10%,および,7.5%酸素吸引が心・脈管,および,呼吸機能に及ぼす影響,とくに,狭心症の診断的価値について
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Part I. The primary reaction caused to 10 % O_2 inhalation is sometimes covered with the secondary, deeply due to the compensatory mechanism of the ptimary, therefore the results appear not seldom to be diverse from case to case, and their explanations get occasionally into a difficulty owing to both variability of the data of the observation and complexity of the mobilization of the compensation. On the other hand 7.5% oxygen inhalation clinically discloses the fairly constant data such as those found during an extreme induced anoxia. The magnitude of the circulo-respiratory response of either 10 % or 7.5 % oxygen inhalation can be different from case to case accrding to the individual extent of the cardiopulmonary reserve power. 1. The circulo-respiratory responses, both immediate and delayed, in the sense of Comroe, took place more early and more markedly in 7.5 % oxygen inhalaiion than in 10 % in 19 cases with cardiovascular diseases in addition to 4 cases with normal health. 2. So far as the provokation of the anginal attack is concerned, there could not be observed any striking difference between 7.5 % and 10 % oxygen inhalation. 3. From the stnd-point of the arterial oxygen saturation, the mobilization of the homeostatic factors due to induced anoxia of both 7.5 % and 10 % oxygen inhalation was completed about at 7' from the begining, so that the precise examination was used to be performed at this time-point. a. The minute ventile volume increased above 50 % in the group of 7.5 % oxygen inhalation; this amount of the increase was larger than that found in the group of 10 % oxygen inhalation. However the CO_2 content of the arterial blood did not show any tendency to be augmented in both groups, so far as the inhalation time used here is concerned. b. As to the time-relationship of expirium and inspirium, as a rule, the expirium was distinctly prolonged by means of the inhalation, then the inspirium was lengthend after the switch on low oxygen content to room air. c. 7.5% oxygen inhalation augmented cardiac output from 30% up to 170%. Even if the arterial saturation grade decreased more than that incuced by 7.5 % oxygen inhalation, 10 % oxygen inhalation did not augment cardiac beyond 100 %, so far as the extent of the induced anoxia observed here is concerned. d. The influence upon the total peripheral vascular resistance showed clear-cut difference between two kinds of inhalation. The lower the arterial saturation grade was, the smaller the total peripheral vascular resistance was. But the total peripheral vascular resistance at 10% oxygen inhalation, even after 7' when the arterial oxygen saturation grade should be further lowered, did not become less than that at 7.5 %. The remarkable reduction of the total peripheral vascular resistance found at 7.5 % oxygen inhalation could not be explained at least only by the acid dilatation of vessels in the sense of Fleisch et al. e. The volume elastic coefficient also varied differently from case by case; its decrease was found in the greater part of cases with the hypertensive regulation and in the lesser with the normotensive, while its increase was observed in the patients with advaced degree of Keith-Wagener's classification, some part of cases with the normotensive regulation and patients with the hypotensive regulation. The volume elastic coefficient of the individual with the normotensive regulation fluctuated to some extent during the inhalation. f. While the systolic pressure tended to be lowered among the group inhalated with 10 % oxygen, it tended to be elevated among that with 7.5 %, although both decreasing and increasing rates were not so large. g. The diastolic pressure had a tendency to be lowered in two sorts of group, however among the group inhalated with 7.5 % oxygen the reducting tendency was greater, so that the pulse pressure became larger. h. ASZ ("Anspannungszeit") and ATZ ("Austreibungszeit") decreased in length among both two groups, but the diminishing rate during 7.5 % oxygen inhalation was more marked than that during 10%. i. The reduction of electrical and mechanical systolic duration due to 7.5 % oxygen inhalation were more evident than those due to 10 %. j. The occurrence of so-called anoxic ecg. depended on the sorts of disease, their severity and the degree of the lowering of the arterial oxygen saturation. Two sorts of groups had the tendency to show abnormal ΔαG, decreased <Gj>^^^^, right deviation of <αQRS>^^^^ and left deviation of α<Tj>^^^^. k. Amplitude and period length of eeg. increased in their amount more strikingly among the group inhalated with 7.5 % oxygen than among that with 10 %; the slow waves could be seen in 16 of 23 coses. However the appearance of both slow waves and anginal attacks did not significantly differ in their frequencies between twe groups. Part II. By means of the analysis of both subjective claims and cardiorespiratory findings the diagnostic evaluation of 10 % O inhalation was performed with special respect to the influence of so-called coronary vasodilatators. The provokation rate of 10 % O inhalation for 20' remained relatively low, i.e., typical anginal pain accompanied with marked coronary ecg. could be seen only one among 16 cases; this one case had been suffered from the discomfort in his chest. The other five patients were provided with the discomfort; 3 of those cases showed either precordial discomfort anginal attack in their anamneses. The provokation did not take place in No. 14 who had been suffered from both angina pectoris and severe discomfort in his chest. In five normal cases there occurred no specific subjective claims. In order to investigate the value of so-called coronary dilatators, 10 % O inhalation was performed before and after the injection of the coronary vasodilatators, theophylline derivate or "Lacarnol". However the complete control of anginal pain or precordial discomfort was possible only in No. 11 among all cases, and the effect upon the other patients, even if appeared, could not be highly appreciated.
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