Acute and chronic effects of verapamil in patients with paroxysmal supraventricular tachycardia

Efficacy of acute intravenous verapamil, 10 mg, and chronic oral verapamil, 320 mg, daily were studied electrophysiologically in 15 patients with paroxysmal supraventricular tachycardia (PSVT). Plasma verapamil concentrations were measured concurrently. Both intravenous and oral verapamil significantly increased the AV node conduction time, the cycle length producing a Wenckebach period, and the refractory period of the AV node. These changes were reflected in changes in plasma verapamil concentration. The echo zone and the supraventricular tachycardia (SVT) zone markedly narrowed after administration of both intravenous and chronic oral verapamil. Verapamil's efficacy was found to be related to the type of SVT. For instance, verapamil was more effective in SVT due to AV nodal re-entry than in SVT due to concealed accessory pathway. Fourteen patients were followed from 3 to 31 months and all except one were well controlled. In conclusion, verapamil was effective in prophylaxis of paroxysmal SVT.

Studies on the light-focusing plastic rod. 15: GRIN rod prepared by photocopolymerization of a ternary monomer system

Plastic GRIN rod and fiber lenses have been fabricated by photocopolymerization of a ternary monomer system, methyl methacrylate-N-vinyl carbazole-vinyl acetate. We now propose the general mechanism for forming radial GRIN in the ternary monomer system using computer simulation. The relationship between the preparation condition and the optical characteristics was clarified. The region having quadratic-index distribution and the numerical aperture were remarkably improved by the ternary monomer system.

Evaluation of alaryngeal voice quality by nonparametric procedures

Alaryngeal voice quality was evaluated based on nonparametric statistics. Twenty voice samples of the vowel /e/ were recorded from sixteen alaryngeal and four normal speakers, and were randomized and presented to twenty normal listeners. The listeners rated the voices using seven-point scales consisting of twelve pairs of polar-opposite adjectives. By means of nonparametric procedures such as the Wilcoxon signed rank test, significant differences in the rating scores were detected for certain combinations of the voice samples, the classes of voicing methods, the listeners and the rating scales. Quality of the alaryngeal voices differed significantly from that of the normal voices on some of the rating scales. The results suggest the nonparametric procedures are useful to evaluate alaryngeal voice quality.

[Clinical evaluation of cefsulodin in Pseudomonas infections in children]

Cefsulodin (CFS) was evaluated for its safety and efficacy in 14 children with Pseudomonas aeruginosa infections. The diagnoses included pneumonia (4), sepsis (1), presumed sepsis (4), acute postoperative ascending cholangitis (1), acute postoperative peritonitis with wandering pneumonia (1), acute enterocolitis with acute UTI (1), recurrent UTI (1), and acute cystitis (1). CFS was administered intravenously with a daily dose of 93 to 299 mg/kg in the cases with normal renal functions. CFS was effective in all but one case both clinically and bacteriologically. A case of pneumonia whose isolate was resistant to CFS responded poorly. Mild transient eosinophilia was observed in 3 cases, but no severe adverse reactions were encountered. Peak MIC values of 18 clinical isolates of P. aeruginosa were 1.56 mcg/ml, 0.39 to 0.78 mcg/ml and 12.5 mcg/ml for CFS, gentamicin, and sulbenicillin, respectively. A half life of the serum CFS levels was 1.09 hours after intravenous bolus injection of 20 to 25 mg/kg of CFS (n = 2). A cerebrospinal-fluid level and biliary levels measured in cases with inflamed meninges or with cholangitis were well above the MIC value. From the present study, CFS appeared to be a safe and effective antibiotic when used in children with susceptible Pseudomonas infections. Combined use of another antibiotic should be considered in the case with polymicrobial infections because of the CFS's very narrow spectrum.

Effects of clonidine and guanfacine on drinking and ambulation in spontaneously hypertensive rats

Present experiment was undertaken to compare the effects of clonidine and guanfacine on water drinking behavior and ambulatory activity in spontaneously hypertensive rats (SHR). Equipotent hypotensive doses of clonidine and guanfacine, 150 micrograms/kg and 1500 micrograms/kg, respectively, given twice a day at 8:00 and 20:00, produced a triphasic pattern of behavioral changes; initial increase in water drinking and ambulation during the light period, decrease in water intake and ambulation at the beginning of the dark period, and a second increase in water drinking and ambulation at the end of the dark period. Guanfacine treated SHR showed less change in water drinking behavior and ambulation than the clonidine treated SHR.

Computer analysis of fixation-suppression of caloric nystagmus

Effects of the ocular fixation upon caloric nystagmus were quantitatively analyzed and compared between normal subjects and patients by using a PDP 11/40 computer. The slow-phase velocity was the best parameter to separate normal from abnormal visual fixation. An analysis of caloric nystagmus with failure of fixation-suppression (FFS) made it possible to classify patterns of FFS into three types. The combination of FFS with impairment of the optokinetic responses provides a useful diagnostic tool with respect to lesions located between the brain stem and the cerebellum.

The conduction velocity of slower and the fastest fibres in infancy and childhood

Motor nerve conduction velocity of the ulnar nerve was measured in 54 infants of various ages. Conduction velocity of slower fibres was measured using Hopf's technique, and maximal conduction velocity was measured with the usual method. Both maximal conduction velocity and conduction velocity of slower fibres increased with maturation. The former was about 65 m/s at the age of about 3-5 years, but thereafter it decreased slightly to about 60 m/s. Conduction velocity of slower fibres increased gradually until about 3 or 4 years of age, and then ranged about 40-50 m/s. The difference between the two velocities increased until 7 or 9 months of age; during the next 8 years, it tended to decrease to about 8-16 m/s. The increasing difference in size between the largest and the smallest myelinated fibres with maturation correlated with the developmental increase of the difference between maximal conduction velocity and conduction velocity of slower fibres. The anatomical evidence of the slight decrease of the axon diameter of the large fibres at the age of 7-14 years may correspond to the slight reduction of maximal conduction velocity after about 5 years of age.

[Changes in circadian rhythms of urinary catecholamine excretion in cold-stressed spontaneously hypertensive rats]

Investigations of the changes in ambulation and water drinking behavior of SHR were carried out and an attempt was made to determine the influence of cold exposure on the systolic blood pressure (SBP) and urinary catecholamines excretion (UCA) in SHR. Twenty week old male SHR-Okamoto strain (approximately 350 g) were used. The automatic Ambulo-Drinkometer was used to determine ambulatory activity and water drinking in SHR. UCA was determined by the trihydroxyindole method using high performance liquid chromatography. Cold exposure was performed for a period of 24 hours in a room maintained between 0--3 degrees C. It was observed that ambulatory activity and water drinking of SHR in dark phase were higher than those in the light phase (P less than 0.001). Significant increases in urinary norepinephrine (UNE), urinary epinephrine (UE), and urinary dopamine (UDA) contents as well as in urine volume were observed in the dark phase as compared with those in the light phase. SBP was significantly elevated after cold exposure. It was also demonstrated that cold exposure produced a significant increase in UNE and UE both in light and dark phases. Significant increase in UDA in cold stressed SHR was observed in dark phase. Although at room temperature (20 +/- 2 degrees C) significant difference in UCA between light and dark phases was observed, during cold exposure no significant difference was apparent. These findings suggest that temperature modulation induces changes in circadian rhythms of urinary CA excretion in SHR.

[Fundamental and clinical investigations of cefotaxime in neonates]

Fundamental and clinical investigations of cefotaxime were carried out in neonates. The following results were obtained. 1. Seven neonates with serious infections caused by identifiable pathogens, including Group B streptococcal meningitis and Group A streptococcal sepsis, were treated by intravenous bolus injection of 20-200 mg/kg of cefotaxime 2 or 3 times daily (60-400 mg/kg/day). The clinical efficacy of cefotaxime was assessed to be good in 6 patients and fair in 1 patient. Bacteriological efficacy was evaluable in 4 patients, all of whom displayed complete eradication of pathogens. 2. Among 22 neonates administered cefotaxime, adverse reactions appeared in 3 patients. Adverse reactions consisted of a transient skin rash in 1 patient and elevation of GOT in 2 patients. 3. Serum concentrations of cefotaxime and desacetyl cefotaxime were investigated in 8 mature infants and 5 immature infants on days 0-7 postpartum. A single intravenous injection of 20 mg/kg produced peak serum concentrations of 31.8-49.7 mcg/ml, associated with a half-life of 1.38-4.47 hours, in mature infants and peak serum concentrations of 35.5-55.0 mcg/ml, associated with a half-life of 3.22-6.43 hours, in immature infants. On days 0-2 postpartum the half-life was longer than on subsequent days. This tendency was particularly remarkable in immature infants. Serum concentrations of desacetyl cefotaxime displayed high individual variations; no consistent trends were noted. 4. Cefotaxime and desacetyl cefotaxime serum concentrations were studied in 3 neonates undergoing exchanged transfusion (exchanged volume 177-180 ml/kg) on 1-4 days postpartum. Serum concentrations of cefotaxime after exchanged transfusion were equivalent to 32.6-63.9% of the pretransfusion level, while those of desacetyl cefotaxime were 75.2-106% of the pretransfusion level. 5. Minimal inhibitory concentration (MICs) and minimal bactericidal concentration (MBCs) of cefotaxime were determined against clinical isolates. MICs for inoculum sizes of 10(8)/ml and 10(6)/ml were respectively 3.13-25 mcg/ml and 3.13-25 mcg/ml against S. aureus, 0.024 mcg/ml and 0.012 mcg/ml against Group A Streptococcus, 0.05 mcg/ml and 0.05 mcg/ml against Group B Streptococcus and 0.39 mcg/ml and 0.1 mcg/ml against E. coli. MBCs for an inoculum size of 10(6)/ml were 3.13-100 mcg/ml or over against S. aureus, 0.012 mcg/ml against Group A Streptococcus, 0.39 mcg/ml against Group B Streptococcus and 1.56 mcg/ml against E. coli.

The significance of blood transfusion in non-A, non-B chronic liver disease in Japan

We performed a follow-up study on 70 patients with acute non-A, non-B (NANB) posttransfusion hepatitis and a retrospective study on 283 chronic hepatitis, 70 cirrhosis and 53 hepatocellular carcinoma patients of type NANB. In acute NANB post-transfusion hepatitis, as judged by the transaminase levels, th duration of the disease exceeded 6 months in 46/70 = 65.7% and 1 year in 32/70 = 45.7%. The histological diagnosis of the 32 cases persisting for more than 1 year was chronic active hepatitis in 5, chronic persistent hepatitis in 2 and unresolved hepatitis in 6. The frequency of previous transfusion in chronic hepatitis, cirrhosis and hepatocellular carcinoma of type NANB was 42.8, 37.1 and 15.1%, respectively, whereas the incidence of early posttransfusion hepatitis was 8.5, 8.6 and 7.5%, respectively. in chronic liver diseases with a history of jaundice and/or hepatitis, previous transfusions are more frequently associated with type NANB than with type B disease. The present study demonstrates that NANB posttransfusion hepatitis tends to develop to chronic liver disease when analyzed prospectively as well as retrospectively.

Studies on the light-focusing plastic rod. 12: the GRIN fiber lens of methyl methacrylate-vinyl phenylacetate copolymer

The light-focusing plastic rod (LFR) and fiber (LFF) were fabricated by photocopolymerization of methyl methacrylate (MMA) with vinyl phenylacetate (VPAc). The MMA-VPAc LFR has much higher clarity than that of the MMA-vinyl benzoate LFR reported previously. Using the benzoin methyl ether as the initiator, which initiates photopolymerization preferentially, led to a much steeper index distribution than using benzoyl peroxide, which initiates thermal- and photochemical polymerization simultaneously. The relationships between preparation condition and optical characteristics were clarified in terms of the index distribution, light scattering, lens function, and attenuation of light transmission.

Distribution of mannosamine and mannosaminuronic acid among cell walls of Bacillus species

The distribution of mannosamine, mannosaminuronic acid, and the enzymes responsible for the formation of these saccharides was studied in nine species (18 strains) of Bacillus. Whereas UDP-N-acetylglucosamine 2-epimerase activity was detected in all of the strains examined, UDP-N-acetylmannosamine dehydrogenase, as well as the activity incorporating N-acetylmannosaminuronic acid residues from UDP-N-acetylmannosaminuronic acid into polymer, was found only in four strains of B. megaterium and one strain each of B. subtilis and B. polymyxa. The cell walls prepared from the six above-named strains were shown to contain mannosaminuronic acid in amounts of 135 to 245 nmol/mg. In contrast, mannosamine had a wide distribution. The cell walls from two strains of B. cereus and one strain each of B. circulans, B. polymyxa, B. sphaericus, and B. cereus subsp. mycoides contained mannosamine in amounts of 370 to 470 nmol/mg. In addition, the cell walls from five strains of B. subtilis, two strains of B. megaterium, and one strain each of B. cereus. B. coagulans, and B. licheniformis also contained this amino sugar in amounts as small as 10 to 35 nmol/mg. On the basis of analytical data, it is suggested that the mannosamine present in small amounts may be a common constituent of linkage units between peptidoglycan and other cell wall components such as glycerol teichoic acid.

Studies on DNA content of hepatocytes in cirrhosis and hepatoma by means of microspectrophotometry and radioautography

In order to clarify the underlying mechanism of malignant transformation from cirrhosis to hepatoma the cell kinetics of hepatocytes were studied in these two conditions. The content and synthesis of DNA in hepatocyte nuclei were investigated, by means of Feulgen-microspectrophotometry and tritiated thymidine radioautography, in cirrhotic and noncancerous parts of hepatoma with concomitant cirrhosis. The distribution of ploidy patterns was widely spread, from hypodiploid to hyperpolyploid, in the noncancerous parts of a cirrhotic liver containing hepatoma. In normal liver, each paired nuclear DNA content of a binucleate cell recorded almost the same amount, whereas in the noncancerous as well as in hepatoma cells much difference of DNA content was observed between the paired nuclei of the binucleate cells. The ploidy pattern of hepatocytes in patients with liver cirrhosis, who had developed hepatoma during follow-up periods of several months to several years, appeared to resemble that in noncancerous parts of hepatoma cases. On the other hand, the incorporation of tritiated thymidine into hepatocytes was found to be markedly increased in noncancerous parts as well as in cirrhotic liver developing hepatoma during follow-up periods. These results suggest the possibility that the hepatocytes in noncancerous parts of hepatoma have deranged cell-kinetics which might be a driving factor for the development of malignancy.

[Clinical results of 9,3"-diacetylmidecamycin in the field of pediatrics (author's transl)]

MOM was administered at a daily dose of 20 to 40 mg/kg q.i.d. orally to 65 pediatric patients. These consisted of 37 cases of acute feverish respiratory tract infection, 13 cases of Mycoplasma infection, 1 case of scarlet fever and 14 cases of whooping cough. Forty pathogenic bacteria were isolated from the 37 patients with acute feverish respiratory tract infection and 1 pathogenic bacteria was isolated from the patient with scarlet fever. Thirty-five of these clinical isolates disappeared as a result of MOM administration. For these 65 cases, the clinical efficacy was good in 51 cases (78.5%), fair in 5 cases (all whooping cough) and poor in 9 cases. Twelve strains of St. pyogenes were isolated from 12 cases and 3 of these isolates persisted (25%). Ten strains of S. aureus were isolated from 10 cases and 1 of these isolates persisted. Superinfection was observed in 3 cases, 2 of which were the same species. Although the clinical effect in the 40 mg/kg/day treatment group was superior to the effects in the 20 mg/kg/day and 30 mg/kg/day treatment groups, the difference was not statistically significant.

[Clinical studies on cefroxadine in the field of pediatrics (author's transl)]

Cefroxadine dry syrup was administered to 57 children with acute febrile respiratory tract infections and 2 children with scarlet fever in the dose of 40 mg/kg/day q.i.d. for 2 approximately 7 days. 65 strains of organism were isolated as pathogen from the 59 patients, and 50 of the 65 strains (76.9%) showed bacteriologically good responses. Clinically, 55 children (93.2%) had good response. Out of 63 strains isolated from the 57 cases with respiratory infections, 48 strains (76.2%) showed good bacteriological response. As for the type of pathogen, all strains of Staphylococcus aureus, 86.4% of Streptococcus haemolyticus and 90.0% of Streptococcus pneumoniae had good response, but as for Haemophilus influenzae it was only 47.6%. In one child, Streptococcus pneumoniae appeared during cefroxadine treatment in addition to the preexisting Haemophilus influenza. From the 4 children having no response for their respiratory infections, H. influenzae were isolated in 3 cases and Streptococcus haemolyticus was isolated in 1 case, before starting the treatment. As for side effects, mild diarrhea developed in only 3 children.