著者

真鍋 幸嗣 花田 雅憲 上石 弘

出版者

近畿大学

雑誌

近畿大学医学雑誌 (ISSN:03858367)

巻号頁・発行日

vol.25, no.2, pp.165-169, 2000-12-25

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性同一性障害患者に対して性別再判定手術(性転換手術)が正当な医療行為として国内で初めて行われたのを契機に, 近畿大学医学部附属病院精神神経科外来においても性同一性障害患者が受診するケースが増加している.今回, 我々は外来受診をした性同一性障害患者30名をMTF(male to female transsexual)とFTM(female to male transsexual)とに分類し, それぞれの臨床的特徴を検討した.個々の症例に対して, 初診時年齢, 職業, 子供の頃の遊び, 性別違和の病歴, 性的指向, 不登校の既往, 自傷または自殺企図の経験, 内分泌治療の有無, 外科的治療の有無を聴取し比較検討行った結果, 以下のことが考えられた.・MTF(1)社会適応の悪さが目立つ(2)polysurgeryの傾向がある・FTM(1)発症が比較的早期(2)性自認に揺るぎがないこういった結果を踏まえ, 性同一性障害患者の診断, 治療を行うには性差を理解した上で判断, 対応する必要があるといえる.

著者

江川 哲雄 眞鍋 幸嗣 花田 雅憲 日下志 厳 上石 弘

出版者

近畿大学

雑誌

近畿大学医学雑誌 (ISSN:03858367)

巻号頁・発行日

vol.25, no.2, 2000-12-25

著者

真鍋 幸嗣 上石 弘 人見 一彦

雑誌

総合病院精神医学 = Japanese journal of general hospital psychiatry (ISSN:09155872)

巻号頁・発行日

vol.9, no.2, pp.170-173, 1997-11-21

著者

真鍋 幸嗣 海賀 和宏 日下 志厳 人見 一彦 上石 弘 花田 雅憲

出版者

近畿大学

雑誌

近畿大学医学雑誌 (ISSN:03858367)

巻号頁・発行日

vol.24, no.2, 1999-12-25

著者

藤井 芳郎 磯貝 典孝 黒住 望 上石 弘 久山 健

出版者

近畿大学

雑誌

近畿大学医学雑誌 (ISSN:03858367)

巻号頁・発行日

vol.11, no.3, pp.367-377, 1986-09-25

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It is quite important to fully comprehend the peripheral blood circulation after transferring flaps and making anastomoses with microsurgical techniques in the field of plastic and reconstructive surgery. Many methods have been developed to assess the peripheral blood circulation. The Laser Doppler flowmeter, which was first utilized in the field of mechanical engineering, is beginning to play a major role in measuring the peripheral circulation in many fields of medicine. The detection of doppler spectral broadening as light is reflected against the moving blood cells in the capillaries. Single-beam and crossed dual-beam velocimetries have been used, and introduction of a microscope into the optics has facilitated the measurment of blood flow in microvessels. The laser beam may be brought into contact with the flaps and related areas by using fiberoptics. The method detects fluctuations in flow occurring in the capillaries within 1.5mm depth of the surface of the skin. In this study, we would like to present the usefulness of this important apparatus, showing the case of a cross-leg flap and the case of replanted fingers with the technique of microsurgery. The Laser Doppler flowmeter showed that delay of the flap was clearly effective through its increased level of peripheral blood flow, so that the cross-leg flap could be released safely. The waveform of the Laser Doppler flowmeter for replanted fingers were consistent with their visual conditions. The apparatus to be a reliable postoperative monitor for measuring flap transfer and replantation of amputated fingers easily, rapidly, noninvasively and continuously, including those without a visual surface. It has advantages over any other instruments in that it facilitates the observation of actual red cell movement at the dermal capillaries. Further development is, however, required for Laser Doppler flowmeter to provide more absolute volume per unit time.