著者 岡山大学温泉研究所|
発行日 1963-01-25
出版物タイトル 岡山大学温泉研究所報告
31巻
資料タイプ その他
著者 岡山大学温泉研究所|
発行日 1963-01-25
出版物タイトル 岡山大学温泉研究所報告
31巻
資料タイプ その他
JaLCDOI 10.18926/21343
タイトル(別表記) A Clinical Investigation of Postgastrectomy Syndrome
フルテキストURL pitsr_031_075_082.pdf
著者 仲原 泰博| 大谷 満|
抄録 In order to investigate the frequency of postgastrectomy syndrome in patients with benign gastroduodenal diseases who gastrectomized partially, the authors studied the case records of consecutive 100 such patients treated at this institute. The results obtained were as follows. 1) Concerning postoperative diagnosis, 55 patients were diagnosed as ulcus ventriculi; 22, ulcus duodeni; 4, ulcus vent. et duodeni; 10, gastric hyperacidity only; 4, perigastric adhesion; 2, ptosis ventriculi; 2, gastric polyp; 1, duodenal diverticulum. 85 patients were male; 15, female. Concerning operative method, 21 patients were operated on Billroth I procedure; 19, Billroth II antecolica oralis inferior with Braun's anastomosis; 60, Billroth II oralis inferior. 2) Of 28 patients with postgastrectomy syndrome, 9 patients had early postprandial syndrome; 6, late postprandial syndrome; 6, postoperative gastric atonia; 2, afferent loop syndrome; 1, obstruction of efferent loop; 2, intestinal adhesion; 2, ulcer of anastomosed site. 3) In our series, there were no significant difference in frequency of postgastrectomy syndrome between B. I and B. II procedure, but postgastrectomy syndrome of patients with B. II were more severe than that of patients with B. I. 4) Of 72 patients without postgastrectomy syndrome, 69,7% (50 patients) continued to gain weight postoperatively, but of 28 patients with postgastreetomy syndrome 28,5% (8 patients) gained weight postoperatively.
出版物タイトル 岡山大学温泉研究所報告
発行日 1963-01-25
31巻
開始ページ 75
終了ページ 82
ISSN 0369-7142
関連URL http://eprints.lib.okayama-u.ac.jp/21336
言語 Japanese
論文のバージョン publisher
NAID 120002310941
JaLCDOI 10.18926/21342
タイトル(別表記) Causes and Prevention of Intestinal Adhesions Part 2. Experimental Study of Intestinal Adhesions
フルテキストURL pitsr_031_054_074.pdf
著者 大谷 満|
抄録 The experiments were designed (1) to investigate the effects of various types of injury to the peritoneum on the formation of adhesions, and (2) to study the hitological changes of the intestinal wall when injured artificially with 5 % iodine tincture. The experimental animals used were Wistar adult male rats with a weight range of 90 to 120 grams. A total of 170 rats were used. Experiment 1. The experimental animals were divided into 10 groups, each group consisting of 10 to 20 rats. Group A. The caecal serosa was injured with 2 % iodine tincture. Group B. The caecal seroSa was injured with 5 % iodine tincture. Group C. The caecal serosa was abraded with gauze until subserosal petechies were produced. Additional trauma to this area waS inflicted with 2 % iodine tincture. Group D. The caecal serosa was injured as in group C, but 5 % iodine tincture was used. Group E. The caecal serosa waS injured with 2 % aqueous mercurochrome solution. Group F. The caecal serosa was rubbed with gauze until subserosaI petechies were produced. Additional trauma to this area was inflicted with 2 % aqueous mercurochrome solution. Group G. The caecal wall was rubbed with gauze 100 times, injuring the subserosa. Group R. The anterior wall of the stomach and caecum was traumatized with a toothbrush and 2 ml of aqueous talcum solution were instilled into the peritoneal cavity. Group I. Excisions of the parietal peritoneum were performed with a surgical knife over areas of varying sizes at both sides of the operation wound. Group J. Adjacent loop of the intestines with normal serosa were connected to one another by No.2 black silk suture at two or three points. In five cases of this group, contacting surfaces of the intestines were injured with 5 % iodine tincture. The results obtained were as follows : (1) Local administration of 2 % iodine tincture and 2 % aqueous mercurochrome solution would not produce adhesions unless mechanical injury, such as rubbing with gauze was also present. (2) When the serosa was slightly injured with gauze, fibrinous adhesions were separated or torn apart by bowel movements. (3) Local administration of 5 % iodine tincture produced in all members of group B. The adhesions were moderate, not extensive in degree. Additional mechanical trauma aggravated the adhesions caused by bacterial contamination. (4) Intraperitoneal instillation of 10 % aqueous talcum solution produced extensive adhesions. The favorite sites of occurrence of the adhesions were the greater omentum and the small intestine. (5) Excision of the parietal peritoneum over areas of vareous sizes caused no adhesion. (6) Even prolonged contact between the intestinal wall and normal serosa did not result in the formation of adhesions. However, firm adhesions resulted from prolonged contact between injured serosal surfaces regardless of the type of injury. (7) The author would like to emphasize that large peritoneal defects should be left untreated, because attempts at peritonealization result in additional injury to the subserosa and often in more extensive adhesions. Experiment 2. (1) Edema and an infiltration of leucocytes occurred in the early stages of the inflammation. These histological changes were seen not only in the subserosa, the muscular layer, and the submucosa, but also in the mucosa. Lesions in the mucosa slowly developed into necroses or ulcers. The intensity of the adhesions varied with the severity of the lesions in the mucosa. (2) Twenty-four hours after injury to the peritoneum, P. A. S. positive substances began to appear in the submucosa, disappearing fourth post-operative day. (3) The process of the formation of the adhesions may be outlined as follow: a) After injury to the peritoneal surface, an exudate is formed. b) Thise xudate coagulates to form fibrin, which causes adiacent surfaces to cohere. c) Dunng organization, fibroblasts or fibrocytes migrate into this area. e) Whth the aid of mucopolysacchrides in ground substances, collagen is deposited and grdually a firm adhesion is formed. In some cases, however, this area becomes membraneous or strand-like in form during the completion of the process of adhesions, and is eventually torn apart.
出版物タイトル 岡山大学温泉研究所報告
発行日 1963-01-25
31巻
開始ページ 54
終了ページ 74
ISSN 0369-7142
関連URL http://eprints.lib.okayama-u.ac.jp/21336
言語 Japanese
論文のバージョン publisher
NAID 120002310954
JaLCDOI 10.18926/21341
タイトル(別表記) Causes and Prevention of Intestinal Adhesions Part 1. Surve of the Literature
フルテキストURL pitsr_031_040_053.pdf
著者 大谷 満|
抄録 1) Seven types of irritation causing intestinal adhesions are recognized in the literature : namely, a) mechanical injury; b) chemical injury; c) thermal injury; d) bacterial infection; e) foreign body; f) blood; and g) exsiccation. Certain minor differences of opinion exist among investigators, according to the experimental methods and the experimental animals used, and blood is not universally accepted as a cause of adhesions. The author believes, however, that the above list includes all of the etiological factors so far recognized in the literature. 2) The mechanism of intestinal adhesions is similar to that of wound healing. The problem of fibre synthesis is still unsolved, despite many advances in electlon microscopy, histochemistory and X-ray analysis. In recent years it has been accepted that fibres are synthesized in extra-cellular space from cytoplasmic materials derived from either mesenchymal cells or fibroblasts, and from polysaccharides in ground substances, althoughth eexact kind of polysaccharides which plays an important role in this process is still unknown. 3) Many papers are recognized with the prevention and treament of adhesions. These may be devided into six groups according to the method suggested: a) limitation of the original peritoneal injury; b) prevention of the coagulation of the exudate; c) avoidance of prolonged contact between the injured surfaces; d) removal of the fibrin after its formation; e) stopping or slowing down of the proliferation of fibroblasts; f) prevention of further obstruction by means of controlling the area of damaged intestine in stepladder fashion, the so-called the plication method. 1. It is the common practice of surgeons to limit the original peritoneal lllJury by laparotomy. Experimental studies have demonstrated that peritonealization of an area denuded of serosa often results in more extensive adhesions. 2. To prevent coagulation of the exudate, Lehman and Boys and other investigators used heparin and dicumarol. The role of heparin in the prevention of adhesions may be summarized as follow: there is a short time interval separating the production of the exudate and its subsequent coagulation with the deposition of fibrin on injured serosal surfaces. Anticoagulants of various types should be effective in preventing this fibrin formation if it is assumed that the coagulation mechanism of both exudate and blood is the same. Though the use of heparin and dicumarol has demonstrated a preventive effect on adhesion formation in experimental animals, many surgeons believe that the risk of hemorrhage from heparin and dicumarol outweighs their possible benefit in the prevention of adhesions. 3. To prevent prolonged contact between injured surfaces, amnion, omental and mesothelial graft, and so on, have been used without success. The stimulation of peristalsis by means of prostigmin and early feeding, however, appears to be effective in the prevention of adhesions, although its use in clinical cases has not been reported. 4. The experimental data indicates that streptokinase alone has no preventive effect on the formation of adhesions, because fibrinolysis is facilitated only by the existence of activated human plasmin. Concernig the use of hyaluronidase, this is an enzyme with the property of hydrolyzing hyaluronic acid, one of the polysaccharides that constitutes the intercellular ground substances. Experimental studies on the use of this material indicate, in summary, that topically administered hyaluronidase reduces the number of adhesions and particularly their density. The reason why hyaluronidase is effective in the prevention of adhesions is still unknown. 5. The use of corticoids and ACTH, according to all available experimental data, appears to delay the formation of adhesions and to prevent talc-induced adhesions, possibly by increasing the absorption of talc. In administrating corticoids, however, their tendency to delay wound healing, to perforate the intestinal wall, and to induce hemorrhage must be taken into account. 6. Experimental study and clinical USe of the plication method demonstrate that in patients with severe recurrent adhesions, or in those for whom the afore-mentio ned methods have been ineffective, this procedure is probably the most effective therapy available.
出版物タイトル 岡山大学温泉研究所報告
発行日 1963-01-25
31巻
開始ページ 40
終了ページ 53
ISSN 0369-7142
関連URL http://eprints.lib.okayama-u.ac.jp/21336
言語 Japanese
論文のバージョン publisher
NAID 120002310946
JaLCDOI 10.18926/21340
タイトル(別表記) Electrcardiographic Changes in Rheumatoid Arthritis: Part 2. Frequency of Electrocardiographic Changes in Rheumatoid Arthritis and Other Diseases
フルテキストURL pitsr_031_031_039.pdf
著者 北山 稔|
抄録 As reported in Part 1 of this paper, the author observed a variety of electrocardiographic aberrations in 27 patients with rheumatoid arthritis. This report will compare the frequency of electrocardiographic aberrations in 45 such cases with the frequencies shown by other groups, namely : a group of 122 patients with normal blood pressure and noncardiac diseases, a group of 121 patients with hypertension, and a group of 14 patients with mitral valve diseases. The results are as follows : 1) The electrocardiographic patterns reported in Part 1 occurred more frequently in both the group of rheumatoid arthritis patients and the groups of hypertension and mitral valve disease patients than in the group with normal blood pressure and noncardiac diseases. 2) On the basis of the electrocardiographic findings, it may be assumed that many of the patients with rheumatoid arthritis suffered from pathological heart conditions, such as heart diseases or cardiac involvement, not accessible to clinical observation. 3) Patients with unequivocal cardiac involvement constituted 21 (46.6%) of the rheumatoid arthritis patients, 65 (53.7%) of the hypertension patients, 9 (64.3%) of the mitral valve didease patients, and 21 (17.2%) of the normal blood pressure and noncardiac disease patients. 4) Patients with suspected cardiac involvement, as defined in Part 1 of this paper constituted 4 (8.9%) of the rheumatoid arthritis patients, 10 (8.3%) of the hypertension patients, 1 (7.1%) of the mitral valve disease patients and 2 (1.6%) of the normal blood pressure and noncardiac disease patients.
出版物タイトル 岡山大学温泉研究所報告
発行日 1963-01-25
31巻
開始ページ 31
終了ページ 39
ISSN 0369-7142
関連URL http://eprints.lib.okayama-u.ac.jp/21336
言語 Japanese
論文のバージョン publisher
NAID 120002311038
JaLCDOI 10.18926/21339
タイトル(別表記) Electrcardiographic Changes in Rheumatoid Arthritis: Part 1. Relationship between Electrocardiographic and Clinical Findings
フルテキストURL 031_010_030.pdf
著者 北山 稔|
抄録 The author studied the relationship between electrocardiographic and clinical findings in 27 patients with classical rheumatoid arthritis, as defined by the criteria for the diagnosis of rheumatoid arthritis proposed by the American Rheumatism Association. The results obtained were as follows: 1) In 26 of the cases, such electrocardiographic aberrations were observed as the following: broad P waves; mitral P-like patterns (either double peaked or with the mean P vector veering to the left in the frontal plane) ; prolongation of the P-Q interval; high amplitude of R in the left precordial lead; elevation or depression of S-T segments; low or flat T waves in the left precodial lead; prolongation of QTc ; and changes of directions of mean QRS and T vectors to the left in the frontal plane. 2) The frequecies of plainly pathologic findings were as follows: prolonged P-Q interval - 1 case (3.7%) ; RV5≧30mm - 3 cases (11.1%) ; elevation of S-T segment - 1 case (3.7%) ; depression of S-T segment - 3 cases (11.1%) ; and prolongation of QTc - 9 cases (33.3%). 3) Pathologic cardiac involvement was found in 13 patients (48.2% of the total group) while 3 other patients were classified as suspected cardiac involvement cases, defined as those characterized by more than three abnormal but non-pathologic findings. 4) Thus, the majority of the test group were characterized by some abnormal or pathologic electrocardiographic finddings, although clinically no heart diseases or cardiac insufficiency had been detected.
出版物タイトル 岡山大学温泉研究所報告
発行日 1963-01-25
31巻
開始ページ 10
終了ページ 30
ISSN 0369-7142
関連URL http://eprints.lib.okayama-u.ac.jp/21336
言語 Japanese
論文のバージョン publisher
NAID 40017532385
JaLCDOI 10.18926/21338
タイトル(別表記) The Effect of Laparotomy (Appendectomy) on Portal Circulaton Time
フルテキストURL 031_005_009.pdf
著者 仲原 泰博|
抄録 Following Ueda-Yasuda's Procedure, the author observed changes on the portal blood circulation time, the body temperature, the blood pressue and the pulse rate of 16 patients (A group, five patients with caecum mobile or appendicitis chronica : B group, six patients with appendicitis acuta non-perforativa : C group, five patients with appendicitis acuta perforativa = appendicular peritonitis). Measurements were taken four or five times: before operation, immediately after operation, on the first, third, and fifth, postoperative day. Portal blood circulation time before operation was significantly prolonged in C and B group as compared with A group. Portal blood circulation time immediately after operation was prolonged in each group as compared with that taken before operation. Postoperative duration of prolonged portal blood circulation time was longer in C group more than in A and B group. Postoperative courses of all 16 patients were good and without postoperative complications.
出版物タイトル 岡山大学温泉研究所報告
発行日 1963-01-25
31巻
開始ページ 5
終了ページ 9
ISSN 0369-7142
言語 Japanese
論文のバージョン publisher
NAID 40017532386
JaLCDOI 10.18926/21337
タイトル(別表記) The Effect of a Single Cold Bath in 27℃ Water on Portal Circulation Time
フルテキストURL 031_001_004.pdf
著者 仲原 泰博|
抄録 Following Ueda-Yasuda's procedure, the author observed changes on the portal blood circulation time, the blood pressure and the pulse rate of five normal men following a cold bath in water. Measurements were taken three times 30 minutes before the bath, immediately after the bath and 30 minutes after the bath (the bath was either 5 or 10 minutes in duration, and ranged in temperature from 26°to 28℃). Portal blood circulation time immediately after a 10 minute cold bath was found to be probably shortened as compared with that taken before the cold bath. The changes in blood pressure and pulse rate observed after the cold bathing were similar to those reported by other authors.
出版物タイトル 岡山大学温泉研究所報告
発行日 1963-01-25
31巻
開始ページ 1
終了ページ 4
ISSN 0369-7142
関連URL http://eprints.lib.okayama-u.ac.jp/21336
言語 Japanese
論文のバージョン publisher
NAID 40017532387
著者 岡山大学温泉研究所|
発行日 1963-01-25
出版物タイトル 岡山大学温泉研究所報告
31巻
資料タイプ その他
著者 岡山大学温泉研究所|
発行日 1963-01-25
出版物タイトル 岡山大学温泉研究所報告
31巻
資料タイプ その他