昭和医学会雑誌
Online ISSN : 2185-0976
Print ISSN : 0037-4342
ISSN-L : 0037-4342
36 巻 , 4 号
選択された号の論文の11件中1~11を表示しています
  • 伊東 佑英, 山崎 薫
    1976 年 36 巻 4 号 p. 275-283
    発行日: 1976/08/28
    公開日: 2010/09/09
    ジャーナル フリー
  • 小田嶋 梧郎
    1976 年 36 巻 4 号 p. 285-294
    発行日: 1976/08/28
    公開日: 2010/09/09
    ジャーナル フリー
    一般に, 人体にある管, あるいは導管は, 一方交通の路であるが, 胆嚢管だけが二方交通になっている.すなわち, 肝臓から胆嚢の側に送られてくる胆汁の流れる方向と, 胆嚢の中で濃縮された胆汁が, 胆嚢管を通って総胆管へと送られる方向との2つがある.
    そこで, 1本の管の中を胆汁が往ったり復たりできる二方交通性の交通整理の絡繰を, 物理数学的理論を裏付けとした実験形態学で証明しようと試みた.
    ヒト胆嚢管の鋳型試料126例を観察した結果, 胆嚢管の多くはanorthospiralであった.胆嚢側から眺めて, 右巻きから左巻きへと変り, その中間部に更旋部torsionを作る.右方に回旋する運動は, 物質の流れが常に負の函数negative functionとして働き, その反対の左回旋運動は, 常に正の函数positive functionとして働くという, つるまき線Helix-Lineの原理に従えば, 総胆管の側から胆嚢管に胆汁が流入するとき, 逆流に都合のよいdextrotatory ductの形態で, ラセンヒダそのものは左巻きとなる.また, 胆嚢の側から総胆管へと向う胆汁の流れは, 管腔のlevorotatory ductと強力な胆嚢頸の筋収縮, いわゆるMilking-Actionとによって, 胆嚢管を流れ出ていくことが理解できる.
    これらの理論を, 左巻きと右巻きのつるまきモデル管やネジの原理の応用によって, 物理数学的に解析し, 実験証明した.
    胆嚢管に巻きもどし, すなわち更旋部のできる疑問の解決は, 植物の巻きひげの巻きもどしと同様に, すべてラセン状の回旋は, 両端が固定しているとき, その中間部は一方向にだけ捩ることが不可能であって, 機械的原理に基き, 一部分は左方に, 一部分は右方に回旋せざるをえない.そして, 左右同回数だけ巻ける中間に更旋部をつくる.このことは, その弾性によって, 他からの刺激で切断されにくいという植物に最も有利な解剖的構造の変化で, ヒト胆嚢管の弾性として働く特徴的形態の一つである.
    更に, 口唇腺のような粘稠度の濃い粘液性物質を運搬する外分泌性の導管が, 概して細く, かつ短く, その分泌物は導管の長軸に沿って回転して進む, いわゆる「回転装置の導管」にすぎないことが, 導管の屈曲性をうみだす特徴を, 特別な三角函数型の彎曲で図説した.なお, 粘稠度の低い漿液性分泌物を運ぶ耳下腺管の屈曲性の直接原因を, 導管内壁の粘膜ヒダによって, 分泌物の流れが一定の長さに対するエネルギー消費を増す関係にも原及し, そして, 小腸の素晴しい粘膜ヒダが吸収面積を広げるという, ただ単なる理由ばかりでなく, 食物運搬に適した基本的な回転操作を形態は示し.すべて発生学的根拠を準備しているのである.あたかも, 扇風機や船舶のスクルーのハネが右ひねりで, 尾方へと物体をおしやるのとまったく同じ絡繰を, 生体みずから示している興味ある事実を, 生物学の基礎である物理学・数学・哲学・心理学などを応用して図説した一篇である.
  • 鈴木 一
    1976 年 36 巻 4 号 p. 295-305
    発行日: 1976/08/28
    公開日: 2010/09/09
    ジャーナル フリー
    IgG, IgM, anti-BSA-IgG and anti-BSA-IgM were measured by the immunodifusion technique. Serum titers of antibody as a whole was measured by the hemagglutination technique.
    (1) Primary response: Prednisolone or 6-MP was administered simultaneously with the 1st immunization of BSA. The quantity of IgG was also lower in both of the 6-MP and prednisolone groups compared with the control group, and its reduction was larger in the 6-MP group than the prednisolone group. There were no differenced in IgM among the three groups. The hemagglutination titers were lower in both groups compared with the control group. The grade of reduction was larger in 6-MP group.
    (2) Secondary response. In this case also prednisolone or 6-MP administered simultaneously with the 2nd immunization of BSA. There were no differenced in the hemagglutination among three groups. No change of serum IgG was observed in the prednisolone group, but it was slightly lower in the 6-MP group. IgM showed a similar tendency with IgG in the three groups.
    (3) The effects of continuous administration of the drugs on the 2nd immunization were examined. IgG gradually decreased by the administration of prednisolone, and showed a tendency of increase by its discontinuance. In the 6-MP treated group, it slightly decreased. IgM also decreased in both of the prednisolone and 6-MP groups. Anti-BSA-IgG increased slightly 7 to 12 days after the immunization and was kept at the same level in the control group. In the prednisolone group, anti-BSA-IgG slightly decreased, while it decreased markedly in the 6-MP group.
  • 高橋 敬蔵, 脇元 敦彦, 宮崎 雄一郎, 千坂 正毅, 坂本 勇人, 渡久山 博美, 奥富 信博, 宮上 順志, 瀬尾 文洋, 関 正純, ...
    1976 年 36 巻 4 号 p. 307-314
    発行日: 1976/08/28
    公開日: 2010/09/09
    ジャーナル フリー
    A series of 250 cases undergoing Cesarean section under spinal anesthesia were presented and analyzed from the clinical points of view.
    Hypotension down to 80 mmHg or less occured in 43.6% of all cases following spinal anesthesia, and the incidence of hypotension was closely related to the level of sensory analgesia (initial level) .
    Hypotension could be mostly restored by changing the position from supine to lateral, but the effects of vasopressor was not uniform.
    It was seen that the amount of rapid intravenous infusion was influenced by the duration and degree of hypotension.
    Associated with anesthesia, Apgar' Score was indicateed 7 to 10 points in 96% of all cases.
    Administration of Droperidol, Diazepam and Pentazocine were effectively choiced for any visceral pain after birth and any emesis.
  • 細谷 純一郎
    1976 年 36 巻 4 号 p. 315-319
    発行日: 1976/08/28
    公開日: 2010/09/09
    ジャーナル フリー
    The activities of glutamate dehydrogenase (EC: 1.4.1.3; GMD) in sera from 57 healthy person and 869 patients suffering from various diseases who had been obtained one or more abnomal results in GOT, GPT, LDH, TTT, ZTT, and CCLF values were investigated.
    Conclusions are as follows :
    1. Normal range of serum GMD levels is 0-1.4 U/l (average ; 0.4 U/l) .
    2. Average level obtained from patients is 3.17U/l. GMD activities obtained from serum hepatitis, alcoholic hepatitis, chronic hepatitis, jaundice, and hemo-dialysis are significantly higher than those from other diseases.
    3. The correlation coefficient between levels of GMD and LDH, TTT is generally lower than that between GMD and GOT, GPT in all cases.
    4. The fluctuation of activities of GMD in serum is closly coincident with the process of clinical findings in serum hepatitis, but in contrary, in acute hepatitis it is observed many cases that GMD level does not or only little change during the higher elevation of other enzyme activities.
  • 本田 公夫
    1976 年 36 巻 4 号 p. 321-336
    発行日: 1976/08/28
    公開日: 2010/09/09
    ジャーナル フリー
    The author studied the adequate flow rate of fresh gas to Jackson-Rees circuit to obtain normal arterial carbon dioxide tension (Paco2) in clinical pediatric anesthesia. The problem, whether the controlled respiration with large tidal volume and low respiratory rate was appropriate or not, was investigated with blood gas study and also hemodynamicaly in clinical cases and adult mongrel dogs. The following results were obtained.
    1. In children aged from 3 months to 5 years old, 220 ml/kg/min of fresh gas flow to Jackson-Rees circuit showed invariably more normal Paco2 than the cases with 31/min of fresh gas flow.
    2. In the similar cases, the controlled respiration with large tidal volume (20 ml/kg) and low respiratory rate (20/min) showed more normal Paco2 and higher arterial oxygen tension than those with smaller tidal volume (10 ml/kg) and high respiratory rate (40/min) .
    3. In the dogs, the controlled respiration with large tidal volume and low respiratory rate showed larger alveolar ventilation, larger fall of mean arterial pressure, smaller rise of pulmonary arterial pressure and smaller increase of cardiac output than those with small tidal volume and high respiratory rate.
    From above results, the author concluded that 220 ml/kg/min of fresh gas flow to Jackson-Rees circuit was sufficient to guarantee the adequate CO2 washout from the body, and the controlled respiration with large tidal volume and low respiratory rate was satisfactory from the viewpoint of gas exchange and hemodynamics.
  • 成尾 昌欣
    1976 年 36 巻 4 号 p. 337-348
    発行日: 1976/08/28
    公開日: 2010/09/09
    ジャーナル フリー
    The thickness of the hypodermic fatty layer was measured in 45 infants (20 males, 25 females) . The measurements were taken from 36 different points of the body on the 3rd day and the 6th day after birth. The results were examined for difference in thickness between the 3rd day and the 6th day in both sexes and for the relationship of such difference with : the physiological decrease of body weight of the infants, the thickness of the hypodermic fatty layers of the respective mothers, and the delivery frequency and age of the mothers.
    1) The distribution pattern of the thickness of the hypodermic fatty layer in infants was the same as the pattern in older individuals, but the disparities between the thicker parts and the thinner parts were smaller than those of the older subjects.
    2) The thickness on the 6th day showed a tendency to be greater than that on the 3rd day in both sexes ; this tendency was more evident in males than in females.
    3) Comparing the differences in relation to sex, they tended to be larger in all the anterior parts of the upper extremities, the posterior parts of the upper arm and the anterior trunk around the navel in males, and in the hips and the posterior parts of the lower extremities in females.
    4) Thickness increase between the 3rd and 6th days tended to be limited to the anterior surface of the arm for infants gaining 101 to 150 gm., and to be generally distributed throughout all parts of the body for those gaining more than 150 gm.
    5) The children of mothers who had thicker hypodermic fatty layers, and were multiparous, and aged, had thicker hypodermic fatty layers than the other children.
  • 今村 一男, 吉田 英機, 依田 丞司
    1976 年 36 巻 4 号 p. 349-353
    発行日: 1976/08/28
    公開日: 2010/09/09
    ジャーナル フリー
    We reported a case of uachal cacinoma with a bladder stone in a 66-year-old man. Patient was admitted to the hospital with gross hematuria and pain on urination on December 21, 1964. Cystoscopic examination revealed a bread basic tumor of a thumb tip size in the dome of the bladder. After the lithotripsy of a bladder stone, partial resection of the bladder including the urachal canal was performed on January 18, 1965. Histological findings of tumor were mucus-secreting adenocarcinoma. 4500 rads of Co60 was given after the operation. As finding the recurrent tumors of rice size in the same part of the bladder, the transurethralelectrocoagulation was done on April 26, 1965. During the course, anuria was occured and right nephrostomy was done on October 4, 1965. He died of the intestinal obstraction on November 7, 1965. Autopsy revealed multiple metastases, lungs and retroperitoneal lymphnodes, and intraperitoneal spread.
    Twenty five cases of urachal carcinoma were collected from the Japanese literature between 1971 and 1974 and clinical and pathological features of this disease were discussed.
  • 武田 昭平, 加々美 建一, 持丸 賢二, 渋谷 正直, 新井 章子, 目黒 郁夫, 石橋 秀雄, 伊藤 考徳, 山本 茂
    1976 年 36 巻 4 号 p. 355-359
    発行日: 1976/08/28
    公開日: 2010/09/09
    ジャーナル フリー
    A 43-year-old female with ileus received resection of small intestine, and a 52-yearold male with bleeding gastric ulcer received gastrectomy. Both patients were operated at emergency situation under general anesthesia in a small private hospital. They had apparently smooth courses until the fifth postopertive day, when we found complete atelectasis of the left lung on chest X-ray films.
    Because no bronchoscopes were available at that time, we treated the atelectases with following rather simple measures and fortunately obtained exellent effects.
    At first balloon inflations were used in each case, and were satisfactory with this measures alone in the latter case. In the former case, bronchial lavage under endotracheal intubation followed by vibration of chest wall brought satisfactory result.
  • 須永 進, 吉本 功
    1976 年 36 巻 4 号 p. 361-368
    発行日: 1976/08/28
    公開日: 2010/09/09
    ジャーナル フリー
    A case of Hallermann-Streiff Syndrome with congenital bowing deformity of radius was reported.
    The patient was a male child of 40 days of age and was showing rare 2 negative signs (congenital bowing deformity of Radius and mental retardation) according to Francois, excepting chief feature. The chief clinical findings consisted of bird like face, hypotrichosis, atrophy of skin, congenital cataract, microphthalmia, nanism and above-mentioned negative sign.
    Cytogentic study used chromosomal analysis was normal.
  • 小口 勝司, 久野 一恵, 池野 美恵子, 小出 良平, 上條 一也, 森 甫夫, 安原 一, 庄 貞行, 深田 潤, 安原 一, 上條 一 ...
    1976 年 36 巻 4 号 p. 369-373
    発行日: 1976/08/28
    公開日: 2010/09/09
    ジャーナル フリー
feedback
Top