扁桃性病巣感染における末梢循環病態生理に関する研究
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Report 1. On the Disturbances of the Microcirculation, especially on Sludge Phenomena.Microscopic study on the disturbances of the microcirculation in vivo in the conjunctival vascular beds was performed before tonsillectomy in 205 cases and after tonsillectomy in 130 cases.Results obtained were as follows:1) Morphological changes such sas considerable constriction and dilatation, tortousity, reduction of blood flow, spasm, stasis, ecchymosis, ishemia and muddy appearances were much more frequently found in the cases with tonsillar focal infection.2) Sludge phenomena were found in 78.2% in tonsillitis chr. focalis, whereas in 32.4% in tonsillitis chr. simplex.3) After tonsillectomy sludge phenomena (S. p) certainly decreased in 64.8% of tonsillitis chr. focalis following to some objective improvements, whereas in 22.0% of tonsillitis chr. simplex.4) A slight, however certain influences in blood sludges were observed in half out of 50 cases examined, according to the increase of vasomotor reflex caused by cold stress.5) Through electron microscopic study, sludged erythrocytes in 5 cases were compared with those of relatively haelthy two (one quite normal, the other tonsillitis chr. simplex).a) By bloch's method, marked coatings on the surface of sludged erythrocytes were proved in all of 5 cases.b) By ultra thin slice method, certain string-like shadows were more frequently observed in sludged blood instead of the coatings just above related, while normal and healthy red cells revealed electron-microscopically no morphological changes.Report 2. On Sludge TestIn order to study sludge phenomena in vitro on a slide glass, sludge test (S. t) was examined before tonsillectomy in 204 cases and after tonsillectomy in 126 cases.Results obtained were as follows :1) Before tonsillectomy, S. t wasre positive in 78.2% of tonsillitis chr. focalis, whereas in 27.9% of tonsillitis chr. simplex.2) After tonsillectomy blood sludging subsided in 57.7% and enhanced in 8.5% of tonsillitis chr, focalis, whereas in 22.0% and in 12.2% in tonsillitis chr. simplex.3) Sludge phenomena in vitro, as for S. t, had more than 80% related with that in vivo.4) S. t was highly related with B. S. R. (especially with 30 mts R.)5) At low temperature (0°-4°C) S. t was considerably enhanced, whereas at high temperature S. t was sometimes enhanced or sometimes subsided. S. t was also influenced according to the changes of colloidal medium.6) S. t positive means clinically dysproteinaemia and the test is available for a screening test.Report 3. On Dermal Capillary ResistanceDermal capillary resistances were examined before tonsillectomy in 184 cases and after tonsillectomy in 125 cases.Results obtained were as follows:1) In 58.8% of tonsillitis chronica simplex and in 81.0% of tonsillitis chronica focalis, capillary resistance before tonsillectomy was lower than normal value.2) As for tonsillar systemic diseases, capillary resistances of nephritis patients (17) indicated 118±15.9mmHg (negative pressure) before tonsillectomy, but after tonsillectomy moderately improved (153, 1±17.41nmHg); slight fever (20) from 146.2±21.7mmHg to 193±14.4mmHg, rheuma (43) from 123.3±8.0mmHg to 153.1±17.4mmHg. tonsillitis chronica simplex from 158.0±15.8mmHg to 171.8±13.5mmHg.3) Capillary resistences of S.p and S. t positive groups were more fragile than those of S. p and S. t negative groups.4) Petechial test showed similar results to those with Miyao's apparatus.
- 社団法人 日本耳鼻咽喉科学会の論文