著者
小松原 正吉
出版者
Okayama Medical Association
雑誌
岡山医学会雑誌 (ISSN:00301558)
巻号頁・発行日
vol.90, no.1-2, pp.101-119, 1978-02-28 (Released:2009-03-30)
参考文献数
37

A pertinent procedure for preserving postoperative urinary and sexual functions was searched in the radical surgery for rectal cancer, from a neuroanatomical point of view, and the clinical status about disturbances of these functions was analized in relation with a mode of preservation of the lower hypogastric and/or the pelvic nerve among the patinet undergone the surgery applied this procedure. The result of the operation was also evaluated as for the influence of this procedure on the curability of the cancer.Results obtained were as follows:1. In the anatomical study with 17 necropsy cases, it was found that the most preferable mean for identifying the lower hypogastric nerve, pelvic plexus and pelvic nerve was to begin with isolating the upper hypogastric nerve dividing the posterior peritoneum along the lower abdominal aorta, and to follow the bilateral lower hypogastric nerves on the inner surface of the pelvic cavity down to the pelvic plexus, from which the pelvic nerves were able to explore by the retrograde approach to the sacral foramina. Since this procedure was able to be progressed in accordance with that of the radical operation by Miles, technical troubles were of eliminable.2. Urinary functions were examined on 47 cases out of 60 patients received the surgery with the nerve-saving procedure above.a) The period before the spontaneous urination occurred after the surgery was prolonged significantly by the bilateral injury to the pelvic nerve and this was not observed in the patient whose pelvic nerve was unilaterally injured, as well as in the patient whose lower hypogastric nerve was uni- or bilaterally injured.b) The result of cystometry and catheterization study showed that cystic hypotonia and urinary retention prolonged as long as 40 days or more, and 23 days in average in the patient with injury to the bilateral pelvic nerves, as compared to 8 days in average in the patient with bilateral denervation of the lower hypogastric nerve and also in the patient with unilateral injury to the pelvic nerve. Duration of sensation as to urinary retention was quite accorded with these results.3. Sexual function was surveyed making inquiries by the letter to 48 subjects and was summarized on 43 including 19 female with satisfactorily recorded answers.a) Ability of the erection was preserved in about 60 to 70% of the patient regardless of presence or absence of the denervation of the lower hypogastric nerve. However, it was impaired in all patients with bilateral injury to the pelvic nerve, although even the unilateral preservation saved the ability in all.b) Ability of the ejaculation was satisfactorily kept only in the subjects whose lower hypogastric nerve was bilaterally saved. Among those who had injury to bilateral pelvic nerve, only the patient whose lower hypogastric nerve was bilaterally saved preserved the ability, suggesting a close participation of the hypogastric nerve to the ejaculation.4. The decrease in the curability of the cancer under this procedure was not observed, compared with that in patients undergone the surgery performed without the positive intention to save the nerve but with the aim to eradicate the cancer.
著者
松海 信彦
出版者
Okayama Medical Association
雑誌
岡山医学会雑誌 (ISSN:00301558)
巻号頁・発行日
vol.101, no.11-12, pp.1049-1061, 1989 (Released:2009-03-30)
参考文献数
44
被引用文献数
1

The thermal damage threshold of brain tissue was estimated from the immediate and delayed histological changes caused by 2450 MHz microwave antenna and an antenna cooling system of a device used for interstitial hyperthermia treatment. An antenna within a cooling system was inserted through the small cranietomy under general anesthesia. The temperature at a reference point, 4 mm radially away from the surface of the cooling system, was maintained at 42 °C, 43 °C, 44 °C, 45 °C or 46 °C for 60 minutes. In a non-survival experiment, 18 animals were used and sacrificed immediately after the treatment. In a survival experiment, 9 animals were used and sacrificed seven days after the treatment. The histological changes were evaluated by microscopic examination with hematoxylin and eosin, Klüver-Barrera, or Bodian stainings. In the non-survival experiment, areas heated below 44 °C showed no obvious irreversible change. In the survival experiment, areas heated at 44 °C or above showed coagulative necrosis. Those histological findings indicate that the thermal damage occurs in normal brain tissue after heating at 44 °C or above for 60 minutes, and suggest that the safety limit for brain hyperthermia is 43 °C for 60 minutes.
著者
池田 嘉一郎
出版者
岡山医学会
雑誌
岡山醫學會雜誌 (ISSN:00301558)
巻号頁・発行日
vol.32, no.371, pp.646-666, 1920

(一)所謂人乳中毒症ニ於ケル精紳症状ハ、輕症ナルモノニ於テハ、一過性ノ興奮性充進竝ニ嗜眠状態ヲ呈スルニ過ギザルモ、重症ナルモノニ於テハ、更ニ進ミテ意識溷濁乃至無慾状顔貌ヲ呈シ、周圍ノ事情ニ對スル識別力ヲ失ヒ笑ハズ泣カズ、眼付曇ヨリシ、時トシテ舞踏病樣不隨意運動乃至不明ノ言ラ發ス、カク特異ナル精紳症状ヲ呈スルハ神經申樞ニ何等カノ病變ノ存スルモノト考ヘザルベカラズ、余ハカカル患者ニ遭遇スル毎ニ勉メテ腰椎穿刺ヲ行ヒ腦脊髓液ノ性状ヲ檢シタルニ、ソノ外觀、比重、糖反應、蛋白量、蜘蛛網状物形成ノ有無等ノ關係ハ、多クハ健康者ノモノト差異ヲ認ムルコト能ハザリシモ、「グロブリン」反應及ビ細胞數ニ於テ輕微ノ變化ノ存スルヲ認メタリ、即チ「グロブリン」反應中、ノンネーアツペルト氏反應竝ニパンヂー氏反應ハ多クハ陰性(時トシテ弱陽性ナルコトアリ)ナルモ野口氏反應ハ毎常弱陽性ヲ示セリ、而シテ淋巴球ノ數ハ通常ナルカ或ハ僅ニ増加セリ、即チ輕度ノ漿液性腦膜炎ノ腦脊髓液ニ相類似ス、カカル腦脊髓液ノ變化ハ唐澤博士ノ報告セル軟腦膜ニ於ケル解剖的變化ト相符合ス。<br>(二)臨牀上ニ於ケル所謂人乳中毒症ト乳兒脚氣トノ主要ナル區別點ハ、伊東博士ニ依レバ血行器症状竝ニ精神症状ノ有無ニ存ス、然レドモ血行器症状ハ兩疾患ヲ鑑別スルニ向ツテ爾カク重要ナル資料トナスヲ得ズ、蓋シ血行器症状ハ乳兒脚氣ニ於ケル必要ナル症状ノ一ツナルモ而モ之ヲ伴ハザルモノ稀ナラズ、又所謂人乳中毒症ニ於テモ血行器症状ハ必ラズ缺如スベキモノニアラザルガ故ナリ、況ンヤ症例(三)ニ於ケルガ如ク、所謂人乳中毒症ニ於テ其ノ經渦中ニ突然衝心症状ヲ表ハシタル事實アルエ於テオヤ。<br>精神症状ノ有無ニ至リテハ、吾人ハ兩疾患ニ於ケル最モ顯著ナル差異タルヲ是認セザルベカラズ、然レドモ大人脚氣ニ於テ稀ニ精神症状ヲ伴フコトアルコト竝ニ余ノ實驗例ノ如ク幼兒脚氣ニ於テ躁暴狂状乃至昏迷ヲ呈シ、而モ軟腦膜ノ病理解剖的所見ニ於テ所謂人乳中毒症ト殆ド同樣ナル病變ヲ呈セルコトアル事實ヨリ推考スル時ハ、乳兒脚氣ニアリテモ亦精神症状ノ表ハルルコトアリテ可ナル理ナリ。<br>(三)所謂人乳中毒症ト母體脚氣トハ甚ダ密接ナル關係ヲ有スルハ余ノ統計的觀察ニ依リテ明カナリ、余ノ症例(四)及ピ(五)ハ正シクコノ事實ヲ立證セルモスト云フヲ得ベシ、即チ余ノ症例ハ哺乳ノ時期ヲ異ニスルモ、脚氣ヲ有スル同一母體ノ乳汁ヲ哺乳シタルニ依リテ、第四子ハ乳兒脚氣ヲ惹起シ、第五子ハ所謂人乳中毒症ヲ惹起セルモノトス、カカル事實ハ、所謂人乳中毒症ハ其ノ本態ニ於テ乳兒脚氣症ト同一ナルモノニアラズヤトノ疑念ヲ益々吾人ニ抱カシム。<br>(四)以上ノ事實ヲ綜合スル時ハ、所謂人乳中毒症ハ其ノ本態ニ於テ乳兒脚氣ト同一上ニ立ツベキ疾患ニシテ、詳言セバ乳兒脚氣ノ一異型ト見做スベキモノナリト信ズ、余思ヘラク、乳兒脚氣ハ脚氣毒素ガ母體ノ乳汁ヲ介シテ小兒ニ移行スルニ依リテ起ル一種ノ中毒症ニ外ナラズ、而シテ臨牀上ニ於テ一方ニハ專ラ心臓機能ヲ障碍スル衝心型アリ又他方ニ血行器症状ヲ件ハズシテ専ラ末梢神經ヲ侵ス所ノ麻痺型ナルモノアリ、コレ等ノ事實ヨリ考フル時ハ脚氣毒素ガ主トシテ心臓ヲ侵ス時ハ衝心型トナリテ表ハレ、主トシテ末梢神經ヲ侵ス時ハ麻痺型トナリテ表ハレ、專ラ腦膜ヲ侵ス時ハ所謂人乳中毒症ノ型トナリテ表ハルルモノニアラザルカ、カカル關係ハカノ麻疹ノ例ニ於テ之ヲ見ル、即チ症状ノ劇烈ナルモノニ於テハ、多クハ肺炎ヲ合併シコレト同時ニ心臓衰弱ヲ招來スルモ、時トシテハ主トシテ中樞神經系統ニ障碍ヲ及ボシ、既ニ前驅期或ハ發疹期ノ初メニ於テ意識溷濁ヲ來シ遂ニ無慾状態ニ陷ルコトアリ、又恢復期ニ於テ稀ニ腦膜ヲ侵シ漿液性腦膜炎ヲ惹起スルモノアリ、是レ麻疹毒ハ時ニ主トシテ中樞神經系統ヲ侵スコトアルヲ意味スルモノニシテ、以上述ベタル余ノ乳兒脚氣ニ於ケル説明ト相符合スル點アルヲ以テ茲ニ之ヲ引用シタルニ過ギズ、カク觀察シ來ル時ハ精神症状ノ有無ハ敢テ問題トナスニ足ラザルナリ、余ハ所謂人乳中毒症ヲ乳兒脚氣腦型トナシ乳兒脚氣中ニ包括スルニ賛スル者ナリ。
著者
石津 日出雄 宮石 智 山本 雄二 高田 真吾
出版者
Okayama Medical Association
雑誌
岡山医学会雑誌 (ISSN:00301558)
巻号頁・発行日
vol.105, no.9-10, pp.839-845, 1993 (Released:2009-03-30)
参考文献数
5

A 63-year-old male died in the hospital from erroneous drip infusion of thrombin, a local hemostatic, after polypectomy for intestinal polyposis. At autopsy, thromboses were observed in the cutaneous veins of the right arm, the right axillary vein and the right subclavian vein, and soft fibrin clots in the superior vena cava, the right atrium, the right ventricle and the pulmonary arteries. Thrombi were also found in the rami of the arteries in both lungs under the microscope. Leucocyte infiltration was recognized in the thrombus, but no organization. This finding shows that the thrombi were fresh. The remainder (150ml) of the drip solution was analyzed for thrombin activity and 8 to 16 units of thrombin activity per ml were demonstrated. From these results, the cause of death was considered pulmonary thrombosis due to intravenous administration of thrombin.
著者
国府島 泉 山本 洋 山本 マリリア明美 中村 知明 長町 栄子 寺坂 昌子 金政 泰弘
出版者
Okayama Medical Association
雑誌
岡山医学会雑誌 (ISSN:00301558)
巻号頁・発行日
vol.96, no.3-4, pp.385-389, 1984-04-30 (Released:2009-03-30)
参考文献数
11

電子レンジによるおしぼり付着菌の殺菌効果について検討した.菌付着おしぼりを1本ずつ照射する実験ではE. coli, S. aureus, P. aeruginosaの細菌類は2分間程度のマイクロ波照射で殺菌された.真菌類のC. albicansも3分で殺菌された.しかしB. subtilisの芽胞は5分間のマイクロ波照射でも10%の生残が認められた.実際面を考慮しておしぼり10本程度を同時に行なう場合は,効率的にやや長時間を要するが,芽胞以外のものを対照にする限り5分照射で充分である.電子レンジによるおしぼりの殺菌は手軽に短時間にしかも効果的になされることが判明し,自家処理おしぼりの殺菌にはもちろんのこと業者処理おしぼりの追加殺菌にも有用であると考えられる.
著者
牧山 宏志
出版者
Okayama Medical Association
雑誌
岡山医学会雑誌 (ISSN:00301558)
巻号頁・発行日
vol.71, no.6-1, pp.3077-3084, 1959-05-01 (Released:2009-03-30)
参考文献数
18

On the basis of the findings on the relationship between tubal muscles and the Eustachian tube as described in the previous report, the actions of various tubal muscles on the Eustachian tube are discussed, and the observations carried out by the methods described below on the movements in vivo of the naso-haryngeal orifice at the time of phonation and of swallowing reveaied the following results.1. Observations were carried out with the use of a nasopharyngoscope.2. Observations were done on the patients who underwent the radical operation for the cancer of maxillar sinus. As the inferior nasal concha was already removed at the time of the operation, it was possible to insert a small nasal mirror into the posterior nasal cavity of the operated side to catch the whole view around the tubal orifice of healty side.3. For the children over 5-6 years old with cleft palate, observations were carried out directly on the pharyngeal orifice through the mouth cavity (motion pictures were taken in this instance).At a result it has been found that the nasopharyngeal orifice of the tube is widened because the posterior lip and the mucous membrane of the base of the Eustachian tube move slightly outward at the time of swallowing. In anatomically summarizing these observations the author arrived at the following conclusions.At the time of swallowing the tensor muscle of the palate dilates the Eustachian tube at the points near the middle part and the anterior part of the tube. The levator palatini muscle assists the opening action of the tensor muscle by fixing or by drawing the base of the tube slightly toward the inferior-interior side. The salpingopharyngeus muscle or the salpingopharyngeal fold, being drawn inward by the cephalopharyngeal muscle and pahryngopalatine muscle and widening the nasopharygeal orified, assists the dilatating action of the tensor muscles.When the muscles are relaxed, the Eustachian tube is closed probably by the elasticity of the lateral cartilaginous lamina and by the pressure of the tissues surrounding the tube.
著者
田村 於兎
出版者
岡山医学会
雑誌
岡山醫學會雜誌 (ISSN:00301558)
巻号頁・発行日
vol.31, no.352, pp.385-392_1, 1919-05-31 (Released:2009-03-31)
参考文献数
14
著者
池田 嘉一郎
出版者
岡山医学会
雑誌
岡山医学会雑誌 (ISSN:00301558)
巻号頁・発行日
vol.32, no.371, pp.646-666, 1920-12-31

(一)所謂人乳中毒症ニ於ケル精紳症状ハ、輕症ナルモノニ於テハ、一過性ノ興奮性充進竝ニ嗜眠状態ヲ呈スルニ過ギザルモ、重症ナルモノニ於テハ、更ニ進ミテ意識溷濁乃至無慾状顔貌ヲ呈シ、周圍ノ事情ニ對スル識別力ヲ失ヒ笑ハズ泣カズ、眼付曇ヨリシ、時トシテ舞踏病樣不隨意運動乃至不明ノ言ラ發ス、カク特異ナル精紳症状ヲ呈スルハ神經申樞ニ何等カノ病變ノ存スルモノト考ヘザルベカラズ、余ハカカル患者ニ遭遇スル毎ニ勉メテ腰椎穿刺ヲ行ヒ腦脊髓液ノ性状ヲ檢シタルニ、ソノ外觀、比重、糖反應、蛋白量、蜘蛛網状物形成ノ有無等ノ關係ハ、多クハ健康者ノモノト差異ヲ認ムルコト能ハザリシモ、「グロブリン」反應及ビ細胞數ニ於テ輕微ノ變化ノ存スルヲ認メタリ、即チ「グロブリン」反應中、ノンネーアツペルト氏反應竝ニパンヂー氏反應ハ多クハ陰性(時トシテ弱陽性ナルコトアリ)ナルモ野口氏反應ハ毎常弱陽性ヲ示セリ、而シテ淋巴球ノ數ハ通常ナルカ或ハ僅ニ増加セリ、即チ輕度ノ漿液性腦膜炎ノ腦脊髓液ニ相類似ス、カカル腦脊髓液ノ變化ハ唐澤博士ノ報告セル軟腦膜ニ於ケル解剖的變化ト相符合ス。(二)臨牀上ニ於ケル所謂人乳中毒症ト乳兒脚氣トノ主要ナル區別點ハ、伊東博士ニ依レバ血行器症状竝ニ精神症状ノ有無ニ存ス、然レドモ血行器症状ハ兩疾患ヲ鑑別スルニ向ツテ爾カク重要ナル資料トナスヲ得ズ、蓋シ血行器症状ハ乳兒脚氣ニ於ケル必要ナル症状ノ一ツナルモ而モ之ヲ伴ハザルモノ稀ナラズ、又所謂人乳中毒症ニ於テモ血行器症状ハ必ラズ缺如スベキモノニアラザルガ故ナリ、況ンヤ症例(三)ニ於ケルガ如ク、所謂人乳中毒症ニ於テ其ノ經渦中ニ突然衝心症状ヲ表ハシタル事實アルエ於テオヤ。精神症状ノ有無ニ至リテハ、吾人ハ兩疾患ニ於ケル最モ顯著ナル差異タルヲ是認セザルベカラズ、然レドモ大人脚氣ニ於テ稀ニ精神症状ヲ伴フコトアルコト竝ニ余ノ實驗例ノ如ク幼兒脚氣ニ於テ躁暴狂状乃至昏迷ヲ呈シ、而モ軟腦膜ノ病理解剖的所見ニ於テ所謂人乳中毒症ト殆ド同樣ナル病變ヲ呈セルコトアル事實ヨリ推考スル時ハ、乳兒脚氣ニアリテモ亦精神症状ノ表ハルルコトアリテ可ナル理ナリ。(三)所謂人乳中毒症ト母體脚氣トハ甚ダ密接ナル關係ヲ有スルハ余ノ統計的觀察ニ依リテ明カナリ、余ノ症例(四)及ピ(五)ハ正シクコノ事實ヲ立證セルモスト云フヲ得ベシ、即チ余ノ症例ハ哺乳ノ時期ヲ異ニスルモ、脚氣ヲ有スル同一母體ノ乳汁ヲ哺乳シタルニ依リテ、第四子ハ乳兒脚氣ヲ惹起シ、第五子ハ所謂人乳中毒症ヲ惹起セルモノトス、カカル事實ハ、所謂人乳中毒症ハ其ノ本態ニ於テ乳兒脚氣症ト同一ナルモノニアラズヤトノ疑念ヲ益々吾人ニ抱カシム。(四)以上ノ事實ヲ綜合スル時ハ、所謂人乳中毒症ハ其ノ本態ニ於テ乳兒脚氣ト同一上ニ立ツベキ疾患ニシテ、詳言セバ乳兒脚氣ノ一異型ト見做スベキモノナリト信ズ、余思ヘラク、乳兒脚氣ハ脚氣毒素ガ母體ノ乳汁ヲ介シテ小兒ニ移行スルニ依リテ起ル一種ノ中毒症ニ外ナラズ、而シテ臨牀上ニ於テ一方ニハ專ラ心臓機能ヲ障碍スル衝心型アリ又他方ニ血行器症状ヲ件ハズシテ専ラ末梢神經ヲ侵ス所ノ麻痺型ナルモノアリ、コレ等ノ事實ヨリ考フル時ハ脚氣毒素ガ主トシテ心臓ヲ侵ス時ハ衝心型トナリテ表ハレ、主トシテ末梢神經ヲ侵ス時ハ麻痺型トナリテ表ハレ、專ラ腦膜ヲ侵ス時ハ所謂人乳中毒症ノ型トナリテ表ハルルモノニアラザルカ、カカル關係ハカノ麻疹ノ例ニ於テ之ヲ見ル、即チ症状ノ劇烈ナルモノニ於テハ、多クハ肺炎ヲ合併シコレト同時ニ心臓衰弱ヲ招來スルモ、時トシテハ主トシテ中樞神經系統ニ障碍ヲ及ボシ、既ニ前驅期或ハ發疹期ノ初メニ於テ意識溷濁ヲ來シ遂ニ無慾状態ニ陷ルコトアリ、又恢復期ニ於テ稀ニ腦膜ヲ侵シ漿液性腦膜炎ヲ惹起スルモノアリ、是レ麻疹毒ハ時ニ主トシテ中樞神經系統ヲ侵スコトアルヲ意味スルモノニシテ、以上述ベタル余ノ乳兒脚氣ニ於ケル説明ト相符合スル點アルヲ以テ茲ニ之ヲ引用シタルニ過ギズ、カク觀察シ來ル時ハ精神症状ノ有無ハ敢テ問題トナスニ足ラザルナリ、余ハ所謂人乳中毒症ヲ乳兒脚氣腦型トナシ乳兒脚氣中ニ包括スルニ賛スル者ナリ。
著者
岡崎 昌一
出版者
岡山医学会
雑誌
岡山医学会雑誌 (ISSN:00301558)
巻号頁・発行日
vol.72, no.5, pp.1351-1357, 1960-07-30

By selecting 4 oxime compounds possessing pyridine nucleus in the molecular construction, namely, PATD, PPATD, PPAPD, and PAD, the author compared their therapeutic effects on alkylphosphate poisoning with the effect of PAM. 1. As for the therapeutic effect on alkylphosphate poisoning in mice, when administered in the maximum safety dose, PATD and PPATD are superior to PAM, but on scrutinous examinations there can be recognized not any significant difference. Effect of PPAPD is about the same as that of PAM. 2. Both PAM and PATD are most effective when administered concurrently with the intravenous administration of alkylphosphate, but as the time before or after the administration of alkylphosphate lengthens, the effect of drugs decreases proportionately. 3. Atropine used concurrently with these oxime compounds yields no better results than without it. 4. The effect of PATD is slightly more lasting than PAM, but the difference is not significant. 5. PATD has been proven to possess a reactivating action on rabbit blood cholinesterase just as PAM. Consequently it is assumed that the effective mechanism of both drugs is same. 6. When an equal dose of PAD and PAM is administered to the mice with ethylparathion poisoning, PAD is inferior to PAM in improving the mortality rate of the mice. 7. There seems to be no benefit in administering intramuscularly 15 mg/kg PAD concurrently with the administration of various oximes.
著者
大重 彌吉
出版者
岡山医学会
雑誌
岡山医学会雑誌 (ISSN:00301558)
巻号頁・発行日
vol.66, no.5, pp.951-957, 1954-05-31 (Released:2009-08-24)
参考文献数
13

From the data gathered by myself and other investigators up to 1954 in every district of Japan, I have chosen those of the mother population according to the law of X2-distribution and from their average value have concluded that the corrected frequency of principal psychoses in rural districts of Japan is as follows:-