噴門痙攣症のX線学的研究
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Cardiospasm or achalasia. is still considered as a peculiar illness of which pathological entity and developmental process are not clearly understood. Author has attempted to obtain some contributory findings on the basis of careful roentogenological observation on the clinical materials in this department with its special referrence to the esophagus and cardiac portion of the stomach. Morphological changes as well as functional pathology are studied rather extensively, and following informations were obtained. (1) This disease is divided into three groups in our department according to the grade and progress of this disease. It is a general tendency that time of the suffering duration is longer than the disease progress to the higher grades. These facts were proven on the basis of delay in time of barium passage through the esophago-cardiac junction and increase in length and tortuosity of the esophagus. Concommitant illness plus this cardiospasm was also present in many cases. (2) When buscopan was injected, decrease of the esophageal peristalsis, decrease in tension of the esophageal wall and lessning of the spasm of the cardiac portion were recognized. When Mecholyle was given, then peristalsis increased, esophageal tension increase reaction and spasmotic contraction of the esophago-cardiac junction occured. In the group that had Adrenaline injection, decrease in both peristalsis and muscular tension were observed. (3) Evacuation of the swallowed barium through the esophagus was accelerated when Buscopan was loaded than the control group. When Mecholyle was loaded, barium passage through the esophagus was accelerated in Group I while it is delayed in Group II & III. In adrenaline was loaded it all accelerated. (4) Activation of various pharmaceutical agents to the sympathetic nervous system in this particular illness, is greater in the esophagus when the lesion is in the limit of Grade I while the activation stimilates the cardia when the patients in Grade It and III. Most of cases with rather long duration of illness responded poorly to those stimulating pharmacological agents. (5) In general, it appears that the patients with this illness are suffering from the atony of the esophageal wall plus the spasm of the esophago-cardiac junction. Predominancy in parasympathetic nerve, was rather persistent and interesting findings, in the lower thoracic esophagus and cardiac portion of the stomach.
- 千葉大学の論文
- 1964-03-28
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