Biomedical subjects
Publications and source records attributed to H Abe.
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The authors report two cases of bitemporal compression injury caused by a static loading mechanism. These head injuries resulted from gradual bitemporal compression of the head. Plain skull films showed multiple skull fractures, and carotid angiography revealed internal carotid artery obstruction at the base of the skull. Neurological examination disclosed a slight disturbance of consciousness, hemiparesis, multiple cranial nerve injuries, and Horner's syndrome. In comparison with impact head injury, the energy from this type of trauma tends to be transmitted to the foramina and hiati of the middle cranial fossa and results in multiple injuries to the cranial nerves, sympathetic nerves, and blood vessels.
The authors describe seven cases of cervical spondylosis in which small high-density areas were detected in the spinal cord on delayed computerized tomographic (CT) myelography. These high-density areas are believed to represent cavities or areas of cystic necrosis. In all seven cases the cervical spinal canal was narrow, and the spondylosis was located at multiple levels, causing a so-called "pincer effect." On the CT scans the high-density areas resembled fried eggs in the gray matter. These areas were localized near the abnormal cervical discs. In two cases in which the Brown-Séquard syndrome was noted, the symptoms could be attributed to the morphology of the high-density area on the affected side of the cord. Following decompressive surgery, most of the symptoms improved except for numbness of the upper extremities and motor weakness of hands.
Intraperitoneal injection of hypertonic glucose solution induced intracranial hemorrhage in rats. Simultaneously determined plasma norepinephrine exponentially increased followed by death. Using in vivo voltammetry, the present study was undertaken to estimate the relationship between neurochemical parameters and intracranial bleedings induced by hypertonic glucose injection. When placed in a solution of dihydroxyphenylacetic acid (DOPAC) and 5-hydroxyindole acetic acid (5-HIAA), electrically pretreated carbon fiber electrodes produced a 3 distinct peaks. Peak 1 and 2 refer to the extracellular fraction of ascorbic acid and DOPAC. Peak 3 refers to that of 5-HIAA. The peaks of the voltammograms obtained in vivo from different areas of the brain are similar to those observed in vitro using DOPAC and 5-HIAA solutions. Electrodes implanted in the ventricular CSF showed that DOPAC increased immediately after glucose injection, while 5-HIAA did not change significantly. When the electrode was inserted into the putamen, 5-HIAA exponentially increased followed by death, whereas DOPAC showed only a small change. It was presumed that the stroke-induced major oxidizable compounds are different in the lateral ventricle and the putamen. These results suggest that during cerebral bleeding, plasma norepinephrine increases accompanied with a potentiation of the central DOPAC and 5-HIAA system in rats.
Intraoperative ultrasonography was performed during craniotomies for nine cases of primary brain tumor. B-mode real-time linear scanner with a small probe head has proven to be extremely useful for detecting and localizing subcortical or deep seated brain tumors. The sonography clearly showed the tumors as hyperechogenic mass except in one case, calcifications as more echogenic particles, cyst as hypoechogenic area. Physical principles of echogenicity are discussed, and major advantages and disadvantages of intraoperative ultrasonography in neurosurgery are mentioned.
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Controlled, prospective, randomized studies were performed to evaluate the effects of 1-(4-amino-2-methyl-5-pyrimidinyl)methyl-3- (2-chloroethyl)-3-nitrosourea hydrochloride (ACNU) and ACNU plus tegafur as additions to radiotherapy for the treatment of malignant gliomas. In the first trial, 105 patients with glioblastoma or anaplastic astrocytoma were randomly divided into two groups after surgery and received radiotherapy (RT, 40 to 60 Gy to the whole brain), or radiotherapy plus concomitant chemotherapy with ACNU (100 mg/m2 on day 1 and 42). Effects of the treatment were compared in 82 evaluable patients from results of CT scans taken before and one month after the completion of radiotherapy. The regression rates more than 50% of the tumor size were observed in 15.0% of patients treated with RT alone and in 47.6% of patients treated with RT plus ACNU. The difference was statistically significant (p less than 0.005). In the second trial, 87 patients were randomly divided into two groups and received RT plus ACNU, or RT plus combined chemotherapy with ACNU and tegafur (400 mg/m2, daily for 8 weeks). Sixty-nine patients were within the valid study group. The regression rates more than 50% of the tumor size were observed in 34.2% of patients treated with RT plus ACNU: and in 41.2% treated with RT, ACNU plus tegafur. No statistical difference was noted in the response rate between the groups. These results indicate that ACNU is an effective agent in conjunction with radiotherapy for patients with malignant gliomas, and that tegafur does not enhance the effectiveness of ACNU.
A 60-year-old female complained of gross hematuria and urinary frequency on November 27th, 1982. Cystoscopic examination revealed papillary invasive tumor around the bladder neck and a transurethral biopsy showed signet ring cell carcinoma. Since there was no adenocarcinoma in any other organs, we diagnosed it as primary signet ring cell carcinoma of the urinary bladder. Total cystectomy with ileal conduit and post-operative irradiation were performed, but she died on May 13th, 1983. We summarize 16 cases of primary signet ring cell carcinoma of the urinary bladder including this case and discuss this rare condition.
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Interleukin 1 (IL 1) production by normal human B lymphocytes was investigated. Normal human peripheral blood B lymphocytes were purified by sequential separation with the use of Ficoll-Hypaque gradient centrifugation, sheep red blood cell rosette formation, Percoll gradients, and treatment with monoclonal antibodies (anti-Leu-M1, B73.1, and T101) and complement. Both purified large B lymphocytes (BL) and small B lymphocytes (BS) produced IL 1-like (thymocyte co-mitogenic and fibroblast mitogenic) activities in response to lipopolysaccharide. Maximal production of IL 1 activity by both BL and BS occurred at 48 hr. The m.w. of IL 1 activities from both BL and BS were about 20,000 with high pressure liquid chromatography, and the major isoelectric point of BL- and BS-derived IL 1 activity was 7.0. A rabbit anti-human monocyte IL 1 antiserum inhibited the activity of B cell-derived IL 1, suggesting antigenic similarities of monocyte- and B lymphocyte-derived IL 1 moieties. These data suggest that normal B lymphocyte-derived IL 1 activity is biochemically and immunologically similar to monocyte-derived IL 1.
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A case of an anteriorly located meningioma in the region of the foramen magnum, successfully treated by a transoral approach, is reported. A 60-year-old woman was admitted to the author's department on January 19th, 1983. Six years before admission, she began to experience the gradual cold dysesthesia in the both palms, and then developed gait disturbance, clumsiness of the right hand and a stiffneck. She was found to have atrophied hands, mild spastic tetraparesis, ataxia and hypalgesia under the bilateral C2 spinal levels. A CT scan disclosed a patchy hyperdense lesion, which was enhanced homogenously with contrast medium, occupying almost all the intradural extramedullary space at the foramen magnum. The transoral approach was employed following preliminary tracheostomy. The tumor, extending about one centimeter superiorly to the basion and inferiorly to the upper border of C2 body, was removed completely, and then the dural defect was covered with a piece of fascia and gelform. An anterior occipitocervical fusion was performed extending to C2 using a block of an antogenous iliac bone. Post-operatively immobilization was secured by a Halo-Vest. But unexpectedly, CSF leakage was disclosed several days after the surgery without neurological deterioration. On the 17th day following first surgery, a re-operation was performed. The dural defect was successfully repaired with a piece of fascia by interrupted sutures in an illustrated fashion (Fig. 5). A piece of muscle was then placed in the epidural space created by bone removal. A fusion of the atlanto-axial joint not extending to the basiocciput was employed.(ABSTRACT TRUNCATED AT 250 WORDS)
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Multicenter clinical trial or TMS-19-Q.O tablet was performed to evaluate the usefulness in oral surgery. The results obtained were as follows: Clinical efficacy was assessed by clinical points. The patients entered into the trial were 77 cases with periodontitis, 23 with pericoronitis, 92 with osteitis of jaw and 18 with other infections, and the each effective rates were 80.5, 60.9, 83.7 and 72.2%, respectively. Overall effective rate was 79.0%. Isolation frequency of organisms were 33.8% in periodontitis, 34.8% in osteitis of jaw and 17.4% in pericoronitis. Bacteria isolated were aerobic organisms (63.1%) and anaerobic organisms (36.9%). TMS-19-Q.O tablet was well tolerated, and no adverse reaction was observed.
Clinical efficacy and safety of TMS-19-Q.GC tablet (TMS), a new macrolide antibiotic preparation, were compared with those of josamycin (JM) in the treatment of acute odontogenic infection under multicentered double-blind controlled study at the daily dosage of 600 mg of TMS or 1,200 mg of JM. The results obtained were as follows: The patients entered into the study were 265 cases and 112 in TMS group and 111 in JM group were adopted to evaluate for the efficacy. The evaluation was made by 2 ways i.e. changes in total clinical scores of the symptom and the doctors assessment. Efficacy rating of TMS and JM were 81.3 and 82.0% judged by the score and 73.2 and 77.5% judged by doctors in charge respectively. In the cases with 15 to 20 of total scores at the initial visit, considered to be suitable for the evaluation of antibiotics, the efficacy rating of both drugs were 86.7% in TMS and 84.6% in JM. Organisms were isolated from 34 cases in TMS and 40 in JM and the clinical effectiveness in those cases were almost the same. Slight adverse reactions were observed in 6 cases (4.6%) of TMS group and 1 (0.8%) of JM. In 3 cases (4 incidences) of TMS group and 1 of JM slightly abnormal laboratory findings were found. On the statistical analysis of the data regarding efficacy, safety and usefulness, both drugs had no significant difference. From these results, TMS was considered as effective as JM in the treatment of acute odontogenic infection at a daily half doses of JM.
A comparative double blind study of lenampicillin (LAPC, KBT-1585) and talampicillin (TAPC) was carried out in order to objectively evaluate efficacy, safety and utility of LAPC in treatment of 238 patients with oral infections. Cases accepted by the Central Committee for evaluation of efficacy and utility were 218, consisting of 101 of the LAPC group and 117 of the TAPC group; safety were 234, consisting of 110 of LAPC and 124 of TAPC. Clinical effectiveness as rated by attending doctor was 84.2% for the LAPC group and 82.9% for the TAPC group. The clinical utility rating was 82.2% in the LAPC group and 82.1% in the TAPC group, showing no significant difference between the 2 drugs. Adverse reactions were found in 6 cases (5.5%) in the LAPC group and 5 cases (4.0%) in the TAPC group, showing no significant difference between the 2 drugs. Cases accepted by the controllers for evaluation of efficacy and utility were 236, consisting of 111 cases of LAPC and 125 cases of TAPC. Those for safety were 236, consisting of 111 cases of LAPC and 125 of TAPC. The clinical effectiveness rating was 77.5% in the LAPC group and 79.2% in the TAPC group. Clinical utility rating was 75.7% in the LAPC group and 78.4% in the TAPC group. Rate of adverse reactions was 5.4% in the LAPC group and 4.0% in the TAPC group, showing no significant difference between the 2 drugs. Cases evaluated for efficacy according to numerical rating on the 3rd day were 200 cases, consisting of 93 of LAPC and 107 of TAPC. The effectiveness rate was 83.9% in the LAPC group and 95.3 in the TAPC group, showing a significant difference between the 2 drugs. On the other hand, taking into consideration evaluation scores of the 5th day, the effectiveness rate was 88.7% in the LAPC group and 96.1% in the TAPC group, showing no significant difference between the 2 drugs. The effectiveness rate in cases of isolated organisms was 84.9% in the LAPC group and 79.7% in the TAPC group, showing no significant difference between the 2 drugs. Adverse reactions were mostly of gastrointestinal origin. Symptoms were not serious and disappeared soon after administration was discontinued or immediately after administration was completed.(ABSTRACT TRUNCATED AT 400 WORDS)
Post-traumatic or post-operative immobilization of cervical spine often requires long term bed-rest. But, bed-rest indeed gave discomfort to patients, nonetheless, sometimes complete external fixation cannot be gained. Since 1982, we have applied Halo vest to the patients who required external immobilization of cervical spine. In this paper, we reported our experiences with 31 cases who were treated by Halo vest. Thirty-one cases comprised 19 cases of cervical spinal trauma, 5 cases of atlanto-axial dislocation, 1 case of foramen magnum meningioma, and 6 cases of ossification of posterior longitudinal ligament (OPLL). In traumatic cases, Halo vest was used as external fixation of injured spine in 8 cases, and as an adjunct to surgical fusion in other cases. In case of atlanto-axial dislocation, 3 cases underwent posterior fusion, and 2 cases underwent anterior fusion. Anterior fusion of C1-2 was also done in case of foramen magnum meningioma after total excision of tumor. Six cases of OPLL underwent anterior decompression and anterior fusion. Mean immobilization time by Halo vest was as follows: 58 days (28-113) in case of cervical spinal trauma, 85 days (56-144) in case of atlanto-axial dislocation who underwent posterior fusion, 92 days (89-93) in case of atlanto-axial dislocation and foramen magnum meningioma who underwent anterior fusion, 59 days (54-70) in case of OPLL. Early ambulation was achieved in many cases. Good external fixation and result was obtained 27 cases out of 31 cases. Re-dislocation of cervical spine occurred in 1 case of cervical spinal trauma while he was in Halo vest.(ABSTRACT TRUNCATED AT 250 WORDS)