[Innovation in bathing a patient receiving IVH (intravenous hyperalimentation)].
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Biomedical subjects
Publications and source records attributed to M Takada.
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Group B Streptococcus (GBS) antibody concentrations were studied in 214 pregnant women, of which 91 were carriers and 123 were noncarriers. The method using EIA was designed to measure antibodies to Type Ia, Ib, Ic, II, III and Group B. By means of AGG (Agglutination), antibodies to Type Ib, II, and Group B could also be measured. 1) The Group B antibody concentration in pregnant carriers of GBS (mean: 13.9 microliters with EIA, 4.77 microliters with AGG) was significantly greater than that in noncarriers (mean: 10.6 microliters with EIA, 3.64 microliters with AGG). 2) In most of the cases studied, the cord serum concentration was similar to the maternal concentration when EIA was used. On the other hand the antibody concentrations in cord serum were lower than those in the maternal serum when AGG was used. 3) In a premature baby (1,768g) and in a baby with Downs' syndrome the cord serum concentration was lower than the maternal concentration, while in a large baby (4,074g) the cord serum concentration was higher than the maternal concentration. 4) Using EIA, the type-specific antibody which coincided with the type of strain isolated from each vaginal carrier showed a higher concentration than any other type-specific antibody.
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Cases found to be positive for human papilloma virus (HPV) infection in the cervix by Southern blot method were evaluated with a newly developed kit for in situ HPV tissue hybridization. By the in situ hybridization method, HPV-DNA was detected without damaging the tissue structure. It appeared as purple or black stains in the nucleus of the epithelial cells that were located at the level of one-third of the epithelial thickness from the surface. The cases that were negative with the Southern blot method were also negative with the in situ hybridization method, but only 55.8% of the cases positive with the Southern blot method were positive with the in situ hybridization. Although in situ hybridization method is not as sensitive as the Southern blot method, it allows analysis of old paraffin blocks and comparison with pathological features.
We detected HPV (Human Papilloma Virus) -DNA in various uterocervical lesions by in situ hybridization using biotinylated DNA probes. In cases positive for HPV, the nuclei of the epithelial cells was purple to blackish purple. In 2 of 6 cases of chronic cervicitis, HPV-DNA was detected in the outer layer of the squamous epithelium. Eleven of 19 with mild dysplasia (57.9%) showed a positive reaction in the upper one-third of the epidermis in a mainly consisting of koilocytotic cells. All 6 patients with moderate dysplasia had positive cells among the koilocytotic cells and atypical cells in the middle layer. Five of 11 patients with severe dysplasia had scattered positive cells. Two of them had atypical condylomatoid lesions. Eight of 32 patients with squamous cell carcinoma were positive for HPV-DNA, but there was no consistent distribution pattern of the positive cells.
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The daily consumption of various nutrients and the daily habits of 241 male stone formers were investigated. The patients (especially uric acid stone formers and hypercalciuric (greater than or equal to 300 mg/day) calcium stone formers) ingested much more total protein and animal protein than healthy Japanese. However, the amount of ingested calcium by the patients (470 mg) was less than that of healthy subjects (553 mg) and did not reach the level of the daily nutritive requirement (600 mg). The amount of ingested nutrients during the evening meal by the patients was about 50% of the daily amount with over 60% of the daily animal protein being ingested at dinner. This tendency was high in subjects who were in their 20's to 40's. The interval from dinner until retiring in the patients was not different from that of healthy males, but it was under 4 hours in over 50% of those in their 30's and 40's in both groups. From these results, we thought that a rapid change in nutritional status and dietary style in the short period after World War II had strongly affected the incidence of renal stone disease in Japan. Therefore, we have established the following general guidelines: 1) increased fluid intake, especially after dinner, 2) correct and avoid unbalanced diet (the diet should include all kinds of food, with vegetables being eaten at every meal and avoidance of an excessive intake of meat), 3) eat three meals a day and avoid an excessive intake at dinner, and 4) extend the interval from dinner until retiring. By following these individual dietary guidelines, the 5-year stone recurrence rate and the stone episode rate decreased remarkably in the period of not only outpatient visits but also in the period when the outpatient visits were discontinued. From these results, we conclude that individual dietary management should be the primary measure for the prophylaxis of renal stone disease in Japan.
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Traumatic rupture of the testicle is rare because of the protection afforded by surrounding structures. Many clinicians now speculate that this entity is underreported due to misdiagnosis. However, the condition should not be overlooked because of the importance of early treatment for the preservation of testicular function. A more aggressive approach to scrotal hematoma has been advocated. A case of traumatic rupture of testicle in a 21-year-old patient is reported. The testicle was surgically explored 6 days after trauma to the scrotum. The tunica albuginea was repaired and the testicle was preserved. Discussion is made especially on the injury to scrotum.
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Eighty-one cases of renal cell carcinoma in last twelve years (1975-1987) have been reviewed and examinations contributing to initial diagnosis of renal cell carcinoma were studied retrospectively. In earlier 5 years from 1975 to 1980, ultrasonography less contributed to detection of renal cell carcinoma than computed tomography. Conversely in the last 3 years from 1984 to 1987, the number of cases were detected by ultrasonography. Since ultrasonography is useful diagnosing renal cell carcinoma of various growth patterns and can detect small space occupying lesions, recently ultrasonography has become a routine examination, and a chance of detecting incidental renal cell carcinoma has been increasing. Ultrasonography should be made at first for screening of renal cell carcinoma.
Various techniques are used for tumor staging of bladder carcinoma such as endoscopic photography, transurethral echography, and computed tomographic (CT) scan. Endoscopic photography enables easy observation of tumor morphology, but we utilized other approaches to determine the presence or absence of tumor infiltration. Magnetic resonance imaging (MRI) has recently found widespread use in the staging of tumors. We first employed this approach at our hospital in February 1987. We compared the diagnostic accuracy rate of MRI with that of transurethral echography and CT scan in 10 cases of bladder tumor. The diagnostic accuracy rate of MRI was 70%, while that of transurethral echography and CT scan was 40% and 50%, respectively. We concluded that MRI was very useful in the diagnostic staging of bladder tumor.
A 59-year-old man was found to have a renal cell carcinoma during about one hundred months of hemodialysis by means of an ultrasound tomography. Nephrectomy was done and renal cell carcinoma, clear cell type, with acquired renal cysts were observed, histologically. The usefulness and routine application of ultrasound tomogram are stressed for examination of the renal appearance during the management of hemodialysis.
N2-[(N-Acetylmuramoyl)-L-alanyl-D-isoglutaminyl]-N6-stearoyl-L-lysine (MDP-Lys(L18), muroctasin), a derivative of muramyl dipeptide, is known to have the activity to augment the number of white blood cells (WBC) via colony-stimulating factor. Muroctasin has been expected to be applied to leukopenia caused by anticancer chemotherapy. When WBC decreased to less than or equal to 3,000/mm3 after the 1st course of chemotherapy, 131 patients with lung cancer, who were previously classified by the combination regimens of chemotherapy, were enrolled in the study and randomized into 3 groups, 200 micrograms (H), 100 micrograms (L) and untreated control (C) groups. The patients were then subcutaneously treated once daily for 6 consecutive days. WBC and its differential count were measured on Days 4, 7 and 15 after commencement of the study. WBCs in H and L groups were recovered greater than in C group. In WBC differential count, the recovery of neutrophil was prominent in muroctasin treated groups. The portion of immature neutrophil in the bone marrow was also increased by muroctasin treatment. A restorative effect on WBC and neutrophil counts was also confirmed only in the second course of H group. On the other hand, fever and pain in the injected site as side effects were common in the H group and L group in both of courses. In this study, the usefulness of muroctasin in leukopenia was suggested when administered at dosages of 200 micrograms for 6 days.
A statistic survey was made on the patients undergoing operations between January, 1984 and December, 1986.