[Return of the practice of home delivery--a projection to the 21st Century].
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Biomedical subjects
Publications and source records attributed to M Numata.
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Patients with ischemic extremities were administered 2 g of cefazolin sodium (CEZ) intravenously from the unaffected extremity. Blood samples were periodically taken from both affected and unaffected extremities and concentrations of CEZ in both samples were compared. No statistically significant difference was observed in the concentration of CEZ in affected and unaffected extremities, which suggested that systematic administration of CEZ has satisfactory effects on ischemic extremities.
Clinical studies were made of 60 patients who had undergone ureterosigmoidostomy at our department. The 45 men and 15 women ranged from 35 to 73 years old, with a mean of 59.2 years. Ureterosigmoidanastomosis was performed using the modified Coffey II technique in this series. Bladder tumor was the reason for the operation in 55 cases, uterine cancer in 2, contracted bladder in 1, vesicovaginal fistula in 1 and urethral stricture in 1. In the excretory pyelogram one month after the operation, normal findings and slight hydronephrosis were observed in 37% and 63% of the patients, respectively. However, the pyelogram 6 months after the operation demonstrated normal findings in 61% of the patients, slight hydronephrosis in 34% and moderate hydronephrosis in 5%. None of them showed severe hydronephrosis. Slightly increased BUN level (less than 30 mg/dl) was seen in 15 out of 45 patients (32%) at one year after ureterosigmoidostomy. However, serum creatinine level was not above normal throughout the postoperative course. Although postoperative hyperchloremia was appreciably detected, it was easily managed by the administration of sodium bicarbonate. Serum sodium and potassium levels remained stationary. Of 35 patients observed for more than one year after operation, 11 patients (31%) had developed fever due probably to pyelonephritis, but sigmoidography failed to demonstrate any ureteral reflux. Either urinary or fecal fistula, a complication in the early postoperative period, occurred in 10 patients (17%). One of these patients died. Five patients were cured by conservative treatment. The remaining 4 patients underwent surgical treatment that was ureterocutaneostomy , nephrectomy, or colostomy.(ABSTRACT TRUNCATED AT 250 WORDS)
Twenty-two patients underwent surveillance colonoscopy for 2 to 54 months (average, 22 months) after ureterosigmoidostomy. The distance between site of ureterocolonic anastomosis and anal verge ranged from 13 to 30 cm (average, 18.3 cm) in right side and from 20 to 37 cm (average, 29.5 cm) in left side. The form of implanted site could be classified into 3 types which were flat, sessile and pedunculated types. Endoscopic biopsies performed on eleven polyp-like regions of ureterocolonic anastomosis revealed inflammation in 10 cases (90%) and adenoma without malignancy in one case (10%). The mucosa more than 5 cm away from implanted site showed findings of inflammation without constitutional abnormality in more than 60% of all patients. The periodical surveillance colonoscopy at intervals of approximately one year seemed to be useful for early detection of the tumors of the colon after ureterosigmoidostomy.
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Two cases of cystic lymphangioma which developed in the neck region of adults are reported. The first case was a 46 year old housewife who noticed a swelling on her right neck region. The tumor was a unilocular cystic benign tumor covered with thin capsule and removed from the surrounding tissue. The second case was a 19-year old male who noticed sudden swelling on his left side of the neck following a traffic accident. The swelling was a multilocular benign cyst which contained yellowish serous liquid, as in case 1. The cyst was removed successfully. The two cases had a favourable post-operative course and there have been no signs of recurrence. Histologically the cysts contained one layer of endothelial cells and an accumulation of lymphocytes.
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A B-lymphocyte tumor (MLB-MN line) was induced by Gross murine leukemia virus in Slc:ddY mice, successively passaged in normal adult mice, and adapted to tissue culture. The surface marker expression of MLB-MN was examined and found to include several markers that are known to occur in normal B-lymphocytes. The cells bore surface immunoglobulin M, detected by indirect immunofluorescence staining, and Fc receptors and complement receptors, detected by rosette formation. Thy 1 antigen and secretion of immunoglobulin were lacking. These results have led us to postulate that the origin of the MLB-MN tumor was a late differentiation stage of the B-lymphocyte.
Based on our view that cephalosporins with potent activities share active hydrogen(s) on the alpha-carbon of the side chain acyl, we undertook to introduce beta-ketoacid moieties onto the cephalosporin structure. Thus, starting with deacetylcephalosporin C (DCPC), first made available in quantities by our own fermentation technique, 7-amino-3'-O-acetoacetyldeacetylcephalosporanic acid (7-AACA) was made accesible. Acylation of 7-AACA with various beta-ketoacids followed by substitution at the 3'-position led to 7 beta-[2-(2-aminothiazol-4-yl)acetamido]-3-[[1-(2-dimethylaminoethyl)-1H-tetrazol-5-yl]thiomethyl]ceph-3-em-4-carboxylic acid (SCE-963, cefotiam), a potent broad-spectrum cephalosporin. Further elaboration of the structure of cefotiam led to an extended broad-spectrum cephalosporin, SCE-1365. These two classes of cephalosporins, together with our previously reported antipseudomonal cephalosporin (SCE-129, cefsulodin), could control a wide range of pathogenic bacteria.
In immunological studies, cytotoxicity assay are extremely important. The assay method was modified so that the radioactivity of beta-decaying isotopes in a large volume of aqueous sample could be counted. Through tests of various scintillators, it was found that emulsion scintillators had a higher counting efficiency than toluene- or dioxane-based scintillators. The results obtained by this method using an emulsion scintillator agreed well with those obtained by the 51Cr release method. The advantages of the emulsion scintillator method are as follows: (a) the activity of a beta-decaying isotope can be counted in a large volume of aqueous sample, (b) a long half-life beta-decaying isotope can be used, (c) the effects of free labeled materials can be eliminated by simple procedures, and (d) no gamma counter is needed.
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Changes of the body fluid exchange and of the composition of metabolites in the hepatosplanchnic area in canine hemorrhagic and endotoxin or septic shock models were studied by investigating the qualitative and quantitative changes in thoracic duct lymph draining from abdominal organs. In the present study, it might be summarized that the changes in the flow rate and composition of thoracic duct lymph were put forward to much more directly and apparently indicate the degree of hepatosplanchnic cellular impairment in canine experimental shock than in the circulating blood.
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The synthesis and antimicrobial profile of a series of 7-(beta-ketoacylamino)cephalosporins (1) bearing an acetoxymethyl or a heterocyclichiomethyl group at the 3-position are described. Of this series, 3-[[(1-methyl-1H-tetrazol-5-yl)thio]methyl]-7-(3-oxobutyrylamino)ceph-3-em-4-carboxylic acid (11) showed moderate antibacterial activities in in vitro and in vivo tests.
New cephalosporins modified in the acyl part of 7-(3'-oxobutyrylamino)cephalosporins (1), which have been described in the preceding paper, were synthesized by thiolation at the 2'- or the 4'-position, or by transforming the 3'-oxo group into a 3'-imino group. The most active compound in vitro was 3-[[(1-methyl-1H-tetrazol-5-yl)thio]methyl]-7-(4-methylthio-3-oxobutyrylamino)ceph-3-em-4-carboxylic acid (7c), which showed superior in vitro activity against Gram-positive and Gram-negative bacteria compared to the parent cephalosporin (1b) with the same 3-substituent. The ED50 value for 7c, however, was essentially equal to that of 1b in mice infected with Escherichia coli O-111.
The synthesis and the in vitro and in vivo antimicrobial activities of a series of 7-[2-(2-aminothiazol-4-yl)acetamido]cephalosporins (1) having varied 3-substituents, such as methyl, hydroxymethyl, acetoxymethyl, pyridiniomethyl and heterocyclicthiomethyls, are described. The derivatives having five membered heterocyclicthiomethyls exhibited strong inhibitory activities against Gram-negative organisms including some strains of Escherichia coli and Proteus morganii which are insensitive to cefazolin and cephaloridine. Pronounced activities were noted with 7-[2-(2-aminothiazol-4-yl)-acetamido]-3-[[[1-(2-dimethylaminoethyl)-1H-tetrazol-5-yl]thio]methyl]ceph-3-em-4-carboxylic acid (1y; SCE-963).
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