[Hokkaido igaku zasshi] The Hokkaido journal of medical science
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Hokkaido Igaku Zasshi · Jan 1987
Case Reports[Alteration in coagulation and fibrinolysis after burn injury and significance of anticoagulation therapy using heparin and antithrombin III concentrate].
Burn injury causes dynamic alterations in the coagulation and fibrinolysis, and so-called DIC often occurs in burned patients. In this study the clinical significance of heparin therapy combined with antithrombin III concentrate in animal experiments and clinical experiences were discussed. The changes in blood coagulation, fibrinolysis and kidney function and the effect of anticoagulation therapy using heparin were investigated in rabbits with third degree burn covering 35% of the total body surface area. ⋯ The antithrombin III plus heparin group showed slightly better results than the antithrombin III group in Ucr/Pcr ratio, creatinine clearance and CH2O. The results of the present study indicate that it is extremely effective to initiate appropriate fluid infusion therapy immediately after a burn and administer antithrombin III concentrate in combination with or without heparin for the prevention of acute renal insufficiency in patient with a severe burn. The effects of antithrombin III concentrate when used clinically were also discussed.
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Hokkaido Igaku Zasshi · Nov 1985
[Study on the genesis of atopic dermatitis--atopic dermatitis and IgE].
For the purpose of investigating how IgE is correlated in the genesis of Atopic dermatitis (abbreviated as AD) micronizing method of RIST (necessary serum 10 microliter) was utilized. Serum IgE obtained from 369 cases AD, age ranged from 1 month old to 52 years old were studied. In 78 cases, IgE of the objects' parents were also studied as well. ⋯ In the Scratch test immediate type of reaction could not induce eczematous lesion of AD. Induction of eczematoid reaction in AD was noted with high incidence following the Scratch test of Candida antigen. From the above it is assumed that in AD, although serum IgE level is high, induction of eczematous lesion could not be made by skin invasion of specific IgE antigen to the skin, pruritus by immediate type of reaction following release of chemical mediator will bring the tearing off the skin by scratch and invasion to the epidermis of inflammation inducing materials like human dander, sweat, bacteria or mycological agents eczematous lesion will start to take place.
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Diseases which manifest with the respiratory distress in the newborn include 1) respiratory diseases-IRDS, type II RDS, neonatal asphyxia, and MAS etc. 2) anemia, CHD 3) CNS and 4) metabolic diseases. Among these, IRDS has high mortality rate because of the lack of the pulmonary surfactant and immaturity of respiratory center, and has many difficult problems in terms of its prevention and respiratory management. The points of its respiratory management are as follows: 1) Estimation of the level of arterial oxygen ation-this is the most important point. ⋯ In MAS, pneumothorax, pneumomediastinum and severe asphyxia, the proper resuscitation, oxygen administration should be given according to several conditions, especially the degree of hypoxia. The peritoneal dialysis can be lifesaving in case of severe renal impairment with RD. As the respiratory distress in the newborn is very frequent in its occurrence and death rate, its proper management is expected to result in the decrease in the newborn death rate in Hokkaido (8.1--6.6 per 1,000 live births) and the increase in the survival rate without any handicap, particularly if hospitals in each Hokkaido district give the newborn medical care more intensively than at present.
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Hokkaido Igaku Zasshi · Jan 1978
[A clinical study with apexcardiogram, kinetocardiogram and carotid pulse tracing in aortic insufficiency (author's transl)].
The apexcardiogram, kinetocardiogram and carotid pulse tracing were studied in 24 normal subjects and 20 patients with aortic insufficiency. The electrocardiogram and phonocardiogram were recorded simultaneously as the time reference. The study of the carotid pulse tracing and systolic time intervals was made using the injection of methoxane and inhalation of amyl nitrite. ⋯ In contrast, amyl nitrite decreased total peripheral resistance and produced a significant decline in the ratio of the height of the tidal wave to that of the percussion wave. In conclusions, the carotid waves contain two systolic maximums, the percussion wave and tidal wave, the former related, at least in part, to peak blood volume and the latter to aortic pressure. Comparing with systolic time intervals in aortic insufficiency and that of normal cases, the patients with aortic insufficiency had statistically significant increase in the ejection time index and pre-ejection time, especially after the injection of methoxamine.
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Hokkaido Igaku Zasshi · Sep 1975
[On the intracerebral hematoma --clinical analysis of 105 operated cases-- (author's transl)].
The hematomas occupied between the inner surface of skull and brain surface are well known and the majority of these intracranial hematomas are elicited by head injury. On the other hand, the intracerebral hematomas formed in the brain tissue are produced by the various causative diseases and the majority of these cause are cerebrovascular disease. The causative diseases of intracerebral hematomas were cerebrovascular diseases like hypertension, intracranial aneurysm and cerebral arteriovenous malformation in 65.7% and head injury in 32.4%. ⋯ Consciousness change in patients of spontane intracerebral hematoma were only 50.0%. Motor disturbance as clinical symptom were 85.0% in hypertensive intracerebral hematoma and this frequency was highest in all causative diseases. The frequency of coincidence between the side of dilated pupil under anisocoria and the side of hematoma was less than 50.0% in average and this frequency was marked lower by compared with the frequency in patients of hematome formed between the skull and brain surface.