昭和医学会雑誌
Online ISSN : 2185-0976
Print ISSN : 0037-4342
ISSN-L : 0037-4342
39 巻, 3 号
選択された号の論文の13件中1~13を表示しています
  • 会田 巌, 長谷川 一彦, 北原 隆, 菱田 豊彦
    1979 年 39 巻 3 号 p. 245-246
    発行日: 1979/06/28
    公開日: 2010/09/09
    ジャーナル フリー
  • 小田切 統二
    1979 年 39 巻 3 号 p. 247-256
    発行日: 1979/06/28
    公開日: 2010/09/09
    ジャーナル フリー
    Studies of the causes of bronchial asthma always point to the common charactaristic of air way hypersensitivity.
    In order to test the effectiveness of Sch 1000 in reducing air way hypersensitivity in the patients, three groups of asthmatics and nonasthmatics were divided up for clinical treatment in the following way.
    One group was administered only Sch 1000 as cholinergic blocker, second group was administered acetylcholine only, and third group was administered acetylcholine after Sch 1000 inhalated.
    The results were as follows :
    1) Among both asthmatics and nonasthmatics in the group which inhalated only Sch 1000, cyclic AMP levels rose considerably after inhalation, however the ammount of increase was higher among nonasthmatics cyclic GMP levels were decreased in nonasthmatics with Sch 1000 inhalation. The lung function was improved in asthmatics. There were no significant differences in pulse and blood eosinophils before and after inhalation among both asthmatics and nonasthmatics.
    2) In the group which inhalated acetylcholine only, cyclic AMP and cyclic GMP levels were much increased and lung function grew worse in asthmatics.
    3) In the group which inhalated acetylcholine after Sch 1000 was administered, cyclic GMP levels didn't increase due to the suppression effect of Sch 1000 inhalated. Lung function tests showed no significant changes, thus indicating the beneficial effect of Sch 1000.
    4) These preliminary tests indicate that the etiology of air way hypersensitivity in asthmatics is derived from not only β-blockade but also cholinergic hypersensitivity, and cyclic nucleotides are closly related with the causes of the hypersensitivity.
  • ―気管支喘息を中心として―
    中島 宏昭, 横川 敏男, 会田 秀介, 井出 宏嗣, 杉崎 徹三
    1979 年 39 巻 3 号 p. 257-267
    発行日: 1979/06/28
    公開日: 2010/09/09
    ジャーナル フリー
    Forty-four patients, including 15 astmatics (5 atopic, 5 infectious and 5 mixed type), 13 lung cancer, 4 chronic bronchitis, 4 other pulmonary diseases and 8 non-pulmonary diseoses, were performed transtracheal bronchial mucosal biopsy.
    The specimens were observed to distinguish the histological abnormality between asthmatics and non-asthmatics by using light-microscopical and immunopathological procedures.
    By light-microscopy, 14 cases of asthmatics showed the thickening of mucous basement membrane (MBM) and infiltration of eosinophils in submucosal area and within or on the mucous lining cell, accompanied with submucosal edema, The pulmonary diseases other than bronchial asthma showed only infiltration of polymorphonuclear leucocytes in submucosal area.
    By immunofluorescence, IgA and IgG deposits along MBM were observed in homogeneous pattern in many cases of atopic or mixed type asthmatics and chronic bronchitis. However, they were not found in the cases of infectious type asthmatics, and other pulmonary or non-pulmonary diseaes. IgE was found in three cases of the atopic type. but never found in any other types. Fibrin deposits along MBM were occasionary found in infectious type of asthmatics and the patients with chronic bronchitis. An attack occured in only one case of atopic type during the biopsy, and this case revealed the deposition of all immunoglobulins, C1q, C3 and fibrin.
    In addition of the biopsy, serial-biopsy were performed on the mucosa were antigen (house dust) was dropped on the MBM to observe time-related histological changes. In asthmatics, IgG and IgA increased with time after the dropping, but not in non-asthmatics.
    Thus, immunological findings of mucous tissue in a variety of diseases were studied. In asthmatics, IgA and IgG deposits were found along the MBM in the atopic and mixed type, but no immunoglobulins were found in the infectious type.
    On the ther hand, IgA, IgG and fibrin deposits were discovered in majority of the cases with chronic bronchitis. Therefore, it is suggested that the deposition of IgA and/or fibrin in MBM resulted due to the chronicity of the illness or bacterial stimulation to the mucosa.
  • 志和池 成世, 佐藤 滋, 米倉 正博, 伊藤 正吾, 菊池 祥治, 杉崎 徹三
    1979 年 39 巻 3 号 p. 269-278
    発行日: 1979/06/28
    公開日: 2010/11/19
    ジャーナル フリー
    Masugi Nephritis induced in rats was employed as experimental model to investigate the possible effects of rheumatoid factor on in-vivo antigen-antibody reactions. Rats injected simultaneously with rheumatoid arthritis serum or Hodgkin's serum (containing high titer of Rheumatoid factor) and rabbit nephrotoxic serum showed a three or four-fold increase with time compared with rats injected with nephrotoxic serum alone. Normal human serum had no effect on the proteinuria produced by a standard dose of nephrotoxic serum. IgM (presumably rheumatoid factor) in glomerular of rat injected the RF serum was detected by immunofluorescence along the glomerular basement membrane with the nephrotoxic serum and rat complement (C3 and C1q) . Rheumatoid factor activity was also recovered by elution from glomeruli isolated from rat kidneys 48 hrs. after the injection of rheumatoid arthritis serum or Hodgkin's disease serum and nephrotoxic serum. Histological changes of kidneys of rat 48 hrs, after injection with rheumatoid arthritis serum (particularly malignant rheumatoid arthritis serum) and nephrotoxic serum showed cortical necrosis (4/6) and severe glomerular changes, compared with the other groups.
    Thus, the deposition of RF in the glomeruli seemed to closely relates to chronicity and sererity of the Masugi nephritis.
  • (免疫電顕オートラジオグラフィー法を中心として)
    橋本 定寛, 山本 純, 北沢 孝三, 佐藤 滋, 米倉 正博, 伊藤 正吾, 志和池 成世, 井出 宏嗣, 杉崎 徹三, 中井 康光
    1979 年 39 巻 3 号 p. 279-287
    発行日: 1979/06/28
    公開日: 2010/09/09
    ジャーナル フリー
    It is well known that majority of the cases with glomerulonephritis are mediated by immunological events. Among the various types of glomerulonephritis, Goodpasture syndrome is typical model which mimick with Masugi nephritis (antiglomerular basement membrean (GBM) disease) . Recent numerous studies of Masugi nephritis using electron microscopy gave us various informations. However precise mechanism of the glomerular injuries are still unknown. On this points of view, precise glomerular injury of Masugi nephritis was investigated by using immunofluorescence, peroxidase staining and electron microscopical immunoautoradiography. GBM antibody which was obtained from rabbits immunized with rat GBM was used for induction of the Masugi nephritis. Masugi nephritis was studied by light-microscopy and electron-microscopy. For the detection of anti-GBM antibody in the tissue specimen, procedures of the immunofluorescent and peroxidase staining and also electron microscopical immunoautoradiography were performed. These three techniques were compared from the points of sensitivity and identifying power of localization of the antibody.
    By light-microscopy, glomeruli of rats received anti-GBM antibody showed accumulation of the polymorphonuclear leucocytes (PMN), hyalin thrombi and crescent formation. By electron-microscopy, the mild thickening of GBM, infiltration of PMN and platelet frequently seen in the glomeruli. By immunofluorescent study, rabbit IgG, rat C3 and rat C1q were found along GBM in linear fashion. On the other hand, rat fibrin was occasionally found in the lumen of glomerular capillary. By peroxidase staining, the staining was seen in the both side of the glomerular capillary walls and the mesangial basement membrane.
    By electron microscopycal immunoautoradiography, a number of the grains were found along GBM, but the precise localization of the grains were not clearified whether they were in the lamina rara interna, lamina densa, or lamina rara externa, because spur of the grains was fairly long. The grains were also found in the mesangial area, surface of the epithelial cells and endothelial cells. In addition of these glomerular findings, the grains were found in the tubular basement membrane and also lumen of the tubules.
    These three immunological techniques, particularly electron microscopycal immunoautoradiography, seemed to be valuable methods for studying the mechanisms of the immunological glomerular injury.
  • 津田 浩史
    1979 年 39 巻 3 号 p. 289-296
    発行日: 1979/06/28
    公開日: 2010/09/09
    ジャーナル フリー
    環境液中のNaイオンをtetraethylammoniumイオンで置換した液を膀胱に作用させると, 最初急速に上昇, その後ゆっくり下降する収縮がひき起こされる.atropineによって振幅の小さい持続的な収縮以外は消失する.従ってTEAによって誘起される収縮はコリン性の収縮で, これは運動神経の神経終末と同じように自律神経系の終末の興奮性をTEAが高め伝達物質の遊離によって引き起こされた収縮といえる.tetrodotoxinの存在下でもこの収縮は誘起されるのでtetrodotoxinはやはり運動神経終末に対すると同じように伝達物質の遊離には関与しない.
    AChによる収縮はatropineによって消失するのでatropineの作用後も残存するTEAによる振幅の小さい持続的な収縮はTEAの筋自身に対する作用によって出現する.またNa欠損環境或いはTTX作用時AChによる収縮は増大して現われ直接間接刺激による収縮は余り影響をうけない.Ca欠損環境液ではTEA, AChによる収縮, 間接直接刺激による収縮, 何れも著しく抑制されるか消失する.
    膀胱の支配神経の神経終末からの伝達物質の遊離及び膀胱筋の収縮はCa依存性であると想定された.
  • 田中 正明, 津田 浩史
    1979 年 39 巻 3 号 p. 297-300
    発行日: 1979/06/28
    公開日: 2010/09/09
    ジャーナル フリー
    筋電図で検したカエルの屈曲反射は, 仰臥位によるいわゆる動物催眠中抑制され, 減弱するか, 消失する.屈曲反射の抑制は, 刺激の強さを変えてひき起こした屈曲反射の程度とは無関係であった.また前庭の破壊はこの反射抑制には無関係であった.中脳の中央の切断はこの屈曲反射の抑制には影響しないが中脳尾側部切断で抑制は現われなくなる.従って, 中脳の尾側部に屈曲反射抑制の中枢が局在することが判明した.
  • 中村 明子
    1979 年 39 巻 3 号 p. 301-310
    発行日: 1979/06/28
    公開日: 2010/09/09
    ジャーナル フリー
    Blood viscosity and hematocrit were measured on 113 newborn infants during the first 6 days of life including 3 cases of neonatal hyperviscosity syndrome. Viscosity examinations were carried out at 37°C with a Epprecht Viscometer Low-shear-100, Contravas Company.
    Blood viscosity of normal term infants with late cord clamping was significantly higher at 2 hours of age than the cord blood (p<0.001), and then decreased gradually until 6 days of age when the value was still higher than that of the cord blood.
    Viscosity of the infants born after cesarean section showed no increase at 2 and 4 days after birth compared with the cord blood, but the value at 6 days of age was significantly higher than that of the cord blood (p<0.05) .
    Viscosity of normal term infants was higher than that of infants born after cesarean section, A F D low birth weight infants and S F D low birth weight infants (p<0.05), the difference was statistically significant. There was no significant difference between the latter 3 groups.
    The relation between viscosity and hematocrit calculated the correlation coefficient to be more than 0.9 with hematcrit (p<0.001) . Therefore, it should be possible to use hematocrit instead of viscosity measurement for simple clinical purposes.
    Three cases of neonatal hyperviscosity syndrome showed significantly high blood viscosity and hematocrit over 65 %. Viscosity and hematocrit decreased after partial exchange transfusion with clinical improvement.
  • ―特に乳頭像, 胆管系・膵管系の部位別造影率および管腔径について―
    新井 一成, 小泉 和雄
    1979 年 39 巻 3 号 p. 311-333
    発行日: 1979/06/28
    公開日: 2010/09/09
    ジャーナル フリー
    Recently, endoscopic retrograde cholangiopancreatography (ERCP) is a necessary examination in morphological diagnosis of bile and pancreas ducts systems. We have experienced 183 successful cases of ERCP from March, 1972 to September, 1976.
    The endoscopic figure of papilla of vater and the regional reflection rates and diamater of bile and pancreas duct systems were investigated in relation with the diseases of the systems.
    1) The characteristics of the endoscopic figure of the papilla of vater in cholelithiasis. Most of cholecystolithiasis group cases were hemispherical type and slit-like type and choledocholithiasis group cases were homiellipsoid type and slit-like type. Particularly plica longi-tudinalis duodeni was often elevated higherly in choledocholithiasis group.
    2) The regional reflection rates of bileduct system by ERCP. In cholecystolitiasis group, the reflection rates of cystic duct and gall bladder were low, and in choledocholithiasis group, reflection rates were low in duodenal portion and its side along the liver.
    The regional reflection rates of the pancreatic duct system, in benign group of pancreatic diseases, the reflection rates were generally lower except in the head part of pancreas in comparing to the control group. In cholelitiasis group, the reflection rate of the pancreatic duct was somewhat high.
    3) Every part of common bile duct and head part of pancreatic duct were enlarged remarkably in choledocholithiasis (P<0.001) . In benign pancreatic disease group, head part of pancreatic duct was also enlarged obviously (P<0.05) .
    4) In benign bile duct disease group, significant corrlation was recognized between the maximum diameter of the common bile duct and that of the pancreatic duct (P<0.001) . A positive correlation was also observed in cholecystolithiasis (P<0.02) and choledocholithiasis (P<0.05) .
  • 小口 勝司, 佐藤 博紀, 小林 真一, 庄 貞行, 青木 秀泰, 高橋 愛樹
    1979 年 39 巻 3 号 p. 335-340
    発行日: 1979/06/28
    公開日: 2010/09/09
    ジャーナル フリー
    胃十二指腸潰瘍, 胃癌, 結腸癌, 胆肝疾患等の消化器疾患と血清MAO値の変動との関係を検討し消化器疾患の診断に血清MAO値が応用できるか検討した.その結果は, (1) 健康成人の血清MAO値は28.9±1.8単位で範囲は20.5~37.3単位であった. (2) 胃癌, 胃十二指腸潰瘍, 結腸癌および胆肝疾患例の血清MAO値はそれぞれ32.0±1.6単位, 34.8±2.6単位, 33.6±2.2単位, 31.2±1.7単位で, いずれも正常値に比し有意の差は認められなかった. (3) 進行胃癌のうち硬性癌例の血清MAO値は34.5±1.5単位, その他の進行癌例では28.9±2.2単位でいずれも正常値に比し有意の差は認められなかったが, 早期胃癌の血清MAO値は37.5±2.8単位で正常値に比し有意に高い値を示した.しかし, 進行癌と早期癌との間には血清MAO値の有意の差は認められなかった. (4) 切除胃十二指腸潰瘍例のうち, 潰瘍期例の血清MAO値は32.4±3.1単位で正常値に比し有意の差は認められなかったが, 瘢痕期例の血清MAO値は41.7±5.6単位で, 正常値に比し有意に高い値を示した.しかし潰瘍期例と瘢痕期例の血清MAO値には有意の差は認められなかった. (5) 進行胃癌, 早期胃癌, 胃十二指腸潰瘍, 胆のう疾患, 結腸癌例の血清MAO値を手術前, 手術後1日, 3日, 1週目および2週目まで経時的に測定した結果, それぞれの疾患の血清MAO値はそれぞれの手術前の値と比較してすべて有意の差は認められなかった. (6) 胃癌, 胃十二指腸潰瘍, 胆肝疾患, 結腸癌例における血清総蛋白量, 血清GOT値, TTT値および血小板数と血清MAO値との関係を検討したが, それらの間には相関関係は認められなかった.以上, 胃十二指腸潰瘍, 胃癌等の消化器疾患と血清MAO値との関係を検討した結果, (1) 血清MAO値の測定はこれら疾患の補助診断として有用ではないと思われる. (2) 血清MAO値の測定は進行胃癌と早期胃癌の鑑別補助診断に有用ではないが, 早期胃癌のスクリーニングとして有用となる可能性がある. (3) 胃十二指腸潰瘍の潰瘍期と瘢痕期との鑑別診断および潰瘍修復の判定には血清MAO値測定は有用ではないものと思われる. (4) 手術侵襲に対する回復度の指標として血清MAO値を測定することは有用ではないものと思われる. (5) 血清MAOを肝機能検査として用いるのは適当ではないものと思われる. (6) 消化器疾患における血清MAO値と血小板数との間には相関関係が認められなかった.
  • 武田 重三, 松崎 浩, 石井 千勝, 山岡 成章
    1979 年 39 巻 3 号 p. 341-345
    発行日: 1979/06/28
    公開日: 2010/11/19
    ジャーナル フリー
    In these days of highly-spread medical care, it is comparatively rare to encounter giant ovarian cystoma. The authors have recently experienced three cases of pseudomuciloginous cystadenoma in patients of middle and advanced ages. The weights of tumor are from 6.2 to 13.6 kg and their abdominal cavities are filled with the adenoma. The authors take this opportunity to investigate the giant ovarian cystoma clinically.
  • 小貫 誠, 波多野 剛之, 児玉 秀文, 小笠原 寛, 舩冨 等, 田中 宣男, 吉田 一明, 竹内 治男, 斉藤 博文, 八田 善夫
    1979 年 39 巻 3 号 p. 347-352
    発行日: 1979/06/28
    公開日: 2010/09/09
    ジャーナル フリー
    The effect of perfusion therapy of intractable ascites was investigated in the patients with liver cirrhosis and peritoneal carcinoma.
    In this procedure the ascitic fluid was reinfused into the cubital vein after being filtrated through cellulose acetate hollow fiber and concentrated by polyacrylnitril hollow fiber. With this treatment, the improvement of symptoms and general conditions of the patients, the protection against the reaccumulation of ascites and the increase of the reactivity to diuretics were observed. This procedure was easily performed without any complainments. No severe side effects were seen.
    From these results, this treatment seemed valuable as the practical therapy for ascites which was difficult to be contrabled.
  • 横山 新一郎, 野津 立秋, 浅野 洋治, 香川 宗也, 鶴岡 延熹, 清水 盈行, 光谷 俊幸, 秋本 芳太郎, 風間 和男
    1979 年 39 巻 3 号 p. 353-359
    発行日: 1979/06/28
    公開日: 2010/09/09
    ジャーナル フリー
    The patient, a 39-year-old man, was admitted on August 23, 1976, because of anemia and general fatigue. Peripheral blood examination revealed leukocytosis of 110, 600/cmm. with 86 per cent of peroxidase positive myeloblasts. A diagnosis of AML was made.
    On the 10 th hospital day, he was clinically improved following the treatment with daunorubicin, methotrexate and prednisolone. On the 15 th hospital day, leukocyte count rose to 10, 000/cmm. with 35% myeloblasts and 12% promyelocytes. Platelet count decreased to 30, 000/ cmm.. Coagulation studies revealed marked decrease of fibrinogen (20mg/dl), increase of FDP (50μg/ml), prolongation of prothrombin time (15sec., 45%) and the extraordinary reduction of euglobulin lysis time (30min.) . Those were suggestive of the presence of disseminated intravascular coagulation. He was treated again with DCP without clinical responses. On the 25 th hospital day, he had a sudden onset of chest pain, fever and bloody expectoration. A chest film showed diffuse infiltration in the left lower field. An electrocardiogram disclosed no findings of pulmonary infarction. He was expired on September 17, 1976.
    On postmortem examination, pulmonary embolus and thrombus adhering to tricuspid valve were found.
    Pulmonary embolus might be originated from the thrombus adhering to tricuspid valve caused by disseminated intravascular coagulation.
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