昭和医学会雑誌
Online ISSN : 2185-0976
Print ISSN : 0037-4342
ISSN-L : 0037-4342
32 巻 , 12 号
選択された号の論文の6件中1~6を表示しています
  • 外丸 輝明
    1972 年 32 巻 12 号 p. 673-686
    発行日: 1972/12/28
    公開日: 2010/09/09
    ジャーナル フリー
    The chemotherapy has been developed today, but pulmonary complication is still one of serious post operative complications. It is well known that obstructive type of ventilatory defect, for which inhalation therapy is effective, is one important facter for occurrence of the post operative pulmonary complication. Therefore the author studied the influence of inhalation of bronchodilator with intermittent positive pressure breathing (I. P. P. B) on blood gas, pulmonary function in the preoperative patients with or without chronic broncho-pulmonary disease. Furthermore the author investigated the relationship among the results of preoperative pulmonary function tests, their change by inhalation therapy and postoperative pulmonary complications in the patients who underwent operation with endotracheal anesthesia. The results are as follows.
    1) Minute uolume (VE) CO2 output (Vco2) and O2 uptake (Vo2) of Asthmatic patients were higher than those of healthy subjects. But partial pressure of Ca2 in arterial blood (Paco2) was same as that of healthy subjects.
    2) VE, Vco2 and Vo2 of the general inpatients who expectorated sputum with I.P.P.B. decreased with treatment than those without expectoration, but peak flow rate, forced expiratory volume in one second (FEV1), Vital capacity (V.C) of the former increased more than the latter. But effects of IPPB therapy in the patients with chronic bronchopulmonary disease were not clear except improvement of expiratory capacity such as peak flow rate, percentage forced expired in one second (% FEV1) and functional residual capacity (FRC) .
    3) All cases of thoracotomy and the many cases of major abdominal surgery suffered from post operative respiratory complications. However, they were chiefly minor complications, such as increase of sputum. Peak flow rate, percentage of actual to predicted vital capacity (% VC) of patients with complication were higher than those without. But it was found no rvlationship between the change of pulmonary function by aerosol inhalation with IPPB and postoperative respiratory complication.
  • 片桐 耿
    1972 年 32 巻 12 号 p. 687-712
    発行日: 1972/12/28
    公開日: 2010/09/09
    ジャーナル フリー
    Since the report of Ehrlich in 1877 on the presence of the tissue mast cells, a variety of facts have so far been clarified on their functions, but a number of points remain yet to be clarified.
    Recently, a hypothesis is presented of Lindholm et al., in which the tissue mast cells are regarded as calcium transporter. So I have experimentally explored whether or not the tissue mast cells of synoival membrane (TMC) which are most closely related to the joint with no periostal membranes have the similar functions as they repoted.
    An experiment was conducted on young, male Wistar strain rats, 250 to 300 gram in weight, under etherial anesthesis, in which the animals were allocated to 4 groups according to the procedure employed for the production of experimental knee joint traumata.
    1. Group with curettage of joint cartilage and without fixation.
    2. Group with curettage of joint cartilage with its intramedullary fixation with Kirachner's wire.
    3. Group without curettage of joint cartilage and with its intramedullary fixation with Kirschner's wire.
    4. Group with mannual lesion knee joint without fixation.
    Each group had 8 sub-group divided for each week covering the period from the fourth day to the end of the seventh week.
    Tetracycline for i.v. was intraperitoneally injected into all the experimented rats 24 hours before their victimization. After victimization, soft tissue was taken with each of the ex-perimented rats and their knee joints were extirpated. From on animal out of each group, non-decalcified triturated specimens were prepared for subsequent contact-microradiography (MRG) and assay with tetracycline labeling (TcL) . All the other animales were used for preparation of specimens decalcified and embedded with paraffin, which were used for stain-ing with toluidineblue at pH 4.1, with PAS, and with haematoxylin-eosin (H-E) in their microtomed specimen forms.
    Taking into consideration the roentgenographic and macroscopic examination thus made, in addition to the histo-pathological examination, TcL, and MRG, the behaviors of TMC in the knee joint traumata, the relationship between calcium and TMC, and the pathological pattern of the synovial membranes were explored to find the following results.
    1) The TMC decreased, or disappeared, at the acute inflammation stage, but gradually increased at it entered chronic stage. Metachromasia also showed various patterns but the TMC decreased as the tissues were gradually returned to normal. Metachromasia also became weaker in parallel to it.
    2) The TMC of the control group was found to have increased generally beyond that the nontraumata group, regardless of the degree of the traumata or the period after receiving the traumata. The reason for this has yet to be clarified, but the traumata are likely to affect somehow the changes in the TMC values over the whole body.
    3) Positive findings with TcL and MRG not detected with the synovial membranes. There was no finding that would histo-pathologically insinuate growth of new bones. Therefore, no possible function as the calcium transporter was found out with the TMC.
    4) Pale yellow fluorescence was observed using TcL at ossification center, curettage location of bones and newly created part of bones,
    5) The restoration of intra-articular fracture was made with the uniting callus and the sealing callus, and pannus also was contributory to the above restoration.
  • 江副 誠
    1972 年 32 巻 12 号 p. 713-727
    発行日: 1972/12/28
    公開日: 2010/09/09
    ジャーナル フリー
    Postoperative acute renal insufficiency is a serious complication which is challenging a surgeon to find its remedy. To find out measures to prevent this complication from occurring is a very important problem. As a step toward finding the solution of this problem, the author investigated the effect of preoperative intake of water and transfusion of water on preoperative, midoperative and postoperative renal function in infants, children, adults and aged people. These effects were studied by measuring osmotic pressures of serum, urine and free water, and clearance of osmotic pressure, urea and creatinine. Further, effects of bleeding were examined in clinical cases by the above parameters, and in dogs with rapid hemorrhagic shock, by the use of 131I-MAA for renal blood flow and its regional blood flow. The results of these studies are as follows:
    1. In infants and children, when plenty of water was given them preoperatively, favorable effects on renal function was found to be produced preoperatively midoperatively and postoperatively. Further, judging from changes in urinary osmotic pressure it was thought that it is better to perform operation in the morning than in the afternoon.
    2. In adults and aged people, preoperative transfusion of 10 ml/kg of Ringer's solution to which lactic acid was added was seen to produce a favorable effect on renal function preoperatively, and midoperatively. Perhaps because midoperative solution transfusion was used, and moreover, whenever bleeding of more than 500 ml occurred, a corresponding amount of blood transfusion was immediately given, the effect of midoperative bleeding on renal function was not clear and no unfavorable effect worthy of special mention was recognized.
    3. In dogs with rapid hemorrhagic shock metablic acidosis was noted to develop, and both cardiac volume and average arterial pressure were reduced nearly by half. Whereas 19.7% of 131-MAA which had been infused was found distributed to the kidney before hemorrhage, only 0.66% of it was found there 60 minutes after hemorrhage. As regards changes in the regional blood flow of the kidney, quite unlike the flow before hemorrhage, the flow after hemorrhage was found to have shifted, now flowing from the medullarly substance toward the cortex.
  • 狩野 充二
    1972 年 32 巻 12 号 p. 728-743
    発行日: 1972/12/28
    公開日: 2010/09/09
    ジャーナル フリー
    This study was undertaken to assess the effect of rheumtaoid factor like substance (RFLS) on adjuvant arthritis, and the assay of serum antibodies and histological examinations of various organs were also carried out.
    The adjuvant which contained 6 mg/ml dry-killed mycobacterium tuberculosis (Type H-2) in parafin oil was used in this study, and was inoculated at the rate of 0.1 ml intradermally into the left hind footpad. The animals used were female, 2-3 month old Sprangue Dawley rats. For production of RFLS, rats of the two groups were treated with isologous denatured γG and BSA-anti BSA complexes at various times before the adjuvant injection. Rats of the other groups received BSA at various times before adjuvant injection or a single challenge injection of adjuvant.
    The remarkable inhibition of the arthritis was observed in the group of the rats which were given simultaneouse injection of BSA and adjuvant, in comparison with control rats which were given adjuvant alone.
    The similar inhibition was observed in the rats which received the pretreatment with the denatured γG and the complexes 5 weeks, 3 weeks and 1 week before, and in the rats which received the same pretreatment 2 weeks and 1 week before adjuvant injection.
    The histological fidings of hearts, lungs, livers, kidneys and spleens were demonstroted no particular differences between the groups of rats with and without arthritis.
  • 岡本 治通
    1972 年 32 巻 12 号 p. 744-759
    発行日: 1972/12/28
    公開日: 2010/09/09
    ジャーナル フリー
    Phonocardiographic studies were made on the Q-Mm interval, that is the time from Q-wave in E.C.G. to beginning of murmur, and the duration of the systolic murmur (DSM) caused by venous etiology.
    In this studies, following 6 groups with systolic murmur have been carried out. (30 normal subjects, 20 children with anemia, 30 with rheumatic carditis, 30 with ASD., 20 with PDA., 30 with VSD., )
    Results were as follows :
    1) The Q-Mm interval in group with the normal systolic murmur was found to be longest among different 6 groups, ranging from 0.11 to 0.16 sec. with a mean of 0.130 sec.
    The ratio of DSM to I-IIa (total length of systole) was found to be 24.0-62.5% with a mean of 42% and this is the shortest value as compared with that of the other groups.
    Both the Q-Mm interval and the I-IIa interval were prolonged with increasing age.
    2) In group with anemic murmur, the Q-Mm interval varied from 0.11 to 0.15 sec. with a mean of 0.128 sec. and the ratio of DSM to I-IIa ranged from 33.3-66.8% with a mean of 47.5%.
    3) In group of rheumatic carditis, the Q-Mm interval varied from just 0.10 to 0.16 sec. with a mean of 0.125 sec. and the ratio of DSM to I-IIa ranged from 33.3-74.2% with a mean of 50.3%.
    4) In ASD, the Q-Mm interval varied from 0.10 to 0.18 sec. with a mean of 0.116 sec. and the ratio of DSM to I-IIa ranged from 41.5-84.6% with a mean of 71.5%.
    5) In PDA, the Q-Mm interval varied from 0.10 to 0.14 sec. with a mean of 0.12 sec. and the ratio of DSM to I-IIa ranged from 70.0-85.2% with a mean of 75.6%.
    6) In VSD, the Q-Mm interval were less than 0.10 sec., with only one exception, with a mean of 0.089 sec. and the average of the ratio of DSM to I-IIa was 84.8%. It was the greatest value in comparison with that of the other groups.
    7) In congenital heart diseases groups and the other 3 groups, there seems to be obvious that the longer DSM, the shorter the Q-Mm interval.
    The Q-Mm interval was longer in the latter than that of the former but DSM was shorter in the latter than that of the former.
  • 木村 通彦
    1972 年 32 巻 12 号 p. 760-769
    発行日: 1972/12/28
    公開日: 2010/09/09
    ジャーナル フリー
    As a part of studies in etiology between nasal and paranasal disease, fibrinolysis of and masaldischarge was measured by applying the Fibrin-plate method to total of fifly case consisting of fifteen patient in chronic inflammation of nasal accessory of paransal sinuses, fifteen patient in nasal allergy, ten patient in atrophic rhinitis, and ten patient in hypertrophic rhinitis.
    The fibrinplate method was also applied to thirly examples of fresh mucous in maxillarin who receined radical surgical operation for paranasal sinusitis chrouica classified into ten examples of edematous type, ten examples of purulentas type, tenexamples of fibrotic type.
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