Biomedical subjects
Publications and source records attributed to Y Nakada.
A case of precocious puberty due to postmeningitic hydrocephalus was presented. Concentrations of serum gonadotropins and estradiol were found to be elevated, and the response of LH to LHRH was also high, similar to that in the late pubertal stage. CT scanning demonstrated marked dilatation of the third ventricle. It was considered that this was one of the factors which caused the precocious puberty.
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Studies on T-1982 (cefbuperazone), a new cephamycin antibiotic, were carried out in the field of pediatrics, and the following results were obtained. 1. Peak MIC of T-1982 against S. pyogenes (group A) lately isolated was 0.39 micrograms/ml, and the drug was active even against highly resistant strains of macrolides, lincomycin, tetracycline and chloramphenicol. 2. Peak MICs of T-1982 were 0.78 microgram/ml against B. pertussis, 0.2 microgram/ml against E. coli and less than or equal to 0.05 microgram/ml against K. oxytoca, and the drug was also active against ampicillin-resistant bacteria. 3. Serum levels and urinary excretions of T-1982 were investigated in 6 cases. When given at a dose of 20-28 mg/kg by 1 hour intravenous drip infusion, serum concentrations of T-1982 attained the peak level of 63.5-75.9 micrograms/ml at the end of administration and sustained the level of 0.9-2.6 micrograms/ml at 6 hours, the serum half-life (T 1/2) ranging 70-82 minutes. Approximately 20-72% of the dose were excreted in the active form into urine within 6 hours. 4. Twenty-seven cases of acute pediatric infections were treated with T-1982 mainly by intravenous drip infusion, and satisfactory clinical results were obtained in all the cases of angina lacunaris, bronchitis, bronchopneumonia, pertussis, sepsis caused by Serratia and acute urinary tract infections caused by ampicillin-resistant E. coli. The efficacy rate was 96.3%. In this study the drug was administered chiefly at a daily dose of 50-70 mg/kg 2-3 times a day for 2-12 days. 5. Gram-positive cocci (S. aureus, S. pneumoniae, S. pyogenes) and Gram-negative rods (H. influenzae, H. parainfluenzae P. vulgaris, B. pertussis, S. marcescens, E. coli) were eradicated by the treatment with T-1982. 6. No noticeable side effects were observed, except for temporary increase of eosinophil in 2 cases and slight elevation of GOT in 1 case.
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We reported four cases with well demarkated low density area in the middle cranial fossa, which was not enhanced with contrast medium and had the same absorption coefficient as the CSF. The operations and histological examinations revealed that two cases were arachnoid cysts and the others were porencephalic cysts. The clinicoradiological differential clues are listed below. 1) The porencephaly has intimate relation with focal neurological signs. 2) The thinning and bulging of the temporal bone are not a specific finding of an arachnoid cyst. Hemicranial atrophy, elevation of minor sphenoid wing and dilatation of paranasal sinuses in addition to focal bulging and thinning are indicative of porencephalic cyst. 3) Hemiatrophy of the brain and dilatation of the lateral ventricle on CT as well as the absorption coefficient of the brain surface facing the cyst are important finding of the porencephaly in differentiation. 4) The investigation of CSF dynamic is by no means helpful in differentiation between arachnoid cyst and porencephaly except intraarachnoid cyst. 5) The horizontal portion of the middle cerebral artery is not elevated in both two porencephalic cases. One of them showed a slight shift of anterior cerebral artery toward the affected side. An obstruction of the vessel is an important finding in porencephaly. 6) The electroencephalography can clearly demonstrate a porencephalic cyst as a localized slow focus, whereas it is not so remarkable in an arachnoid cyst.
Our Computer system linked with CT has been found to be very useful for radiotherapy treatment planning. We apply this system to treatment planning of about one half of the total cases of external beam radiotherapy and of all cases of brachytherapy. In the field of computer aided automation of radiotherapy treatment, we estimate automatic verification of treatment parameters and automatic recording of them are practically useful in routine radiotherapy. Conformation Radiotherapy can be realized to be practical when digital computer and CT are employed. On the basis of 300 cases of our clinical experiences of computer controlled conformation radiotherapy, the indication of conformation radiotherapy and clinical significance are described in this paper.
A 8-day-old boy with congenital hydrocephalus was given a shunt operation. Computed tomography (CT) revealed marked internal hydrocephalus and a high density area about the aqueduct of Sylvius, in the fourth ventricle and perhaps partly in the third ventricle which was completely absorbed one month later. Later conray ventriculography demonstrated aqueductal obstruction. Neuroradiologically there was neither neoplastic nor vascular lesion. The patient achieved almost normal motor and mental development at 9 months of age. The cephalopelvic discrepancy and vacuum extraction are thought to be the most likely caused of the hemorrhage. The site of hemorrhage was quite unusual as a neonatal intraventricular hemorrhage.
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The treatment and prognosis of 4 cases of primary middle fossa arachnoid cyst in children were analyzed with computed tomography, carotid angiography and Radio isotope cisternography at preoperative and postoperative states. In 2 of 4 cases the cysts reduced their sizes and in the other 2 cases they disappeared after operation. Three surgical methods were performed. The postoperative courses of all cases were good. The disappearance of cysts does not depend on the surgical methods.
General pharmacological properties of cefoperazone (CPZ) were studied in various experimental animals. CPZ showed the following effects with intravenous injection to experimental animals. On the central nervous system, CPZ caused vomiting in dogs at 500 mg/kg, pyrexia and slow waves in electroencephalogram in rabbits at 1,000 mg/kg. On the motor and sensory nervous systems, CPZ enhanced slightly the twitch tension of musculus gastrocnemius induced by electrical stimulation in rats at 500 mg/kg. On the respiratory, cardiovascular and autonomic nervous systems, CPZ increased transiently the respiratory rate and potentiated the depressor response to Ach at 125 mg/kg, increased femoral blood flow, potentiated the pressor response to Adr in dogs and decreased the contraction of nictitating membrane induced by electrical stimulation in cats at 500 mg/kg, and then raised the systolic blood pressure in rabbits at 1,000 mg/kg. On the blood, CPZ decreased ChE activity in rabbit plasma at 250 mg/kg, prolonged bleeding time in mice at 500 mg/kg and prothrombin time in rabbits at 1,000 mg/kg. On the smooth muscle organs, CPZ enhanced slightly gastric motility in rabbits and ileal motility in guinea pigs at 62.5 and 125 mg/kg respectively, and promoted gastrointestinal propulsion of BaSO4 meal in mice at 1,000 mg/kg. On the urinary organ, CPZ increased urine volume and electrolytes excretion in dogs at 500 mg/kg. Subcutaneous injection of CPZ scarcely showed any significant effect in experimental animals under the dose of 2,000 mg/kg. In the in vitro experiments, CPZ enhanced slightly the motility of isolated rabbit gastrointestinal tract at 10(-3) g/ml. Assuming the single clinical dose of CPZ should be 10 approximately 40 mg/kg, it is concluded that the occurrence of pharmacological effects observed in experimental animals seems to be very rare clinically.
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Surgical experience of intracerebral hematoma in an 8-month-old boy with severe hemophilia B, which was not diagnosed preoperatively, was presented. Carotid angiography and removal of hematoma by craniotomy were carried out quite safely under fresh-blood-transfusion. After several months ventriculoperitoneal shunt was placed, because of progressing hydrocephalus and multiple porencephaly, this time, under the cover of the factor IX complex. The clinical features of the intracranial hemorrhage in hemophilia were discussed, with analysis of 52 operation cases. Whenever we encounter a patient with intracranial hemorrhage, especially in infancy, hemorrhagic diseases, as hemophilia, must always be borne in mind. Although intracranial hemorrhage is still the most fatal complication of hemophilia, the surgical risk has been greatly diminished by advanced replacement therapy. We stress the need of immediate diagnosis and positive surgical treatment with adequate replacement therapy, if indicated.
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