[Cavernous hemangioma on the fourth ventricle floor. Report of a successfully treated case].
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Biomedical subjects
Publications and source records attributed to T Fujimoto.
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Localization of cell membrane markers in dissociated frog urinary bladder epithelial cells was studied. The bladder cells began to alter in shape immediately after dissociation and became spherical within 15 min at room temperature. The apical marker, dialyzed iron (DI), was found on the entire surface of dissociated and transformed cells, whereas the basolateral marker, horseradish peroxidase-glutaraldehyde (HRP-GLA) staining, first gathered at one pole and then became distributed over a larger area. Thus the apparent loss of polarity was not parallel with the true surface uniformity. When bladder cells were dissociated in the presence of cytochalasin B (CB) or 2,4-dinitrophenol (DNP), the transformation was suppressed and the cells maintained structural polarity. DI and HRP-GLA were mostly confined to the original region in CB-treated cells, but both moved to the other membrane region in DNP-treated cells. The results indicated that an aerobic adenosine triphosphate supply, as well as the tight junction, is involved in maintaining regional differentiation of the cell membrane.
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A comparative well-controlled study was performed to evaluate the efficacy and tolerability of KS-R1 (ampicillin (ABPC) rectal suppository) compared with those of intravenous injection of ABPC against acute bacterial pneumonia caused by ABPC-sensitive bacteria, such as Streptococcus pyogenes, Streptococcus pneumoniae and Haemophilus influenzae in pediatric field. KS-R1 at the dose of 250 mg X 4/day of ABPC in potency, or the intravenous injection at the dose of 125 mg X 4/day of ABPC in potency, was given to 68 cases of patients with bacterial pneumonia, aged between 10 months and 8 years and 2 months, for 7 days, as a rule. The clinical efficacy rates evaluated in 61 cases (KS-R1 group in 31 cases, intravenous group in 30 cases) on standard criteria of committee members were 93.5% for the KS-R1 group and 83.3% for the intravenous group, respectively. There was no significant difference between 2 groups. Evaluation by stratification according to the age showed that KS-R1 was significantly superior, the rate being 90.5% among the children from 1 year to 3 years in the KS-R1 group and 61.5% in the intravenous group. The bacteriological effect was evaluated in 16 cases (KS-R1 group in 7 cases, intravenous group in 9 cases), the disappearance rate was 100% for the KS-R1 group and 88.9% for the intravenous group, without significant difference. With regard to side effects, 66 cases (KS-R1 group in 35 cases, intravenous group in 31 cases) were strictly evaluated in relation to subjective and objective symptoms. As a result, no significant difference was noted between 2 groups in the incidence rate which was 17.1% for the KS-R1 group and 9.7% for the intravenous group. The above results indicate that against acute bacterial pneumonia in pediatric field, the KS-R1 at the dose of 250 mg X 4/day of ABPC in potency possesses clinical efficacy and safety similar to the intravenous injection at the dose of 125 mg X 4/day of ABPC in potency, and that it is a useful suppository.
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Thirty-one strains of Mycoplasma pneumoniae were tested for drug sensitivity to both josamycin (JM) and erythromycin (EM), to evaluate the efficacy of JM for mycoplasmal pneumonia in children. In addition to the sensitivity tests of 31 M. pneumoniae strains against JM and EM, 50 patients, between the ages of 3 years 1 month and 13 years 3 months, suspected of suffering from mycoplasmal pneumonia were treated with 50 or 200 mg JM tablets at an average daily dose of 43.1 mg/kg t.i.d. or b.i.d. for an average period of 14 days; an additional 31 patients between the ages of 2 years 9 months and 11 years, suspected of suffering from this disease were treated with tablet or dry syrup of EM, with the exception of EM estolate, t.i.d. or b.i.d. at an average daily dose of 72.5 mg/kg for an average period of 15 days. Patients were selected in 37 and 22 mycoplasmal pneumonic patients respectively for JM and EM. Clinical and bacteriological effects, efficacy and side effects of the drugs on this disease were studied and the following results were obtained. Drug sensitivity test Of all 31 strains tested for JM sensitivity the populations which exhibited 0.125 mcg/ml were most abundant (18/31, 58.1%) and MIC pattern of all strains were distributed from 0.0313 to 0.125 mcg/ml. In the EM group, 61.3% (19/31) of the populations were sensitive at 0.015 mcg/ml, exhibiting the dominant distribution pattern and MIC range of all organism varied from 0.0078 to 0.0313 mcg/ml. Resistant strains were found to neither JM nor EM. EM was approximately 2 to 10 times more active than JM in MIC evaluation. Clinical effects of JM by daily doses Clinical effects relative to the daily dose were evaluated in 3, 7, 10 days after administration of drugs. The response was favorable, according to assessments of the attending doctors, in 96.7, 100% and 95.8% of the patient group given JM in a daily dose of 40-49 mg/kg, the group to which the largest number of patients belonged. Similar favorable results were obtained by the assessments of Evaluation Committee, showing 86.7, 96.7% and 100% of favorable response. Upon comparison, in the same interval, of these results with those of the groups given EM in a daily dose of 50 mg/kg, the group in which the largest number of patients were seen, there was no significant difference in the assessments either of the attending doctors or of the Evaluation Committee.(ABSTRACT TRUNCATED AT 400 WORDS)
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Clinical effects of ampicillin suppository (KS-R1) were examined in 24 children (11 male and 13 female) aged from 5 months to 7 years 5 months with urinary tract infection. KS-R1 was rectally given to the patients at doses of average 45.6 mg/kg/day divided into 3 to 4 times for average 8 days. Clinical effectiveness was 95.8%. Bacteriologically, the eradication of isolated organisms was observed in 10 (71.4%) out of 14 cases, the decrease in 3 (21.4%) and the persistence in 1 (7.1%). The discharge of suppository within 5 minutes after insertion was observed in 8.7% of patients without diarrhea and in 6.9% of patients with diarrhea. The evacuation rate of the bowels within 10 minutes after insertion was observed in 5.9% of patients without diarrhea and in 41.9% of patients with diarrhea. It was suggested that the administration of KS-R1 to childish patients with diarrhea should be careful. As to the side effects, diarrhea was observed in 2 cases (7.1%) and the elevation of GPT and GOT in 1 case (3.6%).
Current therapy for childhood ALL is effective and certainly much better than what was available 10 years ago. According to our protocol 721, 745, and 765 studies, between 40% and 60% of children with ALL are now on long-term survival, even after discontinuation of the therapy for several years. However, results are not nearly as good in patients who have identifiable poor risk features. A review of 162 patients with ALL was undertaken to determine the important factors, other than therapy, influencing survival. Childhood ALL can be divided into two groups according to major prognostic factors such as age and initial leukocyte counts; Group I -standard risk group and Group II -high risk group. To minimize side effects while trying to improve further efficacy of therapy and to prevent late relapse, our new protocol 811 has been initiated for standard risk patients of ALL. The more aggressive use of current agents such as methotrexate and adriamycin to prevent early relapse has been applied for high risk patients of ALL. The preliminary results of protocol 811 showed that early intensification with high-dose methotrexate and adriamycin seemed to prolong the remission duration of high risk ALL, but further long follow-up study is needed. With considerable progress being made toward the cure of childhood leukemias, the issue of late effects assumes increasing importance. The next generation of treatment studies, in addition to further attempts at improving the proportion of survivors, will need to develop strategies aimed at clearly defining and minimizing these late sequelae.
KS-R1, a new rectal suppository of ampicillin (ABPC) sodium, was compared with oral and parenteral ABPC in terms of absorption and excretion in childish patients and healthy adult male volunteers. In addition, the irritation of KS-R1 to the rectum was studied. 1. Eight healthy adult male volunteers received 250 mg (potency) of KS-R1 rectally and 125 mg of ABPC intravenously in a cross-over study. Then, 4 of them were given intramuscularly 250 mg of ABPC, and 3 of the remaining 4 volunteers were given 250 mg of ABPC orally. The rectal administration of 250 mg of KS-R1 resulted in a mean peak ABPC plasma level (Cmax) of 2.6 mcg/ml at 30 minutes, and then ABPC levels declined with biological half-life (T2/1) of 0.55 hour. The peak time (Tmax) of occurrence after rectal dose of KS-R1 was earlier than that after oral dose of ABPC, and was equal to that after intramuscular dose of ABPC. Cmax after rectal dose of KS-R1 was equal to that after the oral dose, and was about 40% of the value attained with the intramuscular dose. Urinary recovery of ABPC during 6 hours after rectal dose of KS-R1 was 24.0%, compared with 34.0% for the oral dose, 59.6% for the intramuscular dose and 61.4% for the intravenous dose. The relative bioavailability of KS-R1, calculated on the basis of urinary recovery after intravenous administration of ABPC, was about 40%. 2. When KS-R1 (250 mg) was given to 2 adult volunteers 3 times daily for 5 days, no remarkable difference was found in plasma concentration and urinary recovery of ABPC. The pharmacokinetic parameters following the last administration were similar to those following a single administration of KS-R1. 3. KS-R1, oral ABPC and intravenous ABPC were administered at the dose of 125 mg (potency) to 5, 4 and 3 children and at the dose of 250 mg (potency) to 5, 3 and 3 children, respectively. Peak plasma level (Cmax) of ABPC after rectal administration of 125 mg and 250 mg of KS-R1 was reached in 15 minutes, indicating 4.8 and 7.1 mcg/ml, respectively. Peak time (Tmax) of ABPC after the rectal doses of KS-R1 was about 2 hours earlier than that after oral doses of ABPC. Cmax after KS-R1 was 3-4 times as high as that after the oral doses. Area under the curve (AUC) with KS-R1 was 1.38-1.55 times greater than that of oral ABPC, and about 24% of the values obtained with intravenous doses of ABPC. Urinary recoveries of ABPC rectal doses of KS-R1 were 30.4 to 45.6%, compared with 29.2 to 30.8% for the oral doses and 61.1 to 76.1% for the intravenous doses.(ABSTRACT TRUNCATED AT 400 WORDS)
Plasma levels of ampicillin (ABPC) after the single rectal insertion of KS-R1 at doses of 125 and 250 mg in 154 children reached a peak at 11 approximately 15 minutes in children of age less than 1 year old, at 16 approximately 20 minutes in children of 1 approximately 3 years, 4 approximately 6 years and more than 7 years old with the highest levels of 11.50, 8.69, 10.33 and 8.30 micrograms/ml, respectively. Highest plasma levels of ABPC were 6.48, 8.00, 12.32 and 17.83 micrograms/ml by the administration of KS-R1 at doses of less than 10.9 mg/kg, 11.0 approximately 15.9, 16.0 approximately 20.9 mg/kg and more than 21.0 mg/kg, respectively, with dose-dependent response which were observed at 11 approximately 15 minutes or 16 approximately 20 minutes. There was no difference of plasma levels between the administration of 125 and 250 mg of KS-R1. The pain of insertion was observed in 0.6% of total 167 cases, the feeling of defecation in 2.4% and the discharge of suppository or its dissolved material or defecation within 30 minutes after insertion in 12.6%, without the influence of patients ages and dosage level. These figures were almost the same as those after the insertion of other suppositories such as erythromycin suppository or antipyretic suppository. Clinical effectiveness of KS-R1 was examined in 51 childish patients with various infections. KS-R1 was rectally given to them at doses of average 41.6 mg/kg/day divided into 3 to 4 times for 7 days. All cases showed excellent and good effects. Bacteriologically, all pathogens which were isolated from 12 patients were eradicated.
Latamoxef (LMOX) was administered as a one-shot intravenous injection of 10 mg/kg or 20 mg/kg to 28 newborn and immature infants of 1 to 28 days of age. For 6 hours following the administration, the concentrations of the drug in the plasma and in the urine were monitored and the urinary recovery rate was determined. In addition, 17 patients, consisting of newborns, immature infants and suckling infants, aged 0 days to 2 months and diagnosed as having various bacterial infections, were also treated with LMOX; the mean daily dosage was 103 mg/kg, administered in 2 to 6 divided doses as one-shot intravenous injections for an average duration of 11 days. These patients were subjected to the analysis for the clinical efficacy and bacteriological efficacy of the therapy. Furthermore, with the inclusion of 35 drop-out cases, a total of 52 patients was investigated for the occurrence of side effects by the LMOX therapy. The findings of these studies are summarized below. The patients were divided into 5 groups on the basis of age: 3 days old or less, 4--7 days, 8--14 days, 15--21 days and 22--28 days. Only in the 8--14 day-old group administered LMOX at 20 mg/kg, the maximum mean plasma concentration of the drug occurred at the time of 15 minutes postadministration, although some individuals showed peaks at 5 minutes. In all of the other age groups, for both the 10 and 20 mg/kg dosages, the maximum plasma concentration of LMOX occurred 5 minutes postinjection. In each of the age groups, a dose response was seen between the 2 dosage levels. However, a comparison of each group and control infants in terms of the LMOX plasma concentration at 30 minutes after injection revealed that the concentrations in the patients in this study were low. In terms of the half-life of the drug at the 2 dosage levels, both the mean and individual values in each of the age groups were longer than the half-lives in control infants. This tendency was especially marked in the case of infants 7 days of age or less. The values for the AUC also tended to be larger in the younger patient groups. A good level of LMOX was detected in the urine during each of the 0--2, 2--4 and 4--6 hour periods following administration.(ABSTRACT TRUNCATED AT 400 WORDS)
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A 24-year-old female complained of headache and vomiting. The brain-CT scan demonstrated a tumor shadow in the right cerebellar hemisphere. The tumor was partially resected, and irradiation therapy was started. She died of intraventricular hemorrhage about 6 months after the onset of symptoms. Autopsy revealed a recurrent tumor mass in the cerebellum extending to the brain stem. It showed systemic metastases to the leptomeninx, liver, bones and ovaries. Histological examination showed a tumor which was a primarily composed of typical medulloblastoma cells with occasional Homer-Wright type rosettes. It partly showed glioblastoma-like configuration. Some tumor cells were positive for GFAP by the PAP method, suggesting glial differentiation.