[Acute subdural abscess due to mixed infection of Eikenella corrodens and Streptococcus constellatus].

Eikenella corrodens is a gram-negative, facultative anaerobic rod that frequently exists as part of normal human flora in the upper respiratory tract and gastrointestinal tract. Recently, E. corrodens is reported as a rare causative agent of empyematic lesion. We report a case of 10-year-old girl with acute subdural abscess. She developed a high grade fever, swelling of the left periorbital area, right sided partial seizure and hemiplegia. Brain CT and MRI showed left parietal subdural abscess. Because intravenous antibiotic therapy was not effective enough and her neurological symptoms progressed, surgical drainage was performed in order to decompress the brain and to determine the causative agents. Through careful bacterial cultures, E. corrodens and Streptococcus constellatus were detected from the subdural abscess. After the drainage operation and a three week course of appropriate chemotherapy, the abscess completely disappeared and no sequela remained.

Iodine absorption after intraoperative bowel irrigation with povidone-iodine.

PURPOSE: Povidone-iodine is a commonly used intrarectal tumoricidal agent in patients undergoing colorectal surgery. The aim of this study was to assess systemic absorption of total iodine and its effect on thyroid function after intrarectal application. METHODS: Twenty patients with carcinoma of the rectum received intraoperative irrigation with either povidone-iodine (Group A; n = 10) or physiologic saline (Group B; n = 10). Ten patients with carcinoma of the sigmoid colon (group C) were treated the same as Group A. Electrolyte, total iodine, triiodothyronine, thyroxine, and thyroid-stimulating hormone values were measured in serum preoperatively and before intraoperative irrigation and immediately, ten minutes, 1 hour, 6 hours, 24 hours, and two weeks after irrigation. RESULTS: No significant changes occurred in serum electrolytes. A significant uptake of the total iodine was demonstrated in each group. Total iodine levels examined immediately, ten minutes, and one hour after irrigation in Group C were significantly higher than those examined in Group B. Maximum values were obtained one hour after irrigation in Groups A and B and six hours after irrigation in Group C. No significant changes occurred in triiodothyronine, thyroxine, and thyroid-stimulating hormone levels among the three groups. The decrease in triiodothyronine levels after surgery was demonstrated in each group. We noted a decrease after surgery in thyroxine levels for Groups A and B and in thyroid-stimulating hormone levels for Group B. Those hormones were not affected by the administration of povidone-iodine. CONCLUSION: High serum levels of iodine did not cause organ toxicity, suggesting that a single use of intraoperative bowel irrigation with povidone-iodine may be performed with practically negligible risk.

Implantation on the suture material and efficacy of povidone-iodine solution.

Suture implantation of viable exfoliated tumour cells may be responsible for local recurrence of colorectal cancer. Using a colon cancer cell line, we obtained a suture implantation without intraperitoneal metastasis in about 80% of the control animals, when sacrificed on the 2nd postoperative week. The cytotoxic efficacy of povidone-iodine (PVP-I) was tested in vivo by a rat model with viable intracaecal tumour cells, and in vitro by trypan blue exclusion and the MTT assay. In vivo PVP-I at 5% significantly reduced the incidence of tumour growth, while the product at 2.5% had a significant effect in only the monofilament polypropylene group. In an in vitro toxicity study, PVP-I higher than 0.16% was effective at killing almost all tumour cells. PVP-I had effective cytotoxicity in vivo and in vitro, being less cytotoxic in vivo than in vitro.

[Dual biochemical modulation therapy using 5-FU, leucovorin and cisplatin on human rectal carcinoma xenografts in nude mouse].

This study examined a combined treatment for colorectal carcinoma, the dual biochemical modulation therapy, consisting of 5-FU, Leucovorin (LV) and Cisplatin (CDDP). We compared its anti-tumor effects with other treatments: 5-FU alone, CDDP alone and 5-FU with LV. Primary diffuse infiltrated colorectal carcinoma is well known for its biological malignancy and its lack of response to chemotherapy. We used SRM cells from a cell line of carcinoma of the rectum, and subcutaneously injected them into nude mice. The anti-tumor effects were estimated from the growth rate, inhibition rate and thymidylate synthetase inhibition rates in the tumor tissue. Results indicated that even if the concentration of 5-FU and LV were reduced by half, these combined with CDDP were more effective than other therapies. Dual biochemical modulation therapy is particularly promising because the reduction of the dosages would reduce the side effects while still serving as an excellent anti-tumor therapy.

[A model for sensitivity determination of anticancer agents against chemical-induced colon cancer in rats].

Chemically-induced colon cancer was used to test the sensitivity of tumors to chemotherapeutic agents. Thirty-four Sprague-Dawley rats received dimethylhydrazine (40 mg/kg) s.c. once weekly for 10 weeks to induce colon cancer. Twenty weeks after beginning the carcinogen treatment, a barium enema was performed to determine the size of colon tumors. The animals were divided into CDDP group and CPT-11 group, in which the maximum tolerable dose of each drug was given. After 5 weeks of treatment, the barium enema was repeated. "Response" was assessed on the basis of tumor doubling time. Response rates in the CDDP and CPT-11 groups were 6% and 35%, respectively. This reflects the clinical data of those drugs and confirms the results of our previous study. The present study may be a predictive model for screening anticancer drugs for human colorectal malignancy.

[Establishment and characterization of a human rectal cancer cell line, SRM from primary diffuse infiltrating type cancer].

Primary diffuse infiltrative cancer of the large bowel shows poor prognosis. A human rectal cancer cell line, designated as SRM, was established from the metastatic lymph node of a 35-year-old female patient. SRM cells have been cultured with RPMI-1640 medium supplemented with 10% fetal calf serum and grew as monolayers, showing a tendency to pile up. The doubling time of this cell line was 23.0 hours, and the modal number of chromosomes was 64 at passage 14. The cells produced CA19-9 and TPA in the spent medium and formed tumors in nude mice, the histology of which was similar to that of the primary tumor. CA19-9 in the cytoplasma of the transplanted tumor cells was demonstrated by the ABC method and the c-myc oncogene was amplified in the transplanted tumor in nude mice.

[Assessment and treatment of respiratory dysfunction in severely handicapped children: respiratory disorders during sleep].

In severely handicapped patients, chronic respiratory insufficiencies and recurrent hypoxemia especially during sleep are one of the major problems to take care of them. To clarify the pathophysiology of respiratory disorders during sleep, we examined 5 severely handicapped patients with no respiratory distress during wakefulness, but with signs of latent respiratory insufficiency by means of polygraphical all-night study including the arterial oxygen saturation (SaO2) monitoring. In the severely handicapped patients, sleep hypoxemia occurred frequently. The value of SaO2 decreased in proportion to the intensity of apnea determined by polygraph. The relationship between the value of SaO2 and sleep stage was variable in each patient. Four patients had mainly obstructive respiratory disorders and one had a central type respiratory disorder. The density of REM stage decreased in the obstructive type. In the central type, the repeat of REM stage with normal REM density was not observed. In one patient with obstructive type and one with central type, hypoxemia was improved with an increased number of REM stage by O2 inhalation.

Magnetic resonance imaging in Pelizaeus-Merzbacher disease.

Cranial computed tomography of a boy with clinical characteristics of the classic form of Pelizaeus-Merzbacher disease did not reveal a notable abnormality other than enlarged ventricles. Magnetic resonance imaging, however, demonstrated diffuse changes in the white matter with sparing of scattered small areas, suggesting persistent myelin islands which are a typical neuropathologic finding in Pelizaeus-Merzbacher disease. Magnetic resonance imaging appears more useful than computed tomography in confirming the diagnosis of Pelizaeus-Merzbacher disease.

[Cerebral palsy--investigation of its causal factors and genetical background].

In the last 30 years the prevalence rate of cerebral palsy (CP) has remarkably decreased in Japan. The decrease is arbitrarily attributed to the reduced frequency of such risk factors for CP, as low birthweight, severe asphyxia, and kernicterus in the neonatal period. However, there is no statistical data providing the evidence that CP patients complicating these risk factors have actually decreased so far. In order to make clear the bases of the decrease in prevalence of CP, we examined the changing patterns in the suggested cause of CP, experienced in the last 30 years. The investigation included the maternal condition of pregnancy and delivery, in relation to the neonatal risk factors, and genetic background of the family. In CP, low birthweight babies of 2500 gm or less were common (36.9%) and the mean birthweight (2689 gm) was obviously smaller than that of general population. In spite of the constant decline of the incidence of low birthweight babies in the general population in the last 30 years, the ratio of low birthweight to total births in CP group had not changed in this study period. It was concluded that the low birthweight following premature birth is still an important predisposing factor of CP. Asphyxia was frequently seen in the CP population. The rate of asphyxia was significantly higher in the group with a normal birthweight more than 2501 gm (58.4%), or gestational weeks longer than 36 weeks (57.7%), comparing with that of low birthweight (41.1%), or premature (40.7%) group.(ABSTRACT TRUNCATED AT 250 WORDS)