[Feasibility of CHOP chemotherapy--with special reference to age, diabetes mellitus, liver cirrhosis and obesity]

Since 1982, we have performed 384 courses of CHOP chemotherapy for 89 patients with malignancy including 70 with non-Hodgkin's lymphoma, adhering to the original regimen as strictly as possible. As severe acute reactions, myelosuppression, fever, arrhythmia, hemorrhagic cystitis, and perforation of duodenal ulcer were seen. Rates of fever had no tendency to increase with advancing age. Three patients only with diabetes mellitus had no severe side effects. Three patients with liver cirrhosis showed severe myelosuppression and fever. One patient both with liver cirrhosis and diabetes mellitus died from the infection due to CHOP chemotherapy, however the other febrile patients did not have life threatening infection. Thirty three percent (11/33 courses) of the patients with obesity experienced severe myelosuppression (WBC less than 1,000), while 55% (33/60 courses) of the patients without obesity. However satisfactory treatment results were not obtained in the patients with obesity. We consider that CHOP chemotherapy is excellent in feasibility even for the aged patients or the patients with diabetes mellitus. However, we suggest that the dose of CHOP chemotherapy should be reduced for the patients with liver cirrhosis.

An electroencephalographic study of psychiatric inpatients with antipsychotic-induced tardive dyskinesia

The awake EEGs of 48 psychiatric inpatients with tardive dyskinesia were compared with those of 29 matched controls without TD. EEGs of the TD patients were as follows: 22 (45.8%) were normal EEGs; 17 (35.4%), mildly abnormal EEGs; 8 (16.7%), moderately to severely abnormal EEGs. One record was excluded for severe artifacts. The control group showed a similar incidence of EEg abnormalities. EEGs with poor occipital alpha rhythm were significantly more frequent in the TD group than the control group. The TD patients tended to have an alpha rhythm of low voltage. Other characteristics of the alpha rhythm and amounts of theta, delta and beta activity showed no significant differences between the two groups. Severity of TD had no significant influence on EEG findings. The EEG similarities of TD and Huntington's chorea were discussed, and a suggestion was made that not only the basal ganglion, but also the cerebral cortex, could be involved in development of TD.

Regional cerebral blood flow in schizophrenic disorders

Regional cerebral blood flow was measured using a 133Xe inhalation technique in 16 schizophrenic patients and 20 healthy volunteers. The bilateral frontal blood flows in the patient groups were significantly lower than in the control group. In addition, the patient group having auditory hallucination showed a significantly increased blood flow predominantly in the left temporal region. On the other hand, the patient group without auditory hallucination showed a slightly increased flow in the right temporal region. These findings indicate that there are a hypofrontal activity and also a hypertemporoparietal activity in schizophrenics.

Squamous cell carcinoma found in the cardiac region of the stomach of an aged orangoutang

A spontaneous tumor was found in the cardiac region of the stomach of an aged orangoutang (Pongo pygmeans) in the Ueno Zoological Garden. This tumor, which was 10 cm in diameter and had invaded the serosa, was diagnosed as a squamous cell carcinoma. Metastases were found in the lymph nodes at various sites and in the liver, spleen and bronchus.

[Double-blind comparison of cefadroxil and cephalexin granules in the treatment of impetigo]

A double-blind clinical comparison of cefadroxil granules (CDX) and a long-acting preparation of cephalexin granules (L-CEX) was conducted in the treatment of impetigo in children. The long-acting cephalexin preparation was composed of 3 parts of granules soluble in the stomach and 7 parts of those soluble in the intestine. Drugs were administered at 3 different doses depending on the body weight of patients (Group I: less than 10 kg, Group II: between 10 kg and 20 kg, Group III: over 20 kg). Overall clinical evaluation by attending doctors: CDX group scored slightly better but not statistically significant results. Evaluation of usefulness: CDX group scored slightly better but not statistically significant results. Partially standardized evaluation: CDX scored statistically significantly higher points in the evaluation of total cases and Group II on Day 5, and Group II on Day 7. Cumulative points through Day 5 and Day 7 were not statistically significant. Follow-up evaluation by attending doctors: CDX group got a better result in total cases and Group II on day 3, and in total cases on days 5 and 7. Otherwise there was no statistically significant difference. Incidence of side effects was not significantly different between the 2 drug groups. As shown in Fig. 1, CDX was administered on rising in the morning, after lunch, and at bed time whereas L-CEX was given on rising and at bed time when the patients were relatively in fasting condition. This may have reduced the expected merit of L-CEX and some reserve is required in the interpretations of the results shown herein.

[Use of cefroxadine dry syrup in the management of acute skin infections in children (author's transl)]

1. Cefroxadine dry syrup was in principle administered at the dosage of 10 mg per kilogram of body weight 3 times a day. 2. Evaluation was done in 4 grades, i.e. excellent, good, fair and poor. 3. According to subjective judgement by attending doctors, 'excellent' or 'good' was recorded in 90.7%. 4. If the evaluation was partially standardized, 'excellent' or 'good' was obtained in 74.8% of total 163 cases and in 78.7% of 108 impetigo cases. 5. Side effects were observed in 3 cases (diarrhea 1, fever 2). No direct correlation of these complaints with the administration of the present drug was confirmed.

Standardization of parameters in follow-up study after mitral commissurotomy

Two-hundred and fifty-five patients were followed up to maximum 19 years (1879 patient-years) after mitral commissurotomy by means of either the finger fracture, transventricular dilator or open method. During this period of time, patients were asked to answer a questionnaire and to be examined at 2 to 3 years intervals. Twenty-two late deaths and 17 reoperations were encountered, and significant differences according to operative methods were observed in the survival and reoperation-free curves. Values from CTR, Rv1 + Sv5/Rv5 + Sv1 ratio, LAMP and DDR were standardized, and each standard value showed a tendency of significant improvement followed by gradual deterioration after commissurotomy even in patients with normal social activities. Parameters from patients reoperated on were compared with standard values, and statistically significant differences were noted. It would be concluded that standardization of parameters is of a great importance in follow-up study after mitral commissurotomy especially to establish indications to reoperation most adequately.