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Biomedical subjects

K Kuno

Publications and source records attributed to K Kuno.

At least 163 records · Page 9Linked to original sources
PubMed1990

Eight and 12 week courses of cyclophosphamide in nephrotic syndrome.

Seventy-three children with steroid dependent minimal change nephrotic syndrome were randomly allocated to receive treatment with cyclophosphamide (2 mg/kg/day) for either eight or 12 weeks, in combination with prednisolone. All patients had previously relapsed while the dosage was being reduced or within 14 days of discontinuing prednisolone in the six months before receiving cyclophosphamide treatment (steroid dependent), and had severe steroid toxicity. Thirty two patients were treated with cyclophosphamide for eight weeks, and 41 for 12 weeks. There were no differences between the two groups in age at onset of nephrosis or entry into the study, sex ratio, duration of nephrosis, number of relapses before entry, and follow up period after entry. The relapse free rate of patients treated for eight weeks (25%) was similar to that of those treated for 12 weeks (24%) five years after stopping the treatment, and the mean relapse free interval and the sparing effect of cyclophosphamide (if any) on subsequent treatment with steroids did not differ between the groups. We conclude that cyclophosphamide should be used for no longer than eight weeks at a dose of 2 mg/kg/day in children with steroid dependent minimal change nephrotic syndrome.

Child↗
PubMed1990

[Tuberculosis sequelae: pathophysiological aspect (ventilation)].

The percentage of the patients with PaCO2 more than 60 Torr and PaO2 more than 50 Torr were 13% in the patients with tuberculosis sequela (N = 502) and 4% in the patients with chronic obstructive lung disease (COLD, N = 727), who were treated with home oxygen therapy in the western region of Japan. Patients with chronic respiratory failure caused by tuberculosis sequela have higher PaCO2 than patients with COLD. Although the prognosis of patients with hypercapnia and moderate hypoxemia is not necessarily poor, some patients may need treatment for severe hypoventilation to prevent respiratory muscle fatigue and abnormal breathing during sleep. In this study, nine patients with hypercapnic chronic respiratory failure caused by tuberculosis sequela were ventilated by Chest Negative Pressure Ventilation (CNPV). The patients were monitored as in polysomnography by transcutaneous PCO2 (PtcCO2) electrode and Respiratory Inductance Plethysmography (RIP). Tidal volume induced by CNPV was larger during mouth breathing (504 +/- 128 ml, mean +/- s.d.) than during nose breathing (438 +/- 109 ml) calculated from RIP in awake state (N = 7). Oxygen saturation measured by ear oximeter and PtcCO2 were 94.4 +/- 2.9% and 57.8 +/- 12.2 Torr in awake state. Following CNPV SaO2 and PtcCO2 were 95.7 +/- 3.0%, 42.7 +/- 12.1 Torr in awake state (N = 9) and 93.0 +/- 4.4%, 57.0 +/- 15.7 Torr in Non-REM sleep (N = 5), respectively. CNPV is effective in these patients in awake state. During Non-REM sleep, CNPV maintains the PtcCO2 level only in awake state.

Aged↗
PubMed1990

[Laboratory and clinical studies on cefdinir in pediatric field].

Clinical trials of cefdinir (CFDN) in pediatric infections were carried out. Results are summarized as follows. 1. Mean half-lives of CFDN in serum in children when administered on an empty stomach were 1.24 hours (3 mg/kg per os) and 1.85 hours (6 mg/kg per os). 2. Mean 8 hour urinary excretion rates of CFDN were 19.0% (3 mg/kg/per os) and 10.5% (6 mg/kg per os). 3. CFDN was administered to 28 children with various infections: 12 patients with tonsillitis, 8 with bronchitis, 2 with pneumonia, 4 with urinary tract infections, 1 staphylococcal scalded skin syndrome and 1 with impetigo. The overall efficacy rate was 89.3%. 4. Diarrhea was noted in 1 patient. Abnormal laboratory test values encountered were eosinophilia in 2 patients, thrombocytosis in 1.

Adolescent↗
PubMed1990

[Upper airway function and non-intubated, assisted ventilation].

The influence of upper airway patency on ventilation assisted by chest negative pressure ventilation (CNPV) or nasal intermittent positive pressure ventilation (nIPPV) was studied as follows. 1) In seven patients with chronic respiratory failure (PaCO2 more than 50 Torr), the increase in tidal volume (VT) induced by CNPV was larger during mouth breathing than during nose breathing in the awake state. On CNPV transcutaneous PCO2 (PtcCO2) decreased during awake state, but increased during NREM sleep. 2) In four patients with chronic respiratory failure (PaCO2 more than 60 Torr), nIPPV induced the leakage of air from mouth in more than 20 cmH2O of nasal mask pressure during sleep. PtcCO2 increased during sleep, especially during REM sleep in spite of nIPPV. The change in PtcCO2 during REM sleep on nIPPV comparing awake state was 16.1 +/- 1.4 torr and comparing REM sleep in usual sleep was -6.0 +/- 1.4 Torr. 3) Upper airway resistance (UAR) was measured in two patients with tracheostomy. An increase in UAR was associated with a linear decrease in VT during nIPPV, although associated with a curvilinear decrease in VT during CNPV. These results indicate that the efficiency of CNPV and nIPPV depends on the patency of upper airway.

Adult↗
PubMed1990

[Bacteriological and clinical studies on norfloxacin in the field of pediatrics].

Bacteriological and clinical studies on norfloxacin (NFLX) were carried out in the field of pediatrics, and the results obtained are summarized as follows: 1. The MICs of NFLX against clinically isolated organisms were determined to compare with MICs of nalidixic acid, amoxicillin, cefaclor, erythromycin and fosfomycin. NFLX had low MICs against both Gram-positive and Gram-negative bacteria and, particularly, showed higher antimicrobial activity to Escherichia coli, Salmonella sp., Klebsiella pneumoniae, Pseudomonas aeruginosa, Haemophilus influenzae and Campylobacter jejuni than any other drugs tested. 2. Seventeen pediatric patients (11 cases of enteritis, 4 cases of urinary tract infections, 1 case of tonsillitis and 1 case of pyoderma) were treated orally with NFLX in daily doses ranging from 3.1 to 16.7 mg/kg t.i.d. for 6-14 days. Rates of clinical effectiveness and bacterial elimination were 94.1% and 58.8%, respectively. 3. None of the treated children showed clinical symptoms indicating the occurrence of side effects nor abnormal laboratory findings except 1 patient with eosinophilia. These results indicate the usefulness of NFLX in the treatment of bacterial infections in the pediatric field.

Administration, Oral↗
PubMed1989

Breathing during sleep with mild hypoxia.

To investigate ventilatory response to mild hypoxia during non-rapid-eye-movement sleep, we administered approximately 16% O2 (which corresponds to concentrations found in commercial high altitude air craft) to 12 normal subjects by using a Venturi mask, which did not alter the breathing pattern during this study. Under mild hypoxia, inspiratory minute ventilation during sleep showed an initial rapid increase (P less than 0.001) but then declined significantly (P less than 0.001) and stabilized. Stable levels differed among individuals and, compared with those measured before hypoxia, were significantly lower in some subjects, higher in one, and essentially unchanged in the others. The initial rapid increase in minute ventilation after mild hypoxia during sleep correlated with the respective values of hypoxic ventilatory response during the awake state (P less than 0.01), but the final lowered levels did not. We conclude that the ventilatory response after mild hypoxia during sleep is biphasic and hypoxic depression exerts considerable influence on ventilation under mild hypoxia during sleep. So we should take hypoxic depression into consideration to evaluate the response to hypoxia during sleep.

Adult↗
PubMed1989

Evaluation of prostaglandin E1 therapy for sudden deafness.

Prostaglandin E1, a vasodilator and potent inhibitor of platelet aggregation, was administered by intravenous drip infusion to 51 patients who had sudden deafness. The results were compared with results from 362 patients who received no prostaglandin E1 therapy. There was no significant difference in outcome between patients who received prostaglandin E1 therapy and those who did not receive prostaglandin E1 therapy.

Adult↗
PubMed1989

[Laboratory and clinical studies on clarithromycin in the field of pediatrics].

Laboratory and clinical studies on clarithromycin (TE-031, A-56268), a new macrolide antibiotic, were carried out in the field of pediatrics. The results obtained are summarized as follows: 1. Serum concentrations, urinary concentrations and urinary recovery rates were determined upon oral administration on fasting of TE-031 at doses of 5 mg/kg granules in 1 case and tablets in 2 cases, and 10 mg/kg granules in 1 and 15 mg/kg granules in 1. Peak serum levels were obtained at 30 minutes in 2 cases, at 1 hour in 2 cases and at 2 hours in 1 case after administration of the drug with a range of 2.29-7.10 micrograms/ml with half-lives of 2.2-7.5 hours. Urinary recovery rates in 6 hours after administration ranged from 7.1-34.5%. 2. MICs of TE-031 against 49 clinical isolates (Streptococcus pyogenes 5 strains, Streptococcus pneumoniae 9, Staphylococcus aureus 3, Branhamella catarrhalis 4, Haemophilus influenzae 14, Haemophilus parainfluenzae 7, and Campylobacter jejuni 7) were compared with those of josamycin (JM), erythromycin (EM), and ampicillin (ABPC). The antibacterial activity of TE-031 was superior to those of JM and equal to those of EM. 3. Fifty-five pediatric patients with acute infectious diseases (scarlet fever 3 cases, pharyngitis and tonsillitis 15, pertussis 2, pneumonia 10, bronchitis 14, Campylobacter enteritis 11) were treated with TE-031 at daily doses of 10-35 mg/kg t.i.d. as a rule. The efficacy rates were 96% clinically and 72% bacteriologically. 4. Side effects or abnormal laboratory test values were not observed. 5. None of children refused TE-031.

Adolescent↗
PubMed1989

[Bacteriological, pharmacokinetic and clinical studies on cefpodoxime proxetil in the pediatric field].

Bacteriological, pharmacokinetic and clinical studies on cefpodoxime proxetil (CPDX-PR, CS-807), a new oral cephem antibiotic, were carried out in the field of pediatrics. The results obtained are summarized as follows. 1. Antibacterial activities of R-3746 (Na-salt of cefpodoxime (CPDX] against clinically isolated strains of Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus, Enterococcus faecalis, Branhamella catarrhalis, Escherichia coli, Proteus mirabilis and Haemophilus influenzae were compared with those of cefaclor, cephalexin and cefadroxil. R-3746 is superior to other antibiotics against S. pneumoniae, S. pyogenes, B. catarrhalis and Gram-negative rods. 2. Serum concentrations of CPDX after administration of CPDX-PR at doses of 3 mg/kg (fasting), 6 mg/kg (non-fasting) and 6 mg/kg (fasting) were determined. Mean AUC (area under curve)'s of CPDX obtained were 9.60, 31.35 and 17.89 micrograms.hr/ml, respectively for the 3 dosages. The mean half-lives of CPDX were 3.35, 1.88 and 1.76 hours, respectively. The mean urinary recovery rate within 8 hours after administration of CPDX-PR at a dose of 3 mg/kg (fasting) was 39.2%. 3. CPDX-PR was administered to 37 pediatric patients with various bacterial infections (pyelonephritis 9, cystitis 4, pneumonia 7, acute bronchitis 3, otitis media 2, tonsillitis 10, subcutaneous abscess 1 and purulent lymphadenitis 1). The overall clinical efficacy rate was 91.9% and the overall bacteriological eradication rate was also 91.9%. 4. No adverse reactions were observed. Abnormal laboratory findings were moderate, eosinophilia in 2 and slight elevation of GOT and GPT in 1. The taste and the odor of the CPDX-PR preparation was sufficiently tolerable. From the above results we have concluded that CPDX-PR is a useful oral antibiotic in the treatment of bacterial infections in children.

Bacteria↗
PubMed1989

[Limitation of RI imaging in evaluating lung function test--development of new methods].

We developed two methods for determining the regional distribution of (1) RV/TLC and air trapping during forced expiration and (2) the ratio or pulmonary blood volume to blood flow. 1) The regional distributions of RV/TLC and air trapping ratio: A.T.R. (air trapping caused by forced expiration) were measured in respiratory disease cases and normal subjects using Xe-133 gas. In normal subjects, RV/TLC gradually decreased from the apex to the base of the lung. A.T.R. was very low in all lung fields. In chronic emphysema (CPE), both RV/TLC and A.T.R. were much higher than the value in normal subjects at the highly diseased areas. In contrast, in case of diffuse panbronchiolitis (DPB), RV/TLC remained within the normal range and A.T.R. was increased considerably in the diseased regions. These results suggest that airway obstruction occurs only during the forced expiration in DPB. 2) The regional distribution of the ratio of pulmonary blood volume to blood flow (tau p) were measured in a normal subject and a case of mitral regurgitation. In both subjects, the distribution of 1/tau p consisted of three zones: upper, middle and lower. The distribution of 1/tau p was constant in the middle zone, but, in the upper and lower zones, it decreased in proportion to the distance from the middle zone. In the case of mitral regurgitation, the middle zone shifted to the apex. Applying the results to the lung perfusion model proposed by West, it was suggested that these phenomena might reflect the increase of the pulmonary venous pressure and the perfusion disorder in the lower lung.

Blood Volume↗
PubMed1989

[Noninvasive ventilatory support on chronic respiratory failure with hypoventilation].

Chest negative pressure ventilation (CNPV) and intermittent positive pressure ventilation (IPPV) through a nose mask were used for ventilatory support of 4 patients with chronic respiratory failure due to old tuberculosis (2 patients), chronic pulmonary emphysema, and kyphoscoliosis (VC, 0.91 +/- 0.16 L; %VC 31.2 +/- 3.2; FEV1.0, 0.62 +/- 0.19 L). These ventilatory supports were used for relief of chronic arterial CO2 retention, weaning from the mechanical ventilation, therapy for the acute exacerbation on the chronic respiratory failure, and the relief of the respiratory muscle fatigue. After CNPV and IPPV through a nose mask, PaCO2 showed a significant fall from 75.7 +/- 14.8 Torr to 60.2 +/- 12.3 Torr (p less than 0.01). All patients showed improvement of clinical symptoms. Two patients have continued CNPV at home on a regular basis. We conclude that CNPV and IPPV through a nose mask significantly improve hypoventilation and quality of life in some patients with chronic respiratory failure.

Adult↗
PubMed1989

[Impedance analysis using the random noise oscillation method and a body box].

The frequency characteristics (at 10-40 Hz) of airway (Za) and tissue (Zt) impedances in patients with chronic bronchitis (CB), chronic pulmonary emphysema (CPE) and interstitial pneumonitis (IP) were examined using the random noise oscillation method and a body box. Compared with normal subjects, Zar (r:real part) was elevated in cases of CB, but not in those with CPE. Zai (i:imaginary part) was decreased in cases of CB and CPE. Applying an electromechanical analogy to these results, it was inferred that CB increases both central and peripheral airway resistance, while CPE only increases peripheral resistance. In CPE, but not in CB, Ztr fell; only Zti decreased in IP, which suggests a decrease in mass per unit of lung tissue in CPE and a loss of pulmonary compliance in IP. We also measured the impedance of a dog with acute pulmonary edema induced by oleic acid. Zar an Ztr were increased but Zti was decreased, which corresponded with the increase of airway resistance due to hypersecretion and the decrease of lung compliance. We conclude that this method is useful in differentiating interstitial disorders from COLD, and also CB from CPE, because it can detect lung stiffness and can identify sites of airway narrowing.

Adult↗
PubMed1989

[Pharmacokinetic, bacteriological and clinical studies on sulbactam/ampicillin in pediatric field].

Clinical trials were carried out on the use of sulbactam/ampicillin (SBT/ABPC) (combination rate of 1:2) in pediatric infections. Results were as follows: 1. The mean half-lives of SBT and ABPC in the serum following intravenous injection of SBT/ABPC were about 1.05 and 0.90 hours, respectively. 2. The mean urinary excretions of SBT and ABPC in 6 hours after intravenous injection of SBT/ABPC were 71.2% and 62.2%, respectively. 3. SBT/ABPC was administered to 23 pediatric patients with various infections: 17 patients with pneumonia, 3 with tonsillitis, 2 with urinary tract infection and 1 with cervical lymphadenitis. The overall efficacy rate was 95.7%. In particular, 2 urinary tract infections caused by highly beta-lactamase producing Escherichia coli were improved by the treatment with SBT/ABPC. 4. No adverse reactions were observed except 2 cases of mild diarrhea. Abnormal laboratory test values included thrombocytosis in 4 and slight elevation of GOT and GPT in 1, but they were transient.

Age Factors↗
PubMed1989

[Evaluation of respiratory disability in patients of respiratory diseases using relationships between ventilatory drive, ventilation and thoracic pump function during exercise].

We studied the parameters of breathing control during exercise in patients with respiratory diseases for the evaluation of respiratory disability. The ventilatory drive during the same load exercise was increased in patients with respiratory diseases compared with that in normal subjects. In addition, the ratio of ventilation to ventilatory drive during exercise was decreased in patients with respiratory diseases. Impairment of rapid thoracic movement was suggested to be one of the mechanical limitations for ventilation in these patients, based on the findings of smaller esophageal pressure fluctuation during maximum ventilation of 40 respirations per minute than that in normal subjects. Flow at 0.1 sec after initiation of inspiration was designated V0.1. The increase of the ratio of V0.1 at rest to that at maximum voluntary inspiration (V0.0 (rest)/V0.1 (max)) indicate the grade of respiratory disability showing the impossibility of rapid movement of thorax as a parameter of thoracic pump function. It was recognized that the decrease of VE/P0.1 during incremental exercise indicated ventilatory insufficiency.

Exercise Test↗
PubMed1989

[Laboratory and clinical studies of cefodizime in pediatric field].

Clinical trials of cefodizime (CDZM, THR-221) were carried out in pediatric infection. Results are summarized as follows. 1. The mean half-life of CDZM in the serum following intravenous injection of CDZM (20 mg/kg) was about 2.06 hours. 2. The mean urinary excretion rate of CDZM within 8 hours after intravenous injection of CDZM was 60.1%. 3. CDZM was administrated to 19 pediatric patients with various infections; 9 cases of pneumonia, 3 bronchitis, 1 cervical lymphadenitis, 2 tonsillitis and 4 urinary tract infections. The overall efficacy rate was 94.7%. 4. No adverse reactions were observed. Abnormal laboratory test values found were thrombocytosis in 2, slight elevation of GOT and GPT in 1 and eosinophilia in 1 patient.

Age Factors↗