著者

中原 泉 加藤 譲治

出版者

日本歯科医史学会

雑誌

日本歯科医史学会会誌 (ISSN:02872919)

巻号頁・発行日

vol.21, no.2, pp.61-75, 1995-12-25

参考文献数

25

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かつて死病と恐れられ猛威をふるいながら,いつのまにか成書から消えていった疾病は少なくない.口腔外科の難病であったnoma (水癌)も,その一つである.水癌とは,小児の口腔粘膜に現れる進行性の壊疽性口内炎の一臨床型,と定義される.水癌の原因は定まっていないが,要するに機械的化学的刺激のため,組織抵抗が減弱した部に細菌が感染して発症する.治療法は往時,局所的に病巣を切除・焼灼し,清潔安静と滋養強壮を保つ他なく,予後不良で死亡率は70〜95%に及んだ.この魔の疾患は,栄養状態の改善,予防接種の普及,抗生物質の普遍により,昭和30年(1955)以降激減し,古典的疾患へと衰退した.

著者

加藤 譲治 又賀 泉 土川 幸三 土持 真 森 和久 岡野 篤夫 佐藤 栄祐 岡田 広明

出版者

特定非営利活動法人 日本口腔科学会

雑誌

日本口腔科学会雑誌 (ISSN:00290297)

巻号頁・発行日

vol.33, no.1, pp.55-67, 1984-01-10 (Released:2011-09-07)

参考文献数

35

被引用文献数

2

著者

武田 幸彦 加藤 譲治

出版者

Japanese Society of Oral and Maxillofacial Surgeons

雑誌

日本口腔外科学会雑誌 (ISSN:00215163)

巻号頁・発行日

vol.38, no.9, pp.1369-1386, 1992-09-20 (Released:2011-07-25)

参考文献数

58

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The pallor of the skin and oral mucosa that is associated with anemia is thought to be due to a decrease in hemoglobin in the super ficial blood vessels. However, there has been little systematic research on this subject.The authors of this paper used a tissue spectrum analyzer to measure the Lib (indicating hemoglobin concentration) and the Iso2 (indicating saturation). Experiments were conducted to determine the relationship between anemia and hemoglobin level in the oral mucosa, using the hemoglobin (Hb) value as the indicator.The following conclusions were reached.1. The areas of the oral mucosa which best correlate with the blood Hb level are the upper labial mucosa, lower labial mucosa, the back of the tongue, the sublingual surface, and the soft palate. The patients with secondary anemia showed reduced Lib levels (i. e. anemia) in all of these areas.2. Measurements of IHb were graded to appear in the following order, from highest to lowest: labial mucosa, tongue, and then soft palate.3. These measurements did not show a definite relationship between the IHb and the is in either patients with secondary anemia or in normal healthy people.4. It was conjectured that patients on dialysis would tend to show a somewhat higher IHb on the back of the tongue than in other areas.5. Sudden changes in blood volume, as in transfusions, surgery, etc., influence the oral mucosal hemodynamics. Reductions in the blood volume of thebody as a whole are accompanied by reductions in the blood volume of the oral mucosa. It was conjectured that the degree of this change in the oral mucosa would increase as the severity of anemia increased.6. Among the five parts of the oral mucosa which were investigated, the back of the tongue showed the lowest correlation with the true state of anemia.7. In order to determine the degree of anemia by hemodynamics of the oral mucosa, it is thought that the four parts (the upper and lower labial mucosas, the lower part of the tongue, and the soft palate) are the most reliable ones to observe.From the above, it was concluded that, in secondary anemia (patients on dialysis, those having blood dyscrasis, a malignant tumor of the oral cavity, etc.), there is a distinct correlation between the tissue hemoglobin concentration (IHb) in the mucous membranes of the oral cavity and the true degree of anemia. This could be considered a useful method for clinical diagnosis.