著者

大橋 忠将 有山 ゆり 早川 惠理 長沢 美樹 杉山 徹

出版者

一般社団法人 日本糖尿病学会

雑誌

糖尿病 (ISSN:0021437X)

巻号頁・発行日

vol.59, no.6, pp.407-413, 2016

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49歳男性.鍼治療後14日で僧帽筋膿瘍,DKA(血糖値643 mg/dL,pH 6.916,総ケトン体20600 <i>μ</i>mol/L)を生じ,意識障害で当院に救急搬送となった.抗菌薬投与,デブリードマン,局所陰圧閉鎖療法(negative pressure wound therapy:NPWT)にて膿瘍の治療を行い,糖尿病に関しては強化インスリン療法で血糖管理した.感染及び血糖値改善後は基礎インスリン投与と経口血糖降下薬の併用療法(basal-supported oral therapy:BOT)に変更して血糖管理を継続した.もともと無治療の糖尿病(HbA1c 15.1 %)による易感染性があり,鍼治療を契機にして僧帽筋膿瘍,感染に伴うDKAを生じたと考えられた.管理不良の糖尿病の存在下では,鍼治療のような侵襲的医療行為により感染症が引き起こされる危険性があり,注意が必要である.

著者

大橋忠一 著

出版者

要書房

巻号頁・発行日

1952

著者

西村 正雄 三浦 章宏 山際 源二郎 貞包 剛男 大橋 忠 中条 弘 上田 喜一

出版者

Japanese Society of Oral and Maxillofacial Surgeons

雑誌

口腔外科学会雑誌 (ISSN:04541693)

巻号頁・発行日

vol.6, no.2, pp.384-390, 1960-07-01 (Released:2011-07-25)

参考文献数

17

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The amalgam restoration is regarded as the simplest and best method for the mass treatment of earlier carious lesions in pre-ventive dentistry but there are still some practical problems that remain unsolved.More efficient technics is to be divised and also the suppresson of mercury absorption by the operators is the important point in such severe exposure to mercury.This investigation was designed to improve the usual procedure by combining the use of an mechanical amalgamator and pre-prepared amalgam kept in a vacuum bottle containing dry ice.The air turbine (Air Dent Unit) was also applied in full through this experiment to reduce the cutting time and the pain or uncomfortable feeling of the children.1) The mechanical amalgamator which can mix mercury and alloy even at the weight ratio of 6 to 5 involed no need to sequeeze out mercury. Therefore, the time for restoration was markedly reduced to 71.5 sec.in comparison with 150 sec.in the routine manual procedure when the mixing time was set constant as 40 sec.in both methods.2) Urinary mercury excretion of three mixing operators following constantly mixing amalgam far 50 min.showed on the average the increase of 80 μ g Hg per day in the usual procedure, while using amalgamator, it only increased by 15 μ g Hg per day.3) After shaking with the amalgamator, the amalgam enough for three treatment was put in a small polyethylene tube and heat-sealed and instantly researved in a vacuum bottle containing dry ice.On the next day after 24 hours, each small tube was pulled out and kept at room temperature for halt an minute to wait softening and then the amalgam was applied.4) Physical properties of the reserved amalgam were tested with methods approved in J.I.S.(Japan Industrial Standards) and no significant differences were found.5) The time required for treating one caries tooth was 10 min.in the routine procedure, whlie combining the use of Air Dent Unit and pre-prepared amalgam reserved in dry ice bottle, it was exceedingly shortened to 1 min.and 49.5 sec.6) As a field experiment, 80 school children were successively treated by two dentists by this devised procedures in one day.The over-all time needed for the treatment of one children was 144.9 sec.on the average.7) Thus the mass amalgam restoration in preventive dentistry might be applied with high efficiency by our devised procedures.