Search PubMed⌕ Search

Biomedical subjects

K Kumasaka

Publications and source records attributed to K Kumasaka.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Survey of the sensitivities of clinical isolates to antibacterial agents (annual report)].

Research groups were formed in 21 institutions nationwide to investigate carbapenem resistance. The activities of various antibacterial agents, principally carbapenems, were tested against clinical isolates collected from these institutions. The broth microdilution method was used to determine the minimum inhibitory concentrations (MIC) of 17 antibacterial agents for 1,241 strains of 11 bacterial species isolated at all institutions between October and December 1996. The results were as follows: Carbapenems exhibited strong antibacterial activities against MSSA and Streptococcus pneumoniae and showed low activities against MRSA. Their activities against Enterococcus faecalis were comparable to that of ampicillin and piperacillin. The carbapenems showed high activities against Haemophilis influenzae, Escherichia coli, Klebsiella pneumoniae. Enterobacter cloacae. Serratia marcescens and Bacteroides fragilis group. Their activities were greater than that exhibited by other beta-lactam antibacterial agents, but some resistant strains of Serratia marcescens were detected. The antibacterial activity of carbapenems against Pseudomonas aeruginosa was comparable to that of CAZ, and there were some resistant strains.

Carbapenems↗
PubMed1999

[Laboratory automation and information technology in clinical microbiology--computerized support system and clinical competence of laboratory physician].

Laboratory automation and new information technology have considerable potential to improve care through protocols that reduce errors and guide diagnosis and therapy. Computer-based decision-support systems are now in place in many hospitals in the USA. For example, optimal decisions about the use of antibiotics in critically ill patients require access to a large amount of complex information, therefore a computerized decision-support program linked to computer-based patient records can assist physicians in the use of antiinfective agents and improve the quality of care. The support systems can educate physicians, guide their clinical reasoning, and measure the quality of the care that they provide. The installation of the computer components of the system is relatively easy, but the human components of the system may be much more difficult to transfer from hospital to hospital. The successful operation of the system should require a high level of clinical competence in every staff member of the hospital. The project should encompass a broad range of complex clinical conditions and decision algorithms. It must not be focused solely on the sophistication of laboratory methods. We, laboratory physicians/clinical pathologists must modify our behavior effectively and accept the value and limitations of laboratory automation and information technology. We must work more closely with physicians and other health care professionals as the best clients of our clinical laboratories and establish a good collaborative partnership with them.

Clinical Competence↗
PubMed1999

[Clinical analysis of Pseudomonas aeruginosa bacteremia].

UNLABELLED: To determine the outcome of Pseudomonas aeruginosa bacteremia and to identify risk factors for these infections in our University hospital, 46 cases (65 episodes) of Pseudomonas aeruginosa bacteremia were retrospectively investigated. The most frequent underlying diseases or cases were from Emergency and Critical care center (18 cases, including 11 case of cerebrovascular accident and head injury) followed by hematologic malignancies (11 cases) but none of the HIV infection was included in this study. The overall crude mortality rate was 50% and mortality rate within the first 1 week was 17%. Clinical analysis of those cases revealed that possible risk factors were neutropenia, sever sepsis and prior use of antibiotics (antipseudomonal antibiotics were administered before positive blood culture episodes in 90% cases). But these factors were not statistically significant between dead and survived cases. CONCLUSION: To improve the prognosis of Pseudomonas aeruginosa bacteremia, we must change the management of the hospital infection, such as the more rational use of new antipseudomonal antibiotics and the more clean and reasonable management of central venous catheters.

Adolescent↗
PubMed1998

Ovarian immune cells express granulocyte-macrophage colony-stimulating factor (GM-CSF) during follicular growth and luteinization in gonadotropin-primed immature rodents.

To obtain clues as to whether granulocyte-macrophage colony-stimulating factor (GM-CSF) is related to ovarian physiology, the sites, the gene expression and the production of GM-CSF in the ovary during follicular development and luteinization were studied in equine CG (eCG)-primed immature mice and rats. During follicular development, the expression of GM-CSF mRNA was localized in theca-interstitial tissues, oocytes and granulosa cells of small developing follicles in mice. In the mouse ovary after ovulation, luteal tissues as well as the above components had intense signals for GM-CSF mRNA. Mast cells, which were present mainly in the ovarian medulla, also expressed mRNA for GM-CSF in rats. Immunohistochemical analyses with two different antibodies against murine GM-CSF revealed that GM-CSF-like immunoreactivity was detectable mainly in theca-interstitial, luteal tissues, oocytes and mast cells. Intense GM-CSF positive cells in theca-interstitial and luteal tissues were stained with anti-CD11b antibody in mice. Messenger RNAs for GM-CSF receptor subunits were expressed in mast cells of the medulla and in luteal tissues in rat ovary. The levels of GM-CSF released into the culture media by rat ovarian dispersed cells 1-2 days after eCG treatment were higher than those before the treatment, although no significant change in the levels of ovarian GM-CSF mRNA was detected by reverse transcription-polymerase chain reaction analysis. The secretion of GM-CSF was also increased by treatment of the cells with immune stimulators such as phorbol ester, interleukin-1 and lipopolysaccharide. These data indicate that ovarian macrophages and mast cells in addition to theca-interstitial cells, synthesize and release GM-CSF during ovarian cycles, and that ovarian GM-CSF secreting capacity is enhanced during early stages of follicular development in rodents.

Animals↗
PubMed1998

Detection of Coxiella burnetii specific DNA in blood samples from Japanese patients with chronic nonspecific symptoms by nested polymerase chain reaction.

The nested polymerase chain reaction (PCR) was used for direct species-specific detection of Coxiella burnetii in blood samples from 52 patients with chronic nonspecific symptoms, but no diagnostic or treatment history of Q fever. All patients had been in ill-health with general fatigue, muscle and joint pain, headache, etc., for one to more than 10 years. Seventeen (33%) showed evidence of C. burnetii infection, based on amplification of 438-bp fragments specific to C. burnetii by nested PCR, and 94% of positive patients reported close contact with animals. In contrast, five (9.6%) of 52 samples from healthy adult controls and two (2.8%) of 70 cord blood samples were positive by nested PCR. These data suggest a high prevalence of infection among adult patients with long term, nonspecific complaints who live in close contact with animals and the possible existence of a chronic post-acute Q fever syndrome in Japan.

Adolescent↗
PubMed1998

[External quality assessment for clinical microbiology and good laboratory management].

The Tokyo Metropolitan external quality assessment (EQA) program has revealed some serious problems in private independent microbiology laboratories in Tokyo since 1982. The poor performance in the EQA surveys closely related to poor laboratory managements, the type of training, experience of the medical technologists or technicians, and supervisory ability of the consultant physicians in independent laboratories. Social factors impede the reform of the quality assurance of clinical microbiology. Such factors include poor infrastructure of continuing education for small private laboratories, closure of the central clinical laboratories in the hospitals and outsourcing of laboratory tests due to restructuring in response to economic problems, and limited numbers of certified clinical pathologists of the Japan Society of Clinical Pathology (JSCP). Therefore, the Tokyo Metropolitan EQA Scheme is still confidential and its main role is educational. Good two way communication between participants and the organizers' clinical pathologists is essential, if the quality of laboratory tests is to be improved. The new JSCP edition of the postgraduate training requirement in clinical pathology includes "Laboratory Administration and Management". Good laboratory management(GLM) is an increasingly important component of good laboratory practice. The practice activities of clinical pathologists must include general management in addition to exercising there specialized knowledge in medicine and technology. Whereas leadership of a good clinical pathologist provides the direction of where a good laboratory is going, good management provides the steps of how to get there. And I believe quality system models from business and industry may provide us with strong guidance to build a quality system for the good laboratory that will endure into the next century.

Education, Medical, Undergraduate↗
PubMed1998

[Survey of the sensitivities of clinical isolates to antibacterial agents (annual report)].

Research groups were formed in 21 institutions nationwide to investigate carbapenem resistance. The activities of various antibacterial agents, principally carbapenems were tested against clinical isolates collected from these institutions. The broth microdilution method was used to determine the minimum inhibitory concentrations (MIC) of 17 antibacterial agents for 1,282 strains of 11 bacterial species isolated at all institutions between October and December 1995. The results were as follows: 1. Carbapenems exhibited strong antibacterial activities against MSSA and Streptococcus pneumoniae. Their activities against Enterococcus faecalis were comparable to that of ABPC. Carbapenems showed low activities against MRSA. 2. OFLX exhibited the greatest antibacterial activity against Haemophilus influenzae, followed by MEPM. The antibacterial activities of the other carbapenems were comparable to those of FMOX and CTM. 3. The carbapenems showed high activities against Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, and Bacteroides fragilis group. Their activities were greater than that exhibited by other beta-lactam antibacterial agents. The carbapenems also exhibited greater antibacterial activities against Serratia marcescens than the other beta-lactam antibacterial agents, but some resistant strains were detected. 4. The antibacterial activities of carbapenems against Pseudomonas aeruginosa were comparable to those of CAZ, AZT, AMK.

Carbapenems↗
PubMed1997

Body mass index variations by age and sex, and prevalence of overweight in Japanese adults.

OBJECTIVE: To determine the reference value of BMI for Japanese subjects and to estimate the prevalence of overweight based on this reference value. DESIGN: Epidemiological analysis with the LMS method, which provides a way of obtaining normalized BMI distributions. SUBJECTS: 7508 Japanese subjects aged 18-69 y in 1993. MEASUREMENTS: Height, age and body weight. CALCULATION: BMI was calculated and tables for percentiles of BMI were plotted against age and sex. Furthermore, the prevalence of overweight was estimated based on 85th percentile of BMI in the men and women 20-29 y of age, who were considered the reference group. RESULTS: The geometric mean BMI and the prevalence of overweight in men was highest in the 30-39 y age group. For women the maximum BMI and prevalence of overweight occurred in the decade 50-59 y. The cut-off points for overweight in this sample were 24.7 kg/m2 for men and 22.6 kg/m2 for women. These are considerably lower than the figures of 27.8 kg/m2 and 27.3 kg/m2 estimated for Americans. CONCLUSIONS: The prevalence of obesity in Japanese populations should be estimated using ethnic specific values of BMI, rather than those drawn from Caucasians who tend to have higher BMI in each age group. The prevalence of overweight is increased as age increased in both sexes, especially in women.

Adolescent↗
PubMed1997

[Our experience with a 24-hour on-call program in Nihon University Hospitals].

We must recognize that undergraduate clinical training is insufficient in Japan and that we need to improve the role of the laboratory medicine, especially in the area of communication. Therefore, postgraduate training in clinical pathology/laboratory medicine should include; 1. Basic clinical skills (Communication skills, physical examination and common laboratory procedures such as Gram's stain, Wright-Giemsa stain, etc.), 2. Principles, instrumentation and techniques of each discipline of this broad scientific field, 3. How laboratory information is used in a medical setting, 4. The role of the clinical pathologist/laboratory physician in interacting with laboratory staff, physicians and patients. There is an increasing gap between the clinic and the laboratory. Current needs require us to make a major attempt to bridge this gap. This effort will require new and resourceful means of communication and interaction. A 24-hour on-call program was established to enrich the training of the clinical pathology residents in the USA. Each resident in the program is responsible for being on call, which entails learning the day-to-day operation of the laboratory and being available to interpret laboratory data when the need arises. Residents are expected to refer to the appropriate staff member those situations that he or she feels unable to handle. A review of all on-call problems with staff provides to be a valuable education tool, both for the residents and the staff. This learning strategy was adopted from UCSF Hospital and introduced to Nihon University Itabashi Hospital by K. Kumasaka MD in 1984. And that after 12 years of actual experience, we conclude the training program provides a readily available consultative service for the house staff, and facilitates patient care. In addition, we should make rounds with physicians and go to conferences in areas of interest and responsibilities. We could be mainly responsible for a number of problem-solving areas within the laboratory that would be directly responsive to patient problems encountered by physicians.

Clinical Competence↗
PubMed1997

[Survey of sensitivities of clinical isolates to antibacterial agents (annual report)].

Research groups were formed in 20 institutions nationwide to investigate carbapenem resistance of clinical isolates. Activities of various antibacterial agents, principally carbapenems, were tested against clinical isolates collected from these institutions. The broth microdilution method was used to determine the minimum inhibitory concentrations (MICs) of 17 antibacterial agents for 1,326 strains of 11 bacterial species isolated at the institutions between October and December 1994. The results are as follows: 1. Carbapenems exhibited strong antibacterial activities against MSSA and Streptococcus pneumoniae. Their activities against Enterococcus faecalis were comparable to that of ABPC. Carbapenems showed low activities against MRSA. 2. OFLX exhibited the greatest antibacterial activity against Haemophilus influenzae, followed by MEPM. Antibacterial activities of the other carbapenems were comparable to those of FMOX, CTM, and ABPC. 3. The carbapenems showed high activities against Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, and Bacteroides fragilis group. Their activities were greater than those exhibited by other beta-lactam antibacterial agents. The carbapenems also exhibited stronger antibacterial activities against Serratia marcescens than the other beta-lactam antibacterial agents, but some resistant strains were detected. 4. The antibacterial activities of carbapenems against Pseudomonas aeruginosa were comparable to those of CAZ, AZT, AMK.

4-Quinolones↗