A case of syringomyelia: electrophysiological analysis and treatment for attacks of periodical spasms and intractable pain.
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Biomedical subjects
Publications and source records attributed to K Taguchi.
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Following results were obtained from intravenous single administration of cefotaxime 2 g by measuring its levels in uterine arterial blood, elbow venous blood, ovary, oviduct, several sites in uterine tissue, and in the fluid excreted in the dead space formed by radical hysterectomy. (1) Uterine artery and elbow vein blood levels revealed marked increase immediately after administration followed by gradual reduction at slow rate. (2) Peak levels in female internal genital organ tissue were achieved 12 approximately 19 minutes after cefotaxime administration, and ranged between 5 to 8 mcg/g independently from measurement site. In cervix uteri, portio vaginalis high concentration of 4.9 approximately 5.7 mcg/g was achieved within ten minutes after drug administration. (3) In the fluid excreted in the dead space formed by radical hysterectomy cefotaxime levels were maintained around 15 mcg/ml level throughout 5 approximately 6 hours following its administration, and gradually decreased at slow rate later.
This study was designed to extend the clinical indications of ventricular bypass to infants and newborns with severe left ventricular failure. The circuit is composed of 8-mm polyvinyl chloride tubing, microfilter, local heparinization circuit, and outflow-withdrawal cannulas of 10F to 20F. Filling capacity is 150-270 ml. In acute nonpulsatile left ventricular bypass experiments using six dogs weighing 3-7 kg, a bypass equivalent to 100% of the cardiac output prior to bypass could be attained in both normal and induced failure model of heart. Through left ventricular bypass the effects of left ventricular support such as marked reduction of LVP, LVmax dp/dt, and TTI were observed.
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An avcothanized vinyl sheet consisting of a Pall filter, 2 pressure monitoring lilnes, 2 heparinization lines, and a roller pump was used for transapical left ventricular bypass in 36 calves and 11 patients. Blood was returned to the abdominal or ascending aorta or carotid artery. Prolonged left ventricular flow unloading was carried out. All 31 calves that underwent left ventricular bypass and 5 calves that underwent left ventricular bypass and 5 calves that underwent biventricular bypass survived the scheduled period of bypass of up to 7 weeks except for 2 calves that died of accidental air embolism and 2 that were deliberately sacrificed due to infection. Local heparinization for 6 days followed by oral anticoagulation to maintain the prothrombin time at 150-200% of normal were effective in keeping the animals from bleeding and preventing thromboembolism. Eleven critically ill patients with severe heart disease were supported with left or biventricular bypass for periods of up to 172 hours. Four patients ultimately recovered, and 3 others were successfully weaned from bypass and expired 1-4 months later.
A 41-year-old patient underwent surgery for the partial removal of a posterior falx meningioma, which invaded deeply into both occipital lobes. After surgery, the patient complained of marked metamorphopsia, colored photopsia, afterimage and loss of stereopsia. The relationships between these symptoms and features of the VEP and EEG power spectra (both under resting and photic driving conditions) were investigated. Marked photopsia on the 4th postoperative day was accompanied by EEG features indicating asynchronous excitation of injured cortical cells, while the presence of a strong afterimage on days 17 through 24 coincided with indications of an apparent refractoriness in cortical activation.
The effects of horizontal as well as vertical optokinetic stimuli on the body's center of gravity in normal adults were investigated by using Jungtype optokinetic stimulator, a straingage platform and a minicomputer. The following results were obtained. With increasing speed of the optokinetic stimulation, the total length of the center of gravity gradually increased up to 60 deg/sec and then decreased. Meanwhile there was a standard two-phasic course in the position of the center of gravity. The ratio of the anteroposterior component to the lateral component in the movement of the center of gravity was below 1.00 in horizontal optokinetic stimulation, while in vertical stimulation it was over 1.00 and showed the maximum deviation of the position at about 60 deg/sec of optokinetic stimulation. The frequency spectra of the movement of the center of gravity showed some peaks at around 0.3 Hz and 1.0 Hz during optokinetic stimulation. The averaged divisional frequencies were calculated to show the change in the frequency spectra in digital values.
A case of malignant fibrous histiocytoma arising primarily in the left maxillary sinus is described. The patient, a 39-year-old male, who had suffered from sinusitis for 20 years, began to have paresthesia or sharp pain of the left side of the face and toothaches of the left maxilla. At operation a white fibrous tumor developing extensively from the lateral wall to the upper and medial walls of the left maxillary sinus and into the ethmoidal sinus was noted. Following a gradual progression of dyspnea, he died approximately one year after the onset in spite of radiation therapy and anticancer chemotherapy. An autopsy revealed recurrence of the tumor in the left maxillary sinus with wide-spread metastases to the lungs, pleurae, pancreas, kidneys and bone marrows. The direct cause of death was respiratory failure due to extensive growths of the pulmonary and pleural metastases.
An apparatus for the recording of head movements has been developed and a basic study was performed to determine the normal values of head movement and to estimate the significance of the head movement as a righting reflex. The locus traced by the head closely resembled that of the center of gravity, though shorter in overall length. The head also moves more slowly than the center of gravity. The phase delay of its movement was observed during standing with eyes closed. These results suggest that the head's movement is controlled by the body's center of gravity and that the latter moves in order to keep the head steady, maintaining the eyes in normal position.
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A simple circulatory support of transapical ventricular bypass type with nonpulsatile pumping and regional heparinization in 21 patients has revealed that several factors contribute to the patient's outcome. The duration of the bypass was not an essential determinant of prognosis and patients supported for 5--8 days could be weaned from TALVB. Those patients who could maintain steady hemodynamics with flow rates of 30--40% of cardiac output, were usually successfully weaned. Patients who required longer support with high flow rates (60--80% or over) had less probability of being weaned. Persistent or preexistent dysfunction of vital organs, as manifested by renal failure, brain damage, respiratory failure and infection, were main factors determining unsuccessful weaning. The complications related to pumping itself, thromboembolization, bleeding, infection and blood damage, were much less frequently observed with this type of support. The simplicity and less time consuming surgical technique for cannulation and, in addition, less harmful procedure of decannulation and avoidance of thrombus formation were directly related to the improved prognosis.
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