循環疾患における実験的,ならびに,臨床的研究

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Part I. Studies upon hypertensive cardiac disease Taking the by-path of the pressoreceptoric nerve into account, Eb. Koch's unbridling ("Entziiglung") operation is modified to some extent. Within 40 or 60 days the cardiac hypertrophy in company with dilatation can be found in all experimental hypertensive animals macroscopically or histologically. The arteriosclerosis of the unbridled rabbits can be observed mainly in aorta, and is histologically characterized with media fibrosis, of calcification. In the most part of the group additionally injected with cholesterol-vegetable oil, there occured coronary sclerosis, with media hypertrophy or degeneration occasionally in company with cloudy swelling or atrophy of tubuli of the kidney, although the renal lesions are, as a rule, not severe. The lesions of the kidney observed in unbridled rabbits are sure to appear later than those of heart and aorta. This kind of experimental hypertensive rabbit is lacking any significant renal functional disturbance. Epinephrine injected everyday facilitates the formation of the experimental arteriosclerosis found in unbridled hypertensive rabbits, however, this additional' procedure does not bring out the atherosclerosis, but merely enhances the arteriosclerosis of Monckeberg's type which develops occasionally to the dissecting aneurysma due to media necrosis. The electrocardiograms of experimental hypertensive rabbits show the axis deviation or the ventricular strain in conformity to blood pressure level x time duration, and there can be observed not only the left ventricular preponderance but also the right ventricular. Corresponding to the stage of the tonic dilatation of the left ventricle which results the longitudinal prolongation of the heart, there are possible to take place the right axis deviation in the standard leads and the semiperpendicular form in Goldberger's leads. The typical left ventricular hypertrophy curve appears at the stage of the muscular or "Quer"-dilatation of heart in unbridled rabbits. At autopsies of this kind of hypertensive rabbits, it was elucidated that the cardiac hypertrophy initiates from the outflow area to the inflow in accordance with Kirch's observation. These electrocardiographic findings do not mean the contradiction to the left ventricular burden due to experimentally elevated blood pressure. Even in clinical, praxis at the relatively early stage of the arterial hypertension there can not rarely be shown the right axis deviation attended with semiperpendicular form due to the tonic dilatation, indifferently from the level of diaphragma or the deferfnity of thorax. There is mentioned the clinical differentiation between the ecg of the tonogen dilatation seen in compensated hypertensive heart and that of the right ventricular strain sometimes found in decompensated. Part II. Clinical and morphological observation of cardiac states accompanied by the dysproteinaemia, with special reference to the myocardosis (Wuhr-mann) Recently special notice is taken upon a certain pathological state under the idea of the myocardosis which is characterized with circulatory symptoms attributed to the dysproteinaemia among various diseases. There is found haemodynamically ungrounded brady-, or tachycardia which is more or less refractory against digitalis-preparates. This state tends also to show weakness, dyspnea, cyanosis, splitting of the first cardiac tone, edema occasionally without .significantly elevated venous pressure and especially arterial hypotension. In ecg there can be observed the prolongation of PQ and QT interval, the depression of ST segment. The second cardiac tone occurs often so early that Q・2 tone interval is shorten (Hegglin), accompaning sometimes dyselectrolytaemia, especially, the shifting of K. These symptoms are for the most part (Kinoshita et al.) coined with the sense of energic-dynamic insufficiency of the heart (Hegglin's syndrome). There appear not seldom intraventricular conduction disturbance, flatened or negative T wave and general low voltage. Histologically there can be found swelling of myocardial fibers with characteristically marked striation which develop until the complete destruction and the sarcolysis, further the fibrosis. At the early stage when the noxious changes are improved, the symptoms are used to recover slowly, however, at the advanced stage the hepatic disorders (disappearance of fatty and glycogen deposition, changes of cellular nucleols) take place indifferently from the existence of the underlying disease in liver. Wuhrmann explains that the dysproteinaemia is not necessarily the only clue of the diagnosis for the myocardosis intra vitam. This saying may be properly understood that the disturbance of the protein metabolism is the substantial pathognomic factor in the myocardosis, and this substantial factor does not always appear as the dysproteinaemia in the blood phase.
千葉大学の論文

循環疾患における実験的,ならびに,臨床的研究

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