Biomedical subjects
Publications and source records attributed to K Mashimo.
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We examined 24 pediatric patients to evaluate the usefulness of sudden near maximal exercise test (dash method), where the subjects began to run at Bruce protocol of the last stage. 1) No considerable differences between two protocols were found in maximal oxygen consumption (V O2max), maximal heart rate (HRmax), maximal systolic blood pressure, and findings of electrocardiography. 2) The sudden maximal exercise test could be completed during a shorter period compared to Bruce protocol. 3) The sudden maximal exercise protocol reached 84% of HRmax and 47% of V O2max at one minute after the onset of the protocol, and produced 96% of HRmax and 89% of V O2max at two minutes after the onset. We considered that sudden maximal exercise protocol was useful to obtain a response similar to Bruce protocol at maximal exercise within a short period. We have to pay attention to the safety of the patients because their cardiopulmonary response to sudden maximal exercise protocol is dramatic.
A 14-year-old girl was admitted with chief complaints of edema and chest pain. She had hepatomegaly, but did not have heart murmur and accentuation of the pulmonary component of the second heart sound. The electrocardiogram showed right axis deviation, negative T wave in V3,4 and ST depression in III, aVF. But right ventricular hypertrophy was not dominant. Chest radiography showed a cardiothoracic ratio of 54% and a slight prominence of proximal pulmonary arteries. The edema was soon diminished only by the diuretics, but it appeared again without the diuretics. At the cardiac catheterization 3 months after the onset of symptoms, the pulmonary arterial pressure was 150/85 mmHg and the pulmonary resistance was 3,232 dyn/sec/cm5. The right atrial pressure was 9.5 mmHg and oxygen saturation at the pulmonary artery was 31.0%. Prostaglandin E1 reduced the pulmonary artery pressure only a little, but raised the systemic pressure. The patient was treated with several vasodilators, but her condition deteriorated rapidly and she developed severe right ventricular failure. She died only 8 months after the onset of symptoms and 5 months after the catheterization. At autopsy, histological examination demonstrated intimal fibrotic thickening of the small-sized pulmonary arteries and organizing thrombus. But there was not plexiform lesion. Heart failure was easily improved when she was first admitted. But after 3 months the cardiac catheterization revealed that her condition was already severe. Several vasodilators was not effective to such a rapidly progressive primary pulmonary hypertension.
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The pharmacokinetics of micronomicin (MCR) as a model drug of aminoglycoside antibiotics (AGs) was studied in man by applying our results previously obtained in rats. Three-compartment open model analysis of combined serum and total body store (T.B.S.) data obtained from multiple dosing in man was done using a non-linear least-squares regression program MULTI. We found large individual variations of MCR disposition in man and these variations did not appear within the serum concentration range measurable with conventional assay methods. This finding suggests that the disposition of AGs, included MCR, cannot be estimated by only plasma or serum level analyses. We conclude that the therapeutic drug monitoring of AGs by using T.B.S. data analysis should be an effective method for controlling therapy with AGs in the clinical setting.
Some single myocardial cells cultured from the neonatal mouse atrium and ventricle, which beat spontaneously, stopped contracting dose-dependently with the addition of ethanol to the culture medium. The cells of the atrium were arrested more easily than those of the ventricle. The myocardial cells which continued beating in the ethanol medium showed chronotropic responses in a dose-dependent manner. The beat rate of both atrial and ventricular cells changed very little on the addition of a low concentration of ethanol (12.5 mM). Atrial cells showed negative chronotropic responses to high concentrations of ethanol (50 and 200 mM), while ventricular cells showed transient positive responses. Addition of acetaldehyde (100 microM) slowed the beating of atrial cells severely and that of ventricular cells moderately, but failed to arrest either type of cell. The addition of hyperosmolar medium containing 200 mM sucrose caused almost no chronotropic effect on atrial cells but a strong negative one on ventricular cells, and arrested very few of either type of cell. The transient positive chronotropic responses of ventricular cells to ethanol seemed unrelated to either acetaldehyde contained in the ethanol medium or the hyperosmolarity of the ethanol medium.
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The antibacterial spectrum of cefroxadine was as wide as that of CEX, and its antibacterial effect was as strong as that of CEX or even 2-fold stronger against E. coli and Klebsiella. Cefroxadine was also proved to have stronger bactericidal or bacteriolytic effect than CEX and have better affinity with penicillin binding proteins. In clinical trials, an efficacy rate of 82.7% was achieved in a total of 2,009 cases of various infections analyzed. Cefroxadine displayed particularly good clinical and bacteriological effects for the infections of skin, soft tissues, respiratory tract and urinary tract. The rate of bacteria eradication in a total of 1,410 cases was 81.6%, showing good results against the bacteria such as S. aureus (83.9%, 167/199), E. coli (89.0%, 528/593), Klebsiella (78.0%, 78/100) and P. mirabilis (80.0%, 36/45). As for side effects, their incidence was a low of only 2.3%, the main ones being eruption and gastrointestinal symptoms just as recognized in conventional cephalosporins, and none of them was serious. Abnormal laboratory test values were only increases in eosinophil, S-GOT, S-GPT and Al-P values, and their incidence was low. From these findings, we may say that the drug is an effective, safe, and useful antibiotic among all other orally administered cephalosporins.
The biliary excretion of cefoperazone in experimental animals, and humans, was investigated. Biliary excretion of cefoperazone in rats, rabbits, dogs, and monkeys was always higher than that of cephazolin. Biliary excretion was markedly reduced in experimentally-produced liver cirrhosis in rats. Comparing the biliary excretion of cefoperazone and cephazolin in a crossover study in patients, the excretion of cefoperazone was shown to be much higher than that of cephazolin. In clinical studies in 116 patients with biliary tract infections such as cholecystitis, cholangitis, and liver abscess, cefoperazone was effective in 90 (78%). The incidence of side effects was low. In conclusion, cefoperazone was considered to be effective in treating biliary tract infections because of its broad antibacterial spectrum and high penetration into bile.
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A total of 466 patients were treated with cefoperazone. The drug was usually administered by drip infusion of 2 to 4 gm/day. Therapy was described as markedly effective and moderately effective in 64 of 77 patients (83.1%) treated for urinary tract infections; 253 of 316 patients (80.1%) treated for respiratory infections; 37 of 48 patients (77.1%) treated for liver biliary duct infections; ten of 16 patients (62.5%) treated for septicemia; and seven of nine patients (77.8%) being treated for other infections. Overall, cefoperazone was effective 79.6% of all patients treated. With respect to bacteriological activity, the overall eradication rate for gram-negative organisms (including Pseudomonas aeruginosa, Klebsiella sp, Escherichia coli, Haemophilus influenzae, Enterobacter sp, and Proteus sp) was 81% (182/225) and for gram-positive (Staphyloccocus aureus, Streptococcus pneumoniae and Streptococcus faecalis) 90% (36/40). Of 205 patients who failed to respond to previous antibiotic therapy, 67.8% were treated effectively with cefoperazone. Side effects, such as skin eruption, pyrexia and diarrhea, occurred in only 4.8% of patients treated, while laboratory abnormalities, such as elevated glutamic-oxaloacetic transaminase, glutamic-pyruvic transaminase, alkaline phosphatase, and eosinophil values, occurred in only 6.4% of the treated patients. None of these abnormal values were of clinical significance.
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