http://hdl.handle.net/10564/2067 1990-04 2026-04-10T15:40:41Z http://hdl.handle.net/10564/2074 タイトル: 開心術におけるBリンパ球機能の変動 著者: 平井, 勝治 抄録: The present study was attempted to elucidate the mechanism which account for modification of immunoglobulin synthesis following open heart surgery. Operations have been performed on 20 cases of coronary artery disease, 12 cases of acquired valvular disease and 4 cases of congenital heart disease using cardiopulmonary bypass (CPB). As an assessement of B lymphocyte function in vitro, protein A plaque method (Gronowicz) was employed ; numbers of IgM, IgG plaque forming cell (PFC) induced by staphylococcus aureus Cowan 1 (SAC) and pokeweed mitogen (PWM) decreased immediately after CPB and the decrease continued for as long as three days. Interleukin-2 (IL-2) production in mononuclear cell (MNC) was significantly suppressed after CPB, but Interleukin-1 production was not. The numbers of IgG PFC provoked exogenous IL-2 were attenuated following cardiac surgery in these patients. In conclusion, these results suggested that following CPB, suppression of IL-2 production in MNC and attenuated respense to exgenous IL-2 were correlated to the impairment of the B lymphocyte function. The clinical application of immunomodulators may be useful in making a defense against bacterial and viral infections resulting from the depression of antibody production after open heart surgery. 1990-04-29T15:00:00Z http://hdl.handle.net/10564/2073 タイトル: 「登校拒否」現象に関与する環境要因の検討 著者: 圓山, 一俊; 井川, 玄朗; 山下, 節義 抄録: As reported in the previous paper, an analytical study of the growth environment of children refusing to attend school revealed the involvement of school refusing-inducing factors associated with the family environment (K factors) and those associated with the school environment (G factors) in the occurrence of children's refusal to attend school. The four specific factors included a weak father-child relationship, a weak mother-child relationship, a deficiency of companionship and a conflicting situation originating from school. In the present study, subjects who had at some time refused to attend school were studied to examine whether or not these four factors were necessary and sufficient conditions for the occurrence of children's refusal to attend school, and family, school and district environments were analyzed in connection with these four factors. Also investigated was future orientation as to prevention and treatment of school refusal on the basis of case-by-case course observation. The results are as follows : 1) In all cases examined, all the four factors mentioned above were involved in the occurrence of school refusal. 2) The school refusal phenomenon is induced by synergistic effects of family, school and district environments, which are determined by socioeconomic conditions. 3) From prophylactic and therapeutic points of view, it is essential to improve family, school and district environments for elimination or relaxation of the above-mentioned 4 factors. 1990-04-29T15:00:00Z http://hdl.handle.net/10564/2072 タイトル: 肝移植におけるV-V bypassに関する実験的研究 ： 血行動態と移植肝の早期代謝機能監視の立場より 著者: 山下, 治 抄録: The anhepatic period of orthotopic hepatic transplantation is commonly accompanied by specific cardiovascular disorders due to the occlusion of portal and inferior vena caval systems. The present study was undertaken to elucidate the effect of veno-venous bypass (v-v bypass) on hemodynamic and early metabolic function of 16 dogs with hepatic allografts under mechanical ventilation with barbiturate and muscle-relaxants. (Fio₂ : 0.21, Vт=10 ml/kg, f : 10/min.) The dogs were divided into two groups which one group has been performed with stable pressure in systolic, portal and inferior vena cava : functional v-v bypass group (n=8), and poor-functional group (n=8). The survival rate of the functional group was 75% and of the poor-functional group 38%. In comparative assessment of v-v bypass functional and poor-functional groups, the following parameters were determined : pH, Pco₂, Po₂, Base Excess (arterial, portal and inferior vena caval venous), arterial ketone body ratio (AKBR), pyruvate to lactate ratio (P/L), branched-chain to aromatic amino-acid ratio (BCAA/AAA) and hepaplastine test (HPT). These considerations suggest that the monitoring of hemodynamics and metabolic functions play important roles in successful hepatic transplantation. 1990-04-29T15:00:00Z http://hdl.handle.net/10564/2071 タイトル: 脳静脈血行障害時の脳循環動態と病理学的変化に関する研究 著者: 辻本, 正三郎 抄録: In cerebral circulation, there are many detailed reports of arterial circulatory disturbance but few reports of venous circulatory disturbance. In Experiment Ⅰ, regional cerebral blood flow (rCBF) and intracranial pressure (ICP) response to transient superior sagittal sinus (SSS) occlusion were measured in twenty-one anesthetized cats. Cats were divided into three groups according to the duration of SSS occlusion (1, 3, 6 hours). Irreversible changes, such as no recovery of rCBF, thrombosed parenchymal vessel, and loss of nouronal cell, were observed in groups with more than 3 hours' occlusion. Consequently it was suspected that the time limit of transient cerebral venous occlusion was 3 hours. In Experiment Ⅱ, diameter of pial vessels and ICP response to complete cerebral venous occlusion were measured continuously in thirty anesthetized cats. 0.3 ml of cyanoacrylate were injected into anterior SSS to occlude the SSS and cortical veins. Six hours after injection the state of blood-brain-barrier disruption and pathological changes were evaluated. As for the response of pial arterioles in early stages, 2-24% contraction of arteriole was observed in fifteen cats and 2-16% dilatation was observed in six cats. In later stages, 1-87% dilatation of arteriole was observed in ten cats. The elevation of ICP and dilatation of arteriole were observed in the same period. Pathologically intracerebral hematoma (ICH) was observed in eight cats. These were all in the white matter of suprasylvian gyrus. In all ICH cases, two marginal veins surrounding the gyrus were occluded by cyanoacrylate. The dominant mechanism of CBF control is metabolic, not myogenic. According to this theory, the contraction of arteriole cannot be explained. This suggests that pial arterioles contract on very high venous pressure (transmural pressure). Consequently it was suspected that with very high venous pressure, more than 30-100 mmHg, the dominant mechanism is myogenic. Occlusion of adjoining two marginal veins causes severe circulatory disturbance such as brain swelling and ICH. 1990-04-29T15:00:00Z