The Keio Journal of Medicine
Online ISSN : 1880-1293
Print ISSN : 0022-9717
ISSN-L : 0022-9717
Volume 25, Issue 3
Displaying 1-4 of 4 articles from this issue
  • TOYOMI FUJINO
    1976 Volume 25 Issue 3 Pages 101-110
    Published: 1976
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    Microsurgery is divided into 3 categories: microdissection, microvascular surgery and microneurorrhaphy. In plastic surgery, the latter two have been already practiced, but the microdissection technique is not popular and re-ported yet. This paper first reports the clinical application of the microdis-section technique in the 50 common plastic surgical cases. The advantages to use the operating microscope with the lower magnifying power (5-8×) were described in the representative cases; primary repair of laceration of the facial skin, syndactylia of the toe with a full-thickness skin graft, primary repair of the cleft lip, primary repair of the cleft palate, resection of the sebaceous cyst, hypospadias repair and removal of the subcutaneously buried suture.
    In conclusion, the microdissection technique produces more atraumatic and refined surgical results than those by the conventional plastic surgical procedures.
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  • HIROYUKI FUKUDA, TADASHI AKITAYA, JOHN A. KIRCHNER
    1976 Volume 25 Issue 3 Pages 111-122
    Published: 1976
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    As no complete study has been made of reflex response to stimulation of ipsilateral vagus in regard to extramedullary respiratory control system, the authors have tried to clarify the influence of the stimulation of the vagus on the ipsilateral posterior cricoarytenoid muscle (PCA).
    Reflex responses in the recurrent laryngeal nerve and motor action potentials of the PCA elicited by stimulation of the ipsilateral vagus were compared with those elicited by stimulation of the internal branch of the superior laryngeal nerve.
    The latent periods in the case of stimulation of the vagus were much longer and reflex discharges in tonic fibers were not noticeable. In addition, reflex inhibition of spontaneous respiratory activity of the PCA was not re-markable. Decrease in activity of the PCA muscle, which is usually caused by inflation of the lung, was caused by the low frequency of central vagal stimu-lation. On the other hand, high frequency of central vagal stimulation caused increase in activity of this muscle. It is known that forced hyperinflation by introducing excessive amount of air results in increased inspiratory activity (Head's paradoxcal reflex). So it seems most likely that these high frequency of vagal stimulation are equivalent to mechanical inflation by excessive amount of air.
    Based upon the facts mentioned above, it can be said that reflex response in the PCA elicited by vagal stimulation may not take part in laryngeal reflex closure, but may take part in respiratory control system to regulate the activity of the PCA muscle. The PCA muscle, hence, can be firmly considered to be one of the respiratory muscle from the viewpoint of extramedullary respiratory control system.
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  • KENZABURO TSUCHIYA, KEN TAKAHASHI, HARUHIKO SAKURAI, YUKIO SEKI, MINOR ...
    1976 Volume 25 Issue 3 Pages 123-130
    Published: 1976
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    School of Medicine, Keio University, Tokyo, Japan The purpose of this study was to examine the dose-response relationship in low level lead exposures. Four groups of workers were exposed to four different levels of lead in ambient air. The first group composed of industrial lead workers were exposed to about 7μg/m3, 6 hrs per day, 6 days per week, in an electric wire producing factory. A second group consisting of police-men was exposed to lower lead levels of about 0.5 μg/m3. A third group of rubber hose workers was exposed to the highest lead level of 33 μg/m3 during working hours, and the fourth group (control) consisted of white collar workers from the same electric wire factory as the first group. In these four groups, ALA level in urine, which is believed to indicate the earliest un-desirable biologic effect due to lead, revealed about the same values in all four groups. Only one parameter, blood lead level, was significantly different among the groups. Blood lead level in the rubber hose workers revealed 32 μg/100 ml. The other three groups showed from 15 to 17 μg/100 ml. The lowered hemo-globin level in electric wire workers was found to be related to the educa-tional level of the workers but not to lead in blood, since the control workers showed higher hemoglobin values. Thus it was concluded that the lead level in ambient air which results in recognizable increase of blood lead might exist between 3 to 6 μg/m3.
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  • TOSHINORI KITAMURA
    1976 Volume 25 Issue 3 Pages 131-137
    Published: 1976
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    The “drug holiday” has been recently supposed to be necessary in order to protect psychotic patients who have been taking neuroleptics for a long time against the occurance of tardive dyskinesia. But from the fact that neuroleptics have some hormonal, metabolic and autonomic nervous effects besides mental ones, it is reasonable to assume that sudden intermittent withdrawal of neuro-leptics (“drug holiday”) is followed by rebound phenomena such as changes of blood pressure, increase of blood free fatty acids, increase of blood serotonin, and increase of growth-hormone release-inhibiting hormone etc. These rebound phenomena may be consistent with the ischemic heart diseases, the kinds of embolism, and the sudden deaths that are supposed to have a higher incidence among psychotic patients: and the obesity and diabetes that are supposed to be caused by neuroleptics. It remains, however, to be investigated how to decide and decrease the dosage of psychotropic drugs more safely.
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