昭和医学会雑誌
Online ISSN : 2185-0976
Print ISSN : 0037-4342
ISSN-L : 0037-4342
37 巻, 1 号
選択された号の論文の8件中1~8を表示しています
  • 鬼塚 卓弥
    1977 年 37 巻 1 号 p. 1-4
    発行日: 1977/02/28
    公開日: 2010/09/09
    ジャーナル フリー
  • ―カテコールアミン (dopamine, norepinephrine, isoproterenol) , およびdibutyryl cyclic AMP投与時の犬血行動態におよぼす影響―
    秋場 斉
    1977 年 37 巻 1 号 p. 5-13
    発行日: 1977/02/28
    公開日: 2010/09/09
    ジャーナル フリー
    Hemodynamic effects of dopamine (DA; 10 μg/Kg/min.), norepinephrine (NE; 1 μg/Kg/min.), isoproterenol (ISO ; 0.1μg/Kg/min.) and dibutyryl cyclic AMP (DBcAMP ; 30 mg/Kg) on cardiogenic shock were studied. Experimental cardiogenic shock was produced by two stage ligation of the left circumflex coronary artery in the dog. Combination of DA and G-strophanthin was studied in some experiments.
    1. DA showed a moderate positive inotropic action and also increased renal blood flow (RBF), and raised mean blood pressure (mBP) without alterating total peripheral resistance (TPR) . NE had a relatively weak inotropic action, and raised mBP markedly with increased TPR, but decreased RBF considerably. ISO showed the most strongest positive inotropic effects among catecholamines studied. Also it increased RBF slightly, but decreased mBP. From these results, adequate dose of DA was thought to be most useful to treat cardiogenic shock.
    2. ISO and DA increased the elevated S-T segment more in electrocardiogram. This was suggestive of increasing myocardial ischemia.
    3. Combination of DA and G-strophanthin increased a positive inotropic action more than DA alone and decreased HR slightly, however, all the dogs died of ventricular fibrillation at 40 to 60 minutes after administration.
    4. DBcAMP showed a relatively strong positive inotropic action like catecholamines in the doses of this experiment, and also had a slight positive chronotropic action, but this effect was much smaller than ISO and DA.
  • 加藤 敏平
    1977 年 37 巻 1 号 p. 15-30
    発行日: 1977/02/28
    公開日: 2010/09/09
    ジャーナル フリー
    Employing 145 patients with acute myocardial infarction who survived more than one month after the attack, the factors interfering the progress of rehabilitation program and the long-term prognosis of the disease were investigated in this study. The patients were divided into following 4 groups according to the period required for attaining the target of the program : Group A (14 cases) attaining the target within 60 days, group B (97 cases) taking more than 60 days to attain it, group C (23 cases) being unable to attain it even after taking much time and group D (11 cases) quitting the program on the way.
    Main interfering factors included congestive heart failure, anginal attack, arrhythmias, infection, cerebrovascular accident and their sequelae, disorders of movement of the extremities, abnormalities in exercise electrocardiogram taken at each stage of rehabilitation and reattack of myocardial infarction. The patients of group A experienced minimal interfering factors and showed a very favorable prognosis. It was found that the frequency of interfering factors was increased, however the long-term prognosis was favorable in group B. In group C the interfering factors were most frequently seen and the prognosis was very poor with higher mortality rate in the first three months.
  • 坂本 言方, 八田 善夫
    1977 年 37 巻 1 号 p. 31-37
    発行日: 1977/02/28
    公開日: 2010/09/09
    ジャーナル フリー
    The determination of amylase in serum and urine was assumed to be valuable for the diagnosis of pancreatic disease.
    The analytical method of amylase isozymes should be investigated for accurate diagnosis, because high amylase level is often found in some cases other than pancreatic disease.
    A definite separation of amylase isozymes were performed by DEAF-Cellulose column chromatography with serum and urine of rat and man.
    The pancreatic amylase was eluated as the first peak whereas the salivary amylase was in the second peak on this column chromatography and these two amylase were con-sidered to have different chemical composition. As the results, the pancreatic and salivary amylase were almost contained in the same concentration in normal human serum.
    In contrast, the content of the pancreatic amylase was much higher than the salivary type in normal urine and the ratio of these two amylase isozymes were increased markedly in the urine of the pancreatic disease. Major component of rat serum was hepatic amylase suggesting that the amylase existed in the liver of the rat.
  • 徳永 慎介
    1977 年 37 巻 1 号 p. 39-50
    発行日: 1977/02/28
    公開日: 2010/09/09
    ジャーナル フリー
    The histological composition and the percentage of the fatty acids of the adipose tissue on the abdominal wall from 103 subjects (males ; 45, nulliparous females ; 28, parous females ; 30) were examined. The materials used in this studies were obtained from the autopsy subjects in Tokyo Metropolitan Medical Examiner Office.
    1. The subcutaneous fatty layer was divided into two layers of the superficial and deep layer by the middle layer containing abundant connective fiber elements.
    2. The superficial layer was generally thicker than the deep layer, and its increasing tendency was markedly than that of deep layer in male but a few in female.
    3. The numbers of the connective tissue fibers were always more in the superficial layer than in the deep layer in both sexes, and were more in order of male, parous female and nulliparous female, and increased with age.
    4. The size of the connective tissue fiber was larger in the deep layer than in the the superficial layer and showed the tendency becoming smaller in order of male, parous female and nulliparous female in the superficial layer.
    5. Concerning the percentage of the fatty acids, palmitic acid was highest in the both layers, and oleic acid in the superficial layer and linoleic acid in the deep layer were in second order respectively by male. By female, palmitic acid and linoleic acid showed equal percentage in the superficial layer and were in order of linoleic acid and palmitic acid in the deep layer.
    6. Unsaturated fatty acids decreased markedly at 20 and 30 of age in the superficial layer by male and showed the larger sex-difference by the aged.
  • 持丸 賢二, 仁木 寛, 佐藤 元助, 内田 伸昭, 吉田 和正, 長村 洋
    1977 年 37 巻 1 号 p. 51-55
    発行日: 1977/02/28
    公開日: 2010/09/09
    ジャーナル フリー
    Two cases of bronchial spasm in asthmatic patients are presented. In case I, the first operation had been cancelled because of sever bronchospasm. Pharmacological and inhalation therapy with IPPB were continued until symptoms were improved. But during the second operation under epidural anesthesia, slight bronchospasm occurred. In case II, anesthesia was induced with ketamine and maintained with nitrous oxide, oxigen and halothane (1%) . Bronchospasm occurred when pancuronium bromide was administrated intravenously after intubation.
    In both cases, the bronchospasm was cured with intravenous administration of theophylline and hydrocortisone.
    Post operative course was uneventful in both cases.
  • 小林 玄彦, 中西 弘, 林 康夫, 国松 茂生, 東儀 英夫
    1977 年 37 巻 1 号 p. 57-60
    発行日: 1977/02/28
    公開日: 2010/09/09
    ジャーナル フリー
    A 42-year-old female was admitted to the hospital with the complaints of weakness and paresthesia in the four limbs and dysarthria.
    Two weeks before admission, she had headaches and chills. Four days later, she had skin rash typical of German measles. Her two daughters also caught German measles during the same period. When her skin rash began to subside, she noticed difficulty in standing up and felt paresthesia in the four extremities, and could not articulate words clearly.
    Examination on admission revealed bilateral facial weakness. Muscular strength of the four extremities was reduced, especially in their proximal parts. There were sensory disturbance and parestheia in the distal parts of the limbs. Deep tendon reflexes were absent in the four extremities.
    Routine labolatory examinations were within normal limit except moderate elevation of peripheral white blood cell count (10, 000 cells/cmm) . Lumber puncture revealed clear and colorless cerebrospinal fluid under normal pressure, containing 155 mg/cmm of protein and 1 cell/cmm. Haemagglutination inhibition titer for rubella was raised to 1: 516.
    She was treated with steroids and began to show improving strength in the extremities. After 80 days, all neurological symptoms disappeared, and cerebrospinal fluid findings returned normal. Haemagglutination inhibition titers for rubella became 256.
    Her condition was diagnosed as acute polyradiculoneuritis associated with rubella infection. Previous case reports of rubella neuropathy were reviewed, and the pathogenesis of nerve involvement in rubella was discussed.
  • 藤田 力也, ハラダ シゲル, 遠山 啓一郎, 中山 寿朗, 小町谷 琢也, 川瀬 定夫, 佐竹 儀治, 大栗 茂芳, 小林 明文, 成原 ...
    1977 年 37 巻 1 号 p. 61-64
    発行日: 1977/02/28
    公開日: 2010/09/09
    ジャーナル フリー
    Recently gastrofiberscope has been used with increasing frequency instead of gastrocamera as routine examination of stomach. But in comparison with gastrofiberscope, gastrocamera has several important advantages. As for the view field of gastrocamera it is wider than that of gastrofiberscope and thereby all the stomach can be examined more easily. Additionally, film reading is more objective and exact with gastrocamera.
    The purposes of the present study are to compare visual finding with film reading from the point of view of diagnostic accuracy and to consider the importance of gastrocamera in the training of endoscopists.
    In summary, we made a comparative study between visual finding and gastrocamera film reading in 100 random cases with some gastric pathology respectively. Visual oversight occured in 44% of the total cases, and was decreased in frequency according to experience of the examiner. For instance it was 29% in Group I (examiner over 8 years), 60% in Group II (3-8 years) and 42 % in Group III (less than 3 years) . Gastric ulcer scar was the most difficult to recognize even under direct vision. Over-sight was seen in 65% among them and also decreased according to the experience. For the beginers, lesser curvature of the angulus was the favorite site where over-sight incidency was most frequent.
    Visual over-reading occured in 6% and film miss-reading occured in one case (1%) .
    Gastrocamera photography and gastrofiberscopy should be combined together for detection of the lesion and for training of endoscopists.
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