A case of multiple sclerosis with multi-ring-like and butterfly-like enhancement on computerized tomography

We report a case of multiple sclerosis in which CT showed multiple ring-like enhancement and butterfly-like distribution of a low density area with marginal enhancement. The latter finding is found in other demyelinating disorders but is less common in tumors or abscesses. Therefore, it seems to have some diagnostic value in multiple sclerosis.     

The effect of burn wound size on ureagenesis and nitrogen balance.

Hypermetabolic burn patients are frequently in negative nitrogen balance despite provision of estimated caloric needs. We studied 18 thermally injured adult patients in order to evaluate the relationship of burn wound size to urea production and nitrogen balance. We selected data from 147 patient-days when the patients received 100 +/- 25% of their estimated caloric needs. Three significantly different burn size groups (by body surface area [BSA]) were identified by calculation of the catabolic index (CI): group 1, 0-10% BSA (CI = -0.1); group 2, 11-30% BSA (CI = 6.4); and group 3,31-60% BSA (CI = 10.5). The urine urea nitrogen (UUN) for groups 1,2, and 3 was 11.1, 18.9, and 25.3 gm/day, and nitrogen balance was 1.0, -3.9, and -5.8 gm/day, respectively. When nitrogen was given in a calorie:nitrogen ratio of 150:1, only those patients in group I were able to achieve positive balance. We conclude that large burn wounds are associated with increased ureagenesis and impaired nitrogen retention. The protein intake, at the customary calorie:nitrogen ratio of 150:1, may not provide adequate nitrogen to achieve equilibrium, even when energy demands have been met, in patients with burn wounds greater than 10% BSA.     

Estimation of annual incidence of schistosomiasis japonica among school children in the Philippines;.

An attempt was made to estimate the annual incidence of schistosomiasis from the prevalences at ages 7 to 10 in the Philippines.     

Clinical studies on 6059-S for acute peritonitis. Clinical effect and tissue concentration (author's transl)

A new antibiotic drug of oxacephem, with marked resistance to beta-lactamase, 6059-S for parenteral use was tested in 10 patients with acute peritonitis. In 4 cases with appendicitis, 6059-S in a dose of 500 mg was given intramuscularly before operation. In 2 cases with perforate MECKEL'S diverticulitis and intestinal obstruction for right femoral hernia, 6059-S in a dose of 1 g was given by intravenous injection or intravenous drip infusion before or during operation. And in a case with peritonitis after gastrectomy for gastric cancer, 6059-S in a dose of 2 g was given by intravenous drip infusion. Tissue specimens of different sites or body fluids were taken during the operation and from the removed organs. The materials or purulent ascites were subsequently taken at intervals. Determination of 6059-S concentration was performed according to plate agar well bioassay method with Escherichia coli 7437 strain. The peak of 6059-S concentration in purulent ascites of patient with peritonitis for perforate MECKEL'S diverticulitis was 30.5 mcg/ml at 50 min. after 1 g intravenous administration. Concentration of 6059-S in drained pus was 8.38 mcg/ml soon after intravenous drip infusion (2 g, for 2 hrs.). In 10 patients with peritonitis, 6 patients were given 6059-S in a dose of 500 mg by intramuscular administration twice a day, and the serious 4 patients were given in a dose of 1 to 2 g by intravenous drip infusion 1 to 2 times a day. Clinical response was excellent in 6 cases, good in 3 cases, fair in 1 case and poor was none. Any clinical adverse effect was not recognized. On the 6059-S concentration in patients with peritonitis, the concentration in purulent ascites, drained pus and infected tissues were observed higher than the MIC of 6059-S against Escherichia coli and Klebsiella pneumoniae. Therefore 6059-S will be a very useful drug when used for chemotherapy of acute or subacute peritonitis.