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Biomedical subjects

K Deguchi

Publications and source records attributed to K Deguchi.

At least 253 records · Page 14Linked to original sources
PubMed1990

[A case of complete remission from acute unclassified leukemia achieved by using a prodrug of ara C, stearyl-ara-CMP (YNK01)].

YNK01 (a daily oral dose of 450 mg) was administered for 22 days to a 58-year-old-female with Ph1-positive acute unclassified leukemia. Leukemia cells were negative for peroxidase and esterase, but were positive for CD19, CD13, CD34, CD9, HAL-DR, CD25, and TdT. Complete remission was obtained and continued for at least a month. The main side effects noted were diarrhea and melena. The administration of YNK01 resulted in plasma ara C levels that ranged between 15.4 to 23.0 ng/ml, which appear to be nearly equivalent to dose achieved during continuous IV infusion of a low dose (20 mg/m2/day) of ara C.

Acute Disease↗
PubMed1990

[Methicillin-resistant Staphylococcus aureus infection in the Kagoshima University Hospital--special attention to prevalence in otolaryngological infectious disease].

A retrospective study of the characteristics of MRSA (methicillin resistant S. aureus) in Kagoshima University Hospital and its ENT department was reported. There were 231 samples (104 strains) MRSA in all S. aureus 448 samples from Jan. to Sep. 1989 in Kagoshima University Hospital, in which 58 strains (55.8%) were coagulase type II and 35 strains (33.7%) were type VII. The much more predominant numbers of MRSA were observed in all the cases inpatients clinics in surgery, pediatrics, urology, gynecology and dermatology than internal medicine as well as outpatients clinics. In ENT department of this hospital, only 15.4% of all S. aureus were MRSA. On the other hand, bacteriological survey showed 26% of MRSA out of all S. aureus which were detected at Tokyo clinical research center on otorrhea in the patients with chronic otitis media as multicenter clinical trial of Japan. Two cases involved by MRSA after postoperative administration of many types of antibiotics were also demonstrated. These MRSAs were producing type II coagulase and very high concentrations of MICs to many antibiotics were observed. But these cases were not severe and MINO (minocyclin) or GM (gentamicin) were so effective. The effect of combined therapy of some antibiotics or antimicrobial agents was discussed briefly.

Anti-Bacterial Agents↗
PubMed1990

[Acute transverse myelitis associated with ECHO-25 virus infection].

A case of acute transverse myelitis associated with ECHO-25 virus infection was reported here with a brief review of the literature. The patient was a 42-year-old house wife. Without any antecedent symptoms, weakness and paresthesia of bilateral lower extremities, and sphincter disturbance developed suddenly. Neurological examination revealed paraplegia of both legs, hyperreflexia of lower extremities, bilateral positive Babinski sign and impairment of all sensory modalities below Th4 level. No abnormality was found in myelography and CT myelography. Abnormal intensity area was found in lower cervical spinal cord on MRI. Serum antibody titer to ECHO-25 virus was elevated in the convalescent stage (X4096), and 7 month later from the onset of neurological symptoms, high value was continued (X128). We diagnosed her illness as acute transverse myelitis complicating ECHO-25 virus infection. In the literature, only 3 cases of transverse myelitis following ECHO virus infection (type 2, 5, 19) were found. This case seemed to be the first case of transverse myelitis associated with ECHO-25 virus infection.

Acute Disease↗
PubMed1990

[Annual changes in susceptibility of clinical isolates to midecamycin acetate].

To investigate annual changes in the susceptibility of clinical isolates to midecamycin acetate (MDM-AC), minimum inhibitory concentrations (MICs) of MDM-AC were determined for clinical isolates obtained from outpatients since 1985. MDM-AC-resistant strains of Staphylococcus spp. and Streptococcus spp. have shown similar degrees of resistance to midecamycin and josamycin. Regarding this as macrolide resistance, proportions of macrolide-resistant strains tended to increase for Staphylococcus aureus and Streptococcus pneumoniae but to decrease for Streptococcus pyogenes. 1. For S. aureus, 8% of the strains isolated in 1985, 20% in 1987 and 20% in 1989 were macrolide-resistant. Of these macrolide-resistant strains, 70% or more in 1987 and 80% or more in 1989 were methicillin-resistant S. aureus (MRSA). 2. For S. pneumoniae, 8% of the strains isolated in 1985, 12% in 1987 and 12% in 1989 were macrolide-resistant, indicating a tendency for resistant strains to increase annually. 3. For S. pyogenes, 8% of the strains isolated in 1985, 4% in 1987 and 0% in 1989 were macrolide-resistant, showing a decreasing tendency. 4. MDM-AC is still thought to be a clinically useful antibacterial agent because it still shows antibacterial activity against 80% or more of Gram-positive cocci clinically isolated in recent years and a low degree of induction of macrolide resistance in Staphylococcus spp.

Bacterial Infections↗
PubMed1990

[Cerebellar AVM--clinical analysis of 14 cases].

The authors report on their experience with 14 cases of cerebellar arteriovenous malformation (AVM), with emphasis on their clinical symptoms and treatment problems. The incidence of cerebellar AVM was 7.5% in all cases of intracranial AVM. Twelve of them presented with hemorrhages, one with a headache and one with a focal neurological deficit related to the "steal" phenomenon. Three out of 4 poor risk patients with intracerebellar hematoma recovered well after their operations. Thus, we can say that surgical treatment should be performed even if the patient's state seems hopeless. The nidus was located at the vermis in 7, at the cerebellar hemisphere in 5, and at the tonsil in 2 cases. The surgical approach to the superior surface of cerebellum or the tonsil near the brainstem became a problem. In our series, all surgically treated cases were approached through the suboccipital route with the patient in the prone position and the surgical results were favorable. On the other hand, one case which underwent conservative treatment died due to rebleeding. Thus, as the follow-up mortality with conservative treatment is higher and the results of surgery are better, surgical treatment should be attempted. Preoperative MR imaging is one of the useful methods used to determine whether an excision is possible without significant deficit, especially in cases in which the AVM is located near the brain stem. In our series, two patients had concomitant aneurysms related to feeding arteries. Another interesting case of a neonate who had a small tonsillar AVM is reported.

Adult↗
PubMed1990

[Measurement of MICs on 16 antimicrobial agents for freshly isolated methicillin-resistant Staphylococcus aureus strains].

MICs of 16 antimicrobial agents including a newly synthesized aminoglycoside antibiotic, arbekacin (HBK), were determined against methicillin-resistant Staphylococcus aureus (MRSA) strains which had been isolated since 1988 from patients with refractory infections. 1. The proportion of highly methicillin-resistant strains was large, especially among those isolated from blood and respiratory tract. 2. All the MRSA strains were resistant to all the beta-lactam antibiotics tested. 3. Most of the strains were also resistant to aminoglycosides. However, HBK inhibited the growth of 95% of the strains at 3.13 micrograms/ml or less, showing potent activities even against highly resistant MRSA strains. 4. The MIC distribution of HBK against MRSA strains showed no change since 1986 when year to year data were compared. Based on our studies on the drug resistance pattern of MRSA since 1986, a large proportion of MRSA strains isolated from blood and respiratory tract appeared to be coagulase type II. 5. Netilmicin-resistant MRSAs have increased since 1986, and MRSA resistant to fosfomycin, minocycline, ofloxacin and norfloxacin have also increased in 1989 compared to 1988. 6. The drug resistance pattern of MRSA has been changing every year and they are acquiring multi-drug resistance. Thus, in the treatment of MRSA infections, it is very important to identify the drug susceptibility of MRSA quickly and accurately.

Aminoglycosides↗
PubMed1990

[Availability of DDAVP in hemostasis control for the breast tumor resection in a patient with thrombasthenia (type II)].

We reported a 33-year-old woman with thrombasthenia (type II) in whom 1-deamino-8-D-arginine vasopressin (DDAVP) was available for the hemostasis control during breast tumor resection. She has had recurrent nasal bleeding and purpura since 2 years old. On the first admission to our hospital because of hematuria at 18 years old, she was diagnosed as thrombasthenia (type II) from hemostatic studies. At 20 years old, she had a healthy baby by the cesarean section with transfusion of fresh blood and platelet concentrates. On the 5th admission for the breast tumor resection, defect of glycoprotein II b-III a of her platelets was confirmed by using SDS gel electrophoresis. Recently, there are some reports on availability of DDAVP for hemostatic control in platelet dysfunction of various etiologies as well as mild hemophilia and von Willebrand disease. So, DDAVP (0.4 microgram/kg) was used for hemostasis control. After 1 hour, the bleeding time was shortened from over 10 to 4 min, platelet adhesiveness to glass beads increased from 1.8 to 37%. Furthermore, the levels of Ristocetin cofactor and von Willebrand factor antigen (especially large multimer) also increased. But platelet aggregation with various inducers remained unchanged before and after infusion. Breast tumor (fibroadenoma) resection.

Adult↗
PubMed1990

[Long-term results of cerebral arteriovenous malformations--surgical and conservative treatment].

During the past 20 years, we have treated 187 cases with cerebral arteriovenous malformations (AVMs). These 134 patients were treated surgically and the remaining 53 patients were managed non-surgically. The purpose of this study is to clarify the surgical indications of AVMs, based on a comparison of the long-term follow-up results between the surgical and nonsurgical groups. Consequently, good results were obtained in the surgical group: the operative mortality was 7.5% and the morbidity was 12.7%. The long-term follow-up results were as follows: Of the 124 followed cases in the surgical group, there were 16 cases with improvement of neurological deficits (13%) and 3 cases with neurological aggravation (2%). Of the 47 followed cases in the nonsurgical group, there were 5 cases with improvement of neurological deficits (11%) and 6 cases with neurological aggravation (13%). As for the incidence of AVM hemorrhage, there were 8 cases with hemorrhage in the nonsurgical group including 4 cases (3 rebleeding cases) which were fatal (11%), in contrast to one case (subtotal resection) in the surgical group. On follow-up angiography, the size of AVMs were unchanged in the majority of cases in the nonsurgical group, with the exception of 2 cases in which there were slight regressions. In the surgical group, on the other hand, enlargement in 2 cases and spontaneous regression in 3 of residual AVM occurred following incomplete resection. Particularly in 2 cases involving unresectable AVMs, a newly formed aneurysm was discovered in the follow-up angiography, emphasizing the fact that serious follow-up angiography is required in cases of untreated AVMs.

Adolescent↗
PubMed1989

Hypercoagulable state in the Watanabe heritable hyperlipidemic rabbit, an animal model for the progression of atherosclerosis. Effect of probucol on coagulation.

Blood coagulation in a strain of rabbits designated as Watanabe heritable hyperlipidemic (WHHL) rabbits was examined. The activities of vitamin K-dependent clotting factors, contact factors and clotting factor VIII (F VIII) and the fibrinogen level were significantly higher in WHHL rabbits than in normolipidemic rabbits (all age groups). Values for vitamin K-dependent clotting factor were already higher at 2 months of age. Contact factors and fibrinogen levels increased age after 5 to 8 months. F VIII increased between 5 and 8 months and then decreased. At 2 months of age, WHHL rabbits were divided into two groups. Group A was fed standard rabbit chow and group B standard rabbit chow containing 1% probucol. Probucol prevented the progression of atherosclerosis in group B in the absence of a significant reduction in plasma cholesterol level. F VIII and fibrinogen levels were statistically decreased in all rabbits at all ages in group B (P less than 0.05). These differences in clotting factors between the two groups were most obvious at 8 months (P less than 0.02). We conclude that vitamin K-dependent clotting factors may increase with hyperlipemia and that increases in F VIII and fibrinogen may be closely related to the progression of thromboatherosclerosis.

Aging↗
PubMed1989

Ehlers-Danlos syndrome complicated by eventration of the diaphragm, colonic perforation and jejunal perforation--a case report.

A case of a 61 year old woman with Ehlers-Danlos syndrome who developed recurrent gastrointestinal complications is reported herein. She has been followed by Kyoundo Hospital since 1965, when she originally underwent treatment for eventration of the diaphragm and a volvulus of the stomach at the age of 41. During the past 22 years she has experienced perforation of the colon three times and jejunal perforation once. This case was considered to be type II Ehlers-Danlos syndrome. We have found 12 other cases of Ehlers-Danlos syndrome with gastrointestinal complications in the Japanese literature. More thorough examination of Ehlers-Danlos syndrome cases may reveal more subclinical gastrointestinal abnormalities. We concluded from our experience and from the literature that when colonic perforation occurs in this syndrome, total colectomy and ileo-rectal anastomosis is reasonably indicated.

Adult↗
PubMed1989

Alterations in coagulation and fibrinolysis associated with cardiopulmonary bypass during open heart surgery.

The effect of heparin as an anticoagulant was examined and the extent of fibrinolytic activity during cardiopulmonary bypass (CPB) was measured. Twenty patients undergoing valve replacement or aortocoronary bypass surgery were studied. Fibrinopeptide A (FPA) levels gradually became elevated as CPB proceeded, and antithrombin III (AT III) decreased during CPB. This indicates that despite the use of heparin, the coagulation system was activated, leading to fibrin formation in the microcirculation. On the other hand, fibrinopeptide B (FPB beta 15-42) also increased to four times the preoperative value at two hours on CPB. Intrinsic fibrinolytic activity, as determined by the activity of kaolin-activated euglobulin, was transiently increased only at the beginning of CPB. The C1 inactivator-resistant fibrinolytic activity and tissue plasminogen activator antigen (t-PA;Ag) increased sharply during CPB and reached maximum levels one hour after the start of CPB, indicating that enhanced fibrinolytic activity during CPB is predominantly of extrinsic origin as the result of t-PA release from the vascular walls. It is concluded from the above findings that thrombin activity continues during CPB. Enhanced fibrinolytic activity during CPB appears to be important because t-PA activates plasminogen predominantly where fibrin is formed, leading to dissolution of the microthrombi formed during CPB.

Adult↗
PubMed1989

[Activity of procoagulant and fibrinolysis in homogenate of leukemic cells].

We examined activities of procoagulant and fibrinolysis in homogenate of leukemic cells. Procoagulant activity (PCA) was increased in patients with acute myelocytic leukemia (AML) and acute promyelocytic leukemia (APL), but it was significantly decreased in patients with chronic myelocytic leukemia (CML) and adult T cell leukemia. In CML, PCA was increased in the blastic phase. Plasminogen activator activity (PLGAA) was also increased in patients with AML, APL and acute lymphocytic leukemia (ALL) associated with disseminated intravascular coagulation (DIC). Elastase-like activity, trypsin-like activity and chymotrypsin-like activity (CTLA) were increased in those with myelocytic leukemia, but they were low in those with lymphocytic leukemia. PCA, PLGAA and CTLA were significantly higher in patients with DIC than in those without DIC. Measurement of procoagulant and fibrinolytic activity in leukemic cells homogenate may be useful not only for studying hemostatic abnormalities but also for classification of leukemic cells.

Blood Coagulation Factors↗
PubMed1989

[Determination of the MIC of cefotetan against freshly isolated gram-negative bacilli].

Antimicrobial activities (MICs) of cefotetan (CTT) against 575 strains of 16 spp. of Gram-negative bacilli isolated in 1988 were determined to investigate distribution of MICs in comparison with those of cefmetazole (CMZ), cefoxitin (CFX), latamoxef (LMOX) and cefazolin (CEZ). The change in frequencies of incidence of cephem-resistant strains in the latter half of the 1980 was also investigated. Distribution of MIC of CTT varied with test strains. No or very few MICs were at or higher than 12.5 micrograms/ml at an inoculation of 10(6) cfu/ml, thus rates of CTT-resistant strains were low among Escherichia coli, Citrobacter diversus, Klebsiella spp., Proteus spp., Providencia spp., and Haemophilus influenzae. High rates of resistance to CTT were observed, however, among Citrobacter freundii, Enterobacter spp., Serratia marcescens, Morganella morganii, and Bacteroides fragilis. 2. Most CTT-resistant strains of C. freundii, Enterobacter spp. and S. marcescens were also resistant to LMOX. These resistant strains were considered to be multi-resistant strains to antibiotics including oxime type cephalosporins and monobactams. 3. Cephem-resistant E. coli was confirmed to be resistant to 22% of CEZ, 14% of CFX, 10% of CMZ and 2% of CTT tested. The incidence of cephem-resistant E. coli unconditionally showed an increasing tendency. 4. The incidence of resistant strains against cephamycins including CTT is discussed with regard to the mechanism of resistance against all beta-lactam antibiotics, and the problem of the appearance of resistant strains is close and inseparable from social background.

Cefazolin↗
PubMed1989

Coagulation and fibrinolysis in patients with chronic renal failure on maintenance hemodialysis.

Alteration of the coagulation-fibrinolysis system was examined in patients on maintenance hemodialysis. The mean values of fibrinogen, factor V, factor VII, factor VIII, vWF (activity and antigen), factor IX and factor XI were significantly higher in these patients than in control subjects (p less than 0.01), but factor XII alone was significantly lower. Fibrinolytic parameters (euglobulin lysis time, fibrin plate lysis, fibrin degradation products and alpha 2-plasmin inhibitor-plasmin complex) suggested a hyperfibrinolytic state and plasmin generation in the patients' circulation. These findings suggest that the alteration of the coagulation-fibrinolysis system is aggravated by repeated hemodialysis, either by the influence of the dialyzer itself or heparin.

Adult↗
PubMed1989

[Antimicrobial activity of cefteram comparison with other oral antibiotics].

Antimicrobacterial activities of cefteram (CFTM) against clinical isolates collected in 1988 were compared with those of new beta-lactams. 1. Antibacterial activities of CFTM against Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae, Branhamella catarrhalis isolated from acute respiratory tract infections were 8- to 16-fold higher than those of cefaclor (CCL). 2. Activities of cefixime (CFIX) were superior to those of CFTM against B. catarrhalis, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, but were inferior to CFTM against S. pneumoniae, S. pyogenes, Staphylococcus saprophyticus and Staphylococcus aureus. 3. Activities of cefuroxime were superior to those of CCL against each of the 4 tested bacterial species from acute respiratory tract infection and S. aureus by 4-fold, but were inferior to CFTM and CFIX against most of Gram-negative rods. 4. Sultamicillin (SBTPC) is considered to have an activity to inhibit beta-lactamase, but its MICs did not exceed the MICs of ampicillin by itself. SBTPC showed poor antibacterial activities against methicillin-resistant S. aureus (MRSA). Considering these observations, it is apparent that we are faced with a variety of factors in selecting antibiotics for best results.

Ampicillin↗