http://hdl.handle.net/10564/1634 1994-08 2026-04-10T15:40:37Z http://hdl.handle.net/10564/1652 タイトル: 脳外科手術患者におけるエンフルレン，イソフルレン，ジアゼパム-フェンタニール麻酔中の脳皮質血流量のCO₂反応性 著者: 下村, 俊行 抄録: Background : Effects of the CO₂ reactivity on cortical cerebral blood flow (CBF) have not been investigated by non-invasive, non-radioactive procedure in clinical aneshesia (enflurane, isoflurane and diazepam-fentanyl). The purpose of this study is to evaluate the cortical CBF and CO₂ reactivity under anesthesia with a thermal clearance method. Materials and Methods : The CBF were determined by principle of Peltier's effect (thermal clearance method) in 26 patients who have been anesthetized and undergone neurosurgery. The CO₂ reactivities were measured at the clinical steady state of PaCO₂ levels : 35mmHg, 40mmHg and 45mmHg during enflurane (n=8), isoflurane (n=9) and diazepam-fentanyl (n=9)anesthesia, respectively. Results : The CO₂ reactivities of cortical CBF were well maintained during all anesthesia. The slopes of regression line (ΔCBF vs ΔPaCO₂) were 2.74ml・100g⁻¹・min⁻¹・mmHg⁻¹ (enflurane), 1.17ml・100g⁻¹ ・min⁻¹・mmHg⁻¹ (isoflurane) and 1.01ml・100g⁻¹・min⁻¹・mmHg⁻¹ (diazepam-fentanyl). Conclusion : These results suggest that in neurosurgery under enflurane, isoflurane anesthesia, it should be cared for the great reduction of CBF induced by hypocapnic cerebrovascular reactivity. 1994-08-30T15:00:00Z http://hdl.handle.net/10564/1651 タイトル: プロスタサイクリン(PGI₂)による人為的低血圧時のネコの局所脳血流および炭酸ガス反応性に及ぼす影響 著者: 長畑, 敏弘 抄録: The effects of Prostacyclin (PGI₂) on regional blood flow (r-CBF) and CO₂ reactivity were studied in experimental hypotension with cats. The 19 cats, weighing 1.6-4.0 kg, were divided in two groups, PGI₂ administration group (n=10) and the control (n=9). Animals were anesthetized with midazolam, fentanyl, pancuronium and nitrous oxide/oxygen by mechanical ventilation. Closed cranial-windows were prepared on the bilateral parietal bone, through which r-CBF was measured by laser Doppler flowmetry, and intracranial pressures were recorded. Under induced hypotension with PGI₂ (30% reduced from the control value), r-CBF was significantly decreased at 88.9%. In steady states of hypo-, normo-, and hypercarbia, the CO₂ reactivity of r-CBF (Δ%r-CBF/ΔPaco₂) was calculated and compared between the control group and PGI₂ group. There were no significant changes in CO₂ reactivity of r-CBF. We concluded that r-CBF was attenuated by PGI₂ administration which had no effects on CO₂ reactivity. 1994-08-30T15:00:00Z http://hdl.handle.net/10564/1650 タイトル: 慢性腎不全患者におけるアルミニウムに関する研究 ： 造血能への影響 著者: 新井, 邦彦 抄録: Among several inhibitory factors proposed in refractory anemia for rHuEPO, Aluminium (Al) is of most importance in the clinical setting, ruling out an iron deficiency. So, an evaluation of Al accumulation in the patient with chronic renal failure and an inhibitory effect by Al in erythropoiesis have been investigated in this study to infer some aspect of the pathogenesis of Al-induced anemia. An inhibitory effect by Al in erythropoiesis was assessed by in vitro culture method of CFU-E colony formation using fetal mouse liver cells. 1) Evaluation of Al accumulation : RBC-Al content in patients was apparently higher than that in healthy subjects and disclosed clear correlation with ΔAl(r=0.540, p<0.05). In addition, comparative analysis between RBC-Al and Hb concentration also showed significant correlation (r=-0.400, p<0.001) and RBC-Al value corresponding to Hb concentration of as low as 6 g/dl was to be 65 μg/10¹³ cells or so. 2) In vitro study of CFU-E : CFU-E colony count was significantly reduced by application of Al in all experimental conditions. Furthermore, inhibitory effect found in Al application preceding the addition of EPO was to be about double the degree found in other experiments. 3) Erythropoietic activity : CFU-E/logEPO of each patient correlated significantly with RBC-Al value (r=-0.486, p<0.05). Based upon the above three studies, the following conclusions could be proposed, which may substantially contribute to protecting patients with chronic renal failure from Al-intoxication more safely. Conclusions : RBC-Al content is a precise parameter for prediction of Al-intoxication ; 2) RBC-Al measured in patients showed that a patient on maintenance dialysis having a risk of Al is not uncommon, irrespective of current widely expanded prophylaxis measures ; 3) Al inhibitory effect on CFU-E formation is confirmed by in vitro study as well as in vivo study ; 4) RBC-Al value of 65 μg/10¹³ cells is proposed as the critical value to predict the risk of Al intoxication ; 5) in the rHuEPO therapy of patients having an RBC-Al level higher than this level, removal therapy of Al should be considered. 1994-08-30T15:00:00Z http://hdl.handle.net/10564/1649 タイトル: 角膜における臨界現象 著者: 松浦, 豊明 抄録: Primary corneal opacity investigated by dynamic light scattering indicates that it is due to reversible critical density fluctuations associated with phase transitions of the corneal gel. Critical phenomena normally asstciated with phase transitions the cornea, as well as upon increasing temperature. The critical behaviour dependence upon increasing temperature indicates that hydrophobic interactions, arising from changes in the local entropy of water, are dominate in inducing the phase transition. 1994-08-30T15:00:00Z