[Clinical studies on TMS-19-Q.O tablet in respiratory tract infection]

A new macrolide antibiotic preparation, TMS-19-Q.O tablet, was used to investigate the efficacy in the treatment of patients with respiratory tract infection, and the results obtained were as follows: Three hundred and seven cases were included in this report, and overall efficacy rate was 76.2%. Especially high clinical effect (86.0%) was observed in the treatment of patients with pneumonia including mycoplasmal pneumonia. Bacteriological effect was 87.5% in 51 cases identified as single infection of Gram-positive cocci and was 48.0% in 34 cases Gram-negative rods infection. Side effects were observed in 11 cases (3.50%): gastrointestinal disorder in 8, eruption in 2 and other in 1. Abnormality in laboratory tests was observed in 23 cases, hepatic disorder in 13, renal disorder in 3 and other laboratory tests in 7. It was considered from the results of clinical and bacteriological efficacy in different dose study that dose of TMS-19-Q should be 600 mg.

Axial resolution and the value of interpolating scan in multislice positron computed tomography

We have calculated the aperture function of a positron computed tomograph (PCT) with computer simulation, and evaluated the axial resolution of a multislice PCT, Positologica III, both theoretically and experimentally. The axial point spread function (PSF) was approximately a triangle at or near the center of the field, and the sensitivity for the slice decreased significantly as the source moved away off the image plane. Accordingly, there were low sensitivity areas between an in-plane and the adjacent cross-plane. This invisible region was clinically significant if the object was thin enough in the z-axis. In order to fill up the gaps between adjacent slices, it is valuable to move the patient half the slice interval in the z-axis and perform an " interpolating scan."

Cardiodynamic effects of experimental right bundle branch block in canine hearts with normal and hypertrophied right ventricles

Cardiodynamic effects of acute experimental right bundle branch block (RBBB) were studied in canine hearts: group A included 15 normal hearts; group B-1 had seven hearts with mild right ventricular hypertrophy (RVH), and group B-2 had 11 hearts with marked RVH. The main sequential changes following RBBB were marked prolongation of the Q upstroke interval of the right ventricle and striking shortening of right ventricular systolic time that affected right and left ventricular interaction, particularly in the hearts with RVH. Hemodynamic changes were: the right ventricular end-diastolic pressure was elevated markedly (4.4 +/- 2.2----9.8 +/- 2.6 mm Hg, p less than 0.001) in group B-2, moderately (p less than 0.01) in group B-1, and not at all in group A. The right ventricular positive peak dp/dt decreased remarkably (1036 +/- 151----827 +/- 152 mm Hg/sec, p less than 0.001) in group B-2 and negligibly in the other groups. A significant correlation existed between the percentage of decrease in right ventricular peak dp/dt and the QRS duration of RBBB in each group (p less than 0.01). The left ventricular peak negative dp/dt decreased distinctly (2570 +/- 326----+/- 2055 +/- 362 mm Hg/sec, p less than 0.01) in group B-2 and not at all in the other groups. The stroke volume showed 12% decrease in group B-2 (p less than 0.001), 8% decrease in group B-1 (NS), and no decrease in group A. In the presence of RVH, acute RBBB causes significant impairment of right and left ventricular function. The magnitude of the impairment invariably depends upon both the prior degree of RVH and the width of the QRS complex.

Purification and characterization of cytochrome P-450 with high affinity for 7-alkoxycoumarins

A unique form of cytochrome P-450 (called P-450(2] with high affinity for 7-alkoxycoumarins was purified from liver microsomes of phenobarbital-treated rabbits with an overall yield of about 0.6%. The purified preparation had a specific cytochrome P-450 content of 15-16 nmol per mg of protein and was homogenous on sodium dodecyl sulfate-polyacrylamide slab gel electrophoresis. The apparent molecular weight estimated for P-450(2) was 50,500. In the oxidized state its absorption spectrum was characteristic of low-spin cytochrome P-450. The activity of purified P-450(2) to catalyze O-dealkylation of several 7-alkoxycoumarins in the reconstituted system was compared with those of P-450(1), the major phenobarbital-inducible form in rabbit liver microsomes, and rat P-448(2), purified from liver microsomes of beta-naphthoflavone-treated rats. With 7-ethoxycoumarin as substrate, the pH optimum for P-450(2) was 6.5, whereas those for P-450(1) and rat P-448(2) were 7.5-8.0. P-450(2) showed Km values of 0.38 to 1.4 microM for the five alkoxycoumarins tested, whereas the corresponding Km values determined for P-450(1) and rat P-448(2) were 40- to 700-fold higher. The Km values of P-450(2) and P-450(1) were relatively unaffected by the length of the alkyl chain in the alkoxycoumarins, whereas those of rat P-448(2), decreased markedly as the length of the alkyl chain increased. For all the three forms of cytochrome P-450, the highest Vmax values were observed with 7-ethoxycoumarin, and Vmax values tended to decrease with increase in the alkyl chain length in the substrate. Only P-450(2) catalyzed 7-hydroxylation of coumarin, though at a low rate. Progressive and irreversible inactivation of P-450(2), but not P-450(1) and rat P-448(2), was observed during the catalysis of 7-methoxycoumarin O-demethylation, and this inactivation was considerably prevented by inclusion of cytochrome b5 in the reconstituted system.

A successful repair of tricuspid atresia by modified Björk's procedure--a case report

A ten-year-old Japanese boy with tricuspid atresia type IB was treated by direct anastomosis from the right atrium (RA) to the right ventricle (RV), entirely with autogenous material. An incision of the RA anterior wall was designed for a flap of RA appendage. A valveless conduit was created, with this flap and a large piece of pericardium. Atrial septal defect (ASD) and ventricular septal defect (VSD) were closed with a patch. Cardiac catheterization and angiocardiography two months postoperatively, showed good results of the surgery.

Kay's mitral valve repair for mitral regurgitation due to ruptured chordae tendineae--clinical and hemodynamic observations

Kay's mitral valve repair was performed in six consecutive patients with symptomatic mitral regurgitation due to ruptured chordae tendineae of the posterior leaflet. All patients including one with mild residual murmur showed a marked decrease in the heart size and significant clinical improvement. Postoperative hemodynamic studies, performed in four patients, showed restoration of normal or near-normal dynamics. The medium-term follow-up, 15 to 30 months after the operation, revealed continuing asymptomatic states in all. The function of the repaired valves was significantly better than that of the Hancock mitral bioprostheses. The advantages of this procedure compared with mitral valve replacement for the same condition were stressed.

Bentall's operation. A modification for coronary-graft anastomosis in an annuloaortic ectasia without displacement of the coronary origins

Bentall's operation using a composite graft for complete replacement of an ascending aortic aneurysm and associated incompetent aortic valve is being widely used. In case of no displacement of the coronary origins, however, this technique often leads to difficulties in restoring the coronary flow. We now report a successful modification for this coronary-graft anastomosis.