著者

阪本 茂 小竹 正雄 宇野 源太

出版者

関西医科大学医学会

雑誌

関西医科大学雑誌 (ISSN:00228400)

巻号頁・発行日

vol.13, no.2, pp.462-475, 1961-07-20 (Released:2013-02-19)

参考文献数

10

著者

岡本 緩子

出版者

関西医科大学医学会

雑誌

大阪女子医科大学雑誌 (ISSN:21864926)

巻号頁・発行日

vol.7, no.1-3, pp.41-45, 1955-03-20 (Released:2013-02-19)

参考文献数

9

著者

大橋 嘉樹 柳生 隆視 加護野 洋二 斎藤 直巳 延原 健二 木下 利彦 岡島 詳泰 斎藤 正己

出版者

関西医科大学医学会

雑誌

関西医科大学雑誌 (ISSN:00228400)

巻号頁・発行日

vol.42, no.2, pp.146-149, 1990-06-20 (Released:2013-02-19)

参考文献数

5

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In this communication, the present authors have studied on a case of the submissive female partner of induced psychosis, of which her lover was the dominant partner and she developed an identical psychophathology to the partner after having been influenced by his psychotic state.The dominant partner (proband) was 21-year-old male student and he had some delusions of possession, that he was possessed by fox and ox, with ideas of persecution, and he was involved in religious activities. He was suspected as paranoid type of schizophrenia in the psychiatric interview, but the diagnosis was not confirmed because he refused to take either further examinations or psychological testings.The submissive partner, who was a 21- year-old female and working in an insurance company, at first made a tout resistance to his delusional ideas, but she was gradually influenced by her lover's psychotic state, particularly after she became interested in spiritual phenomina. Finally she became to share the delusions and the common ideas with him after their cohabitation for several days. The cohabitation was forcibly discontinued by her father, and she was seperated from him, but her state of possession remained unchanged therafter until her emergency admission to our university hospital. Almost complete remission from her psychotic state was after two months' treatment in our inpatient ward.In the present case, the persistent repetitions of unitary spiritual idea by the dominant partner and the entire dependence due to love relationship of the submissive partner appear to be the most important factors for induction of the psychotic state. Recently, spiritual phenomena have come into nation-wide fashion and a large number of people seem to have special interests in the spiritual world etc., so that the possible prevalence of "spiritually"induced psychoses including folie A deux might be expected more frequently among adolescence in particular.

著者

後藤 幸弘

出版者

関西医科大学医学会

雑誌

関西医科大学雑誌 (ISSN:00228400)

巻号頁・発行日

vol.35, no.2, pp.353-383, 1983-06-20 (Released:2013-02-19)

参考文献数

71

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The purpose of this study is to examine the relationship between the amount of muscle electrical activity and oxygen requirement as to the speed changes in walking and running, and also to determine electromyographically the optimum speed and the metabolic intersection speed of walking and running, that were reported by former investigators.Twenty-two young trained male adults participated in the experiment. They were all athletes who belonged to university sports clubs.EMG activity in the right leg w as measured through two surface electrodes placed 2.5cm apart on the belly of each muscle as shown below. The following muscles were monitored in all subjects.Tibialis anterior (T.A.), Soleus (So.), Gastrocnemius (L.G.), Vastus medialis (V.M.), Rectus femoris (R.F.), Biceps femoris (B.F.), and Gluteus maximus (G.M.).The subjects O.O. and U. E. had additional muscles monitored as described below:Rectus abdominis (R.A.), Sacrospinalis (Sac.), Deltoid anterior portion (D.A.), Deltoid posterior portion (D.P.), Triceps brachii (T.B.), and Trapezius (Trape).The EMG signal was amplified and recorded by a multipurpose electr oencephalograph (San-ei Type IA-14) (paper speed: 3cm/sec, sensitivity: 6 mm/O.5mV, time constant: 0.01 sec). Simultaneously it was integrated with a Miller's circuit (Nihonkouden Integrator RFG-5).

著者

金田 浩由紀

出版者

関西医科大学医学会

雑誌

関西医科大学雑誌 (ISSN:00228400)

巻号頁・発行日

vol.72, pp.1-10, 2021 (Released:2021-07-20)

参考文献数

36

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臨床倫理コンサルテーションは医療従事者から希求されているが,その普及は十分ではない.臨床倫理的なジレンマが存在するというコンセンサスはあるものの,どのように対応するのかのコンセンサスがないことが課題である.本稿では,臨床倫理コンサルテーションでの具体的な対応について考察していく.まず臨床倫理に関する過去の文献を振り返り,臨床倫理の具体的な作業について考察をし,その本質は価値の比較考量と選択であることを明らかにし,その手順を4段階に整理した.次に,臨床倫理コンサルテーションの手順を確認し,当事者への応答について考察を行い,自験例から典型的な臨床倫理的問題への確認事項の返答と価値判断を伴う返答における具体例を示し,円滑に活動できるための手順の提案を行った.これらにより,臨床倫理支援が病院機能として医療安全対策や感染防止対策と同じ様に,恒常的に機能するための一助となることを期待する.

著者

内田 奎佑

出版者

関西医科大学医学会

雑誌

関西医科大学雑誌 (ISSN:00228400)

巻号頁・発行日

vol.17, no.2, pp.208-211, 1965-06-20 (Released:2013-02-19)

参考文献数

4

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Fibrin Film is a thin membranous strip of fibrin recently produced for public for clinical use as an ointment for dressing wounds. Clinical studies on the effectiveness of this material are reported in this paper with the following conclusions.1) This film was embetted in the tissue adjacent to the tibia of four patients and was found that this film can be safely packed into areas surrounding human bony tissue.2) In dressing open wounds this film was found effective with wounds which are clean and whose grade of infection is extremely low but not effective with wounds associated with pus or exudate.3) The clinical use of this film can best be indicated for clean fresh wounds without any sign of infection or inflammation such as fresh clean skin laceration or sterile finger tip wound in which the nail is extracted.

著者

杉原 肇

出版者

関西医科大学医学会

雑誌

関西医科大学雑誌 (ISSN:00228400)

巻号頁・発行日

vol.26, no.1, pp.72-88, 1974-03-20 (Released:2013-02-19)

参考文献数

55

被引用文献数

2 3

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The effects of the semisynthetic diets containing a refined coconut oil upon the growth of DMBA-induced mammary cancers were investigated in 87 young adult female Sprague-Dawley rats. Eighty young female rats were maintained on a commercial pellets, CMF type of Oriental Yeast Company, and injected to a caudal vein with 3 mg of DMBA at the age of 55 and 58 days. In the ages of 85 to 145 days for promotion stage of the tumor growth, the experimental animals were distributed to 4 groups (Table 2) and fed on 4 different semisynthetic diets, respectively. The diets (Table 1) were isocaloric (395 Ca1/100g), although they Contained a refined oil (coconut oil or corn oil) at either 8(ordinary) or 20 (high) percentage. The rats were observed in 3 months after the first injection of the carcinogen. The time of appearance of the first palpable mammary cancer was dated from the first injection of DMBA (Incubation Time). All rats were sacrificed at the age of 145 days. Mammary cancers in a rat were counted in the gross at necropsy (Active Center). Total mammary cancers per an animal were weighed on a balance (Tumor Weight). All detectable mammary tumors were observed histologically, and the above-mentiond mammary cancers were verified by the histological examinations.

著者

杉本 治良 城戸 一哉 今村 一輝 蒲生 松助 西窪 靖和 村上 満彦

出版者

関西医科大学医学会

雑誌

関西医科大学雑誌 (ISSN:00228400)

巻号頁・発行日

vol.25, no.2, pp.179-187, 1973-06-20 (Released:2013-02-19)

参考文献数

11

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従来細胞膜の興奮はNaイオンの細胞への流入によつて始ると主張するナトリウム説で説明されてきたが,その後,外液のCaイオンが内向電流の担体であるとするカルシウム説を主張する一派があり,今日ではこれが一般に受け入れられているようである.しかしわたくしたちは,モルモット輸精管の摘出標本を等張蕉糖液申に置いた場合,少量の塩化カリウムによつて収縮が起ることを見出した.この現象は,外液中にCaイオンが全くなく,Naイオンも極めて少い状態で現われたので,この収縮過程にKイオンが主たる役割を果していると考えられた.また同時に行われた案験でCaイオンあるいはNaイオンはいかなる濃度においてもこの標本に収縮を来たすことがなく.またある一定濃度以上外液中に存在する場合には,かえつて上述のKイオンによる収縮を抑制することが見出された.このような実験的事実は,平滑筋収縮について従来用いられてきた概念では直ちに解釈できなかつたので,これに関連した実験もあわせて行い報告したい.

著者

阪口 起造

出版者

関西医科大学医学会

雑誌

関西医科大学雑誌 (ISSN:00228400)

巻号頁・発行日

vol.21, no.4, pp.38-54, 1969-12-20 (Released:2013-02-19)

参考文献数

47

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The problem of retrograde amnesia (R. A. ) has long been discussed but certain details yet remained unclarified. For seven years, the author has investigated 847 cases of the head injured presenting R. A. in the Neuro-psychiatric Department of Kansai Medical School. In this survey, however, the cases in the acute stage of the injury and those with amnestic syndrome have carefully been excluded from the materials.The results are as follows:1) The correlation between R. A. and post-traumatic amnesia (P. T. A. ) is hardly recognized as Russell has already pointed it out. R. A. is seldom found in cases with P. T. A. of short duration (less than an hour). In addition, the presence of long-lasting R. A. has no direct relationship with the duration of P. T. A.2) Precise clinical investigation of 13 cases with fairly long-lasting R. A. (more than an hour) has resulted in the following findings.a) Statistically, it might be probable that manifest and long-lasting R. A. tended to be found in car drivers.b) Various offenses of the traffic law or responsibility due to unskilful driving technique and consequently certain feelings of guilt are frequently found in those cases, and expectation of compensation is never observed among them.c) Organic damage of brain, especially of m nemic system, is not always suspected in them.d) The presence of such type of R. A. might rather be considered in connection with character traits than with the factors of intelligence of the patients.e) Treatment of R. A. was intended by means of psycho therapy in eight cases: sufficient or remarkable recovery of memory were obtained in two cases by intensive suggestion and five by hypnotherapy.

著者

小谷 澄夫

出版者

関西医科大学医学会

雑誌

関西医科大学雑誌 (ISSN:00228400)

巻号頁・発行日

vol.22, no.4, pp.582-600, 1970-12-20 (Released:2013-02-19)

参考文献数

49

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心臓外科とくに直視下心臓手術の最近における発展と普及にはめざましいものがあるが,これは診断技術や手術手技等の向上とともに,手術の補助的手段とくに体外循環や低体温法等の改善に負うところが大きい.しかし体外循環法や低体温法がいかに改善されても,その営む呼吸や循環は所詮は非生理的なものであり,長時間にわたる施行は生体に対して生理学的および生化学的な種々の障害を惹起しうることは明らかである.これらの障害のうち,体液の酸塩基平衡障害としてのアシドーシスは不適正な体外循環操作により1次的にも発生するし,また種々の原因による代謝異常の結果として2次的にも発生するものであるが,いずれにしても惹起されたアシドーシスはさらに心循環機能および全身機能に悪影響を及ぼし,一連の悪循環を形成することが臨床的に知られている.アシドーシスの心循環機能におよぼす影響に関しては従来も若干の報告をみているが,呼吸性および代謝性に関する両者の比較等については業績も乏しく,現在なお一致した見解をみるに至つていない.また,先に教室の高橋は心臓手術前後における心筋のジギタリス耐容度の変動を臨床的および実験的に検討し,その変動の1次的原因が代謝性アシドーシスにあることを推定しているが,これもアシドーシスと心筋機能との関係についての定量的な検討を行なうには至らなかつた.著者は心筋機能とくにその収縮性および興奮性におよぼす代謝性および呼吸性アシドーシスの影響を心筋収縮力,心筋ジギタリス耐容度および心室細動閥値の面から定量的に検討を加え,若干の知見を得たので報告する.

著者

山村 學

出版者

関西医科大学医学会

雑誌

関西医科大学雑誌 (ISSN:00228400)

巻号頁・発行日

vol.43, no.4, pp.369-384, 1991-12-20 (Released:2013-02-19)

参考文献数

130

著者

幸塚 嘉一 内藤 博江 堀川 惺子

出版者

関西医科大学医学会

雑誌

関西医科大学雑誌 (ISSN:00228400)

巻号頁・発行日

vol.12, no.1, pp.1-8, 1960-03-20 (Released:2013-02-19)

参考文献数

20

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1) It is demonstrated that the peripheral cut end of the medullary bull-frog's trigeminal nerve is stimulated by means of Kotsuka's “glycerine spot method” intracranially, there follows a pupillary constriction on the isolateral eye.Therefore, it is evidenced that there exist efferent pupilloconstricting fibers in the trigeminal nerve.2) Pupillary dilation is observed on the atropinized eye when the peripheral cut end of the trigeminal nerve is stimulated intracranially with “glycerine spot method” as in 1).Thus, it is demonstrated that there exist efferent pupillodilating fibers in the trigeminal nerve besides the above evidenced efferent pupilloconstricting fibers.3) It is revealed that efferent trigeminal pupilloconstricting fibers dominate over efferent trigeminal pupillodilating fibers of a non-atropinized eye.4) The results of 1) and 2) support to consider that the iris musculature of bull-frogs is governed by “efferent trigeminal double innervation”.5) The above experimental results are presented to disapprove Langley's law of double innervation of the centrifugal autonomic nerves on the iris.

著者

平沢 美瑠子

出版者

関西医科大学医学会

雑誌

関西医科大学雑誌 (ISSN:00228400)

巻号頁・発行日

vol.10, no.3, pp.108-117, 1958-09-20 (Released:2013-02-19)

参考文献数

9

著者

鮫島 美子

出版者

関西医科大学医学会

雑誌

大阪女子医科大学雑誌 (ISSN:21864926)

巻号頁・発行日

vol.5, no.3, pp.11-13, 1953-03-20 (Released:2013-02-19)

参考文献数

17

著者

小川 道子 佐伯 邦雄 松尾 博 大久保 滉

出版者

関西医科大学医学会

雑誌

関西医科大学雑誌 (ISSN:00228400)

巻号頁・発行日

vol.28, no.4, pp.805-814, 1976-12-20 (Released:2013-02-19)

参考文献数

32

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Reported: A case of myasthenic gravis (Osserman group IV) of late onset with thymoma in a 45 year old female. Thymecctomy and subsepuent cobalt radiation therapy had yielded no significant effect. Three years after thymectomy, she was admitted to our department of the Kansai Medical University hospital because of a myasthenic crisis of the brittle type with an anti-choline-esterase resistance.After admission, tracheostomy was performed and an intermittent positive pressure respirator was applied. During course, however, a number of complications occurred, including cardiac shock, disturbed inflation of fhe left lung due to mediastinal pleural adhesion, severe infections (lung and urinary tract by pseudomonaus aeruginosa, klebsiella, and candida developing into candida sepsis in the prolonged cour se), drug allergies (sulpenicillin, ampicillin,, and amphotericine B), hepatomegaly with liver dysfunctions, and kidney involvement.Therefore, the patient was treated with intensitive chemotherapy, adrenal corticosteroid, ACTH, transfusion to maintain electrolyte balance, and nasal feeding of a high caloric diet.These treatments finally rescued the patient from the crisis, and eight months later, she was discharged. Discussed: The Management of a severe myasthenic crisis in due consideration of pathophysiological conditions.

著者

覚道 奈津子 下間 亜由子 楠本 健司

出版者

関西医科大学医学会

雑誌

関西医科大学雑誌 (ISSN:00228400)

巻号頁・発行日

vol.61, pp.200-205, 2009 (Released:2013-04-27)

参考文献数

16

著者

大久保 進 藤井 康英 岡本 緩子 大久保 滉

出版者

関西医科大学医学会

雑誌

関西医科大学雑誌 (ISSN:00228400)

巻号頁・発行日

vol.33, no.1, pp.47-54, 1981-03-20 (Released:2013-02-19)

参考文献数

22

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I. A 26 years old woman, complainig of general malaise and hypermenorrhea was admitted to our hospital in Feb.,1978. She had been suspected of idiopathic thrombocytopenic purpura (ITP) by her home doctor.Laboratory examin ations (Tab.1, Fig.1) revealed thrombocytopenia (26,000/cmm) and abnormal immuno-serological findings, including LE phenomenon (+), LE test (+), DNA test (×640), ANA (×160), BFP (+), RAT ( + ), Coombs test D (+) and hypergammaglobu linemia (1.84-1.36g/di). Her bone marrow picture was typical of ITP, i. e. an increased count in megakaryocytes lacking platelet production.Clinically, the patient showed slig ht fever and sometimes complained of bilateral knee joint Pain.She was diagnosed as SLE, chiefly manifesting thrombocytopenia, and was treated with corticoid (prednisolone), resulting in an improved platelet count (253,000/cmm) in three weeks.II. This case drew our attention to the relationship between ITP and SLE, which led us to investigate the autoantibodies in ten cases of ITP (Tab.2, Figs.2,3) treated at our department during the last five years.1) The positive rates o f the immuno-serological tests in our ITP cases were as follows: Anti-platelet antibody 1/7, LE phenom.0/6, LE test 0/9, DNA test 3/6, ANA 2/9, Microsome test 4/9, Thyroid test 4/9, RAT 4/8, BFP 4/8 and Coombs test 2/4 (Figs.4,5). Comparing these data with those of the SLE cases reported in the literature (Fig.4), some differences suspected to exist between the immunological failure in ITP and that in SLE.2) In all the four ITP cases responding well to corticoid therapy, the BFP was positive: in the non-responding cases, it was negative.In each case, little correlation could be seen between the number of positive tests and response to therapy.The han dling. of ITP cases necessitates a follow up in which attention is paid to the possible concomitance or succession of other auto-immune diseases.An accumulation of case studies in this direction may reveal the pathogenic correlations between ITP and SLE or other auto-immune diseases.

著者

小川 亮恵

出版者

関西医科大学医学会

雑誌

関西医科大学雑誌 (ISSN:00228400)

巻号頁・発行日

vol.27, no.4, pp.757-777, 1975-12-20 (Released:2013-02-19)

参考文献数

26

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As for the tendon lesions of the rheumatoid hand the reports of pathohistological studies are very limited except the works of Kellgren and Ball, Ehrlich et al and Potter and Kuhns. There still remain several problems not yet settled in the field of pathohi- stology, especially in the pathogenesis of tendon nodule and its relation to the development of tenosynovitis.The author made a pathohistological research using specimens removed from thirty-two patients operated on by himself, which includes the treatment of 22 hands of extensor tenosynovitis,18 fingers of digital flexor tenosynovitis and three cases of flexor tenosynovitis of the wrist. Ordinary staining such as H. E., Azan-Marolly, van Gieson, Toluidin-blue, Weigert-fibrin and Silver stainings were performed for microscopic examinat ion.The following conclusions were drawn not only from pathological findings but also from clinical features and operative findings.1. From the findings of forty-three tendon lesions the lesions could be classified into the following three groups: 1) tenosynovitis in 34,2) tendinitis in one,3) co-existence of tenosynovitis and tendinitis in 8. This suggests that the tendinitis does not always occur as a secondary product from the tenosynovitis.2. Microscopic manifestations of the findings of tenosynovitis are in many respects very similar to the synovitis of the joint of rheumatoid arthritis, but the findings of tenosynovitis are rather simple in histological manifestation as compared to joint synovitis.3. Histologically a nodule-like swelling or a nodule formation in the tissue of tendon substance is most characteristic. These nodule-like tendon lesions were classified into three types by the author,1) proliferated granuloma in epitendineum which is seen in 4 tendons,2) a. proliferated granuloma in peritendineum which is seen in 4 tendons,2) b. degenerative changes in tendon substance in one tendon. In addition to the above findings the author noticed that the inflammatory findings both in epitendineum and peritendineum were very similar to those in articular synovial tissue.

著者

水野 誠

出版者

関西医科大学医学会

雑誌

関西医科大学雑誌 (ISSN:00228400)

巻号頁・発行日

vol.40, no.2, pp.129-148, 1988-06-20 (Released:2013-02-19)

参考文献数

66

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Dynamic mechanism of severe head injury was studied and analyzed clinically with special reference to the brain damage and the outcome of it in 149 cases, in which more accurate mechanism of severe head injury could be informed during these three years. The outcome of the head injury had a significant correlation with the occurrence of intracranial lesion, especially with the degree and extent of the brain damage, and the severity of consciousness disturbance was most important as the clinical presentation of the brain damage and had a relation to the prognosis. Dynamic assessment performed in the present series showed that the dynamic force and direction closely related to the occurrence of intracranial lesion, especially brain damage. In other words, fatal brain injury such as diffuse brain injury or brain stem injury occurred when an extremely severe force was delivered on the head. It was suggested that a rotational accelerating force and shearing force to the he ad would be most important as the characteristics of dynamic force in the development of severe brain damage. In the present report, the above mechanism was discussed. Not only clinical and morphological assessment by CT but also dynamic assessment of the head injury has much more value for the diagnosis, prediction of the outcome, and treatment.

著者

錦織 壮

出版者

関西医科大学医学会

雑誌

関西医科大学雑誌 (ISSN:00228400)

巻号頁・発行日

vol.30, no.1, pp.97-128, 1978

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The present author has studied from various viewpoint 14 patients who had epileptiform convulsive disorders under choronic Meprobamate intoxication and 47 additional cases which were already reported in Japanese and other languages.<BR>1) There were no specific convulsive predi sposition and family history in the author's cases. Remarkable personality disorder of these cases were often seen in the peoples who addicted any drugs and others. They had no intellectual defect.<BR>2) Generally, convulsive seizure broke out when one took Meprobamate more than 3g daily over one to several years.<BR>3) In the literature, ev ery other author understood that these convulsive seizures had occured only as abstinence syndrom. It is certain that the majorities of these convulsions occur as abstinence syndrom but others occur during the intake of this drug. Delirium or disturbance of alertness also would develop likeweise. The present author differentiated four types regardig to the occurrence of convulsive seizure as well as the intake of this drug. A: Convulsion precipitated by abrupt withdrawal. B: Convulsion which occured during intake of this drug. C: Convulsion which occured under marked consciousness disturbance. D: Convulsion which occured particularly during the treatment of marked consiousness disturbance. Clinical types mentioned above were not always same in one patient.<BR>4) A lmost all the convulsive seizures appeared to be of epileptic nature but they often came out in the form of status epilepticus.<BR>5) Neurological signs and s ymptoms such as fever, nausea, vomiting, shaking and ataxia would frequently accompanied convulsions.<BR>6) Before and after convulsion, the r e was stormy consciousness disturbance which was certainly different from initial and postical twilight state. Convulsive seizures associated with fever and neurological symptoms and severe consciousness disturbance tend to have the form of status epilepticus. Therefore these signs and symtoms suggest some serious oragnic brain damage. In this regard, the present author discovered in the literatures three cases, of whom two died during status epilepticus and the other got into comatose with fever from delirium.<BR>7) EEG finding s showed convulsive readiness under Meprobamate abuse, so it is quite natural that the convulsive seizure appears even under its abuse. Moreover, some focal signs in EEG suggest localized damage.<BR>8) It was not effective to gi ve Meprobamate for the treatment of abstinence syndrome. When, once convulsion and related disorder happened to occur, such disorders would reoccur short after re-use of Meprobamate. However, if a patient does not fall in abuse again, another convulsive disorder does not occur and clinical outcome is very favourable, so that it is not necessary to prolong anticonvulsant medication. These convulsive disorders do not look over as accidental outbursts in the patient with convulsive predisposition or as rebound phenomena after long abuse of Meprobamate that has mild anticonvulsant action.