昭和医学会雑誌
Online ISSN : 2185-0976
Print ISSN : 0037-4342
ISSN-L : 0037-4342
39 巻 , 5 号
選択された号の論文の16件中1~16を表示しています
  • 窪田 哲昭
    1979 年 39 巻 5 号 p. 469-476
    発行日: 1979/10/28
    公開日: 2010/09/09
    ジャーナル フリー
  • 安原 一, 中村 幸雄, 坂本 浩二
    1979 年 39 巻 5 号 p. 477-482
    発行日: 1979/10/28
    公開日: 2010/09/09
    ジャーナル フリー
  • 舟木 正朋, 鈴木 親良
    1979 年 39 巻 5 号 p. 483-494
    発行日: 1979/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    Sugar metabolism were studied upon twenty patients who were totally gastrectomized. They were survived for one year or more after operation for gastric cancer. Ten cases of partially gastrectomized patients and five healthy normal subjects were selected as control. Reconstruction after gastrectomy were performed with double tract method (in ten cases), jejunal interposition method (in three cases), Roux-en-Y method (in five cases), and other methods (in two cases) on totally gastrectomized patients and Billroth I method on all of partially gastrectomized patients.
    Studies were performed upon oral glucose tolerance test (OGTT), intravenous glucose tolerance test (iv GTT), and oral xylose absorption test (OXAT) . Blood sugar, serum immunoreactive insulin (IRI), and xylose in urine were determined during those tests. The results were as follows ;
    1) After OGTT, the blood sugar curve in the gastrectomized groups showed oxyhyperglycemic curve and this tendency was more dominant in the totally gestrectomized group. The IRI level reached its peak at thirty minutes in the totally gastrectomized group and began to fall thereafter, however, the IRI level reached its peak later in the partially gastrectomized group.
    2) After iv GTT, the blood sugar levels were higher in the gastrectomized groups than in the healthy normal group. The blood glucose curve in the totally gastrectomized group was similar to that in the partially gastrectomized group. The IRI level in the totally gastrectomized group was lowest in the three groups.
    3) After OXAT, although the xylose levels in urine in the three groups were in a normal range, there was slight difference in the blood xylose levels. Namely the blood xylose level in the totally gastrectomized group reached its peak earliest in the three groups.
    4) Concerning the reconstructive methods after total gastrectomy, the blood sugar levels after OGTT reached their peak earlier in double tract method and jejunal interposition than in Roux-en-Y method. This seemed to be due to some factors in the intestinal tract, for instance, glucose absorption was accelerated by cibarian passing in the duodenum.
    5) There was no significant change in the capacity of glucose tolerance among the totally gastrectomized patients combined with about resection of the pancreas.
    6) Probablely, there is no possibility that repeated insulin hypersecretion following hyperglycemia after gastrectomy causes beta islet cell hypofunction and develops secondary diabetes.
  • 島田 徹治
    1979 年 39 巻 5 号 p. 495-505
    発行日: 1979/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    It has been said that the pancreatic secretion is related with autonomic nerves and humoral factors, but mechanism of the pancreatic secretion is not proved in detail. In this series, the effect of 6-Hydroxydopamine (=60 HDA) that causes the chemical sympathectomy, on the change of the pancreatic exocrine secretion was examined by measuring the pancreatic blood flow and the volume of pancreatic juice.
    As the results, the volume of pancreatic juice was decreased and its bicarbonate concentration was deteriorated markedly after 6-OHDA administration.
    In addition, the effect of secretin on the pancreatic blood flow was not affected after administration of 6-OHDA. On the other hand, the pancreatic exocrine secretion was increased by vagal stimulation, and the volume of pancreatic juice increased 146.2% on the average. But after administration of 6-OHDA, the pancreatic secretion was disappeared by vagal stimulation, but accelerated by L-Dopa administration.
    Becausa 6-OHDA depletes the adrenergic amines from the sympathetic nerve terminals, if the pancreatic exocrine secretion is controlled only by the factor of blood flow, it should be accelerated with the increase of pancreatic blood flow after 6-OHDA administration. However in this studies, not only the nervous pancreatic secretion by vagal stimulation but also humoral secretion of pancreas was inhibited after 6-OHDA administration. From this, I considered that 6-OHDA acted on a factor except the blood flow. Namely, the inhibition of pancreatic secretion by 6-OHDA depends on the decrease of dopamine because 6-OHDA depletes not only noradrenalin but also dopamine. In this studies, the fact that the nervous and humoral pancreatic secretion were inhibited by 6-OHDA administration suggests the existence of charactor like the endocrine cell in the exocrine cell and the possibility that the production of pancreatic juice and synthesis of dopamine take place in the cells. Since amines contained in endocrine cells were concerned with the mechanism of endocrine secretion, exocrine secretion was affected by amines equally and then pancreatic exocrine secretion was caused by dopamine.
  • 吉田 広, 道 健一, 朽名 正也, 鈴木 規子, 上野 正, 伊東 節子
    1979 年 39 巻 5 号 p. 507-517
    発行日: 1979/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    This study was carried out to investigate the factors influencing to the results of speech aid appliance and the indications of it, examining the improvement of speech and velopharyngeal function, and asking the patient's adaptation by means of opinionaire.
    The subjects of this study consisted of 92 patients with cleft lip and palate, and congenital velopharyngeal incompetence.
    As a result, following conclusions were obtained.
    1. Good results were obtained in cases having well-shaped soft palate under 4 years old, and taking speech aid appliance under 7 years.
    2. Poor results were obtained in cases having ill-shaped soft palate, treated at older age, and associated with little movements of the lateral pharyngeal walls.
    3. In 26 cases (28.3 %), speech aid appliances were removed as the result of good velopharyngeal closure, almost of them were treated at early age.
    4. As the complaints of patients for speech aid appliance, unsuitable feeling, contact pain, decrease of appetite, hearing loss, snore, and inconvenience were recognized, but they were very few.
    5. In 24 cases (26.1 %), speech aid appliance were reconstructed due to unsuitability and breakage.
    6. As the other therapy, operations were desired in 13 cases (20.6 %) of the patients with good result, and 1 case (7.7 %) with poor result.
  • 松本 一夫, 後藤 英道, 長谷川 貢, 切士 博文, 鈴木 嘉茂
    1979 年 39 巻 5 号 p. 519-529
    発行日: 1979/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    By the recordings of the serial echocardiograms of the patients with acute myocardial infarction, analysis of aortic root motion and prognosis in the acute phase was investigated.
    The subjects employed were 62 cases, in which 49 alive and 13 died (21%) in the hospital.
    (1) Significant correlations were observed between aortic wall excursion (AWE) and stroke volume (r=0.51) .
    (2) In most cases, AWE and mean aortic wall velocity (mAWV) on admission were smaller, and they were increased gradually.
    (3) In the group with smaller AWE, more cases with heart failure were observed.
    (4) AWE was smaller (under 7 mm) in eleven of thirteen died cases. In the group with small AWE, wide left ventricular dimension, wide left atrial dimension, small mitral valve excursion and short PR-AC time, five cases out of six were complicated with heart failure and five out of six died. On the other hand, in the group with normal AWE, left ventricular dimension, left atrial dimension, mitral valve excursion and PR-AC time, only one case was complicated with heart failure and none of them was died and the prognosis for this group was considered to be good.
  • 東 慶紀, 朴 恩〓, 中西 弘, 猪口 清一郎
    1979 年 39 巻 5 号 p. 531-536
    発行日: 1979/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    The M. rectus abdominis of man was examined, noting the cross-sectional area of venter musculi, the number of muscle fibers per sq. mm., the total number of muscle fibers, the thickness of muscle fibers and the occupational area of muscle fibers in cross-section of the right abdominal rectus specimen of 22 adults. The results obtained were compared with the previously reported pertinent data of the other muscles.
    1. The average values (M) of each data of the M. rectus abdominis examined was 205 mm2 in cross-sectional area, 172, 327 in total number of muscle fibers, 1151 μ2 in muscle fiber size and 91% in occupational ratio of muscle fibers.
    2. Those muscle specimens which have large cross-sectional area tend to be inferior in number of muscle fibers and to be superior in total number of muscle fibers, size of muscle fibers and occupational ratio of muscle fibers than the specimens which have small cross-sectional area. But the muscle specimens with broader cross-sectional area do not always have a larger size and larger density of muscle fiber while some one of them do contain rich interfibrous connective tissue.
    3. As to the relationship of the size of muscle fiber to cross-sectional area of venter musculi, a positive correlation was found to exist, and its of number of muscle fibers per sq. mm. to those showed a tendency of negative correlation.
    4. Comparing the myofibrous organization of Rectus abdominis with the other muscles, we found that the cross-sectional area and the total number of this muscle was smaller than that of adductor longus and biceps brachii, and that the size of muscle fibers of this muscle was larger than that of the other muscles except adductor longus.
  • 村居 真琴, 田中 正明, 蜂須 貢, 藤下 悌彦, 武重 千冬
    1979 年 39 巻 5 号 p. 537-542
    発行日: 1979/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    1.ラットの尾逃避反応を痛覚閾として針麻酔の刺激を与えると, 5%の危険率で有意の差のある鎮痛が現わる動物は約半数みられ, 動物を針鎮痛有効群と無効群とに区分できる.
    2.針鎮痛有効群, 無効群の脳内の内因性モルヒネ様物質の含有量には差異があり, 前者は後者に比べ3H naloxoneのオピエートレセプター結合の阻害率で約10倍多く, ユニット単位に換算すると25倍多かった.
    3.針刺激開始45分後の尾逃避反応の潜伏期の増加率 (鎮痛) と内因性モルヒネ様物質の含有量との間には相関係数0.71の高い相関関係がみられた.
    4.各個体の正常時の痛覚閾と内因性モルヒネ様物質の含有量の対数との間の相関係数は0.11で, 相関関係は認められなかった.
    5.針鎮痛有効群と無効群の脳の種々な部位でのオピエートレセプターの含有量は, 両群の問で差異は認められなかった.
    6.以上から針鎮痛の有効性の個体差は脳内モルヒネ様物質の含有量の個体差に帰することができる.
  • 蜂須 貢, 村居 真琴, 田中 正明, 瀬川 克己, 武重 千冬
    1979 年 39 巻 5 号 p. 543-550
    発行日: 1979/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    1.D-フェニルアラニンのペプチダーゼ阻害作用を生物学的に検定した.モルモット空腸の収縮はエンケファリンで抑制されるが, この抑制はペプチダーゼを含む脳の抽出液が存在する時は消失するが, D-フェニルアラニンを添加すると消失しないで, 脳の抽出液を熱処理して酵素活性を失わせた時と同じになる.
    2.ラットの脳室内に投与したエンケファリンによる鎮痛はD-フェニルアラニンの腹腔内投与によって著しく増強される.
    3.ラットの尾逃避反応の潜伏期を痛覚の閾値として, 針麻酔の刺激を加えると, 5%の危険率で有意の差のある鎮痛が現われるラットと現われないラットがあり, それぞれ針鎮痛有効群, 無効群とに区分できる.
    4.D-フェニルアラニンを投与すると, 針鎮痛無効動物の針鎮痛は著しく増強され, 有効群にD-フェニルアラニンを投与した時のわづかに増強された針鎮痛とほぼ等しくなり, 針鎮痛の有効性の個体差は消失する.
    5.針鎮痛有効群ラットは中脳中心灰白質刺激による鎮痛も有効で, 針鎮痛の有効性の個体差と中脳中心灰白質刺激による鎮痛の有効性の個体差はよく並行する.D-フェニルアラニンを投与すると, 針刺激ならびに中脳中心灰白質刺激無効群ラットの, 中脳中心灰白質刺激による鎮痛は増強し, D-フェニルアラニン投与後わづかに増強された針刺激有効群ラットの中脳中心灰白質刺激による鎮痛とほぼ等しくなり, 中脳中心灰白質刺激による鎮痛の有効性の個体差は消失する.
    6.モルヒネ鎮痛の有効性の個体差も針鎮痛の有効性の個体差と並行するが, D-フェニルアラニン投与後はモルヒネ鎮痛は増強され, 鎮痛の程度は両群ともほぼ等しくなり, モルヒネ鎮痛の有効性の個体差は消失する.
    7.針鎮痛, 中脳中心灰白質刺激による鎮痛, モルヒネ鎮痛何れにも鎮痛性ペプタイドの内因性モルヒネ様物質が関与し, これら鎮痛の有効性の個体差はぺプチダーゼの活性の個体差に依存していると考察した.
  • 久光 正
    1979 年 39 巻 5 号 p. 551-557
    発行日: 1979/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    1) 家兎の脳内に双極の慢性電極を植え込み, 無麻酔, 無拘束の状態で針麻酔の刺激によって現われる誘発電位を記録し, 針麻酔の鎮痛の出現にあづかる求心路について検索した.
    2) 中脳中心灰白質の背側部の限局された部位から, 耳根部に与えた針刺激によって誘発電位が記録された.
    3) 誘発電位は陽性, 陰性波から成り立ち, 針刺激によって筋に収縮が現われ始める強度となると誘発電位が出現し, 更に強度を増大し筋収縮が大となるにつれ誘発電位も増大した.刺激が侵害性刺激の強度となると新たに潜時の長い陽性, 陰性波が出現した.
    4) 10mg/kgのモルヒネは誘発電位には殆んど影響を示さなかった.
    5) 針鎮痛の起こり易い耳根部刺激で誘発電位が記録されたのに反し, 針鎮痛の起こり難い躯幹部の刺激では誘発電位が出現し難かった.
    6) 針刺激によって視床中心核, 中隔核, 帯状束, 海馬などの痛覚の古脊髄視床路及びいわゆる痛みの情動系に誘発電位が記録された.誘発電位の波形は, 中脳中心灰白質から記録されたものとほぼ同様で, 刺激を強めると遅い成分が出現する点も同様であった.尾状核からは誘発電位は記録されなかった.
    7) 中脳中心灰白質の電気刺激によって, 中隔核, 帯状束, 海馬から誘発電位が記録されたが, これらの誘発電位の波形は末梢に刺激を与えた時とほぼ同様であった.また帯状束の誘発電位の潜時と末梢刺激により中脳中心灰白質に出現する誘発電位の和は, 末梢刺激により帯状束に出現する誘発電位の潜時にほぼ等しかった.
    稿を終るに臨み, 終始御懇篤なる御指導を賜わりました恩師武重千冬教授に深甚なる感謝を捧げます.
  • 羅 昌平, 佐藤 三千雄, 清水 信介, 武重 千冬
    1979 年 39 巻 5 号 p. 559-568
    発行日: 1979/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    1.ラットの尾逃避反応を指標として, 針鎮痛有効群のラットの針鎮痛, モルヒネ鎮痛に対する帯状束破壊の影響を検した.
    2.電極 (直径0.5mm) を帯状束を通過して尾状核まで挿入すると, 針鎮痛も0.5mg/kgのモルヒネによる鎮痛もともに消失した.
    3.電極の挿入を帯状束までに止めても中隔核に電極を挿入しても同様のことが観察された.
    4.電極の挿入が帯状束に達しない時は針鎮痛もモルヒネ鎮痛も対照と同様に現われた.
    5.中隔核に挿入した電極を介して電気刺激を与えると鎮痛が出現し, この鎮痛は1mg/kgのnaloxoneによって拮抗された.
    6.中脳中心灰白質背側部の刺激によって誘起された鎮痛は帯状束の破壊で消失した.
    7.中脳中心灰白質から内側前脳束を通って中隔核, 帯状束を通って海馬に到る系は針鎮痛の求心路と考えられ, この系の活動によって内因性モルヒネ様物質が遊離し針鎮痛が出現しモルヒネもこの系を活動させて鎮痛を現わす可能性を論じた.
  • 岡 潔, 武重 千冬
    1979 年 39 巻 5 号 p. 569-580
    発行日: 1979/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    1.ラット脳幹網様体から侵害刺激に応ずるニューロン活動を記録した.ニューロンによって反応様式を異にし, 侵害刺激中にのみ放電の変化を示すニューロンと, 刺激の時点とは直接関係なく刺激終了後も放電の変化を示すニューロンとがあり, それぞれに放電頻度が増大する型と減少する型とがみられた.上記4つの型のニューロン活動が単独に出現するニューロンの他に, これら4つの型が組合さって放電変化を示すと考えられるニューロンも数多く見出された.
    2.針刺激によって侵害刺激に応ずるニューロン活動の変化が抑制をうけるニューロンが見出された.この抑制の発現には潜時があり, 後効果もあり, 針鎮痛の特長を示した.針刺激によって, 侵害刺激中のニューロン活動のみ, あるいは持続性のニューロン活動の変化にのみが抑制をうけるニューロンや, 両者ともに抑制をうけるニューロンが見出されたので針刺激の抑制にはシナプス前抑制が考えられた.
    3.中脳中心灰白質の刺激, 及び侵害性刺激の両者でニューロン活動の変化を示すニューロンが脳幹網様体に見出された.そのニューロン活動の変化は放電頻度の増減であった.
    4.中脳中心灰白質の刺激で放電頻度の変化を示さず, 侵害刺激に応答するニューロンの中には, 中脳中心灰白質の刺激で侵害刺激に対する反応が抑制されるニューロンがあり, この抑制は刺激終了後も可成り長く持続した.Naloxoneは中脳中心灰白質の刺激中の抑制には拮抗しなかったが, 刺激終了後の抑制には拮抗した.
    本論文の要旨は, 第55回日本生理学大会 (昭和53年4月2日) で報告した.
  • 高橋 吉政, 篠塚 明, 砂田 英二, 志村 秀夫, 北原 隆, 菱田 豊彦
    1979 年 39 巻 5 号 p. 581-585
    発行日: 1979/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    We investigated the distribution in the chest of 67Ga-citrate. 14 cases with diffuse lung accumulation of 67Ga-citrate include as follows;
    1) pleural invasion 2) disseminated lung lesion 3) carcinonmatous lymphangitis 4) chronic diffuse lung disease and 5) liver fuuction desorder.
    Diffuse lung accumulation of 67Ga is able to help diagnosis of several lung diseases, even when chest x-ray films have scarecely abnormal findings.
  • 永納 和子, 与儀 洋
    1979 年 39 巻 5 号 p. 587-590
    発行日: 1979/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    A 38-year-old man underwent continuous lumbar epidural anesthesia for laparoscopy.
    When removal of the catheter was attempted, it was found to be firmly fixed in the back and could not be removed even with the patient maximally flexed.
    After laparoscopy, anterior-posterior and lateral roentgenographs were taken by injection of contrast media through the catheter, and it was found that the catheter looped in the epidural space.
    After making another attempt, we succeeded to remove the catheter without severance. But examination of the catheter revealed that it was severely extended and almost severed.
    We warned that there is the possibility of difficult removal and severance of epidural catheter at any time.
  • 田中 賢治, 上村 正吉, 森 義明, 平沼 晃, 西村 哲, 高野 吉則, 服部 憲明
    1979 年 39 巻 5 号 p. 591-594
    発行日: 1979/10/28
    公開日: 2010/09/09
    ジャーナル フリー
    Definite and classical rheumatoid arthritis (R. A.) in our clinic were examined in relation of the period of contraction and roentgenogram. Sixty-nine patients of R. A., 138 hips were studied by roentgenography, who were male 9 and female 60, ranged from 24 to 76 years of age. We observed several roentgenological changes and obtaind the following results :
    1) The narrowing of joint space were observed in 7 cases, i.e. 9 joints. The past history were 12.3 years on the average.
    2) The desetruction of bone were observed in 5 cases, i.e. 8 joints. The past history were 13.6 years on the average.
    3) The luxation were observed in 8 cases, i.e. 12 joints. The past history were 14.3 years on the average.
    4) In one side of 6 cases which undergone T. H. R., in other side roentgenological changes were observed in weigting 4 cases, on which undergone T. H. R. soon after.
  • 河村 一敏, 九島 己樹, 塩川 章, 秋本 芳太郎, 篠原 文雄, 鈴木 孝, 岡田 拓郎, 光谷 俊幸, 太田 秀一, 杉山 喜彦, 風 ...
    1979 年 39 巻 5 号 p. 595-602
    発行日: 1979/10/28
    公開日: 2010/09/09
    ジャーナル フリー
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