著者

神谷 純広 清水 智治 園田 寛道 目片 英治 遠藤 善裕 三宅 亨 山口 剛 森 毅 仲 成幸 谷 徹

出版者

日本外科系連合学会

雑誌

日本外科系連合学会誌 (ISSN:03857883)

巻号頁・発行日

vol.37, no.4, pp.826-831, 2012 (Released:2013-08-25)

参考文献数

14

---

(症例)42歳女性,既往歴:23年前からうつ病,20年前にも針を誤飲.自殺企図にて3日前に5cmほどの縫針5本をプリンと一緒に飲んだという.排便時に肛門痛を自覚し当院を救急受診した.初診時,肛門部皮膚には異常は認めなかった.胸腹部X線写真にて上腹部に1本,下腹部に2本の陰影を認めた.腹部CTにて胃・上部および下部直腸内に陰影を確認でき,下部直腸では管腔外に脱出している可能性が示唆された.初診12時間後に肛門部右前方皮下に異物を触知し局所麻酔下に針を摘出した.胃内の針は内視鏡下に摘出した.上部直腸内に残存する針は2日後には自然排出を確認した.誤飲した針が肛門括約筋外から排泄された症例は極めて稀である.針のような臓器損傷の可能性が高い異物は,アプローチしやすい部位に存在する場合は積極的に摘出処置を行い,それ以外の部位では誤飲から日が浅ければ経過観察することも可能であると考えられた.

著者

三宅 亨 Toru Miyake

雑誌

桃山学院大学人文科学研究 = THE JOURNAL OF HUMAN SCIENCES, St. Andrew's University (ISSN:02862700)

巻号頁・発行日

vol.21, no.2, pp.23-43, 1985-12-20

著者

清水 智治 三宅 亨 北村 直美 遠藤 善裕 谷 徹 谷 眞至

出版者

一般社団法人 日本エンドトキシン・自然免疫研究会

雑誌

エンドトキシン・自然免疫研究 (ISSN:24341177)

巻号頁・発行日

vol.23, pp.1-6, 2020 (Released:2020-10-29)

参考文献数

4

---

Toraymyxin® (Toray Medical Co., Ltd, Tokyo, Japan) has been developed as a direct hemoperfusion column that contains polymyxin B-immobilized fiber to bind endotoxins in the patients’ blood. Toraymyxin was approved by the Japanese National Health Insurance system for the treatment of endotoxemia and septic shock in 1994. We reviewed and analyzed clinical history and evidence of Toraymyxin, and assessed the current status of Toraymyxin use for the treatment of severe sepsis and septic shock. Our review shows that Toraymyxin appeared to be effective in improving hemodynamics and respiratory function in septic shock requiring emergency abdominal surgery. The recent large-scale RCTs could not demonstrate whether prognosis is improved by Toraymyxin. The clinical studies based on large-scale data-base from Japan revealed that Toraymyxin appeared to have a survival benefit in patients with severe condition of septic shock. We also commented on the revised version of health insurance adaptation of Toraymyxin in April, 2020.

著者

三宅 亨

出版者

桃山学院大学

雑誌

桃山学院大学総合研究所紀要 (ISSN:1346048X)

巻号頁・発行日

vol.37, no.3, pp.173-196, 2012-03

---

This paper aims to describe the history of the East China Sea area in the medieval Japanese age, with an emphasis on the activities of wako in the area. Their activities have been largely neglected in official historical accounts as marginal. Wako is often defined as "Japanese pirates" in the 14th to 16th centuries. This simplified definition, however, fails to give the entire picture of wako. It is true that wako in their early days were Japanese who raided neighboring Korean islands and coasts for food and local people, whom wako used as their slaves or sold elsewhere as slaves, but this is only part of the wako history. In the latter half of the 14th century, the Mongols, who ruled China in those days, invaded Kyushu, the western part of Japan, twice (in 1274 and 1281), but failed to conquer the country and had to withdraw. A great many people in northern Kyushu suffered the damage caused by the two wars, but the Japanese government in Kamakura did not have enough property for compensation. Some of the dissatisfied common people, as well as samurai warriors, in northern Kyushu began to sail as far as Korea and eventually China sometimes to trade and sometimes to attack and pillage coastal towns and villages. They were referred to as wako and were a source of fear for Koreans and Chinese. The Mongolians were defeated in China and expelled to the north of the border in 1368. The newly-established Ming dynasty faced two problems: the Mongolians, who retreated into the north and the wako, who advanced to the southeastern part of China. While they were busy defending themselves against Mongolian invasions, the Ming dynasty imposed a strict ban on overseas trade by private citizens and merchants for fear that they might cooperate with wako intruders. The Chinese government monopolized overseas trading and began to trade formally with the Muromachi government in Japan, which had replaced the Kamakura government in 1333. The Japanese and Ming trade was temporarily suspended in 1423 as a result of a clash between two Japanese trading ships. Some Chinese merchants took advantage of this incident and started smuggling with Japanese. They joined hands with Chinese pirates to protect themselves and their trading goods. Eventually, they armed themselves and came to work together with their Japanese counterparts. Although the word wa means "Japanese", Chinese predominated the wako in the middle of the 16th century. There were Koreans, Southeastern smugglers, and even Portuguese among the wako. One of the most prominent wako leaders was Wang Zhi (?-1559). He was originally a Chinese merchant, but he joined wako groups after he failed in his business in the 1530s. He sailed to Japan as a smuggler and settled in Goto, an island at the western end of Japan, and later in Hirado, a seaport in the northwestern tip of Kyushu. According to official school textbooks in Japan, two Portuguese visitors to a small island introduced matchlock muskets to Japan in 1453. Actually, however, their visit to Tanegashima island was arranged by Wang Zhi, who decided that the gun business was his new business opportunity. Wang also helped a Portuguese mercantile ship to come to Hirado, the first visit ever by Westerners to mainland Japan. By this time he was acknowledged as the paramount wako leader and the most wanted pirate by the Ming dynasty. In 1548, the Ming authorities attacked an island off Ningbo, a port for official Japanese-Ming trade. The island had served as the largest base for wako activities since 1526, but now their facilities were completely destroyed, and wako had to retreat from the island and seek new bases elsewhere. This triggered a series of large counterattacks by Chinese wako. They raided southeastern coastal cities. The Ming dynasty could not control them any longer, and many cities were captured and looted, and numerous innocent citizens were killed during the raids. The wako attacks lasted until 1557 when Wang Zhi decided to return home from Japan to China after his mother, wife and children were held in custody. He was executed later in 1559. The other Chinese wako fled west to the Fujian and Guangdong area. It was at the end of the 16th century that wako disappeared from the South China Sea. As we have seen above, wako were not necessarily "Japanese pirates". They were armed smugglers consisting of Chinese, Japanese, Koreans, and Southeast Asians. They contributed a great deal to the economic development and advance in civilization of the East China Area in the transitional period from the medieval age to early-modern times of Eastern Asia.

著者

三宅 亨 Toru Miyake

雑誌

英米評論 = English Review (ISSN:09170200)

巻号頁・発行日

no.3, pp.1-31, 1991-01-25

---

Languages characteristically have regional varieties. The English language, being a world language, has several major national varieties. Thus the English spoken in Canada has its own distinct features as well as similarities to the varieties of English used in the United Kingdom and the United States. In this paper I try to clarify Canadian preference in pronunciation, based on a survey conducted with 74 Canadians. The results show that Canadian speech sometimes follows a dominant American pattern, sometimes the British usage, sometimes a mixed pattern, and sometimes its own. Canadians tend to pronounce such words as ate, tomato, leisure, and missile in the same way as most Americans do. Some of these words reflect features of 17th and 18th century English speech which have been retained in most of North America, including Canada, but changed over time in standard English. On the other hand, Canadians prefer British pronunciation in such words as ration, lever, soot and route. This can be partly ascribed to the fact that many Canadians have identified themselves more with Britons than with Americans since the American Revolution. However, the cultural and linguistic influence of the United States upon Canada has always been so strong that it is not surprising that Canadian speech shows a mixed pattern in such words as student, progress, schedule, etc. At the same time, Canadians have their unique pronunciation in such words as out, write, father, calm, vase, guarantee, almond, etc., most of which have been carried over from the days of the early 19th century immigrants from various parts of the British Isles, where phonological changes have long since taken place. It is interesting to observe how Canadian speech will change in the years to come under the constant strong influence of the giant to the south.