[Surgical management of infants under 6 months of age with total anomalous pulmonary venous drainage].
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Biomedical subjects
Publications and source records attributed to S Takeuchi.
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The behaviors of a protease-producing strain of Staphylococcus aureus, including the production of alpha- and beta-hemolysin, protease, and nuclease in the skin tissue of mice, were examined by the fluorescent antibody technique and hematoxylin and eosin staining. When about 10(6) viable cells were subcutaneously inoculated into a mouse, they were phagocytized by leukocytes and a suppurative focus developed in situ. No active extracellular substances other than alpha-hemolysin were demonstrated in this mouse. When 10(7) viable cells were inoculated, most of them were also phagocytized by leukocytes, and a rather large suppurative focus was formed. In this focus a low degree of multiplication of the organisms was observed. Protease and alpha-hemolysin could be detected in the neighborhood of the leukocytes. When 10(8) to 10(9) cells were inoculated, they multiplied transitorily in the subcutaneous tissue and produced the four substances mentioned above. The multiplication of bacterial cells as well as the production of extracellular substances ceased within a comparatively short period and the transitory state was similar to that in a batch fermenter. Necrotic and histolytic lesions were observed only in the mice inoculated with 10(8) to 10(9) viable cells. Similar dermatolytic lesions were also found in mice injected with 0.5 to 1.0 mg of pure protease.
Prior to 1970, 35 patients of VSD with Pp/Ps of 0.8 or more were subjected to primary closure of the defect, resulting in 11 operative deaths. Since 1971, however, the surgical results have been much improved and 29 such patients were operated on without death. It has been considered the optimal time of elective closure of VSD with severe pulmonary hypertension is at the age of 1 to 3 years, however, if decrease in apical diastolic rumble and heart size are found, earlier operation less than one year of age is to be scheduled. Surgical indications and results of PDA, PDA with VSD, and ASD associated with severe pulmonary hypertension were also discussed.
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Since 1963, regional intra-arterial infusion of anti-cancer agents combined with surgery has been used in the treatment of 56 patients with osteosarcomas. The histologic examination of amputated limbs after prolonged intra-arterial infusion therapy showed remarkable degeneration and necrosis throughout wide areas of tumor tissue. The overall estimated 5-year survival rate improved from 4 to 31.4 per cent. In cases where the infusion period was of more than 3 weeks duration, the estimated 5-year survival rate was 43.8 per cent. The period from operation to pulmonary metastasis was prolonged and the incidence of pulmonary metastasis within the first year was markedly decreased. The use of intra-arterial infusion prior to surgery coupled with postoperative bronchial arterial infusion and systemic chemotherapy improved the prognosis in osteosarcomas.
Gastrointestinal contractile activity from the lower esophageal sphincter to the terminal ileum in the conscious dogs was continuously recorded on a multi-channel polygraph for several weeks by means of chronically implanted strain gage force transducers. It was found that the 24-hour gastrointestinal motor activity consisted of the two different major patterns; the digestive and interdigestive patterns. The interdigestive motor activity was characterized by a cyclic recurring, caudad-moving band of strong contractions interrupted by long lasting motor quiescence. When one band of strong contractions reached the distal ileum, another developed in the LES, stomach and duodenum again and propagated in a caudad-direction. Such recycling episodes repeatedly occurred until the next meal. After ingestion of food, gastrointestinal motor activity was continous and such characteristic interdigestive patterns were not observed. Synthetic motilin, 0.1-2.7 mug/kg/hr, was assayed for its motor stimulating activity in the both states. In the digestive state, an i.v. infusion of motlin had no influence upon the motor activity even if the dose was increased up to 6.0 mug/kg/hr. On the other hand, when motilin was infused during the interdigestive state, it induced a pattern precisely like the naturally-occurring interdigestive contractions. Not only the naturally-occurring contractions but also motilin-induced contractions were strongly inhibited by the ingestion of food or an i.v. infusion of pentagastrin (0.2-1.8 mug/kg/hr). Duodenal acidification (0.1 N HC1, 3-16 ml/kg/hr) in the interdigestive state disturbed or inhibited the regular cycle of the natural contractions but was counteracted by exogenous i.v. infusion of motilin. These findings strongly suggest the view that the interdigestive gastrointestinal motor activity is at least in part regulated by circulating motilin concentration in the blood, however, its cyclic recurring, caudad propagating mechanism may be controlled in part by the nervous system. Motilin is the only substance known to be active during the interdigestive state and therefore may be called the interdigestive hormone.
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Rabbits were inoculated subcutaneously with the protease-producing strain, CH-91, of Staphylococcus aureus of chicken origin. Dermatolysis was observed at the site of inoculation in them. Then the lesion outwardly healed up 5 to 6 weeks after the inoculation. When these recovered rabbits were reinoculated subcutaneously with the same number of viable cells as used in the first inoculation, none of them were affected with dermatolysis; that is, they had acquired a protective ability against an experimental challenge with viable cells. Antibodies against staphylococcal cells, alpha-hemolysin, and protease were detected in the serum of these rabbits 10 or 20 days after the first inoculation, but antibody against nuclease or beta-hemolysin was not. After the reinoculation, those antibodies showed a remarkable rise in most of the rabbits. These results suggest indirectly that the inoculated cells might have produced sufficient amounts of alpha-hemolysin and protease in the cutaneous tissue of rabbits. When rabbits were immunized with detoxicated culture supernatant of S. aureus strain CH-91, they exhibited antibody responses to alpha-hemolysin and protease mainly. Moreover, they were proved to have acquired a protective ability to an experimental challenge with viable cells when examined for the occurrence of dermatolysis as a marker of infection. On the contrary, when rabbits were immunized with killed cells, they presented a remarkable antibody response to staphylococcal cells. The immunized rabbits, however, acquired no protective ability.