昭和医学会雑誌
Online ISSN : 2185-0976
Print ISSN : 0037-4342
ISSN-L : 0037-4342
31 巻, 8 号
選択された号の論文の5件中1~5を表示しています
  • 岩堀 嘉和, 鈴木 征男, 中島 正和, 野村 健一, 中山 寿朗, 李 鴻謨, 前田 洋, 太田 宏, 李 雅弘, 川田 忠典, 藤原 道 ...
    1971 年 31 巻 8 号 p. 381-391
    発行日: 1971/08/28
    公開日: 2010/09/09
    ジャーナル フリー
    Shock is the considerable interests and important problems to the surgeon, but, recently increased attention has been devoted to it.
    We experienced thirteen shock patients postoperatively in the past 3 years.
    In the treatment of hypovolemic patients, the attention must be payed to maintenance the effective blood volume, which restores cardiac output, blood pressure, urine flow, and tissue perfusion as a guide to central venous pressure. Central venous pressure measurement, along with arterial blood pressure and urine output measurements, has greatly improved the care of the shock patients.
    Treatment is best based on giving enough volume replacement to achieve a reasonable arterial blood pressure, good urine output, and good peripheral perfusion as judged by palpable peripheral pulses and warms, dry skin without elevation of arterial pressure. This represents an effective circulating blood volume.
    If arterial pressure and urine output do not respond satisfactorily to volume replacement and central venous pressure rises, drugs which increase myocardial contractility, such as lsoproterenol, Dopamin and digitalis, should be considered. Drugs which produce vasoconstriction and increase myocardial contractility such as norepinephrine or aramine must be used cautionaly in attempts to produce primarily an inotropic effect on the heart. Other vasodilator, phenoxy benzamine or chlorpromazine are indicated as effective therapeutic agents upon the restoration of microcirculation.
  • 小室 正
    1971 年 31 巻 8 号 p. 392-411
    発行日: 1971/08/28
    公開日: 2010/09/09
    ジャーナル フリー
    1) As the result of investigation for 186 cases of thyroid disease, 93 cases (50%) of them became the object for surgical operation. Among them, 13 cases were malignat thyroid which was 7% of total patients examined. And 21 cases were treated as malignant before the operation, among which 8 cases were benign thyroid. Histologically, there were 7 cases of papillomatosis, 5 of folliculary and 1 of disgerminoma., from which 8 cases (61.5%) were survivor for five years.
    2) As the result of thyroid test using B.M.R., 131I-uptake, 131I-RSU and cholesterol examination, BMR and 131I-uptake were found to be less correlative and unreliable. However, since 131I-RSU ref ected its function clearer, the more exact foundation for diagnosis would be obtainable by refering these three testing methods.
    3) Thyroid sintigrams estimated good for the differential diagnosis for the size, change and metastasis of thyroid, distinguishing neck tumor and thyroid disease, cold nodule or hot nodule of thyroid. 22 cases out of 73 presented cold nodule by thyroid scintigrams, of which 8 cases were diagnosed benign for malignancy. Therefore, it is difficult to diagnose cancer of thyroid only by sintigrams.
    4) When comparing surgical operation made under hypothermia and those made under normothermia upon understanding the thyroid, the variation of 131I-RSU showed that the degree, under hypothermia, kept going up for three hours after the operation and then restored gradually to its basis. The same tendency was also noticed in the animal examination. Under the normothermia, the variation of 131I-RSU was scarcely noticed, having no relation with operation.
  • 第1編臨床的研究第2編実験的研究 (注射が筋に及ぼす影響について)
    阪本 桂造
    1971 年 31 巻 8 号 p. 412-431
    発行日: 1971/08/28
    公開日: 2010/09/09
    ジャーナル フリー
    The objects of this paper are to suggest an important factor in the etiology of contracture of the quadriceps muscle is the giving of intramuscular injections and transfusions of Ringer fluid into the thighs. After clinical and experimental study, the results are descrived as follows:
    1 All the clinical cases of the quadriceps muscle contracture had received injections or transfusions into the thighs.
    2 Sixty percents of the clinical cases had received injections of antibiotics or transfusions.
    3 All the operated cases had more or less the fibrous degenerations in the rectus femoris muscle.
    4 After five or ten years, the further restriction of flexion tends to be caused by the operation of incision and lengthening of the rectus femoris muscle at its origin.
    5 A reoperation is necessary, because the bone does not grow up in parallel with the affected muscle fiber.
    6 In the group of subcutaneous transfusions of Ringer fluid, fibrous degeneration of the muscle fiber was observed at the subcutaneous layers or the muscle layers under the transfused regions.
    7 In the group of intramuscular transfusions of Ringer fluid, the effect to the muscle fiber is slight than the group of subcutaneous transfusions.
    8 In the group of subcutaneous injections, the pathological findings is same as the subcutaneous transfusions.
    9 In the group of muscle injections of chloramphenical, fibrosis, atrophy and regressive degeneration in the muscle fibers are observed relative localizedly or at times diffused. This finding occurs with repeated injections and parallels injected dosage and the number of times.
    10 It is considered that fibrosis and atrophy of the muscle fiber in the experiment combine not directly with the quadriceps contracture. To think about the experimental results, muscle degeneration suggests an important factor in the etiology of the quadriceps muscle contracture.
  • 岩堀 嘉和, 鈴木 征男, 中島 正和, 野村 健一, 太田 宏, 前田 洋, 李 雅弘, 李 鴻謨, 藤原 道夫, 清水 敬介, 川田 忠 ...
    1971 年 31 巻 8 号 p. 432-440
    発行日: 1971/08/28
    公開日: 2010/09/09
    ジャーナル フリー
    Nowadays, chest injuries have become the most frequent problems. Thirty- three patients with chest injuries admitted to the Showa University Hospital during five years (1965-1970) .
    Especially, the most cause of injuries was trafic accident by motor vehicles.
    Six, (18.1%) of thirty-three thoracic injuries had Flail chest, and then, regarding to the management of these severs Flail chest, the attention must be payed to the advisability of early operative procedures and maintenance of the respiration using I.P.P.B.
  • 柳 〓烈
    1971 年 31 巻 8 号 p. 441-450
    発行日: 1971/08/28
    公開日: 2010/09/09
    ジャーナル フリー
    In the present experiment, Saponin was injected intramusculary into rabbits twice weekly at a concentration of 1, 4, and 8mg/kg, respectively.
    The maximum number of injections reached 117 times, and they were divided into 3 groups of short, middle and long term administration. Studies on the changes of the surrouding soft tissue of the optic funicle in the orbit to reveal the following results were then carried out.
    1) On both lobes of Harder's gland, there were observed atrophy, irregular arrangement, colliquative change and crumbling of epithelia of epithelia of the gland in the group of short term as a fundamental findings. Degeneration, dissociation, thyloida-change, fusion and enlargement of ducts became remarkable with the increase of dosage.
    2) We have seen atrophy of epithelia of excretory duct, but there was no relation between the dosage and administrating term.
    3) Hyperemia in interstitium of Harder's gland was common finding, and there was rarefaction of tissue in a slight degree receiving a large quantity and above medium quantity.
    4) As to edema of the surrounding soft tissue of the optic funicle in the orbit, it appeared slightly in all cases, except 4 cases in those receiving 1mg/kg. A remarkable edema of muscle (short term group), and of nerve tissue (middle term group) was found in one case each. It was observed slightly in all cases in the middle and long term group in those receiving 4mg/kg, and in all cases of every group in those receiving 8mg/kg. In the long term group transitional figures to fibrosis from edema were frequently.
    5) It is assumed that the thyroidal changes of glandular lumen of the superior lobe indicate hyperfunctional condition, and fusion, enlargement and narrowing of ducts show hypofunctional condition.
    6) Edema occured in the surrounding soft tissue of optic funicle in orbit containing nerve and muscle tissue in every group, and edema with rarefaction of interstitium of Harder's gland situated in the posterio-lateral wall work together and cause of exophthalmus.
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