[Care of a patient facing labor with no preparation for childbirth].
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Biomedical subjects
Publications and source records attributed to S Ishida.
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Purity of the parent toxin influenced greatly the immunogenicity in guinea pigs of HR1 component of Habu-venom toxoid. The potency of HR1 toxoid in terms of the immunizing unit (ImU) appeared to be related to the antigen and aluminum contents. The immune response of the animals differed depending on the purity of the toxoid when the dose-response curve was examined over a wide range of the antigen dosage. Anti-HR1 titers of the guinea pigs immunized with crude toxoid (adsorbed) reached a plateau at about 10-20 U/ml ane further rise was not remarkable even when the amout of the antigen was increased several times, while 200 U/ml (maximum 400 U/ml or higher) of annti-HR1 was produced with a large amount of highly purified HR1 toxoid. Purified toxoid showed an excellent immunogenicity also in monkeys. The amounts of antigens necessary for the basic immunization to resist the challenge with a certainly lethal dose of crude venom were 18 and 0.5 mg as protein, for a crude and a highly purified toxoid, respectively. The total amount of aluminum was also reduced from 8.1 (crude toxoid) to 0.5 mg (purified toxoid). Multiple injections for the primary immunization enhanced early production of anti-HR1 in monkeys. However, at later stage of immunization, significant correlation was observed between the amount of HR1 toxoid (in ImU) for the primary immunization and the circulating anti-HR1 titer irrespective of the schedule of immunization. Anti-HR2 higher than 10 U/ml was produced consistently in monkeys with HR2 toxoid of 1.0 ImU for the basic immunization. However, excess HR2 toxoid of more than 10 ImU seemed rather unfavorable for anti-HR2 production.
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IgG immune deposits in glomerular lesions were found in 62% of 4-week-old mice born from anti-DNA antibody positive mothers but not in the mice born from anti-DNA antibody negative ones. In the former mice anti-DNA antibody producing cells could not be detected in spite of the presence of antibody. These results indicate that maternal anti-DNA antibody might be responsible for the development of glomerular lesions in the offsprings. Renal lesions, however, was not observed in the 2- to 3-month-old mice indicating that permanent lesions were not induced by this transient maternal antibody.
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In 45 cases of Lennox syndrome treated with ACTH, the immediate and long-term effects and the various factors affecting them were investigated by a follow-up study. 1) Regarding the immediate effect, 23 (51.1%) of the 45 cases became "seizure free" for over 10 days. 2) As to the long-term prognosis of these 23 cases, 10 cases relapsed into Lennox syndrome within 6 months and in the remaining 13 cases, seizures were suppressed for over 6 months; out of these 13, seizure relapse was observed in eight cases from 9 months to 7 years later, and the other five cases followed a very favorable course without relapse. 3) The favorable factors related to the effect of ACTH for Lennox syndrome are: a) age at ACTH treatment: up to 4 years old, b) time lag between onset of Lennox syndrome and initiation of ACTH treatment: the shorter the better; at least within 1 year, preferably within 3 months, c) presumptive causes and underlying diseases: idiopathic cases are best, d) mental defects before treatment: the slighter the better, e) seizure patterns: without tonic seizures, and f) EEG findings: disorganized diffuse slow spike-waves without asymmetry. 4) It is desirable to continue the ACTH treatment as long as possible, with the goal of the disappearance of seizure discharges, or at least the disappearance of diffuse seizure discharges.
A retrospective study was carried out on 261 patients with various epilepsies who had undergone convulsive status epilepticus prior to the subsequent onset of epileptic seizures. 1. Convulsive status epilepticus was found more in partial epilepsy and secondary generalized epilepsy at about the same rate, and evidently less in primary generalized epilepsy. On the average, three-fourths commenced their convulsive disorders with initial status epilepticus. 2. There were free intervals of years following initial status and preceding subsequent epilepsy. The interval was evidently shorter, less than two years, in a majority of patients with secondary generalized epilepsy, whereas the interval was mostly longer, more than six years, in patients with partial epilepsy. 3. The permanent deficient sequelae resulting from initial status were most closely associated with secondary generalized epilepsy. This was also exemplified by the higher rate of atrophic change on CCT. On the contrary, such permanent sequelae were less marked in partial epilepsy especially of complex seizure. 4. It was concluded that secondary generalized epilepsy resulted in cases with more severe brain damage within a relatively shorter interval, whereas complex partial seizure resulted from less severe damage with an obviously longer interval following convulsive status epilepticus.
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The combined diphtheria-pertussis-tetanus and combined diphtheria-pertussis vaccines, of which the contents of endotoxin, LPF and HSF were reported in the previous paper, have been tested for the respective potencies of pertussis, diphtheria and tetanus components. In order to obtain some information concerning possible adjuvanticities of the toxic components of pertussis cells, relationship between respective toxic activities and the potencies of the respective antigenic components were tested by applying the multiple regression analyses. The results showed that the effects of the toxic components were fairly complicated. Within the ranges of contents of the respective toxic components of the vaccines used in the present experiment, LPF appeared to enhance all the three potencies as the content increased, while the effects of endotoxin and HSF were either enhancing or suppressive depending on the antigenic components.
Precise and reproducible quantitative determination of hepatitis B surface antigen by applying the parallel line bioassay method was proposed. In this method, the value of any given sample can be expressed in terms of a relative value to a fixed standard or reference preparation. Decrease in antigenic reactivity due to the lowered protein content could be prevented by using 0.02% human albumin in physiological saline solution as the diluent. The use of such stabilizer(s) should be considered in the dilution or storage of samples containing HBs antigen.
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The parallel line bioassay method was applied to the potency test of anti-HBs immunoglobulin by radioimmunoassay (RIA) in an attempt to express the relative potency of three test samples in terms of ratio to the BoB reference preparation. By plotting the net c.p.m. readings without being divided by the 'cut-off' values against the dilution factors, both being converted to log10, parallelism between linear regression lines could be observed within wide ranges. Calibration of relative potency was possible wherever the regression lines were parallel, thus making any attempt of comparison at specified points alone, such as ED50, unnecessary.