Autonomic dysfunction on the affected side in Meniere's disease

For ascertaining the existence of autonomic dysfunction on the affected side as being the cause of Meniere's disease, the mecholyl tests were conducted by means of conjunctival instillation in normal subjects as well as in patients with Meniere's disease, labyrinthitis and vestibular neuritis. The rate at which significant miosis (more than 10%) appeared in the mecholyl test was 3.1% among normal subjects, whereas the rate among Meniere's disease patients on the affected side was significantly higher during the attack, quasi-attack and interval stages. The appearance rate among Meniere's disease patients on the unaffected side was not different from that in normal subjects during any of the three stages. None of the patients with labyrinthitis or vestibular neuritis showed significant miosis on the affected side alone in the mecholyl test. This indicates that abnormality of vestibular-autonomic reflex in itself does not cause a positive reaction in the mecholyl test. Hence it can be concluded that the cause of Meniere's disease is related to the existence of autonomic dysfunction on the affected side.

[Clinical studies on PC-904 in biliary tract diseases (author's transl)]

The clinical effects of PC-904, a new semisynthetic penicillin, were studied in patients with biliary tract diseases, and the results were as follows: 1) PC-904 showed an average peak serum level of 40.7 +/- 11.6 microgram/ml 2 hours after an intravenous drip infusion of 1 g of the agent. The biliary level showed a peak value of 126.5 +/- 85.4 microgram/ml 2 hours to 3 hours after the infusion. 2) Isolated organisms from bile before the treatment were E. coli, Klebsiella, Proteus, Pseudomonas, Enterococcus and Bacteroides. MIC of PC-904 on 18 strains of isolated organisms was almost 6.25 microgram/ml or less. All isolated organisms except one strain of Klebsiella oxytoca disappeared after the treatment. 3) Six patients with cholelithiasis were medicated with PC-904 to prevent post-operative infections. The clinical effects were good in 4, poor in 1 and unknown in 1 case. 4) As to side effects no adverse reactions and allergic reactions were noted. Also no significant abnormalities of laboratory findings were observed.

[Therapeutic effect of midecamycin on Mycoplasma pneumoniae pneumonia in adults (author's transl)]

The clinical efficacy of a macrolide antibiotic, midecamycin, was studied in 12 adult cases with Mycoplasma pneumoniae pneumonia. The therapeutic effects were excellent or good in 9 cases and fair in 2 cases. On defervescence and disappearance of shadows on chest X-ray the therapeutic effect was satisfactory, but on disappearance of cough therapeutic effect was not clear in some cases. Taking into consideration the antimicrobial activity of midecamycin against Mycoplasma pneumoniae, serum concentration and side effects of midecamycin, this antibiotic is expected to be effective in the treatment of Mycoplasma pneumoniae pneumonia.

[Laboratory and clinical studies CS-1170 (author's transl)]

CS-1170 is a new antibiotic, a derivative of cephamycin C. In vitro, 50 strains of E. coli and Klebsiella consisting of gentamicin-sensitive isolated from the blood and gentamicin-resistant strains isolated from the urine were inhibited at concentrations from 0.4 to 12.5 mcg/ml of CS-1170, whereas only 2 strain of Klebsiella isolated from the blood had MIC more than 50 mcg/ml of the antibiotic. Moreover, CS-1170 was significantly more effective than cefazolin and cephalothin against these strains. Ten strains of gentamicin-sensitive Serratia isolated from the blood and the 2 gentamicin-resistant strains were inhibited at concentrations from 3.2 to 50 mcg/ml of CS-1170 and only one strain was resistant to this agent. All tested Serratia were resistant to cefazolin and cephalothin. CS-1170 was not effective against Enterobacter. Three cases of biliary tract infections consisting of 2 cases of cholelithiasis and a case of carcinoma of bile duct were treated with 4 g/day dosage of CS-1170. The remarkable effects were obtained in the two cases with cholelithiasis, whereas a case with the carcinoma was treated not so effectively by administration of CS-1170.

[Therapy for severe anaerobic infections with clindamycin (author's transl)]

Ten adult patients with severe Bacteroides infections were treated with 0.9 approximately 1.8 g/day of parenteral or oral clindamycin, and a child was treated with 0.3 g/day orally. Remarkable responses and cures were obtained in all the patients, who had no underlying diseases and pure anaerobic infections; a case of sepsis, two cases of liver abscess, a case of subcutaneous abscess and a case of spinal epidural abscess. The other six patients who had ultimately fatal underlying diseases or mixed infections did not respond well to the combination of clindamycin and the other antibiotics therapy, althought bacteriological cures were obtained in all but two cases. Clindamycin was well tolerated and generally nontoxic, nevertheless it was administrated for long term (34 approximately 49 days). But transient development of transaminase was seen in a patient. The data suggested that clindamycin should be considered a first choice antibiotic for the treatment of an aerobic, especially, Bacteroides infections.

Studies on the relationship between the histological changes and liver cell function or plasma proteins in hepatic diseases

Histological changes of liver biopsy specimens were compared with functioning liver cell mass estimated by an index, ICG capacity, and with plasma levels of various proteins, in 85 patients with liver diseases. IGC capacity was inversely proportional to the degrees of liver cell degeneration and lymphocyte infiltration in the portal tracts and parenchyma, in contrast to plasma disappearance rate of ICG (K), which was inversely proportional to the degrees of portal tract fibrosis and bridge formation. Among the plasma proteins synthesized in the liver, the plasma levels of prealbumin, and alpha1-acid glycoprotein showed the tendencies to decrease with the increase in the degrees of liver cell degeneration. The levels of ceruloplasmin, haptoglobin beta1A/C and transferrin were proportional to the degree of the degeneration. Plasma albumin had no correlation to any histological change. The plasma levels of gamma-globulin and IgG were both proportional to the degrees of portal tract fibrosis and bridge formation. IgM also paralleled to the degree of the fibrosis. The level of IgA was inversely proportional to the degree of liver cell swelling. It was concluded that quantitative estimations of some histological changes in the liver are valuable for the estimations of liver function and the grade of the diseases of the liver.