Biomedical subjects

K Deguchi

Publications and source records attributed to K Deguchi.

At least 163 records · Page 9Linked to original sources

PubMed1993

Hemostatic study before onset of disseminated intravascular coagulation.

Early diagnosis is necessary for the treatment of disseminated intravascular coagulation (DIC), but criteria for the stage preceding the diagnosis of DIC (pre-DIC) have not yet been established. To clarify hemostatic abnormalities that occur before the onset of DIC, we performed hemostatic studies in 117 patients within at least a week before the onset of DIC (pre-DIC), in 237 patients with DIC, and in 50 patients without DIC or pre-DIC (non-DIC). Levels of FDP, PT, and fibrinogen, and platelet counts were significantly abnormal after the onset of DIC, but not before. Thrombin-antithrombin III complex (TAT), plasmin-alpha 2 plasmin inhibitor complex (PIC), and FDP-D-dimer levels were significantly higher before the onset of DIC compared to the non-DIC patients. Hemostatic abnormalities were observed within a week before the onset of DIC. Monitoring the plasma levels of TAT, PIC, and FDP-D-dimer might be useful for the diagnosis of a pre-DIC condition.

Antithrombin III↗

PubMed1993

Increased vascular endothelial cell markers in patients with disseminated intravascular coagulation.

We examined vascular endothelial cell markers, thrombomodulin (TM), plasminogen activator inhibitor-I (PAI-I), tissue plasminogen activator (t-PA), and von Willebrand factor, in 80 patients with disseminated intravascular coagulation (DIC). The levels of thrombin-antithrombin III complex (TAT), plasmin-alpha 2 plasmin inhibitor complex (PIC) and FDP-D-dimer were significantly increased both before and after the onset of DIC, but were not correlated with organ failure or prognosis. However, the PIC/TAT ratio was lower in patients with poor prognosis than in those with good prognosis, and it was also lower in those with organ failure than in those without. Plasma TM, PAI-I, and t-PA levels were increased in DIC patients with organ failure or poor outcome, but were not significantly increased before the onset of DIC. We consider that the prognosis of patients with DIC might be related to organ failure or endothelial cell damage and that plasma levels of TM, PAI-I, and t-PA might be useful in the detection of these disorders and in assessing prognosis. A hypofibrinolytic state might enhance organ failure in patients with DIC.

Antifibrinolytic Agents↗

PubMed1993

Increased levels of vascular endothelial cell markers in thrombotic thrombocytopenic purpura.

We found that patients with thrombotic thrombocytopenic purpura (TTP) have significantly elevated plasma thrombin antithrombin III complex (TAT) and FDP-D-dimer levels, while the plasmin-alpha 2 plasmin inhibitor complex (PIC) level was only slightly increased. The tissue-type plasminogen activator (t-PA) level was increased, but it was well correlated with the plasminogen activator inhibitor-I (PAI-I) level. These findings suggest that hypercoagulable and hypofibrinolytic states coexist in these patients, in contrast to patients with disseminated intravascular coagulation, who exhibit coexisting hypercoagulable and hyperfibrinolytic states. Levels of vascular endothelial cell markers, such as PAI-I, thrombomodulin (TM), and t-PA, were increased at the onset of TTP, but the level of von Willebrand factor (vWF) antigen was not increased. The outcome in TTP patients was correlated with plasma t-PA and TM levels but not with TAT or PIC. These results suggest that vascular endothelial cell markers, such as TM and t-PA, are released from injured or stimulated endothelial cells, reflecting the degree of vascular endothelial damage, and that the main factor in the pathogenesis of TTP is vascular endothelial cell injury.

Adolescent↗

PubMed1993

Liver sarcoidosis showing low-density intrahepatic septa on postcontrast computed tomography.

The authors present a patient with massive liver sarcoidosis, showing only slight hepatomegaly on precontrast computed tomogram and multiple low-density intrahepatic septa on postcontrast computed tomogram. Sarcoidosis frequently involves the liver, but rarely shows abnormal findings other than hepatomegaly on computed tomograms. Only a few cases have demonstrated a low density intrahepatic area on computed tomograms. In this report, we present a patient with massive liver and pulmonary sarcoidosis, showing low density intrahepatic septa and pulmonary fibrosis on computed tomograms.

Humans↗

PubMed1993

Spa bathing activates fibrinolysis in patients with cerebral infarction.

The effects of spa bathing on blood coagulation and fibrinolysis were studied in 20 patients with chronic cerebral infarction. Blood was obtained before and after a 10-minute period of spa bathing at 41 degrees C. Prothrombin time, activated partial thromboplastin time, fibrinogen, factor VIII activity, von Willebrand factor activity, and antithrombin III activity did not show significant changes after bathing, but euglobulin lysis time was significantly reduced (p < 0.01) and fibrin lysis activity was increased (p < 0.05). These findings suggest that spa bathing activates fibrinolysis without markedly changing blood coagulation in patients with chronic cerebral infarction. It is thought that the activation of fibrinolysis without the activation of coagulation has a favorable effect on blood circulation. The results of fibrin-plate assays using C1 inactivator indicated that tissue-type plasminogen activator was the major contributor to the activation of fibrinolysis during spa bathing.

Aged↗

PubMed1993

[Pure sensory stroke due to pontine lacunar infarction].

A 72-year-old woman presented a sudden onset isolated sensory deficit of medial lemniscal type in the right half of the body. MRI showed a small lacune in the left paramedian pontine tegmentum corresponding to the location of the medial lemniscus. MRI appeared to be most valuable in the topographic delineation of lacunar infarctions which were responsible for pure sensory stroke.

Aged↗

PubMed1993

Penetration of cefpirome into sputum in chronic respiratory infections: comparison of administration of 0.5 g and 1.0 g in the same patient.

This study evaluated the sputum penetration of cefpirome following slow intravenous infusion of 0.5 and 1.0 g using a comparative cross-over design to reduce variability. Five patients with chronic respiratory tract infections were randomized to receive either 0.5 g followed by 1.0 g, or by 1.0 g followed by 0.5 g cefpirome, by slow intravenous infusion over 1 h, with a 24-h wash-out period between each treatment. With the exception of one patient, sputum concentration correlated well with plasma concentration. Higher sputum levels of cefpirome were achieved following the higher dose.

Adult↗

PubMed1993

[Antibacterial activities of cefmenoxime against recent clinical isolates from patients of otitis media and otitis externa].

Bacteria clinically isolated from patients of otitis media and otitis externa were collected from various medical facilities across Japan during years 1988, 1990 and 1992, and minimum inhibitory concentrations (MICs) of cefmenoxime and of reference drugs were determined against these strains. A comparative analyses of the obtained results revealed some trends described below. 1. Methicillin-resistant Staphylococcus aureus (MRSA), multiple drug resistant Coagulase-negative staphylococci (CNS) and multiple drug resistant Proteus spp. showed a year to year trend toward a steady increasing. Relative frequencies of occurrence of MRSA in these years, however, remained comparable to that of early 1980's. 2. A year to year trend toward increasing was also found for resistant or insensitive Streptococcus pneumoniae to penicillins and cephems. 3. Multiple drug-resistant Pseudomonas aeruginosa strains were also detected but they showed no trend toward increasing.

Bacteria↗

PubMed1993

[Antimicrobial activity of cefodizime against fresh clinical isolates].

In order evaluate antimicrobial activities of cefodizime (CDZM), minimum inhibitory concentrations (MIC's) of CDZM and other control drugs were determined against various clinical isolates, that were sent to our center from nation-wide medical institutions or were isolated and identified in our laboratory from various specimens of infected patients. The followings are a summary of the results: 1. Bacterial species with no or few strains resistant to cephems including CDZM included Streptococcus pyogenes, Haemophilus influenzae, Citrobacter diversus, most of Klebsiella pneumoniae and Proteus mirabilis. Some strains of Klebsiella oxytoca were resistant to cephems increases in beta-lactams resistant Streptococcus pneumoniae and cephem resistant Escherichia coli seemed likely. Among Citrobacter freundii, Enterobacter spp., Serratia marcescens, Proteus vulgaris, Morganella morganii and Providencia spp. belonging to a category of so-called "mildly toxic bacteria", high portions of the strains examined were resistant to cephems including CDZM and these strains were also resistant to new quinolones, thus they showed multiple drug resistance. 2. MIC90's of CDZM against Streptococcus spp., H. infleunzae, Moraxella subgenus Branhamella catarrhalis, E. coli, Klebsiella spp. and P. mirabilis, frequently found in daily treatment of infections, were less than < or = 0.025 to 1.56 micrograms/ml. This indicates that CDZM would be expected to have enough antibiotic activity in infections caused by above mentioned bacteria. However, cautions are needed in the treatment of infections by beta-lactam resistant S. pneumoniae, cephem resistant E. coli and cephem resistant K. oxytoca with CDZM. 3. Among the above mentioned "mildly toxic bacteria", many multiple drug resistant strains exist. Therefore, we evaluated an usefulness of concomitant use of CDZM with aminoglycosides in the treatment of infections by these bacteria, using other reports which indicates the usefulness in vitro and in vivo. 4. Antibacterial activities of CDZM we observed in this study seem to indicate that CDZM concentrations in infected areas are maintained at above MIC levels for relatively long periods of time.

Bacteria↗

PubMed1993

[Antimicrobial activities of polymyxin B against clinically isolated microbial strains. Results of MIC determination including high concentrations].

Minimum inhibitory concentrations (MICs) were determined for polymyxin B (PL-B), gentamicin, ofloxacin and norfloxacin against clinically isolated microbial strains collected since November 1992, and the following conclusions were obtained: 1. Judging from the MIC distribution of PL-B against the studied strains including multi-drug resistant organisms of major strains of family Enterobacteriaceae, such as Escherichia coli, Klebsiella pneumoniae, Enterobacter spp., and Pseudomonas aeruginosa, it appeared that no PL-B resistant strains were detected among those Gram-negative organisms within the antimicrobial spectrum of PL-B. 2. MICs of PL-B against most strains including methicillin resistant Staphylococcus aureus and coagulase-negative staphylococci were distributed between 100 and 800 micrograms/ml. These results supported reports of other investigators that the eradication of Staphylococcus spp. including MRSA (methicillin-resistant S. aureus) was possible by the use of PL-B at 1 mg/ml. 3. MIC distribution of PL-B against organisms of the Bacteroides fragilis group was almost the same as the results described above.

Bacteria↗

PubMed1993

[Antimicrobial activities of sultamicillin against clinical isolates obtained from outpatients].

Minimum inhibitory concentrations (MICs) were determined for sultamicillin (SBTPC), and for other major oral beta-lactam agents against clinically isolated strains collected from outpatients during a period from August, 1992 to February, 1993, and the following conclusions were obtained. 1. The ratio of penicillinase (PCase)-producing strains of Staphylococcus aureus was 96.0% and that of methicillin-resistant S. aureus (MRSA) was 12.0%. MIC90 of SBTPC against S. aureus including MRSA was 6.25 micrograms/ml. No increasing tendency was observed for S. aureus resistant to SBTPC. 2. No resistant strains were found among Streptococcus pyogenes and Enterococcus faecalis against penicillins (PCs) including SBTPC. But PCs and cephems (CEPs) insensitive or resistant Streptococcus pneumoniae were observed in 22.0% among all the strains of S. pneumoniae. 3. 100% of the tested both strains of Escherichia coli and Proteus mirabilis were beta-lactamase producers. 12.0% of the tested strains of Haemophilus influenzae and 16.0% of the strains of Neisseria gonorrhoeae were also beta-lactamase producers. SBTPC showed strong antimicrobial activity against most of these beta-lactamase producing strains. However, in our study of beta-lactamase productivity using plural substrates and test methods, it appeared that a part of strains of E. coli might produce beta-lactamase of "Extended broad-spectrum". MICs of SBTPC and CEPs against those strains were distributed rather in a high range. 4. The results of the study suggested that the resistant strains of S. pneumoniae against PCs and CEPs might be increasing year by year. Some of strains of E. coli, resistance against the 2 agents were observed. It is important to keep observing changes in resistance of such organisms in the future. 5. The antimicrobial activities of SBTPC against clinically isolated strains in this study indicated potential problems such as those mentioned above. It is, however, also confirmed that SBTPC shows still strong antimicrobial activities against most of beta-lactamase producing strains found in daily medical examinations. Taking into consideration of the strong activities of SBTPC against so-called indirect pathogenicity caused by beta-lactamase producing indigenous bacteria reported lately, SBTPC may be a useful antibiotic for community acquired infections in the 1990's.

Ampicillin↗

PubMed1993

[Antimicrobial activities of arbekacin against methicillin-resistant Staphylococcus aureus isolated from patients of a pediatrics ward].

Aiming at measuring the antimicrobial activities of arbekacin (ABK) against the strains of methicillin-resistant Staphylococcus aureus (MRSA), isolated from pediatrics patients in 1992, the minimum inhibitory concentration (MIC) of 8 antibiotics including ABK was determined and the coagulase types of those strains were also examined. The obtained results are summarized as follows. 1. Among coagulase types of a total of 78 strains, Type II, Type IV and Type VII were 84.6%, 12.8% and 2.6%, respectively. No clear difference in coagulase types were observed among their origins of isolation. 2. MIC90 of ABK against 42 strains isolated from the air passage of suspected pneumoniae patients and 36 strains isolated from the blood of suspected septicemia patients were 1.56 micrograms/ml and 3.13 micrograms/ml, respectively, and MIC90 of ABK against the 78 strains was 1.56 micrograms/ml, which was equal to that of vancomycin (VCM). 3. Most of these strains exhibited resistance against multiple antibiotic agents including cefmetazole (CMZ), imipenem (IPM), fosfomycin (FOM) and minocycline. Strains isolated from the blood were mostly resistant to multiple agents, and most of them were especially highly resistant to CMZ and IPM. ABK, however, showed potent antimicrobial activities even to those strains. These results were similar to the results obtained several years ago. 4. Considering the fact that ABK demonstrates not only potent antimicrobial activities against MRSAs isolated from the pediatric patients, but also shows remarkable clinical effects with concomitant use with beta-lactams or FOM, the prospect of ABK use in MRSA infectious diseases of children is excellent.

Aminoglycosides↗

PubMed1993

[The antimicrobial activity of cefteram against recently clinically detected and isolated strains].

In order to examine antibiotic activities of cefteram (CFTM), its minimum inhibitory concentrations (MIC's) and those of other cephem drugs were determined against clinically isolated strains received from July 1990 to June 1991 and from July 1992 to February 1993 from medical facilities throughout the country and against clinically isolated strains detected in our laboratory in samples from patients with various infectious diseases. The obtained results are summarized below. 1. No CFTM-resistant strains were found among beta-streptococci, Klebsiella spp., Proteus mirabilis, Haemophilus influenzae, and Neisseria gonorrhoeae or even when found, they were present in extremely low proportions. 2. It appeared that Streptococcus pneumoniae insensitive or resistant to beta-lactams, as well as cephems-resistant strains of Escherichia coli were increasing. The former included benzylpenicillin (PCG)-insensitive S. pneumoniae (PISP) of PCG-resistant S. pneumoniae (PRSP), and the presence of the latter suggests the possibility of the existence of "Extended broad-spectrum beta-lactamase" producing strains. The MIC's of beta-lactams against the above PISP or PRSP, and against cephems-resistant E. coli tended to be high, but those of CFTM were relatively low (in most cases). 3. Proportions of strains resistant to cephems, including CFTM among Citrobacter spp., Enterobacter spp., Serratia marcescens, Proteus vulgaris, Morganella morganii, and Providencia rettgeri were high, and in addition, the existence of these cephem resistant species suggests an increase in multiple drug resistant strains that show resistance to new quinolone drugs. 4. As mentioned above, CFTM is by no means a perfect drug or utility drug and its antimicrobial activities do not cover some recent isolates with multiple drug resistance. Except problems encountered with so-called "attenuated" strains of bacteria, increases in resistance can only be observed at a level of MIC90's, and as far as MIC80's are concerned, CFTM still is as active as before and may be used in the treatment of most infections we encounter in normal medical practices.

Bacteria↗

PubMed1993

[Bacteriological evaluation of combined effects of vancomycin and beta-lactams. I. Results against methicillin-resistant Staphylococcus aureus].

We previously reported a part of the results we obtained regarding antibacteriological synergism between beta-lactams and vancomycin (VCM) against methicillin-resistant Staphylococcus aureus (MRSA). This paper reports an additional assessment we made subsequently to the previous report regarding antibacterial effects of different beta-lactams and VCM concurrently used against MRSA. Assessed in this study were bacteriological synergistic actions between flomoxef (FMOX) and VCM, latamoxef (LMOX) and VCM, cefpirome (CPR) and VCM and imipenem (IPM) and VCM against MRSA. 1. Synergistic enhancements of therapeutic activities were observed against MRSA with FMOX +VCM, CPR + VCM and IPM + VCM, but the activity of LMOX + VCM was low. 2. Concentration dependencies of actions of these antibiotic agents against MRSA were strong for beta-lactams, but weak for VCM. These observations were opposite of the results for beta-lactams and aminoglycosides, or beta-lactams and tetracyclines against MRSA we reported previously. 3. It appeared that strong synergistic antibacterial effects were obtained with FMOX or CPR concentrations between 8 and 32 micrograms/ml when used with VCM, and IPM concentrations between 4 and 16 micrograms/ml when used with VCM, hence, in the therapy using these combinations, concentrations and dose intervals of beta-lactams employed should be carefully considered. 4. When these antibiotics are used together in in vitro experiments, values of MIC and FIC-index may be different depending upon experimental systems used.

Anti-Bacterial Agents↗

PubMed1993

[Bacteriological evaluation of combined effects of vancomycin and beta-lactams. II. Results against gram-negative rods].

Evaluations were made for antibacterial activities of combination uses of flomoxef (FMOX) + vancomycin (VCM) against clinically isolated bacteria of family Enterobacteriaceae, and latamoxef (LMOX) + VCM, cefpirome (CPR) + VCM, and imipenem (IPM) + VCM against also clinically isolated Pseudomonas aeruginosa. The obtained results are summarized as follows. 1. FMOX and VCM appeared to act independently against Enterobacteriaceae without showing synergism or antagonism. 2. Regarding antibacterial effects of LMOX + VCM, or CPR + VCM against P. aeruginosa strains, MIC values under the combined uses were approximately 1 dilution (2 folds) higher than LMOX or CPR used alone, but we did not consider that these results meant the presence of antagonism between the beta-lactams and VCM. 3. Experimental results suggested that an antagonistic relationship was present between IPM and VCM against P. aeruginosa. The degree of the antagonism was dependent on VCM concentrations. In other words, when VCM is present at a concentration between 4 and 128 micrograms/ml, MIC values for IPM increased 2 to 4 dilutions (4 to 16 folds), whereas in the presence of 1 to 2 micrograms/ml VCM, MIC values for IPM were close to those of IPM alone. Further, some of this tendency was observed for FMOX against bacteria of family Enterobacteriaceae in the presence of VCM. 4. These results suggest that the dose level of VCM should be considered based on a low range when a combination therapy is considered between beta-lactams and VCM in the treatment of infections with MRSA alone or with Gram-negative rods with MRSA.

Anti-Bacterial Agents↗

PubMed1993

[A case of central alveolar hypoventilation syndrome associated with cerebral infarction].

Central alveolar hypoventilation syndrome (CAH), or Ondine's curse, is a very rare disease characterized by dysfunction of respiratory center in the brain stem. Here, we report a case of CAH associated with cerebral infarction. A 59-year-old man developed right facial sensory deficit at age 56. Then, the facial sensory deficit spread to the left side and dysarthria and dysphagia also developed. Since age 58, he often developed respiratory failure and consciousness disturbance. Arterial blood gas analysis revealed alveolar hypoventilation and respiratory acidosis. Disorders of peripheral organs such as lung, airway, thorax and neuromuscular diseases were ruled out. Brain MRI showed cerebral infarction in the brain stem. We diagnosed him as CAH associated with brain stem infarction.

Blood Gas Analysis↗

PubMed1993

[Antibacterial activities of ofloxacin against recent clinical isolates from patients with ocular infections].

In order to study antibacterial activities of ofloxacin (OFLX), minimum inhibitory concentrations (MICs) of OFLX were determined against clinical isolates obtained from ophthalmic institutes all over the country and those isolated and identified from patients with various ocular infections during three years from September 1989 until August 1992, and the results were compared with those of the control drugs. The following results were obtained. 1. Compared with the reports by others presented from 1984 through 1986, increases were observed for strains with moderate or low susceptibilities to OFLX such as Staphylococcus spp., Corynebacterium spp., Serratia spp., and glucose-nonfermentative Gram-negative rods ((G) NF-GNR). 2. Although incidence of resistance to OFLX increased among the above strains, remarkably low frequencies was observed for the occurrence of highly resistant strains to OFLX with MIC value > 100 micrograms/ml. 3. The antibacterial spectrum of OFLX covered (G)NF-GNR, and the activity of OFLX was superior to those of aminoglycosides, penicillins and cephems used as the control drugs. 4. Low incidence of highly resistant strains to OFLX and its broad antibacterial spectrum suggested the usefulness of a 0.3% OFLX ophthalmic solution in achieving concentrations exceeding MIC for a prolonged period of time.

Drug Resistance, Microbial↗

PubMed1993

[Bacteriological evaluations of combination effects with cefotiam and other antimicrobial agents against methicillin-resistant Staphylococcus aureus. I. Synergistic actions of cefotiam with imipenem and vancomycin].

We assessed the bacteriological efficacies of cefotiam (CTM) plus imipenem (IPM) and CTM plus vancomycin (VCM) therapies against methicillin-resistant Staphylococcus aureus (MRSA) in an in vitro system. The results are summarized as follows. 1. It appeared that the bacteriological efficacies of CTM+IPM therapy against MRSA strains were different against different target MRSA strains. In other words, the FIC indices of CTM+IPM were distributed in a wide range of < or = 0.5- > 2.0. The strains showing MIC levels of < or = 8 micrograms/ml in IPM concentrations showed a strong correlation with FIC index values of < or = 0.5, and the strains showing the MIC level of > or = 128 micrograms/ml in IPM concentration showed a strong correlation with FIC index values of > 2.0. Hence, the strains showing FIC indices < or = 0.5 were considered to be newborn strains with penicillin-binding protein 2' (PBP-2'), those showing FIC indices > 0.5- < or = 2.0 were considered to be strains with increasing production in PBP-2', and those showing FIC indices > 2.0 were considered to be strains with increasing productions in both PBP-2' and PBP-m2. In strains with FIC indices higher than 2.0, the 2 drugs may possibly share the action mechanism and the activity center thus they compete with each other.(ABSTRACT TRUNCATED AT 250 WORDS)

Cefotiam↗