[Experimental and clinical evaluation of cefmenoxime in children].
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Biomedical subjects
Publications and source records attributed to H Cho.
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Bile samples were obtained from 13 patients with cholesterol gallstones at laparotomy. Control bile samples were obtained from 15 patients with gastric cancer or gastric ulcer. One mixed stone was cut in half and serial thin sections, 10 micrometers in thickness, were prepared from the cut surface. The solubility of cholesterol in these gallstone sections after immersion in the bile samples was observed microscopically after 1, 3, 5 and 24 hr. Of 15 control bile samples, 9 showed a marked cholesterol dissolution after 1 hr, and 6 showed it after 3 and 5 hr. Three out of 13 bile samples from the patients with cholesterol stones dissolved the gallstone section after 1 hr, and 7 after 3 and 5 hr. The dissolution was not observed in the remaining 3 bile samples. Cholesterol and total bile acid concentrations of the control bile were significantly higher than those of the bile from the cholesterol gallstone patients (p less than 0.05 and p less than 0.02, respectively). Correlative studies of the composition of bile and its ability to dissolve cholesterol revealed that bile samples with a high total bile acid concentration possessed a higher dissolution ability, even when the ratios of total bile acid to cholesterol were almost the same in control and cholesterol gallstone bile. On the basis of these findings, it may be concluded that the solubility of cholesterol in bile cannot simply be explained in terms of relative concentrations of cholesterol, phospholipids and total bile acid, because the absolute concentration of total bile acid also plays a significant role for the dissolution ability.
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The anterior commissure technique of partial laryngectomy is useful for treating "horseshoe" lesions of the larynx. As originally described, a McNaught keel is used after the excision to maintain an open glottic chink and to prevent webbing. After three weeks, this keel is removed as a surgical procedure. During the past four years, we have treated 12 patients using 0.020-gauge Silastic sheeting to replace the McNaught keel. The Silastic sheet is anchored above and below the glottis with externally tied 2-0 proline stutures. Two to three weeks later, a direct laryngoscopy is performed and the stent is removed. This modification avoids a second surgical procedure, decreases the hospital stay, and allows for inspection of the glottis.
The protein in palatine saliva was investigated and compared with that in parotid saliva by means of SDS electrophoretic method. It was found that palatine saliva contains a large amount of high molecular weight protein (higher than 300,000) which is identified as mucin-rich glycoprotein and sialoglycoprotein, while no such protein is present in parotid saliva. The protein composition of palatine saliva has qualitatively smaller individual difference when compared to that of parotid saliva. We suggest that the high molecular weight protein which is specific to palatine saliva probably contributes to the rentention of complete maxillary dentures.
Administration of large doses of vitamin D2 brought about a marked increase of 25-hydroxyvitamin D in both the patients with vitamin D dependency and hypophosphatemic vitamin D-resistant rickets. During the administration of vitamin D2, increment of 1,25-dihydroxyvitamin D was marked in hypophosphatemic vitamin D-resistant rickets, but far smaller in vitamin D dependency. In the latter, however, the 1,25-dihydroxyvitamin D reached the level close to the normal adult values. 1 alpha-hydroxyvitamin D3 was found 50 approximately 100 times as effective as vitamin D2 in 2 patients with vitamin D dependency (optimum maintenance dose: 0.05 micrograms/kg/day). It was concluded that 1 alpha-hydroxylation in the renal tubules is markedly defective in the patients with vitamin D dependency, but that a large dose of vitamin D2 is able to cause a definite increase in serum concentration of 1,25-dihydroxyvitamin D resulting in improvement of the rickets.
A 12-yr-old female patient with an unusual form of vitamin D dependency and alopecia is described. She was a product of consanguineous mating and developed signs and symptoms suggesting vitamin D dependency early in life. Neither 150 microgram/day (6 microgram/kg.day) 1 alpha-hydroxyvitamin D3 nor 5 microgram/day (0.2 microgram/kg.day) 1,25-dihydroxyvitamin D3 proved to have an effect on her abnormal serum chemistry. Seven million international units per day (about 2 x 10(5) IU/kg.day) of native vitamin D restored her serum chemistry to normal and brought about marked improvement on skeletal radiographs, when her serum 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, and 24,25-di-hydroxyvitamin D were 4250, 4.8, and 35 ng/ml, respectively. Even with the high serum levels of vitamin D metabolites, her intestinal 47Ca absorption rate remained in the lower normal range and urinary calcium excretion was decidedly low. Association of hypoparathyroidism was ruled out. These results suggest that the patient has extreme and-organ (intestine) hyposensitivity, probably of congenital origin, to the biologically active metabolites of vitamin D.
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The biological activity of 1(OH) vitamin D3 was evaluated in 2 cases of vitamin D dependency. For the improvement of serum chemistry and increment of urinary excretion of calcium 1(OH) vitamin D3 was 500--1000 times more active than vitamin D2. The administration of 0.05 microg/kg/day and 0.1 microg/kg/day of 1(OH) vitamin D3 were equally effective to keep the serum chemistry within normal limits. However, urinary excretion of calcium increased to an abnormal height on 0.1 microg/kg/day of 1(OH) vitamin D3. On the other hand, administration of 0.05 microg/kg/day of 1(OH) vitamin D3 kept both serum level and urinary excretion of calcium normal. It is suggested that 0.05 microg/kg/day is close to the optimum requirement of 1(OH) vitamin D3 in vitamin D dependency and this should correspond to the essential requirement of 1(OH) vitamin D3 in man.
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Three hundred and ninety three cases of ossicular reconstruction are presented. In the most favourable cases with both malleus handle and stapes present, this presents a closure of the air-bone gap to within 20 dB better than 80%. With connective tissue, underlay and fixation technique and staging are all important aspects of ossicular chain repair. Preservation of the function of the sound conduction mechanism in most favourable cases (malleus handle and stapes arch present) were improved by the employment of a sculptured, fitted incus prosthesis between the handle of the malleus and the head of the stapes.
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