Biomedical subjects
Publications and source records attributed to K Kitamura.
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Liquid scintillation counting of alpha rays with pulse shape discrimination was applied to the analysis of 226Ra and 239+240Pu in environmental samples and of alpha-emitters in/on a filter paper. The instrument used in this study was either a specially designed detector or a commercial liquid scintillation counter with an automatic sample changer, both of which were connected to the pulse shape discrimination circuit. The background counting rate in alpha energy region of 5-7 MeV was 0.01 or 0.04 cpm/MeV, respectively. The figure of merit indicating the resolving power for alpha- and beta-particles in time spectrum was found to be 5.7 for the commercial liquid scintillation counter.
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A cloned effector-type suppressor T cell line, 3D10, which is known to suppress the antibody response against dinitrophenylated keyhole limpet hemocyanin (KLH), produced a soluble KLH-specific factor (TsF) that can replace the function of parental T cell clones. High activity of TsF was released spontaneously into the culture supernatant when cultured in interleukin 2 (IL 2)-containing medium, requiring no antigenic stimulation. The culture supernatant of 3D10 was also capable of inhibiting the KLH-induced proliferative response of primed T cells in an antigen-specific manner. The direct target of TsF was found to be Lyt-1+2- T cells undergoing an early stage of antigen-specific proliferation. TsF was antigen binding but lacked any other serologic markers such as I-J and immunoglobulin heavy chain-linked allotypic determinants on T cells. No genetic restriction was found in its action on allogeneic T cells. The production of IL 2 in proliferative T cells by antigenic stimulation was not inhibited by TsF. These results indicate that the TsF described here is the legitimate mediator produced by the effector-type suppressor T cell that suppresses the antigen-specific responses of Lyt-1+2- T cells. The m.w. of TsF was approximately 75,000.
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The occurrence of epileptic seizures is not rare after craniotomy. The authors examined the incidence of postoperative epilepsy in 150 patients of intracranial aneurysm. Anticonvulsants were given to all patients after operation, but in 12 cases anticonvulsants were discontinued because of liver dysfunction. One hundred and eight out of 138 cases (78%) were prescribed polypharmaceutically, and 30 of 138 cases (22%) were monopharmaceutically. The daily dose of anticonvulsants was as follows; diphenylhydantoin (DPH) was 150-300 mg, phenobarbital (PB) was 50-100 mg, valproic acid (VPA) was 600-1200 mg, and carbamazepin (CBZ) was 200-600 mg. Postoperative epilepsy occurred in 14 of 150 cases (9.3%); 13 cases with anticonvulsants, and 1 case without anticonvulsants. The site of aneurysm was as follows; 6 cases (10.3%) of AC aneurysm, 3 cases (9.7%) of MC aneurysm, 1 case (2.4%) of IC aneurysm, and 4 cases (21.1%) of multiple aneurysm. The interval between operation and epileptic seizure was ranged 2 to 57 months (mean 19.8 months); in 7 cases (50%) within 1 year, and in 13 cases (93%) within 3 years. The authors emphasize that prophylactic use of anticonvulsants is effective to control subclinical epileptic seizures, prescribing anticonvulsants to all patients after craniotomy in general. The medication of anticonvulsants for 3 years would be necessary for avoiding postoperative epileptic seizure.
Gangliogliomas are rare central nervous system neoplasms. The clinical features, radiological findings and surgical results in 6 histologically proven cases of gangliogliomas in the cerebral hemisphere are reviewed. The ages varied between 8 and 58 years old at the time of diagnosis. Five patients had seizure disorders without focal neurological deficit or clinical signs of increased intracranial pressure. These 5 patients had been treated as epilepsy for 6 months to 12 years. The other one patient had right sided motor weakness and left homonymous hemianopsia without seizure disorder. Plain roentgenograms of the skull revealed abnormal calcification in 3 out of 6 patients. Angiography showed an avascular mass in all 6 patients. CT scan were examined in 5 patients. In 3 patients the tumor were isodense, 2 of which demonstrated contrast enhancement. The other 2 showed low density lesion. One showed a single large cyst and another ill-defined low density containing high density calcification. In all 5 patients mass effect was slight. Three tumors were located in the temporal lobe and another 3 in the parietal lobe. At surgery total removal was accomplished in 3 patients. One patient had subtotal removal and 3 patients partial removal. Histological study revealed figures characteristic to the ganglioglioma. The predominant glial cell was astrocytic in 4 cases and oligodendroglial component was found in the other 2 cases. All patients either completely or nearly asymptomatic at the follow up for 1 to 12 years. The clinical study in 6 cases, along with a review of the literature suggest that these epileptogenic neoplasms should be aimed at surgical removal or total extirpation if possible.
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In the previous report, it was insisted that traumatic intracerebral hematoma should be regarded as a variety of cerebral confusion and that conservative treatment would be therapy of choice in these situations. Adversely, unjudicious operation would sometimes result in more expansion of hematoma by untamponade effect of decompressive craniectomy. In the present investigation, it was attempted to provide therapeutic policy in the management of traumatic intracerebral hematoma. Consecutive thirty two cases of traumatic intracerebral hematomas were selected for this study. Those cases with other hematoma such as epidural or subdural hematoma were excluded. These 32 cases were divided into two groups, operative (15 cases) and non-operative (17 cases). Whether to be operated or not was arbitrarily decided by the surgeons who were faced to the patients. Disturbance of consciousness of the patients were divided into three categories, namely severe (III-100 to 200 level), moderate (II-10 to 30 level), and mild (I-1 to 3 level). They were 8 cases, 5 cases, 1 case in operative cases and 6 cases, 10 cases, 1 case in non-operative cases respectively. Mortality rates were 13.3% (2 cases) in operative cases and none in non-operative ones. Concerning the patients of severely disturbed consciousness, there were no difference in their final outcomes between the two groups. On the other hand, 7 out of 10 cases of moderately disturbed consciousness recovered completely without operation, whereas all operative cases of the same category were, more or less, handicapped.
Okutano district, consisting of Manba-machi, Nakazato-mura and Ueno-mura all in Tano-gun, Gunma Prefecture, population 7,778 according to the 1980 Population Census, is the remotest district in Gunma Prefecture and had a depopulation rate of 9.2% in the 1975-1980 period. In this remote district the economically and socially bad conditions today such as the aging trend, working conditions, etc. are accelerating the depopulation, and the absolute shortage of medical services is making the health breakdown of the residents more serious than expected. This study is on the birthplace of the residents in the district mentioned above, and through analysis and examination of the 2,384 records of birth and to find cases of maternal death and infant death during the last two decades. The results were as follows: The reversion in the number of hospitalized and non-hospitalized births came in 1967, which was 8 years later than the national average. These days almost 99% of deliveries occur in hospitals. Accordingly, the distance between the residence and the birthplace has increased. Hospitalized deliveries was took place mostly at clinics until around 1969, and at hospitals thereafter. On the selection of the hospital there is a tendency to choose a nearby one if the receiving conditions permit. The rate of hospitalized deliveries goes down in proportion to the increase in the number of times of the delivery or the age of the mother. Though cases of the maternal death and infant death occur in high frequency in remote areas, the improvement in medical care along with the increase in hospitalized deliveries has contributed a great deal to the decrease of such cases.
We studied eye movements and clinical findings in 1225 patients with complaints of dizziness. Downbeat nystagmus was demonstrated in 11 patients during eye closure. Simultaneous vertical and horizontal eye recordings were examined to demonstrate vertical eye position during eye closure. Downbeat nystagmus appeared on midline position even during eye closure in six patients. An electrooculography was demonstrated in three out of above six patients. A 24-year-old woman (Case 1) complained of a single spell of vertigo. There was no remarkable finding on neurological examination. An audiogram was an abrupt type sensorineural hearing loss in both ears. A caloric test was normal. Horizontal and vertical smooth pursuit was normal. Optokinetic nystagmus showed normal response in both horizontal and vertical planes. Both eyes were elevated on eye closure. They were depressed to the midline position with mental task and downbeat nystagmus appeared. A 68-year-old man (Case 2) had a history of dizziness on walking of three-year duration. On examination neurological findings were normal. A caloric test was normal in both ears. Optokinetic nystagmus and smooth pursuit were normal in both horizontal and vertical eye recordings. He had a transient eye elevation on eye closure. Both eyes immediately came downward to midline position and downbeat nystagmus was demonstrated. His nystagmus had persisted for four years. A 68-year-old woman (Case 3) complained of positional vertigo of seven-month duration. Neurological findings were normal. A caloric test was normal. There was a conductive hearing loss on the left ear. The right ear showed a normal audiogram.(ABSTRACT TRUNCATED AT 250 WORDS)
A 28-year-old man was admitted to the Kyushu University Hospital with an episode of severe headache. When driving a car, he suddenly developed severe headache and this was followed by nausea and vomiting. he had been quite well except for slightly decreased libido before this episode. On admission, he showed galactorrhea. The pubic and axillary hairs appeared normal and the development of the external genital organs seemed normal. However, the movement of the sperma was decreased. Ophthalmologic examination was negative. Endocrinological studies revealed hyperprolactinemia of 697 ng/ml, and the serum prolactin level was suppressed by bromocriptine and L-DOPA loading test. The serum testosterone level was 282 ng/dl. Growth hormone and gonadotropin levels were normal. Plain films of the skull and tomograms of the sella showed double floor and slight ballooning. CT scan showed an isodensity mass in and above the sella, and this mass was slightly enhanced with contrast media. The suprasellar extension was better demonstrated by metrizamide cisternography and CT. The diagnosis of prolactinoma was made, and a radical removal of the tumor was done through the transsphenoidal route. During surgery, dark reddish fluid was aspirated in an amount of 1.8 ml. Histologically the tumor was chromophobe adenoma, and immunohistochemical stain revealed prolactin granules in the majority of the tumor cells. Postoperative serum prolactin level decreased to 150 ng/ml and finally returned to normal by administration of 2.5 mg of bromocriptine. The serum testosterone level was slightly elevated. The movement of the sperma showed no improvement. There were no postoperative complications such as hypopituitarism and CSF rhinorrhea. The usefulness of combination therapy of operation and medication with bromocriptine was suggested.
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