The Keio Journal of Medicine
Online ISSN : 1880-1293
Print ISSN : 0022-9717
ISSN-L : 0022-9717
36 巻, 2 号
選択された号の論文の7件中1~7を表示しています
  • 飯塚 哲太郎
    1987 年 36 巻 2 号 p. 148-167
    発行日: 1987年
    公開日: 2009/03/27
    ジャーナル フリー
    The carbon monoxide (CO) complex of hemoprotein is highly sensitive to light and the CO molecule bound to heme-iron readily dissociates from the complex upon light illumination. This enables us to study the kinetics of CO recombination reactions as well as photochemical properties of the CO complexes in various hemoproteins by using the flash photolysis technique. In this article are reviewed basic aspects of the photochemical properties of hemoproteins, the principle of flash photolysis method and its applications to the characterization of respiratory hemoproteins such as myoglobin, peroxidase, and cytochrome P450.
  • 明楽 泰
    1987 年 36 巻 2 号 p. 168-178
    発行日: 1987年
    公開日: 2009/03/27
    ジャーナル フリー
    Digitalis glycosides have been used for more than 200 years to treat chronic congestive heart failure although they often fail to provide adequate support in a patient with a severely depressed heart at the dose that does not cause toxicity. Improvement of this class of drugs is not feasible because both the therapeutic and toxic actions are caused by the same mechanism, i.e., inhibition of the sarcolemmal sodium pump. Despite the initial optimism with “newer” positive inotropic drugs, they are not free from toxicity which is caused by Ca2+ overload or from their tendency to inhibit relaxation. Moreover, these drugs fail to reduce risk factors in patients with advanced heart failure. Mortality of these patients is reduced by vasodilator therapy combined with digitalis and a diuretic. This therapy reduces preload and afterload, and hence workload, in addition to increasing the force of myocardial contraction, and minimizes deficiencies of failing heart. In this regard, importance of nonpharmacologic therapies for re-duction of cardiac workload should also be emphasized. All these treatments, however, are palliative. We know very little about the basic changes that lead to heart failure, and treatments to prevent those changes are presently unavailable.
  • 鶴見 清彦, 鈴木 茂
    1987 年 36 巻 2 号 p. 179-186
    発行日: 1987年
    公開日: 2009/03/27
    ジャーナル フリー
    We have endoscopically treated a total of 114 cases, mainly having biliary tract stones, since May, 1976. The techniques we employed were endoscopic sphincterotomy (EST), percutaneous transhepatic choledochoscopic lithotomy (PTCL) and postoperative choledochoscopic lithotomy (POCL), which were per-formed in 75, 33 and 6 cases, respectively. Some of the patients had residual-recurrent bile duct stones or intrahepatic stones; cholelithiasis was also seen in aged or low risk patients. Since endoscopic treatment greatly contributed to an increase in the clinical cure rate, we strongly believe that these endoscopic tech-niques will not only be more widely utilized but will also be improved in terms of clinical significance.
  • 鶴見 清彦, 恩田 昌邦
    1987 年 36 巻 2 号 p. 187-201
    発行日: 1987年
    公開日: 2009/03/27
    ジャーナル フリー
    We studied how the autonomic nervous system participated in the develop-ment of experimental duodenal ulcers due to cysteamine hydrochloride. Sym-pathetic fibers showed a slight increase in activities in the duodenal mucosa 1 h after cysteamine administration, and a marked decrease thereafter. The release of noradrenaline (NA) into the blood was suggested. Of the activities of para-sympathetic fibers, true cholinesterase activities, that are concerned with secre-tions, began to increase 1 h after cysteamine administration, which was observed most notably around the Brunner's glands in the duodenal submucosa, peaked at 8h, and then decreased or disappeared at 24h when ulcer formation was established. Pseudo cholinesterase activities that are concerned with motor func-tion, decreased over time with a resulting decrease in gastroduodenal move-ments and emptying. Meanwhile, it was confirmed by estimation of NA and cholinesterase (ChE) by means of a fluorescent histochemical study. The above findings suggest that, though the sympathetic and parasympathetic systems play their roles with a complicated interrelationship in the development of cysteamine-induced duodenal ulcers, sympathetic fibers are initially depressed, and ulcera-tion develops and advances under the parasympathetic dominance. In other words, the development of ulcers seems to depend more on the parasympathetic system than on the sympathetic system.
  • 村上 泰, 猪狩 武詔, 原口 茂徳, 岡田 康司, 丸山 毅, 館野 秀樹, 藤村 昭子, 浦尾 弥須子, 中山 尚樹
    1987 年 36 巻 2 号 p. 202-216
    発行日: 1987年
    公開日: 2009/03/27
    ジャーナル フリー
    We report our experiences with 283 reconstructions of pharyngoesophageal defects after adequate extirpation of hypopharyngeal cancer that have been accomplished in the past 17 years through 1970 to 1986 using various kinds of pedicled flaps such as Bakamjian's DP skin flap, slit technique of DP skin flap, pectoralis major and latissimus dorsi myocutaneous flaps, skin-grafted pectoralis major muscle flap and gastric or colic pull-ups. We conclude that each flap has its own merits and demerits and any one of these flaps cannot totally replace the others and that we must be familiar with characteristics of these flap techniques including free flap transfer to be able to indicate the best selection of reconstructive technique for every patient with different situations and, then, to obtain optimal result.
  • 田中 耕太郎, 後藤 文男, 五味 愼太郎, 高嶋 修太郎, 美原 盤
    1987 年 36 巻 2 号 p. 217-222
    発行日: 1987年
    公開日: 2009/03/27
    ジャーナル フリー
    The operational equation developed by Sokoloff et al. for measuring the local rate of cerebral glucose metabolism assumes that the arterial plasma glucose concentration (Cp) remains constant during the measurement. However, temporal changes in Cp may occur in actual studies. Savaki et al. proposed a modified operational equation for changing Cp. Their modified equation has frequently been used, although no systematic evaluation of its validity has been attempted. In this study, the derivation of Savaki et al.'s modified operational equation was examined to assess its validity from the theoretical standpoint. A few assump-tions which are essentially incorporated in Savaki's and Sokoloff s original equations, are no longer upheld under conditions of changing Cp. One is that the net uptake of glucose from the blood equals the rate of glucose utilization in the tissue. If Cp changes, this assumption can not be valid because of no steady-state condition in terms of the glucose kinetics between the blood and tissue. Changes in the lumped constant which are expected to accompany changes in plasma glucose level may also complicate the situation. The deoxy-glucose method based on Sokoloff's theory should be avoided under conditions of changing Cp, even though a modified operational equation for this situation does exist.
  • Edward E. Wallach
    1987 年 36 巻 2 号 p. 223-227
    発行日: 1987年
    公開日: 2009/03/27
    ジャーナル フリー
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