昭和医学会雑誌
Online ISSN : 2185-0976
Print ISSN : 0037-4342
ISSN-L : 0037-4342
32 巻, 3 号
選択された号の論文の5件中1~5を表示しています
  • 第1報ST上昇を示した狭心症
    平木 誠一
    1972 年 32 巻 3 号 p. 107-120
    発行日: 1972/03/28
    公開日: 2010/09/09
    ジャーナル フリー
  • 第2報狭心症と指尖容積脈波
    平木 誠一
    1972 年 32 巻 3 号 p. 121-127
    発行日: 1972/03/28
    公開日: 2010/11/19
    ジャーナル フリー
    Since Prinzmetal and others reported the cases of angina pectoris, in which the attacks were precipitated only at rest and accompanied by transient S-T elevation, and named it the variant form of angina pectoris in 1959, over 120 cases of this form of angina pectoris have been reported in Japan. However, there is a lot of cases which does not fully coincide with their definition. Therefore, it was thought of interest to investigate the clinical characteristics and precipitating mechanism of the attack of this form of angina pectoris. In the first paper, these problems were investigated in 12 patients with angina pectoris, in whom no laboratory findings of real myocardial infarction were observed and there exist only transient S-T elevation on ECG but no abnormal Q waves, and following results were obtained : (1) It was noted that anginal attacks were observed not only at rest but also in effort and positive exercise test was proved in almost all the cases. (2) It was observed in the majority of the cases that the attacks occurred between the mid-night and the early morning, its duration was generally within 15 minutes, and its frequency was 2-4 times a day. (3) Although the blood pressure elevated during the attack in some cases, it was unlikely that the trigger of the attack was the elevation of the blood pressure, because no elevation of the blood pressure or no increase in pulse rate was generally found immediately before attack. It is probable that the elevation of blood pressure and increase in pulse rate was not the cause but the result of the attack, being induced from the chest. pain. It was assumed that, in addition to the particiption of sympathetic nervous system, a decrease in coronary blood flow resulted from the spasm of the coronary artery may play a major role in the precipitation of the anginal attack. (4) As to the prognosis of this form of angina, in only one of 12 patients it developed to the real myocardial infaration. (5) Amyl nitrates were found to be effective for ceasing anginal pain and in the majority of the cases coronary dilators were thought to be effective in preventing precipitation of the attacks. (6) It seemed to the reasonable to widely define, in the present stage, that the variant form of angina pectoris includes any types of angina with S-T elevtion which occur not only at rest but also in effort, or that one handles these types altogether as ‘the angina pectoris with S-T elevation’.
    In the second paper, plethysmographic changes during spontaneous anginal attacks or attacks induced by exercise loading were investigated and following results were obtained: (1) The types of pulse waves at rest were sclerotic rigid, delta and trapezoid waves indicating sclerotic changes. (2) The plethysmogram of the majority of the cases revealed a decrease in height of pulse wave and in effect of cardiac beat, and plateau formation at anginal attacks, indicating transient heart failure. (3) The occurrence of anginal attack was not observed in the patients in whom no change in the type of pulse wave was observed before and after exercise loading, although there exist distinct S-T depression, decrease in the height of pulse wave and decrease in the effect of cardiac beat. Similar phenomenon was observed in the patients with mild anginal attacks. (4) An evident increase in the ratio of arterial elasticity was observed in the patients with anginal attacks.
  • ―基礎的研究ならびに本態性高血圧症に対する臨床薬理学的検討―
    村山 義治
    1972 年 32 巻 3 号 p. 128-159
    発行日: 1972/03/28
    公開日: 2010/09/09
    ジャーナル フリー
    Bei der Untersuchung der blutdruckherabsetzenden Wirkung der beiden ω-Aminosulfonsäuren, Taurin und Homotaurin, wurden folgende Ergebnisse festgestellt:
    1. Taurin und Homotaurin wurden bei Normalkaninchen und -hunden intravenös injiziert. Es wurde beobachtet, daB Homotaurin eine ausgesprochene Blutdrucksenkung veranlaBt. Diese Wirkung wick je nach der Versuchstierart ab und trat bei Hunden besonders. deutlich auf.
    2. Bei Hunden mit renaler Hypertonie veranlieB Homotaurin eine Blutdrucksenkung, deren AusmaB jedoch nicht einheitlich war.
    3. Kaninchen, die auf längere Zeit Homotaurin einnahmen, zeigten pathologisch wie histologisch keine anormalen Veränderungen.
    4. Bei Patienten mit essentieller Hypertonie, die mit 6.0 bis 9.0 g Taurin oder 50 bis 300 mg Homotaurin verordnet waren, wurde stets eine Blutdrucksenkung beobachtet. Durch den doppelblinden Versuch wurde ferner eine positive wirkung von Homotaurin festgestellt.
    5. Wenn für Patienten mit essentieller Hypertonie andere Blutdrucksenkungsmittel zu Taurin oder Homotaurin zusätzlich angewandt werden, wird die Blutdrucksenkung weiter gefördert. Die Einnahme dieser kombinierten Arzneimittel ist nicht nur für lange Zeit zulässig, sondern auch trägt dazu bei, einen stabilen Blutdruck zu erhalten.
    6. Sowohl bei Tierversuchen als auch bei klinischen Untersuchungen wurde es beobachtet, daß Gesamtcholesterin, β-Lipoprotein und Neutralfette in Serum durch Anwendungvon Taurin oder Homotaurin abnehmen.
    7. Bei Patienten mit essentieller Hypertonie, die Taurin oder Homotaurin auf längere Zeit einnahmen, wurden keine anormalen Veränderungen sowohl in Serumelektrolyten als auch in peripherischem Blut beobachtet.
    8. Als Nebenwirkungen bei Patienten mit essentieller Hypertonie traten bei Anwendung von Homotaurin lediglich Symptome wie Übelkeit and Unbehaglichkeit auf, die allerdings nur vorübergehend waren.
  • 本多 儀一
    1972 年 32 巻 3 号 p. 160-179
    発行日: 1972/03/28
    公開日: 2010/09/09
    ジャーナル フリー
    Changes in the growth of the apophysis of rabbits were studied by giving continuous tonus stimulation to it through auto-muscles, and based on the results of this study, the following conclusion was reached about the etiology of the so-called apophyseopathy.
    1) Hypertrophy at the part where the tendon inserts to bone (tendon cartilage region) began in one week. Hypertrophy, deformity, and hyperplasia in the tracted direction were observed up to the 25 th week, but no remarkable changes were noted after 30 th week.
    2) Lateral and ventral bending deformity appeared at the diaphysis of the corpus ossis ischii. More marked deformity and hyperplasia were observed in the procesus lateralis ischiadicum inserted to the tendon than in the tuber ischiadicum directly inserted to the muscle.
    3) X-ray examinations revealed the early appearance of the apophyseal nucleus on the treated side, the gradual falling into irregularity of the boundary between the bone and the cartilage, the aspects of abnormal hypertrophy of the tendon cartilage region, and the aspects of segmentation and loosening like small fragments of the bone in the apophyseal nucleus at the end of 2 weeks. After 20 th week, light and dense bone image, transparent zone, and the island-like bone trabecula were observed.
    4) Histological examinations manifested the onset of hypertrophy and proliferation of the tendon-cartilage layer and the gradual transition to the growing cartilage layer. As days went by, intense proliferation of chondrocytes in the tendon-cartilage layer and growing cartilage layer, separation of chondrocyte into the bone marrow, formation of cartilageisland, hyperplasia owing to the mechanism of vigorous ossification by these chondrocytes were observed.
    5) Apophysis of young rabbits showed remarkable changes as described above, but that of the adult showed almost no changes.
    6) Hyperplasia of apophysis can be produced by giving the continuous stimulation through auto-muscles, but does not grow unlimitedly. Its growth stops when the growing cartilage layer closes, but the growing cartilage layer does not always close so early.
    7) Genetic mechanisms of epiphyseopathy and apophyseopathy seems to have to be considered individually since there is a difference of functional and pathologico-anatomical relationship, especially of the insertion of muscle and tendon.
    8) The so-called apophyseopathy-liked condition could be provoked by giving continuous tonus stimulation to tuber ischiadicum non-physiologically through auto-muscles, and this suggests the etiology of apophyseopathy such as Osgood-Schlatter disease, acromial apophyseopathy, humerus epicondyle apophyseopathy, tuber ischiadic apophyseopathy, and calcaneal apophyseopathy. It may be surmised that abnormal muscle tonus is the major cause of apophyseopathy.
  • 大木 紘, 広木 忠和, 大房 武利, 阿部 敏夫, 秋谷 行男, 小林 寛
    1972 年 32 巻 3 号 p. 180-184
    発行日: 1972/03/28
    公開日: 2010/09/09
    ジャーナル フリー
    The patient fell when he was hit by a car and lost his consciousness for several minutes but later regained consicousness and was hospitalized. However, on the third day after the accident, there appeared symptoms of unconsciousness and he fell into a coma dhnrtly thereafter. He died on the seventh day after the accident.
    The patient had been suffering from diabetes for about ten years and had all the while received insulin injections under doctor's order. The hospital where he was confined learned of this for the first time when he fell into a coma.
    The blood sugar count taken on the third day from the accident was 290 mg/dl while one taken at the time of post-mortem examination (7 days later) was 150 mg/dl. The hisstological examination of the various organs such as the liver, the pancreas and the kidneys showed evidence of ailment characteristic to a diabetic. In contrast, there was no evidence in the brain that the patient would be normal for three days and then fall into a coma. In view of this, it is believed that death was caused by “diabetic coma”.
    This cases shows that there was lack of consideration for any ailment the patient may be suffering from. It was pointed out that the hospital staff was rather late in understanding the case and treating the patient accordingly. This clearly shows the importance of studying the case history of an emergency patient.
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