
    In surgical treatment of aortic valve dysfunction, “particuarly aortic insufficiency”, prosthetic valve are widely used for aortic valve transplantation, while aortic homograf is are used in some patients recently.
    Although many of these valve substituts have shown considerable promis, non is entirely satisfactory, and it is unsolved whether these procedures are advantageous or disadvantageous.
    Therefore, instead of orthotopic homotransplantation of aortic valve, the author intended to insert the aortic valve or pulmonary valve into the descending aorta and also to perform aortic valve replacement at the subcoronary position using mono cusp in dogs.
    Experimental study was performed by using occlusion of descending aorta beneath the branching part to the subclavian artery under normothermia and mild hypothermia at 30°C. of rectal temperature, and mono cusp aortic valve replacement was studied under deep hypothermia at 20°C. of rectal temperature.
    The results were obtained as follows.
    1) Safety interruption time of descending aorta under normothermia which caused no palaplegia was about 20 minutes.
    2) It was safely occluded over 20 minutes under hypothermia at 30°C. of rectal temperature without palaplegia.
    3) In homotransplantation of the aortic valve with a piece of segment from ascending aorta which was sutured as a cuff to the myocardial side of the valve, it takes shorter time to transplant than without segment, but thrombosis was more frequently seen in segment series.
    4) In homotransplantation of the pulmonary valve at descending thoracic aorta, it had similary normal function of valve, but pulmonary valve was disadvantegeous for reason of thin arterial wall and making rupture on the suture line. Accordingly, it was effective to overlap the suture line with a piece of pericardium.
    5) The homoaortic mono cusp valve replacement was the most difficult technically, because of the anatomical peculiarity on the myocardial side of aortic valve ring. The results were poor.
    6) Infection was the most unpref erable complication on the all of these studies, and due to forming thrombosis or rupturing suture line, long term survivals were not obtained.
  • 渡辺 富雄, 小林 寛, 下島 弥, 伊東 志朗, 浅川 春巳
    1968 年 28 巻 9 号 p. 576-584
    発行日: 1968/09/28
    公開日: 2010/09/09
    ジャーナル フリー
    In recent years much attention has been paid to external injuries of the head, especially to intracranial hematoma. With the advancement in its diagnosis and treatment, effective treatment is gradually being exercised. In intracranial hematoma, differing from direct lacerations of the brain, hematoma and accompanied edema compress the brain stem, and this leads to death. Thus, early removal of hematoma is absolutely necessary in order to decrease the effect of edema.
    In the case of intracranial hematoma, it is believed to be important to find out the time involved from the early stage of its formation until death to promote proper treatment and from the point of legal medicine. Thus, statistical observation was made of deaths caused by intracranial hematoma among deaths caused by external injuries which occured during the 16 year period, from 1951 to 1966. The time involved until death occurred was as follows :
    1. Total number of cases observed : 560 with 459 cases in male (82 %) and 101 cases in female (18 %) . Epidural hematoma (hereafter referred to as E. D. H.) consisted of 184 cases (33 %) ; subdural hematoma (hereafter S. D. H.) 338 cases (60 %) ; cases of the above two combined numbered 38 (7 %) . In this report the last is omitted due to its small number.
    2. In these cases, ages range from 3 months old to 90 years old. In general, the youth and middle-age groups were the most affected. S. D. H. quite frequently was found in infants less than 4 years old and those more than 60 years old while deaths from E. D. H. were found to be extremely few among infants and old-age groups.
    3. Time involved from injury to death : The shortest is 25 minutes while the longest is 165 days (S. D. H.) . Some 60 % died within 24 hours while 74 % died within 48 hours.
    4. Time until death, depending on the severeness of intracranial hematoma : Those suffering from a severe case died shortly, but in the case where hematoma existed in the basal region of the brain or the occipital region, time until death was short even with a slight injury.
    5. Death and position of hematoma : In most of the cases hematoma was observed in the temporal region (E. D. H. 64 % ; S. D. H. 56 %), followed by the frontal, occipital, basal and parietal regions, in order. When hematoma existed in the basal region or the occipital region, time until death is short as compared to other regions. It is believed that this is due to immediate effect on the brain stem.
    6. Injured region and hematoma : In the case of E. D. H., some 2 % died with hematoma existing on the opposite side from the injured region while for S. D. H. it was 17 %.
    7. Death and contusion of the brain : Some 53 % died from contusion of the brain (chiefly limited to cortex region) combined with E. D. H. or S. D. H. It is believed that death is related more with the scope and degree of contusion rather than the effect on the region.
    8. Death and fracture of a bone : Some 85 % died from E. D. H. combined with fracture of a bone and 44 % from S. D. H. and fracture. It is natural that there is more death occur ring from E. D. H, but time is short according to the region of the fracture, such as the base of the skull, temporal bone or occipital bone. In the case of front bone, time is comparatively long.
    9. Death and lucid interval : Some 70 % died with lucid interval in E. D. H. and 75 % died within 24 hours regardless of contusion or not. Some 46 % died with lucid interval in S. D. H. and death arrived within 24 hours for 67 %. Contusion of the brain also contributed 1o death while those without contusion consisted of 45 %.
  • 山田 重男, 桃井 不二麿, 小野寺 哲夫, 室田 理一
    1968 年 28 巻 9 号 p. 585-590
    発行日: 1968/09/28
    公開日: 2010/09/09
    ジャーナル フリー
    Effects of histamine and antihistaminics on the cilia in isolated oral mucous membrane of frog was studied and following results were obtained.
    1. Except anergen, histamine, benadryl and pyribenzamine showed a potent acceleration of ciliary movement, while anergen showed no effect on this movement. The acceleration of ciliary movement by histamine were entirely abolished by these three antihistaminics.
    2. Atropine, ephedrine and regitine showed neither any effect on ciliary movement, nor antagonism on the accelerating effect of histamine.
  • 三須 徳雄, 大山 世旭, 飯島 恒司, 山里 将人, 大田 秀男, 青木 隆一, 尾上 保夫
    1968 年 28 巻 9 号 p. 591-594
    発行日: 1968/09/28
    公開日: 2010/09/09
    ジャーナル フリー
    A case of internal hernia (mesenteric hernia) of 40 year old woman, operated successfully, was reported.
    Twenty cases of this disease (Internal hernia) were reported on the literature during past 10 years. Some discussions were performed.
  • 土持 喬, 佐野 俊正, 水谷 俊治, 藤崎 裕, 酒井 孝夫, 松村 直枝
    1968 年 28 巻 9 号 p. 595-602
    発行日: 1968/09/28
    公開日: 2010/09/09
    ジャーナル フリー
    A case of a seventeen year-old female with von Willebrand's disease was reported.
    Since childhood, she had noticed hemorrhagic tendency such as purpura, gum bleeding and epistaxis.
    She had an onset of anemia following melena around late in October, 1967 and was admitted to the hospital on November 16th.
    Physical examination on admission showed pale skin and purpuras on the extremities, but no enlargement of lymph nodes, liver and spleen.
    Anemia was severe and bleeding time was remarkably prolonged, but the results of hematological and coagulation tests were quite normal and AHF and PTC were within normal value.
    The administration of AC-17 resulted in the shortening of bleeding time.
    From the findings above-mentioned, we assumed this case as a vascular pseudohemophilia, a type of von Willebrand's disease in wide meaning.
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