Benign bile duct stricture associated with intraductal mucous substance: report of a non-jaundiced case.
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Biomedical subjects
Publications and source records attributed to M Takemoto.
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The antigenicity studies of a beta-lactam antibiotic, cefodizime sodium (THR-221), were examined in mice and guinea pigs and the following results were obtained. 1) In passive cutaneous anaphylaxis (PCA) with sera from BALB/c or C3H/He mice, a slight PCA reaction was observed only in BALB/c mice by using THR-221-ovalbumin (OVA) plus Freund's complete adjuvant (FCA) as the immunogen and THR-221 itself as the eliciting antigen. 2) Immunological cross-reactivity between THR-221 and CTX was present at the rat PCA reaction. 3) Antibodies against THR-221 were detected by PCA in guinea pigs. The anti-THR-221 antibodies gave PCA responses smaller than those of CMZ by using antibiotic plus FCA as the immunogen and the antibiotic-bovine serum albumin (BSA) as the eliciting antigen. 4) In the observation of active systemic anaphylaxis (ASA), no symptoms were observed in guinea pigs sensitized with THR-221 and provoked with THR-221-BSA. On the other hand, guinea pigs sensitized with THR-221 plus FCA by injecting THR-221-BSA showed fetal anaphylactic reactions. 5) The results of passive hemagglutination (PHA) also indicated that the PHA titer of THR-221 was lower than that of CMZ. 6) Protein binding property of THR-221 with human serum albumin was lower than other beta-lactam antibiotics. 7) Antibodies against THR-221-OVA by using THR-221-BSA as the eliciting antigen were detected in any tests above mentioned. It is concluded from these results that immunological activity of THR-221 was equivalent to the other beta-lactam antibiotics.
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1. Cefmetazole (CMZ) and netilmicin (NTL) were administered by one-shot intravenous and intramuscular injection, respectively, and measurements were made on their concentrations in the serum as well in the cerebrospinal fluid (CSF) which was collected using a drainage tube inserted into the cisterna basalis after the operation of ruptured cerebral aneurysm. 2. Concentrations of CMZ and NTL in the CSF changed nearly in parallel to those in the serum. 3. A one-shot intravenous injection of these drugs seemed to achieve their high concentrations in the CSF, though high concentrations may not last very long.
After a diagnosis of advanced carcinoma, a 77-yr-old female underwent gastrectomy. A 6 X 5 cm ulcerative mass in the angle was shown to be differentiated adenocarcinoma in the surrounding wall, and malignant lymphoma in the bottom. Carcinomatous infiltration was limited to the muscularis mucosae. Neither generalized lymphoma nor locoregional lymph node metastasis of either neoplasm was noted. A survey of 35 Japanese patients, including our own case with the two coexistent neoplasms in the stomach, revealed that the male-to-female ratio was 2.3:1, with no significant difference between the mean age of the sexes. The prevalence of adenocarcinoma in its early stage (60% of 35 patients) and of a histologically differentiated type (85% of 27 patients) of adenocarcinoma is quite different from that of usual Japanese gastric carcinoma, and it may suggest that there are some factors influencing the coexistent development of both neoplasms.
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A male with mitochondrial myopathy, encephalopathy, lactic acidemia, and strokelike episodes is reported. He had also recurrent episodes of ileus. Muscle biopsy revealed ragged-red fibres. The cytochemistry of cytochrome c oxidase (CCO) showed scattered nonstained fibres, while all muscle fibres were heavily stained by immunocytochemistry using CCO antibody. These findings suggest that partical CCO deficiency may be present in the skeletal muscles of the patient. NADH cytochrome c reductase in the patient's muscle mitochondria was low compared with normal controls (about 26%), although succinate cytochrome c reductase was normal. Coenzyme Q10 administration (90 mg/day) did not improve CSF lactate levels, but did decrease plasma lactate levels. His muscle weakness slightly improved.
A 54-year-old man had palpitations on swallowing without any esophageal or heart disease. Electrophysiological findings, including an A wave in the high right atrial leads appearing prior to the A wave on His bundle electrogram, revealed that the arrhythmia was paroxysmal supraventricular tachycardia originating in an ectopic focus of the atrium with intraventricular aberration. Treatment with verapamil, 120 mg/day, reduced his symptoms in spite of an insignificant decrease in the arrhythmia observed with Holter dynamic electrocardiography.
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A 44-year-old housewife with a mass in the left upper quadrant of the abdomen was admitted. The tentative diagnosis was cystadenocarcinoma arising from the pancreatic tail, as determined by CT and selective angiography. Excision of the mass with removal of the spleen, pancreatic tail, left renal capsule and surrounding lymphnodes was performed. Photomicroscopic sections revealed proliferation of malignant cells and malignant osteoids. The final diagnosis was osteogenic sarcoma arising from the retroperitoneum. Among the extraosseous osteogenic sarcoma arising from the somatic soft tissue, involvement of the retroperitoneum is rare. Only 12 cases including our own case have been reported as being of retroperitoneal origin. No patient survived for five years and in our patient, there are signs of recurrence one year after the surgery.
Twenty-two patients with esophageal cancer (8: preoperative, 8: one-month after surgery, and 6: more than 3 months after surgery) were orally loaded with 50 g of glucose, to determine the plasma gastrin levels. They were also loaded with oral 0.1N hydrochloride preoperatively and also one month after operation to examine the secretion kinetics of plasma secretin. In addition, the correlation between the G-cell (gastrin secretory cell) population in the pyloric region of the postoperative intrathoracic stomach and the plasma gastrin was investigated. The following results were obtained. Hypergastrinemia developed one month after surgery, but after 3 months or later, plasma gastrin levels almost returned to normal. Plasma secretin levels tended to decrease postoperatively; however, no statistically significant differences were observed. G-cell stain by the enzyme antibody method revealed hyperplasia of G-cells in some of the hypergastrinemic cases without accompanying atrophy of the pyloric mucosa and/or the intestinal epithelial metaplasia, although there were some hypergastrinemic cases with a decrease of G-cells due to the atrophy of the pyloric mucosa and/or the intestinal epithelial metaplasia. In the latter cases, gastrin was thought to be secreted probably from the duodenal mucosa.
The kinetics of secretion of gastrin and secretin before and after pancreaticoduodenectomy were studied. Prior to pancreaticoduodenectomy, gastrin secretory function was within the normal range; it was significantly reduced postoperatively. Preoperatively, patients had elevated basal levels of secretin with depressed reactivity. During pancreaticoduodenectomy, the upper part of the jejunum should be preserved as far as possible. Ulcers occurring after pancreaticoduodenectomy are more probably due to vagus nerve activity and other factors rather than to an imbalance between gastrin and secretin.
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