Distal pancreatectomy using the harmonic scalpel.
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Equipment Design↗
Biomedical subjects
F Matsumoto
Publications and source records attributed to F Matsumoto.
In vitro activities of a new lipopeptide antifungal agent, FK463, against a variety of clinically important fungi.
The in vitro antifungal activity and spectrum of FK463 were compared with those of amphotericin B, fluconazole, and itraconazole by using a broth microdilution method specified by National Committee for Clinical Laboratory Standards document M27-A (National Committee for Clinical Laboratory Standards, Wayne, Pa., 1997). FK463 exhibited broad-spectrum activity against clinically important pathogens including Candida species (MIC range, <==0.0039 to 2 microg/ml) and Aspergillus species (MIC range, <==0.0039 to 0.0313 microg/ml), and its MICs for such fungi were lower than those of the other antifungal agents tested. FK463 was also potently active against azole-resistant Candida albicans as well as azole-susceptible strains, and there was no cross-resistance with azoles. FK463 showed fungicidal activity against C. albicans, i.e., a 99% reduction in viability after a 24-h exposure at concentrations above 0.0156 microg/ml. The minimum fungicidal concentration (MFC) assays indicated that FK463 was fungicidal against most isolates of Candida species. In contrast, the MFCs of FK463 for A. fumigatus isolates were much higher than the MICs, indicating that its action is fungistatic against this species. FK463 had no activity against Cryptococcus neoformans, Trichosporon species, or Fusarium solani. Neither the test medium (kind and pH) nor the inoculum size greatly affected the MICs of FK463, while the addition of 4% human serum albumin increased the MICs for Candida species and A. fumigatus more than 32 times. Results from preclinical in vitro evaluations performed thus far indicate that FK463 should be a potent parenteral antifungal agent.
Antifungal Agents↗
Efficacy of FK463, a new lipopeptide antifungal agent, in mouse models of disseminated candidiasis and aspergillosis.
The efficacy of intravenous injection of FK463, a novel water-soluble lipopeptide, was evaluated in mouse models of disseminated candidiasis and aspergillosis and was compared with those of fluconazole (FLCZ) and amphotericin B (AMPH-B). In the candidiasis model, FK463 significantly prolonged the survival of intravenously infected mice at doses of 0.125 mg/kg of body weight or higher. In disseminated candidiasis caused by Candida species, including FLCZ-resistant Candida albicans, FK463 exhibited an efficacy 1.4 to 18 times inferior to that of AMPH-B, with 50% effective doses (ED(50)s) ranging from 0.21 to 1.00 mg/kg and 0.06 to 0.26 mg/kg, respectively, and was much more active than FLCZ. The protective effect of FK463 was not obviously influenced by the fungal inoculum size, the starting time of the treatment, or the immunosuppressed status of the host. The reduction in efficacy was less than that observed with FLCZ or AMPH-B. The efficacy of FK463 was also evaluated in the disseminated candidiasis target organ assay and was compared with those of FLCZ and AMPH-B. Efficacies were evaluated on the basis of a comparison between the mean log(10) CFU in kidneys in the groups treated with antifungal agents and that in control group. A single dose of FK463 at 0.5 mg/kg or higher significantly reduced the viable counts in kidneys compared with the numbers of yeast cells before treatment, and its efficacy was comparable to that of AMPH-B, while FLCZ at 4 mg/kg showed only a suppressive effect on the growth of C. albicans in the kidneys. In the disseminated aspergillosis model, FK463 given at doses of 0.5 mg/kg or higher significantly prolonged the survival of mice infected intravenously with Aspergillus fumigatus conidia. The efficacy of FK463 was about 2 times inferior to that of AMPH-B, with ED(50)s ranging from 0.25 to 0.50 mg/kg and 0.11 to 0.29 mg/kg, respectively. These results indicate that FK463 may be a potent parenterally administered therapeutic agent for disseminated candidiasis and aspergillosis.
Animals↗
Efficacy of FK463, a new lipopeptide antifungal agent, in mouse models of pulmonary aspergillosis.
The efficacy of FK463, a novel water-soluble lipopeptide, was evaluated in mouse models of pulmonary aspergillosis and was compared with that of amphotericin B (AMPH-B). In the pulmonary aspergillosis models induced by intranasal inoculation, FK463 exhibited good efficacy, with 50% effective doses in the range of 0. 26 to 0.51 mg/kg of body weight; these values were comparable to those of AMPH-B. In an Aspergillus target organ assay with immunosuppressed mice, under conditions of constant plasma levels of FK463, using a subcutaneously implanted osmotic pressure pump, a significant reduction in viable fungal cells was observed at plasma FK463 levels of 0.55 to 0.80 microgram/ml or higher. We conclude that FK463 is highly effective in the treatment of pulmonary aspergillosis in this animal model. These results indicate that FK463 may be a potent parenterally administered antifungal agent for pulmonary aspergillosis.
Amphotericin B↗
A case of serial homicide by injection of succinylcholine.
The abstract of this paper was presented at the 14th Meeting of the International Association of Forensic Sciences, Tokyo in 1996. We report a bizarre criminal case of suspected serial homicide by injection of a muscle relaxant (succinylcholine). Five victims were found buried in a rural area. In two victims showing moderate decomposition (about three months after death), intense pulmonary oedema with pleural effusion was observed. Evidence of a puncture site was found in one of the victims. Succinylcholine could not be detected in the victims, but was identified in a syringe found near the corpses. The 40-mg ampule dose of succinylcholine administered intramuscularly to the victims, possibly causing prolonged apnea, was considered to be at least around the minimum lethal dose, although the combined effect of the sedation with hypnotics also used was not negligible.
Adult↗
[Congenital hydronephrosis detected by prenatal ultrasonography: the effect of pyeloplasty on renal function].
PURPOSE: Prenatal detection of congenital hydronephrosis has raised new questions with regard to the need of management and the indications for operation. Moreover, there is considerable controversy whether or not pyeloplasty improves long-term renal function. We evaluated the operative results of this entity under the setting of well defined indications for surgery. MATERIALS AND METHODS: The indications for pyeloplasty included Society for Fetal Urology-grade (SFU-grade) 3 and grade 4 hydronephrosis on ultrasonogram together with obstructive pattern on modified "Well Tempered" diuretic renogram. We analysed the postoperative changes of ultrasonographic findings, differential renal function, and renogram patterns in 28 children with unilateral hydronephrosis detected prenatally. RESULTS: Of the patients, 27 had grade-4 hydronephrosis on preoperative ultrasonogram. Pyeloplasty was effective in decreasing the grade of dilatation in all kidneys except one. Of the involved renal units, 14 (50%) had reduced differential renal function less than 45% on the preoperative renogram. Differential renal function increased significantly by absolute value of 5% or greater in 8 kidneys (29%), but decreases in 5 kidneys (18%). In the remaining 15 kidneys (54%) there was no significant differences between pre- and post-operative differential renal function. Postoperative diuretic renogram changed to non-obstructive pattern in 26 kidneys (93%). Another 2 kidneys showed hypofunctioning pattern. CONCLUSIONS: The results suggest that, although pyeloplasty decreases ultrasonographic dilatation of hydronephrosis and improves excretory pattern of diuretic renogram, significant increase of differential renal function is expected in only one third of the involved kidneys.
Humans↗
[Prenatal diagnosis of urological abnormalities].
The frequent discovery of fetal congenital abnormalities has led to a better understanding of pediatric urological disorders. On the other hand, new questions on clinical examinations and management of the children have given rise to much controversy. We reviewed the difficulties and pitfalls surrounding the urological prenatal diagnosis. Accuracy of ultrasonography is operator-dependent, and main factors leading misdiagnosis include oligohydramnios and rare incidence of the abnormalities. Underlying disorders of prenatal hydronephrosis are multifactorial. Efforts to obtain co-existing findings, such as ureteral dilatation or bladder abnormalities, are essential to make accurate diagnosis. Evaluation of fetal renal function is mandatory in critical cases with decreased amniotic fluid volume. Biochemical analysis of fetal urine may be most reliable in differentiating fetuses with a good prognosis from those with a poor prognosis.
Female↗
Ectopic vas deferens opening into the ureter.
PURPOSE: A pediatric case of ectopic vas deferens opening into the ipsilateral ureter is reported. METHODS/RESULTS: Ectopic opening of the vas deferens was detected incidentally at ureterocystotneostomy being performed for vesicoureteral reflux to the solitary kidney of a 7-month-old boy with anorectal anomaly. CONCLUSIONS: The preservation of the patency of the seminal tract is recommended.
Cystostomy↗
Crystallization and preliminary x-ray analysis of beta-amylase from Bacillus polymyxa.
A truncated beta-amylase (E.C. 3.2.1.2) from Bacillus polymyxa has been crystallized using the hanging-drop vapour-diffusion method at 277 K. The crystals belong to the orthorhombic space group P212121 with cell dimensions a = 64.6, b = 141.9, c = 155.1 A and diffract to 2.5 A resolution. The asymmetric unit containing three protein molecules was derived from an electron-density map calculated at 4 A resolution using MIR phases. This gives a Vm value of 2.36 A3 Da-1.
Bacillus↗
[Preventive effect of postoperative disinfection of endoscope on bacterial adhesion to endoscope].
We took culture of throat swab from 77 subjects who were negative for infection of HBV, HCV, HIV and syphilis infection before and after endoscopy. Moreover, the existence of bacterium including Helicobacter pylori at overcoat of endoscopic instrument was investigated right after examination and after disinfection of endoscope. Povidoneiodine, 70% alcohol and 1% benzalkonium chloride was used as a disinfectant for endoscope, and it took less than 10 minutes to wash by hand to disinfection. alpha-haemolytic streptococci, Staphylococcus epidermids, Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Enterococcus faecalis, Candida, Pseudomonas aeruginosa and MRSA were cultured in throat swab. The rate of adhesion of bacterium especially such as Candida, K. pneumoniae and S. epidermids to endoscope was considerably high. 23 of 77 subjects had H. pylori infection, and the adhesion of H. pylori to endoscope was found to be 65.2% of the subjects. On the contrast, no bacterium was detected from the endoscopic instrument after careful disinfection. These findings stress the importance of postoperative disinfection of the endoscope to prevent the chance to acquire bacterial infection.
2-Propanol↗
[Fetal megacystis with idiopathic intestinal pseudo-obstruction syndrome: a case report].
A 2,510 g female newborn was delivered by Cesarean section at 33 weeks gestation due to increasing volume of her huge bladder and bilateral hydronephrosis. Just after birth 190 ml of urine was drainaged by catheterization without difficulty. Voiding cystourethrography showed no VUR. She had no ureteral dilation, either. Urodynamic study revealed large bladder capacity and detrusor hypocontractility. Neither neurological nor gastrointestinal abnormality was detected neonatally. Clean intermitted catheterization was performed every 4 hours. At 12 months of her age she had no history of urinary tract infection. However, as she grew up with normal diet, severe constipation became apparent. This is a case of idiopathic intestinal pseudo-obstruction syndrome whose gastrointestinal symptom was masked in the newborn period. Attention should be paid for gastrointestinal tract as well as urinary tract when the body has congenital megacystis with unknown etiology.
Female↗
In vitro antibacterial activity of FK041, a new orally active cephalosporin.
The in vitro activity of FK041, a new orally active cephem antibiotic, against a wide variety of clinical isolates of bacteria was investigated and compared with those of cefdinir (CFDN) and cefditoren (CDTR). FK041 exhibited broad spectrum activity against reference strains of Gram-positive and Gram-negative aerobes and anaerobes. FK041 was active against clinical isolates of Gram-positive organisms except Enterococcus faecalis with MIC90s less than 1.56 microg/ml. FK041 was more active than CFDN and CDTR against Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus agalactiae and was comparable to CFDN and CDTR against Streptococcus pyogenes and Streptococcus pneumoniae. FK041 had no activity against methicillin-resistant staphylococci, like CFDN and CDTR. FK041 showed moderate activity against penicillin-resistant S. pneumoniae with an MIC range of 0.05 approximately 3.13 microg/ml, and was superior to CFDN but inferior to CDTR. Against clinical isolates of many Gram-negative organisms such as Neisseria gonorrhoeae, Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis, FK041 had good activity comparable or superior to those of CFDN and CDTR. However, it was inferior to CDTR in activity against Moraxella catarrhalis, Haemophilus influenzae, Morganella morganii, and Serratia marcescens, and was inactive against Pseudomonas aeruginosa. With FK041 a small difference between MIC and MBC against S. aureus, E. coli, K. pneumoniae, and H. influenzae was found, indicating that its action is bactericidal against these species. FK041 was stable to group 2beta-lactamase hydrolysis but was unstable to group 1beta-lactamase hydrolysis. The stability of FK041 to these enzymes was similar to those of CFDN and CDTR. FK041 showed high affinity for the main penicillin-binding proteins (PBPs) of S. aureus (PBP 3, 2, and 1) and E. coli (PBP 3, 4, lbs, 2, and 1a).
Bacteria↗
In vivo antibacterial activity of FK041, a new orally active cephalosporin.
The therapeutic activities of orally administered FK041 were evaluated in mouse models of systemic and local infections with a variety of bacteria and were compared with those of cefdinir (CFDN) and cefditoren pivoxil (CDTR-PI). FK041 exhibited potent therapeutic activity against lethal systemic infections induced by intraperitoneally inoculated Staphylococcus aureus, Escherichia coli, and Klebsiella pneumoniae with 50% effective doses (ED50) in the range of 0.20 to 0.36 mg/kg and was more active than CFDN and CDTR-PI. This result correlated well with its in vitro activity. The therapeutic effects of FK041 and reference drugs on murine local infections were evaluated in an in vivo pharmacokinetic model simulating human plasma concentrations for oral administration of 50 mg, 100 mg, and 200 mg. Against murine subcutaneous abscess induced by S. aureus, FK041 was as effective as CFDN and significantly more effective than CDTR-PI in reducing the number of recoverable viable bacteria in the skin at the infection sites. The efficacy of FK041 against murine pneumonia with H. influenzae was comparable to that of CDTR-PI and was superior to that of CFDN in reducing viable bacteria activity in the lungs. These results strongly suggest that FK041 has potential for clinical use against various bacterial infections.
Animals↗
[Antimicrobial activities of beta-lactam antibiotics against clinically isolated Haemophilus influenzae].
Antimicrobial activities of oral beta-lactam antimicrobial agents against clinically isolated 131 strains of Haemophilus influenzae were studied. The peak of MICs of ampicillin (ABPC) was 0.20 microgram/ml. Those of cefaclor (CCL), cefotiam (CTM), cefteram (CFTM), cefpodoxime (CPDX), cefdinir (CFDN), cefditoren (CDTR), cefcapene (CFPN), and faropenem (FRPM) were 1.56, 0.39, 0.013, 0.05, 0.20, 0.013, 0.013, and 0.39 microgram/ml, respectively. The antimicrobial activities of CFTM, CDTR and CFPN were superior to those of others. There was 74.8% of ABPC-sensitive strains, of which the MICs were below 0.78 microgram/ml. The percentages of beta-lactamase-positive strains and beta-lactamase-negative ABPC-resistant H. influenzae (BLNAR) were 14.5% and 14%, respectively.
Anti-Bacterial Agents↗
[Fluoroquinolone].
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Anti-Infective Agents↗
[Clinical evaluation of biapenem in various infectious diseases].
The clinical usefulness of injectable biapenem (BIPM) was examined for various infectious diseases in the fields of internal medicine, urology, surgery, orthopedics, obstetrics and gynecology, otorhinolaryngology, ophthalmology, dermatology, oral surgery, and plastic surgery. BIPM was administered by intravenous drip infusion at a dose of 150, 300, or 600 mg twice a day. The concentrations in various body fluid and tissues were also examined. 1. In the total enrollment of 256 cases, the numbers subjected to the analyses for clinical efficacy, bacteriological efficacy, side effects and abnormal laboratory findings were 214, 170, 252 and 251 cases, respectively. 2. The clinical efficacy rate was 85.5% (183/214 cases) as a whole, being 2/2 for sepsis, 6/8 for cellulitis and lymphangitis, 76.2% (16/21) for traumatic, operative wound and burn infections, 4/6 for osteomyelitis and arthritis, 92.9% (13/14) for peritonsillar abscess and peritonsillitis, 83.3% (15/18) for chronic lower respiratory tract infection, 7/7 for pneumonia, 83.3% (30/36) for complicated urinary tract infection, 100% (14/14) for cholecystitis and cholangitis, 88.2% (15/17) for peritonitis, 86.5% (32/37) for internal genital infection, 8/9 for pelvic peritonitis, 2/4 for corneal ulcer, orbital infection and panophthalmitis, 1/2 for otitis media, 4/4 for sinustitis, 93.3% (14/15) for osteitis of jaw and cellulitis of mouth floor. The efficacy rate in the poor responders to the pretreatment by other antibiotics was 86.4% (70/81). 3. 300 strains of causative organisms were isolated from 170 cases which contained polymicrobial infections. The elimination rate of causative organisms was 85.3% (256/300 strains), in terms of bacteriological efficacy. 4. Side effects were noted in 11 of 252 cases (4.4%) with 11 events. The signs and symptoms were the skin symptoms (5 cases), gastro-intestinal symptoms (3 cases), interstitial pneumonia (2 cases), and feeling bad (1 case), all of which disappeared during treatment or after the discontinuation of treatment. The abnormal laboratory findings were observed in 31 of 251 cases (12.4%) with 50 events, and major ones were an increase in eosinophils, and elevations of AST, ALT, gamma-GTP and Al-p. 5. The concentrations of BIPM in body fluid and tissues were determined in 46 cases (212 samples) most of which were administered 300 mg of BIPM by intravenous drip infusion for 60 minutes. The concentrations in the sputum within 6 hours after administration were 0.1-2.5 micrograms/g. The maximum concentrations in body fluid and tissues were 0.2-1.8 micrograms/g or ml in the bile, middle ear mucosa, tonsillar tissue, aqueous humor and bone tissues and were 2.0-5.7 micrograms/g or ml in the gallbladder, maxillary sinus mucous membrane, ethmoidal sinus mucous membrane, oral tissues, skin, woman genitals, synovia, joint tissue, and the eschar. The concentrations in the uterine arterial plasma and retroperitoneal fluid were almost similar to those in the cubitl vein plasma. From the above-mentioned results of clinical efficacy, bacteriological efficacy, and safety, injectable BIPM was confirmed to be useful in the treatment of moderate, severe and/or refractory infections in various fields.
Adult↗
S-adenosyl-L-methionine attenuates ischemia-reperfusion injury of steatotic livers.
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Alanine Transaminase↗
Follow-up of children after fetal treatment for obstructive uropathy.
BACKGROUND: Improvement in the ability to evaluate fetuses with obstructive uropathy, combined with technologic advances, has allowed successful fetal treatment of these conditions in Japan. We analyzed the prenatal and postnatal clinical courses of patients who underwent shunt placement in utero. METHODS: We treated 6 patients who underwent fetal intervention and were transferred to us for urologic management. Gestational age at detection of abnormalities ranged from 11 weeks to 31 weeks, and fetal intervention was done between 16 weeks and 32 weeks. Excluding 1 infant who was delivered 6 days after the intervention, the mean period between shunt placement and delivery was 17 weeks. RESULTS: Urologic pathology included prune belly syndrome with urethral hypoplasia in 3 patients, cloacal anomaly in 1, posterior urethral valves in 1, and pelviureteric junction stenosis of a solitary kidney in 1. Four patients required ventilation support in the neonatal period, and 2 of them suffered frequent infections during follow-up. Five patients who underwent vesico-amniotic shunt placement continue to require clean intermittent catheterizations via vesicostomy because of hypoactive detrusors and hypoplastic urethras. After urologic treatment, serum creatinine in 5 patients reached a minimum of less than 0.4 mg/dL at some time during the first year of life. Another patient with a minimum creatinine level of 1.0 mg/dL has moderate renal insufficiency. CONCLUSION: From our series, it appears that early (before 20 weeks of gestation) shunt placement in severe lower urinary tract obstruction may benefit renal and pulmonary function. However, its efficacy in regard to bladder function remains questionable: shunt placement does not permit regular storage and evacuation, which may be essential for functional bladder development.
Female↗