昭和医学会雑誌
Online ISSN : 2185-0976
Print ISSN : 0037-4342
ISSN-L : 0037-4342
38 巻, 5 号
選択された号の論文の13件中1~13を表示しています
  • ―特に67Ga腫瘍シンチグラム及びX線像との比較―
    会田 巌, 前田 陽一, 鈴木 真, 徳永 宏司, 岩崎 統, 長谷川 一彦, 平林 晋一, 北原 隆, 菱田 豊彦
    1978 年 38 巻 5 号 p. 455-462
    発行日: 1978/10/28
    公開日: 2010/09/09
    ジャーナル フリー
  • 新田 増雄
    1978 年 38 巻 5 号 p. 463-475
    発行日: 1978/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    We studied the relationship of the liver-bile duct system and kidneys and pancreas with 22 patints by the laboratory data and histopathological appearances. The patients had cholelithiasis, acalculous cholecystitis or gastroduodenal disease and were not complicated by malignant tumor, hepatic cirrhosis and severe systemic disease had not begun on hemodialysis.
    Then, they were selected from the patients routinely examined during the past twenty years in the 1st department of pathology of the medicine, Showa university. The following are the results of the above studies:
    1) Comparing the obstructive jaundice group with that of the non-obstructive jaundice, especially in the former we recognized a close relationship of the liver-bile duct system and kidneys and pancreas.
    2) In the obstructive jaundice group, comparing the oparated patients for bile duct disease-cholelithiasis -with the non-operated patients, there was no difference between the two.
    3) In the non-obstructive jaundice group, comparing the operated patients for up-perabdominal disease, except bile duct disease, with the non-operated patients, there was a little closer relation of the three organs in the former than in the latter.
    4) Comparing the gall-stone group with the non-gallstone group, there was a closer relation of the three organs, especially in the gallstone group with obstructive jaundice.
    5) On histopathological study, there were icteric change and fatty degeneration and slight fibrous degeneration in the liver, and cloudy swelling and necrobiosis and precipitation of the bile pigment of the renal tubules in the kidneys, and acute necrotic inflammatory changes and slight fibrosis in the pancreas.
    6) On the laboratory data, there were increased alkaline phosphatase, blood urea nitrogen (BUN), serum amylase and elevation of bilirubin.
    As stated above, we recognized significant correlation of the liver-bile duct system and kidneys and pancreas, especially severe in the patients of obstructive jaundice, studying mainly patients of cholelithiasis.
  • 新井 章子
    1978 年 38 巻 5 号 p. 477-488
    発行日: 1978/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    Clinical data of 288 elderly patients who received general, spinal or epidural anesthesia from June 1976 through September 1977 were studied, as compared to 43 patients from 40 to 55 years of age (A group) . The elderly patients included 213 patients from 65 to 74 years of age (B group) and 75 patients above 75 years of age (C group) .
    Results are as follows :
    1. Induction dose of thiamylal and maintenance concentration of halothane were distributed more frequently to lowest range in C group, to middle range in B group, and to highest range in A group, respectively. However, dose or concentration required in a few elderly patients were as large as in A group, suggesting disparity between chronological and biological age.
    2. Dose (mg/kg/hour) of pancuronium necessary for abdominal muscle relaxation was larger in B group than in A group, being largest in C group. The elderly patients anesthetized with neuroleptanesthesia required more pancuronium than the patients under nitrous oxide-oxygen-halothane anesthesia.
    3. The intraoperative fluid requirements, usually about 8-9 ml/kg/hour, were increased in the patients undergoing prostatectomy or anesthetized with neuroleptanesthesia, as compared with other cases.
    4. Results failed to show a significant correlation between urinary output and the volume of the intraoperative fluids.
    5. Hypotension following induction and endotracheal intubation was observed in about one-third of the cases anesthetized with thiamylal, and in more than half of the cases anesthetized with neuroleptanesthesia or ketamine, which was used for the patients with bronchial asthma or bleeding.
    6. During gastrectomy under nitrous oxide-oxygen-halothane anesthesia, blood pressures were higher in C group than in B group. The elderly patients undergoing gastrectomy under neuroleptanesthesia showed higher blood pressure than the patients under nitrous oxide-oxygen-halothane anesthesia, during earlier period of surgical procedure. However, this relationship was reversed during later period of surgical procedure.
    7. During prostatectomy, blood pressures were lower in B group under epidural anesthesia than in the elderly patients under nitrous oxide-oxygen-halothane anesthesia, being lowest in C group under epidural anesthesia.
    8. The incidence of hypotension to be treated with vasopressor was higher in neuro-leptanesthesia than in spinal anesthesia, being highest in epidural anesthesia.
    9. The incidence of hypertension above 160 mmHg was higher in the patients with hypertension or anesthetized with neuroleptanestheisa, as compared to other cases.
    10. The need for blood transfusion was determined by preoperative hematocrit, blood loss, and the age of the patient.
  • 原 太平, 武重 千冬
    1978 年 38 巻 5 号 p. 489-496
    発行日: 1978/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    1) 家兎の深部脳波を周波数分析して仰臥位・耳介の基部の強圧・末梢低周波刺激などの動物催眠誘起の操作を行い, 動物催眠脳波の特性を検した.その結果374例の仰臥位による深部脳波の変化は, 覚醒時の脳波と比べるとθ・α成分共に減少したのが67.4%, θ成分のみの減少21.9%, α成分のみの減少が6.4%であった.
    2) 耳の基部の圧迫28例, 末梢の低周波刺激12例について検した結果もほぼ仰臥位と同じような比率でθ・α成分の変化がみられた.
    3) 仰臥位による動物催眠374例のうち66.7%に動物催眠の後期にδ成分の増大がみられた.
    4) 仰臥位にした動物催眠中, 音・光などの外来刺激をδ成分の増大が出現した時に与えると, 増大したδ成分のみ消失し, θ・α成分には影響がみられなかった.5) 自発性にδ成分が増大した時は, θ・α成分の変動を伴う.増大したδ成分が消失した時に, θ・α成分の変動も消失した.
    6) 鎮静薬, 催眠薬, chlorpromazine, phenobarbita1投与後δ, θ, α各成分は変動するが, 脳波成分がどのように変動しても, 仰臥位にするとその時のθ・δ成分は投薬前の仰臥位にした時のθ・δ成分とほぼ同じ値を示すことが6匹56例において検した結果から明らかになった.これらの値は正常時を100とすると, それぞれ103.75±2.59, 98.78±3.52であった.
    7) 以上の結果から動物催眠脳波の特性はθ・α成分の減少であり, 動物催眠は薬物投与による睡眠様状態とは異なった神経機序によって誘起されることが推論された.
  • 原 太平, 武重 千冬
    1978 年 38 巻 5 号 p. 497-500
    発行日: 1978/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    The effect of parachlorophenylalanine (PCPA), the inhibitor of tryptophan hydroxylase which is the catalyzer for tryptophan to 5-hydroxytryptophan (5 HTP), on the duration of animal hypnosis induced by inversion has been investigated to test the possibility of the involvement of 5-hydroxytryptamine (5 HT) in animal hypnosis.
    The duration of animal hypnosis in rabbits was diminished gradually for 9 days and the diminished duration of animal hypnosis lasted for about 3 weeks by treatment of 300 mg/kg of PCPA.
    Animal hypnosis could be divided into two periods by reference of frequency analysed subcortical EEG during inversion. One is the period of reduced θ and α activities and the other is of the additional augementation of δ activity. PCPA mainly reduced the second period and influenced on the first period slightly.
    When 40 mg/kg 5 HTP, a precussor of 5 HT, was applied intraperitoneally 21 days after PCPA treatment, the reduced duration of animal hypnosis which exhibited first period of EEG alone increased to control value causing second period of EEG change.
    These dataes indicated the involvement of 5 HT in the maintenance of the second period of animal hypnosis by inversion.
  • 特にその地方差について
    野井 信男
    1978 年 38 巻 5 号 p. 501-512
    発行日: 1978/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    Subcutaneous adipose tissue (SAT) in 36 parts of the body was examined on 92 junior high school girl subjects in Tokyo, and 167 junior and senior high school girls in Okinawa. During their menarche years, the thickness and distribution of SAT were studied and the following results were obtained :
    1) Before menarche, the thickness of SAT on most parts of body was thicker in Tokyo girls than in Okinawa girls, and was especially predominant on the hip, abdomen and the proximal parts of the extremities of Tokyo girls. However, no geography related differences were seen around the nipple and waist.
    2) On the premenarche girls in Tokyo, the thickness of SAT was largest primarily at the lower halves of the hip, secondarily at the upper hip and upper posterior thigh, followed by the middle region of the thigh and waist, and the nipple, calf and navel in that order. This distribution pattern of SAT seemed to be nearly the same on the premenarche girls in Okinawa ; although the thickness of SAT around the nipples of Okinawa girls was equal to that in the middle thigh and waist, while on the calf it was thinner than in Tokyo girls.
    3) The thickness of SAT in the nipple part proceeded to increase for one year in Tokyo girls and for 2.5-3.5 years in Okinawa girls after menarche. It reached the thickness of hip, middle thigh and waist SAT in Tokyo girls, and matched the largest parts in Okinawa girls.
    4) On the post-menarche girls, the thickness of SAT increased strikingly in the thigh, calf and proximal parts of the upper extremities during 1-2 years after menarche in Tokyo, while in Okinawa the thickness gradually enlarged during 3-4 years after menarche and reached the same values as those of Tokyo girls. The thickness of SAT which was seen in the post-menarche girls in Tokyo was greater than in Okinawa in the shoulder, abdomen, hip, anterior parts of the lower extremities and posterior parts of the legs.
    5) In the post-menarche years, the development of thickness of SAT was a rapid type in Tokyo and a gradual type of Okinawa. The former seemed to be close to the type seen in Kagoshima prefecture which was reported by Kawamura (1954) .
    These facts suggest that the differences in development of thickness of SAT in young girls during their post-menarche years is one of the effects of regional environment differences.
  • 胆汁分泌ならびに胆汁成分に及ぼす影響
    中山 貞男, 栗本 忠, 初鹿野 誠彦, 狩野 元成, 坂本 浩二
    1978 年 38 巻 5 号 p. 513-523
    発行日: 1978/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    We investigated the effects of NKK-105, diisopropyl 4-hydroxy-1, 3-dithiolan-2-ylidene malonate (NKK-103), diisopropyl 1, 3-dithiolan-2-ylidene malonate (NKK-100), ursodeoxycholic acid (UDCA) and trithio-p-methoxy phenylpropene (TMPP) on the hepatic blood flow, bile flow and biliary components of Beagle dogs and Sprague-Dawlay rats. The results were as follows
    1) NKK-105 showed little inhibitory effect on respiration, and lowering of blood pres-sure by about 20 mmHg in the dogs by a dose of 5.0 mg/kg, i.v..
    2) NKK-105 (5.0 mg/kg, iv.) caused a significant increase in the quantity of hepatic blood flow and bile flow in the dogs. The similar effect was observed by the administration of NKK-103 and NKK-100. UDCA increased bile flow but had no effect on the hepatic blood flow. TMPP decreased hepatic blood flow but had little effect on the bile flow.
    3) NKK-105 and NKK-103, when administered to rats, increased bile flow, but had no effect by administration of NKK-100.
    4) An increase in the biliary bile acids, bilirubin and lipids concentration was observed after the i.v. administration of NKK-105, NKK-103, NKK-100 and UDCA in the dogs. TMPP increased the excretion of bilirubin markedly but had little effects on the bile acids and lipids.
    5) NKK-105 and NKK-100 increased the excretion of bile acids, bilirubin and lipids in the bile components of rats. NKK-103 had no effects on the excretion of bile components of rats.
  • 木村 忠直, 阿尻 貞三, 井原 敬二, 猪口 清一郎
    1978 年 38 巻 5 号 p. 525-533
    発行日: 1978/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    Myofibrous organization of the M. tibialis anterior of 9, one and a half year old rats which were subjected to running exercise on a treadmill, were examined and compared with controls.
    The following results were achieved:
    1) Muscle weight, cross sectional area of venter, total number of muscle fibers and thickness of muscle fibers were greater in males and the number of muscle fibers per sq. mm, was higher in females. On the other hand, the experimental males were well developed in cross sectional area of venter, total number of muscle fibers and thickness of muscle fiber, and the control females had greater thickness of muscle fibers, in general.
    2) White or red muscle fibers always exceeded intermediate fibers in control females. Intermediate fibers were always least in evidence. Exercise increased the number of white fibers in both sexes, slightly decreased red fibers in females ; and decreased intermediate fibers, slightly in females, and greatly in males.
    3) The thickness order for each type of muscle fiber was always : largest, white; then intermediate ; and red, smallest. All three of these types were larger in male than in female. On the other hand, white and red fibers in males were larger in the experimental group than in the control group, and those of females were larger in the control group.
    4) In comparison of body weight with thickness of muscle fiber for experimental and control groups, no significant differences were observed in the red muscle fiber of both groups. For the intermediate fiber, there was no correlation with body weight of the control group, but muscle size was positively correlated with body weight in the experimental group. White fiber size was positively correlated with body weight for both control and experimental groups.
    5) The thickness of muscle fiber was increased in male and decreased in female by exercise. The increase rate was greatest in white fiber, second in red fiber and least in intermediate fiber ; and the rate of decrease was largest in the intermediate fiber.
    6) The relative cross sectional area occupied by the each type of muscle fiber was always largest for white fiber. Comparing the experimental with the control group, white fiber was larger in both sexes in the experimental group, red fiber was larger in females in the control group, and in males in the experimental groups. Intermediate fiber was larger in both sexes in the control group than in the experimental groups.
    7) It is concluded that the following factors are important in the sex related differences of muscle fiber change: decrease in the number of intermediate fibers and increase of the red fibers in the male; and decrease in size of each type of muscle fiber, especially intermediate fiber, in the female, and which were caused by excessive exercises, especially for females.
  • 鈴木 真, 本田 実, 菱田 豊彦
    1978 年 38 巻 5 号 p. 535-542
    発行日: 1978/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    1) tumorへ放射線照射を行なうと, 数日のインターバルを経てからBAIABの排泄増加が認められる.これは照射による細胞破壊を反映していると考えられる.
    2) 癌患者に制癌剤を継続投与しているとBAIBA排泄値は減少傾向を示した.これは生体のthymidine poolの減少に基づくためであるかもしれない.
    3) BAIBAのgenetic low excretorのヒトはhigh excresorのヒトに比べてBAIBAの処理能力が優る.このことはthymine cataboliteであるBAIBAが増加するような場合において, BAIABの排泄パターンが両者では異なり, low excretorではhigh excretorよりもその排泄量の増加は少ない.
  • 渡辺 浩之, 副島 和彦, 諸星 利男, 新田 増雄, 浅沼 勝美, 盛山 真行
    1978 年 38 巻 5 号 p. 543-547
    発行日: 1978/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    Polyarteritis nodosa is not often in frequency and further in childhood than in adulthood. An autopsy case of polyarteritis nodosa complicated by rupture of left coronary ar-tery aneurysm in nine years old girl was reported with some literatures.
  • 本田 公夫, 岡庭 豊, 清水 比登美, 永納 和子, 長村 洋, 吉田 和正, 持丸 賢二, 武田 昭平, 加々美 建一, 稲田 豊
    1978 年 38 巻 5 号 p. 549-556
    発行日: 1978/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    In clinical pediatric anesthesia, the authors compared the Bain's circuit with the Dundas' circuit, under manual controlled ventilation with the fresh gas flow of 31/min by means of blood gas study.
    The following results were obtained.
    1. On the Bain's circuit, normal arterial carbon dioxide tension (Paco2) could be obtained. But on the Dundas'circuit, lower Paco2 was obtained and the respiratory alkalosis developed.
    2. On the Bain's circuit, direct linear correlation was recognized between Paco2 and body weight, but on the Dundas'circuit such correlation was not recognized.
    3. On the Bain's circuit, moderate increase of CO2 washout was observed in the patients weighing less than 10 kg body weight, therefore we presumed that the fresh gas flow might be reduced further in the children under 10 kg body weight.
    4. In regard to oxygenation, between two circuits we could not found statistically significant difference.
    From above results, the authors concluded that the fresh gas flow of 31/min was sufficient to guarantee the adequate CO2 washout from the body with the Bain's circuit in children, but the same fresh gas flow to Dundas' circuit caused the respiratory alkalosis.
  • 時田 信仁, 許 瑞光, 岡本 途也, 風間 玲子, 青木 記美恵
    1978 年 38 巻 5 号 p. 557-562
    発行日: 1978/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    The clinical picture of localized encephalitis is characterized by the sudden onset of severe gait ataxia with complete recovery within a few months.
    This condition is not rare, there have been many cases reported in the past, though neurotological observations have not been made enough in the recent papers.
    Two cases of localized encephalitis were viewed from neurotological aspects.
    Case 1. A boy aged 10 developed ataxia, double vision, dysarthria and vomiting. A slight degree of adiadochokinesis and intention tremors were found in the upper extremities.
    Neurotological findings indicated the upper brain-stem and cerebellar dysfunction.
    Case 2. A boy of 14 had slight vertigo and tinnitus for ten months. In early November, 1976, headache was followed by drowsiness. It decreased for one week, then ptosis, abducens palsy and hemiparesis developed.
    Neurotological findings revealed an expansive process in the region of brain-stem.
    CT scanning performed on two cases did not show any abnormalities.
    Neurotological examination may elicit valuable additional information also when such a expansive process is suspected elsewhere than in brain-stem.
  • 井上 恒一, 宮 哲正, 太田 宏, 尾上 保夫, 森本 和大, 石井 淳一
    1978 年 38 巻 5 号 p. 563-570
    発行日: 1978/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    There are conflict evaluations on the effects of vasodilator drugs for the postoperative low output syndrome (LOS) . We have used sodium nitroprusside for perioperative hypertension and postoperative LOS without ill effects.
    The cardiac output and urine volume were increased in the most situations, but decreased in the some situations. It seems difficult to as certain the net effects of sodium nitroprusside on LOS, as the severity of LOS, simultaneous use of inotropic drugs, the state of circulating blood volume and others may influence a great deal on its action.
    But we realized that sodium nitroprusside is a much and useful agent as a periopera-tively available antihypertensive drug, as long as the continuous arterial pressure monitoring and the small starting dose are used.
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