[When patients fall into silence. Silence is telling].
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Biomedical subjects
Publications and source records attributed to Y Taguchi.
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Histidine decarboxylase (HisDCase, EC 4.1.1.22) activity in mouse skin increased by a factor of more than 10 after a single application of phorbol 12-myristate 13-acetate. The cell type that was responsible for the increase in HisDCase activity was examined by using (WB X C57BL/6)F1-W/Wv mice, which are genetically deficient in tissue mast cells. In contrast to a report that increase of ornithine decarboxylase (EC 4.1.1.17) activity occurs in the epidermis [O'Brien, T. G., Simisiman, R. C. & Boutwell, R. K. (1975) Cancer Res. 35, 2426-2433], the HisDCase activity was found to increase in the dermis. Although most of the histamine in the dermis was present in mast cells, the increase in HisDCase activity in the skin in W/Wv mice was comparable with that in congeneic +/+ mice. This increase of HisDCase activity in the skin of W/Wv mice was abolished by prior x-ray irradiation (800 rads; 1 rad = 0.01 gray) but was restored by subsequent bone marrow transplantation. Because mice, in general, are known to lack basophilic leukocytes, the present results suggest the existence of histamine-producing cells without basophilic granules that are derived from the bone marrow.
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The most common treatment of chronic subdural hematomas is evacuation and irrigation via burr holes. The theory is that chronic subdural hematomas will undergo a natural healing process if such surgery is performed. However, there is no information concerning the course of hematoma absorption. In this work, 111In-DTPA was injected into the hematoma cavity before and after hematoma evacuation and irrigation in 12 cases of chronic subdural hematoma with comparatively mild symptoms. The radioactivity in the head was measure with time using a scintillation counter and the attenuation rate was obtained. The values measured hourly were expressed as ratios of the 1st measured value. Because of the properties of 111In-DTPA, this attenuation rate was considered to be the absorption rate of the liquid components of the hematoma. In 8 of the preoperative cases, the average measured values, were 84.8 +/- 12.6% after 3 hours, 77.3 +/- 12.1% after six hours, 34.5 +/- 13.8% after 24 hours and 13.3 +/- 13.5% after 48 hours. In six of the postoperative cases, the values were 70.4 +/- 14.3% after 3 hours, 47.8 +/- 10.8% after 6 hours, 12.4 +/- 6.7% after 24 hours and 3.6 +/- 2.0% after 48 hours. In a comparison between the two, the postoperative cases showed clearly advanced absorption with a significant difference at a risk factor of 0.1% or less in each case. This is because the osmotic pressure is the same for the liquid in the hematoma, the blood and the cerebrospinal fluid and an explanation based on this alone is difficult; it is necessary to consider colloid osmotic pressure. When the radioactivities in the liquid in the hematoma, blood and cerebrospinal fluid were measured, the values for the blood were always higher than those for the cerebrospinal fluid and most of the absorption of the hematoma is considered to originate in the vascular bed in the hematoma cavity (sinusoidal channel layer). Therefore, for the conservative treatment of chronic subdural hematomas, it is necessary to consider methods which promote absorption of the hematoma.
Changes in the levels of adenosine 3',5'-monophosphate (cAMP) and guanosine 3',5'-monophosphate (cGMP) in the discrete regions of rat brain during the sleep-wakefulness cycle were studied using a microwave fixation method. Rats were restrained in a specially designed frame in which they could move their heads and extremities freely and take food and water ad libitum. The rats were acclimatized to the microwave applicator for 1 h a day for 5-7 days, and then they were sacrificed by microwave irradiation of the heads under polygraphic monitoring. This procedure made it possible to obtain tissue for the analysis of cyclic nucleotides at different times during the sleep-wakefulness cycle. The content of cAMP in the various regions of the brain except the cerebellum decreased during sleep. In the hippocampus, midbrain, pons-medulla and cerebellum, the level of cGMP was highest during wakefulness, whereas in the striatum it was highest during paradoxical sleep. In the midbrain and pons-medulla, the level of cGMP was higher during paradoxical sleep than during slow-wave sleep. These changes of cyclic nucleotide contents may reflect the changes in the release of putative neurotransmitters during the sleep-wakefulness cycle. Our findings suggest that cyclic nucleotides may play some roles in the regulation of the sleep-wakefulness cycle.
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Gas-containing brain abscesses are rarely seen. Recently, in a 28-year-old man, such an abscess ruptured into the lateral ventricle but was treated successfully. Fusobacterium nucleatum, an anaerobic bacillus, was cultured from the pus obtained.
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A case of cholesteatoma, clearly delineated by preoperative air contrast retrograde pyelography, was treated like stone disease by removal of the obstructing material from the renal pelvis and pelvic ureter. A 7-year followup suggests that conservative surgical management may be the preferred treatment, since there is no evidence to date that cholesteatoma is a pre-malignant lesion nor necessarily a recurrent condition.