[Studies on penetration of antibiotics to gallbladder tissue and bile, its surgical significance. Mainly with cefmenoxime]

Basic and clinical studies in 37 patients with biliary tract disease on comparison between cefmenoxime (CMX) and cefotiam (CTM) were studied and the following results were obtained. In vitro antibacterial activities of CMX and CTM against 25 strains (15 organisms) isolated from bile of patients with biliary tract disease were stronger than that of cefazolin (CEZ). In cholecystectomized patients, CMX (2 g) or CTM (2 g) was injected intravenously, followed by determination of concentration in bile and gallbladder tissue about 2 hours after administration. In CMX administration, the mean concentration in gallbladder bile was 812.1 micrograms/ml, and the mean concentration in duct bile was 1,050.6 micrograms/ml, and the mean concentration in gallbladder tissue was 100.7 micrograms/g. In CTM administration, the mean values were, 1,092.5 micrograms/ml, 1,287.8 micrograms/ml, 28.5 micrograms/g, respectively. The concentration of CMX and CTM were almost similarly. The bile concentration of CMX (i.v.) was compared with CTM (i.v.) by cross-over method in cases of T-tube drainage. The peak bile concentrations of CMX and CTM were as high as 172.4 micrograms/ml and 182.2 micrograms/ml, respectively, 1 approximately 2 hours after 2 g intravenous administrations. Furthermore, the concentration of them were highly gained, 16.1 micrograms/ml of CMX and 33.8 micrograms/ml of CTM, even at 5 approximately 6 hours. In choledochostomized patients, CMX (4 g/day) was injected intravenously, followed by determination of concentration in intraperitoneal exudate. The mean concentration of CMX was 15.3 micrograms/ml on the first day after the operation, and 6.0 micrograms/ml even on the third day after the operation. Those results suggest that the high antibacterial activity of CMX against organism in bile and, the high penetration of CMX to bile, gallbladder tissue and intraperitoneal exudate will promise its important role in treatment of biliary tract infections.

Gallbladder necrosis after transcatheter hepatic arterial embolization: a technique to avoid this complication

We present a technique used to avoid unnecessary embolization of the cystic artery in the treatment of hepatoma by transcatheter arterial embolization. A special long tapering catheter that is flexible and soft enough to be inserted into the distal small branches of the heptic artery is used. Embolic material ( Oxycel , absorbable cellulose) was mixed with Mitocin -C (mitomycin) and contrast material. This mixture will help to avoid reflux.

Correlation of the real-time ultrasonographic appearance of hepatic hemangiomas with angiography

The ultrasonographic appearance of hepatic hemangiomas was studied in 19 patients (31 lesions). The detectability rate by real-time ultrasonography was 77%. A hyperechoic, sharply-marginated and internally homogeneous lesion is highly suggestive of hemangioma. If the hypoechoic lesion has homogeneous internal echoes and/or strong marginal echoes, it is also suggestive of hemangioma. It is difficult to detect small lesions in the lower lateral part of the right lobe and lesions in the right lobe immediately under the diaphragm. Computed tomography should be the next procedure of choice in the evaluation process. If the computed tomography is not characteristic, angiography should be done to confirm the diagnosis.

Improved distributed-index planar microlens and its application to 2-D lightwave components

A recent improvement of a 2-D array of distributed-index (DI) planar microlenses is presented to demonstrate a 2-D integrated optical component using a planar microlens array. These components are made by stacking planar microlens arrays and other planar optical devices. The improved planar microlens has f = 2.0 mm, a N.A. = 0.23, and its spherical aberration is very small. A fiber coupler is demonstrated. From a preliminary experiment, it is shown that the coupling loss of each channel is <0.5 dB for coupling 50-micron core DI fibers.

Ray traces in a distributed-index planar microlens

In this paper ray-optical treatment in a planar microlens with 3-D distributed refractive index is presented. An integral form of the ray equation has been derived when the index distribution is expressed by the sum of decomposed functions of radial distance r and axial distance z as in actual fabricated devices. The integral equation is solved independently with respect to r and z, and an analytic form of the ray trace has been obtained in some cases. By applying the result to a planar microlens with index distribution which can be almost approximated by the profile assumed here, its optical properties such as focal length, numerical aperture, and spherical aberration have been estimated.

Stacked planar optics: an application of the planar microlens

In this paper we present a new development of the distributed-index planar microlens of 2.5-3-mm focal length and 0.15 N.A. and also show that it is usable with optical components in fiber communications. We then propose a concept of stacked planar optics consisting of a stack of arrayed planar microlenses and other optical components. From this configuration a 2-D array of optical devices is monolithically available, and many discrete components can be separated from the array. An optical tap array has been fabricated as an example of stacked planar optics.

[Laboratory and clinical investigations of cefotiam in surgical biliary tract infections]

Laboratory and clinical comparative investigations with cefotiam (CTM) and cefazolin (CEZ) were performed to confirm efficacy and safety in surgical, biliary tract infections. The following results were obtained. 1) The MICs of CTM against organisms, 20 strains, which were isolated from bile of patients with cholecystitis, were studied, especially those of CTM against E. coli and Klebsiella were 0.2 - greater than or equal to 100 micrograms/ml and 0.1--12.5 micrograms/ml, respectively, considerably lower than those of CEZ. And moreover against CEZ-resistant Proteus morganii and Serratia marcescens, CTM showed potent activities, that is, MIC values, 12.5--50 micrograms/ml and 0.78 microgram/ml, respectively. 2) In cholecystectomized patients, 2 grams of CTM was injected intravenously, followed by determination of bile concentration in gallbladder, common bile duct and concentration of gallbladder and liver tissue about 2 hours after administration. The mean bile concentrations of CTM in gallbladder and common bile duct were 1,213.2 micrograms/ml and 1,287.8 micrograms/ml, respectively. The peak concentration of CTM was 2,919.0 micrograms/ml. The mean concentrations of CTM in gallbladder and liver tissue were 28.5 micrograms/g and 45.7 micrograms/g, respectively. On the other hand, the mean bile concentrations of CEZ in gallbladder and common bile duct were 138.7 micrograms/ml and 128.8 micrograms/ml, respectively. 3) Bile concentrations of CTM was compared with those of CEZ by crossover method. The concentration of CTM was 37.7 micrograms/ml even at 5 or 6 hours after 2 grams intravenously administration. CTM showed extremely higher concentration than CEZ in bile. 4) The clinical effect was studied in 6 cases of surgical, biliary tract infections. The results were excellent in 2 cases, good in 3 cases and poor in 1 case, and the clinical efficacy was 83%. 5) CTM was administered to 6 patients who showed negative to intracutaneous reaction test. Nausea, itching, and eruption were observed in each 1 case after intravenously administration of CTM 2 g, however these adverse reactions disappeared within several hours. Throughout the course of treatment, any unusual laboratory findings related to CTM were not observed.

Distributed-index planar microlens

Planar technology has been used to make a microlens array monolithically. By selectively diffusing a dopant into the planar substrate a distributed-index planar microlens has been realized. The monomer exchange technique for the plastic substrate and ion exchange and electromigration techniques for the glass substrate are used. In particular a 2-D planar microlens array was fabricated in a glass substrate. Each microlens was 1.2 mm in diameter and the focal length was 9.4 mm. The focused spot of the collimated He-Ne laser beam was as small as 17 micromphi.

Electronmicroscopic finding of surface structure and capsular swelling reaction of a strain of Klebsiella pneumoniae

To investigate a capsular swelling reaction of the strain K-9 of Klebsiella pneumoniae, possessor of large capsule, ultra-thin sections of the organisms were stained with uranyl acetate and lead citrate and were treated with rabbit antiserum. The ultra-thin sections of above stained organisms showed spike-like structure in outmost layer of the cell wall. When they were treated with rabbit antiserum, the outmost layers of the organisms was surrounded by a zone of oval to round polymorphous vesicular structure which covered the spike-like appendages. These findings were assumed being capsular swelling reaction of these organisms. However, when they were treated with rabbit antiserum which was previously absorbed with the polysaccharide surface antigen, polymorphous vesicular structures did not appear and sharp spiked structures issuing from the cell wall were exposed.

Right axillary lymph node visualization by bipedal lymphography: a case report

In the course of bipedal lymphography, the right axillary nodes were filled with contrast medium from the right pelvic region via the subcutaneous lymphatics. This was verified in the absence of lymphatic obstruction or abnormal corollary lymphatic routes.

A morphological and quantitative study of tumor blood flow. I. During growth and immune rejection

We have used serial microangiography and radioactive 133 Xe to study microvascular morphology and quantify blood flow in Walker 256 carcinomas implanted in rat tails during growth and immune rejection. No previous angiographic/quantitative studies during immune rejection are reported. Two tumor groups were identified. Group A grew rapidly, with a two- to six-fold increase in blood flow, and caused death in 10 days. Group B grew more slowly, and increased blood flow two to four times. At 6 to 8 days postimplant the B tumors diminished in size; blood flow decreased and extensive lymphocytic infiltration developed. By 21 days all evidence of the tumor had disappeared. The rejection appears to be cell-mediated, and the high incidence (65-70%) to be related to the number of tumor cells and/or presence of accumulated antigen in the innoculum. Microangiographic changes during immune rejection were specific, and included marked tortuosity of feeding vessels and a "ghostlike" fading out of tumor vessels, quite unlike the appearance of necrosis.