高血圧症にたいするReserpine療法中に生じる脊髄伝達回復曲線について : 附:Phenyl-(α-piperidyl)-aceticacid methylester (Ritalin"Ciba")の脳波
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Prof. Schroeder has pointed out the occurrence of Parkinsonism as the rare side effect of Reserpine in his monograph. Despite of its rarity, yet the induced Parkinsonism is worth further studying, because Reserpine is still widely used for the treatment of arterial hypertension in which the myostatic disturbance is not quite seldom found especially among the senile patients complicated with cerebral arteriosclerosis, and moreover the exact site of the action of Reserpine remains still obscure especially with regard to its relationship to the extrapyramidal centres. So that the influence of Reserpine upon the excitability of the cerebro-spinal reflex was investigated by means of prof. J. W. Magladery's method (1955), modified by prof. M. Suzuki and Associated prof. S. Honma in the physiological laboratory, Chiba University, and following results were obtained: A. The daily fluctuation. It is necessary to study the daily fluctuation of the recovery curves of the spinal reflex conduction defined by prof. J. W. Magladery, because of the protracted action of Reserpine. Both supernormal phase and subliminal fringe tend to increase, while the depression time to decrease. These tendencies were strikingly observed in the cases with hyperthyroidsm. Among normal health the supernormal phase measured 52 msec in length, and 25 % in variation rate, the subliminal fringe measured 20 % in amount and 150 % in variation rate. The mean values of the supernormal phase and the subliminal fringe in the arterial hypertensive group were found as much as those in normal health, but the depression time in the former group measured in variation rate twice as long as that observed among the latter. B. The changes in the recovery curve with the use of Reserpine. The augmentation of the supernormal phase was found in eight of ten cases from ninety minutes to six hours after the intramuscular injection of 1 mg. There could not be any constant tendency npon the changes in both depression time and sufliminal fringe.Except for two patients suffered from the marked Parkinsonism already before the treatment, the patients observed here did clinically show neither tremor nor rigidity by the intramuscular injection of 1 mg. The effects of various drugs upon the patients with hypertensive cerebral disease who showed the remarkable Parkinsonism during the Reserpine treatment: The reflex inhibition was seen by the intramuscular injection of 2 cc of 10 % Mephnesin, whereas the reflex was rather enhanced by the intramuscular or the intravenous injection of 4 cc. This augmented reflex was transitorily suppressed with the combined use of phenobarbital, chlorpromazine-S-oxid, and dimetyltubocurarine iodide. Scopolamine hydrobromide showed the striking reflex inhibition, although sometimes there was found some slight and transitory reflex augmentation at the begining and the ending of its effect. Amobarbital did not disclosed the definite effect and strichinin nitrite tended to enhance the reflex action. Appendix: The influence of Phenyl-(α-piperidyl)-acetic acid methylester (Ritalin "Ciba") upon the electroencephalogram. Several reports as to Phenyl-(α-piperidyl)-acetic acid methylester Ritalin (Ciba) were also published in Japan, but the most of them were confined in the neuropsychiatric field. So that some supplementary observations as to Ritalin were made in its internal medical application especially with respect to its effect upon the neurovegetative function and the electroencephalogram. The intravenous injection of 0.5 mg per kilo of Ritalin raised the blood pressure of non-anesthetized rabbit transitorily and slightly, but did not affect the respiration of which amplitude was enhanced with 1 mg per kilo. Immediately after the injection from 2 to 4 mg per kilo the blood pressure went down transitorily, then showed the irregular level owing to the respiratory stimulation and the marked restlessness. In the ecg. there could be seen the sinus tachycardia with or without changes in ST-T.In eeg. there were observed the marked decrease on period and the increase in amplitude especially in the cortical lead due to the intermingle of the fast wave. Although the synergism could not be assured between LSD-25 and Ritalin, there could be seen the slight antagonism between Reserpine and Ritalin, whereas the counteraction between Chlorpromazine and Ritalin was inconstant so far as the dosage in this observation was concerned. Clinically the favourable effect was observed among the hypertensive patients complained of drowsiness. Although the tensionheadache could not usually be cured by the medication of Ritalin, a certain sort of headache found in the depressive patients was satisfactorily improved. The blood pressure tended to be elevated more or less, but the change in heart rate was inconstant. The dysrhythmy in eeg. was converted into the rhythmy among those who showed the clinical improvement, but such an eeg-raphic effect could not be seen in the clinically refractory patients. There were no definite tendency of changes in the mean period, but the amplitude as a rule increased in its amount.
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