[Treatment of acute subdural hematoma in infancy-tapping only method and a follow-up study (author's transl)]

Acute subdural hematoma in infants is characterized by convulsive seizure, disturbance of consciousness, vomiting and irritability soon after mild head injury. The majority of cases have tence or bulged anterior fontanel and preretinal hemorrhage. Eleven cases, all traumatic in etiology and male under the age of one year were reported. Nine of them were treated by percutaneous subdural tapping alone, i.e., "Tapping Only Method". For the first several days, tappings were carried out daily. The subdural content was liquefied old dark blood or liquefied fresh-appearing blood in most cases. After that taps were performed only in the presence of intracranial hypertension. Vomiting and irritability were fairly reliable indicaters of intracranial hypertension but the most consistent signs were the fontanel tension to palpation and the measurement of head circumference. As soon as it could be determined that increased pressure did not recur within ten days after the last tap or that dry tap was confirmed the infant was discharged and follow as an outpatient. Follow-up studies on this series by cerebral angiography, EEG, skull measurement and Denver developmental screening test revealed normal physical and mental development in nine cases, although three out of nine cases showed mild but persistent avascular area. The remaining two cases showed more or less physically and mentally retarded developments: the initial treatment for both of them was delayed more than ten days. Acute infantile subdural hematoma due to mild head injury should be divided into the following two types: "Fulminant type", which rapidly falls in coma and may be fatal. The another, "Mild type" manifests only signs and symptoms of mild intracranial hypertension. This mild type should be treated by tapping only method without delay. There is a possibility that some mild type cases are overlooked and later progress to chronic infantile subdural hematoma. For comparison, thirteen cases of acute infantile subdural hematoma treated by trephination and/or craniotomy were reviewed. Pathological study revealed that early formation of capsular membrane is one of the characteristic findings.

Study on the photochemical reaction of HCN and its polymer products relating to primary chemical evolution

The photochemical reaction of HCN at 184.9 nm is studied in the gas phase. (CN)2, H2, CH4, NH3, N2H4, C2H6, and CH3NH2 are identified as gas phase products, and a reaction mechanism is proposed. HCN polymers are also obtained as solid reaction products, and their structure is investigated by Infrared Spectorscopy, UV-Visible Spectroscopy, Mass Spectrometry, and Amino Acid Analysis. The process and nature of the formation of the polymers are discussed.

The skin-reactive antigens of Mycoplasma pneumoniae

Guinea pigs experimentally infected with Mycoplasma pneumoniae or immunized with the orgnaism in combination with Freund's complete adjuvant developed a delayed hypersensitive skin reaction following on intradermal injection of the M. pneumoniae antigen. The amount of protein necessary to produce the delayed skin reaction was as low as 0.01 mug. When the sonicated whole cells were extracted with aqueous acetone, the delayed skin reactivity was found mostly in the acetone insoluble (lipid-depleted) fraction. On the other hand, the lipid fraction which was isolated by a chloroform-methanol extraction of the acetone-soluble fraction and had a high titer of complement-fixing activity, exhibited little delayed skin reactivity. The lipid-depleted antigens as the whole cell antigens produced delayed skin reactivities in human patients.

The antigens participating in the macrophage micration inhibition to Mycoplasma pneumoniae

Recently the association of cellular immunity with pulmonary infiltrates in Mycoplasma pneumoniae infection has been suggested. Guinea pigs infected experimentally with M. pneumoniae developed a cellular hypersensitivity that could be demonstrated in vitro by the macrohage migration inhibition test. Peritoneal exudate cells obtained from guinea pigs sensitized with the organism were inhibited from migrating out of capillary tubes by the whole cell antigen. When the whole cells were extracted with aqueous acetone, the activity was found in the acetone insoluble (lipid-depleted) fraction, but not in lipid fraction. The activity was heat resistant, but diminished by treatment of 0.8 N HC1 at 100 degrees C for 30 min. The antigens responsible for the cellular immunity of M. pneumoniae were separated from the lipid, which had been considered the specific hapten associated with humoral immunity to this organism.

Macromolecules and the origin of life

From our knowledge of present day organisms, it is hard to imagine a living assembly, even at its most primitive stage, without macromolecules. In order to look for the macromolecules which possibly participated in the assembly of the primitive organisms, the reaction and formation of polymers in HCN under irradiation of ultraviolet ray of 184.9 nm. was studied. As an example of a simple way of producing an assembly of macromolecules, the mechanism of coacrevation was studied by using gelatin as the material.

Positive antinuclear antibody in atopic dermatitis

Serum samples from atopic dermatitis (AD) patients were examined with two antinuclear antibody-detecting methods, using HEp-2 cells as substrate. 34.0% of 47 AD patients tested with FITC-conjugated polyvalent immunoglobulins (method 1) had positive antinuclear antibody (ANA). 26.3% of 57 AD patients examined with FITC-conjugated anti-IgG (method 2) had positive ANA. We found that AD patients who had facial lesions tended to have positive ANA, whereas severe AD patients tended to have high titres of ANA.