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Biomedical subjects

M Kaku

Publications and source records attributed to M Kaku.

At least 145 records · Page 8Linked to original sources
PubMed1993

[Detection of mecA gene of methicillin resistant staphylococci from oral swabs by polymerase chain reaction].

We evaluated the polymerase chain reaction method (PCR) for the rapid detection of methicillin resistant Staphylococcus aureus (MRSA), and compared it with the conventional culture method. Primers for amplification of mecA gene were synthesized by DNA synthesizer according to the published sequences of mecA gene. The results were as follows: Specificity of PCR was excellent, as there was no cross-reaction with any organism other than MRSA. Fifty colony forming units of MRSA were detected, indicating good sensitivity. We examined oral swabs from 13 bed-ridden patients (age range: 65-82 yrs) by PCR and the conventional culture method. The PCR elicited positive results in 6 out of 13 cases. MRSA or coagulase negative Staphylococci (CNS) in Mueller-Hinton agar containing 12.5 micrograms/ml methicillin were obtained from all of these PCR-positive specimens. Two of 7 PCR-negative specimens raised MRSA or CNS colonies, but the number of colonies from these specimens was below the sensitivity threshold of the PCR. The good specificity and sensitivity of the PCR method for the detection of mecA gene obtained in this study suggest the possibility of application of this method for detection of MRSA in clinical specimens.

Aged↗
PubMed1993

[A case of Campylobacter fetus subspecies fetus meningitis].

A 40-year-old male with no history of underlying disease was admitted to Hokusho Central Hospital on May 25, 1991, complaining of high fever and headache. Physical examination on admission revealed a temperature of 38.5 degrees C, a pulse rate of 84 beat/min (relative bradycardia) and no abnormal findings for the chest or abdomen. Slight neck stiffness without Kernig's sign was observed at neurological examination. Laboratory data were: ESR 11 mm/lh, WBC 12000/mm3, C-reactive protein positive. Lumbar puncture showed an initial pressure of 230 mmH2O; CSF revealed a cell count of 2633/3 mm3 with mononuclear pleocytosis, total protein of 76 mg/dl and sugar of 54 mg/dl (CSF:blood glucose ratio 0.47). We initially suspected tuberculous or cryptococcal meningitis, but Campylobacter fetus subsp. fetus (C. fetus) was isolated from the CSF and venous blood on the 27th hospital day. IPM/CS 1 g/day, MINO 200 mg/day and FOM 4 g/day were intravenously administered. This antibiotic therapy was very effective: the patient was soon afebrile, and gradually all signs and symptoms were resolved. C. fetus was sensitive to IMP/CS, MINO, KM, GM, EM, OFLX, CP. The patient was discharged with no complication. He has eaten raw beef frequently before admission, but stool culture for C. fetus was negative.

Adult↗
PubMed1993

Efficacy of intravenous itraconazole against experimental pulmonary aspergillosis.

The efficacy of intravenous itraconazole solubilized in hydroxypropyl-beta-cyclodextrin was assessed in a rat model of Aspergillus fumigatus pneumonia. Immunosuppressed rats were infected by intratracheal inoculation of A. fumigatus conidia. Intravenous administration of various doses of itraconazole was started immediately after infection and continued once a day for 7 days. A 10-mg dose of intravenous itraconazole per kg was as effective on survival as 1 mg of amphotericin B per kg daily (a survival rate of 100% in 28 days), while treatment with 1 mg/kg did not increase the survival rate. The 50% lethal dose of intravenous itraconazole given to immunosuppressed and uninfected rats for 7 days was 24.5 mg/kg/day. A microbiological assay to estimate accumulation in tissue after five daily intravenous administrations of itraconazole at 10 mg/kg showed that itraconazole and its active metabolites were present in the lungs for at least 6 h, reaching the MIC as previously described (B. Dupont and E. Drouchet, Rev. Infect. Dis. 9(Suppl. 1):71-76, 1987; A. Espinel-Ingroff, S. Shadomy, and R. J. Gebhart, Antimicrob. Agents Chemother. 26:5-9, 1984). Intravenous itraconazole was considered to be worth evaluating in clinical trials of aspergillosis.

Animals↗
PubMed1993

In vivo production of exotoxin A and its role in endogenous Pseudomonas aeruginosa septicemia in mice.

We have examined the production of Pseudomonas aeruginosa exotoxin A (ETA) and its role in endogenous bacteremia in mice. Mice given P. aeruginosa D4 orally died of bacteremia between days 10 and 13 following cyclophosphamide-induced leukocytopenia. In this model, serum endotoxin was detected beginning on day 7 by the Limulus assay and P. aeruginosa was cultured from blood beginning on day 9. ETA and tumor necrosis factor alpha (TNF) were also detected in serum by enzyme-linked immunosorbent assay beginning on day 9. Purified ETA did not stimulate the production of TNF in normal mice primed with a synthetic derivative of muramyl dipeptide in the absence of endotoxin. However, ETA enhanced and primed endotoxin-induced TNF production in mice. The mortality rate of mice given ETA mutant PAO-PRI (5.0%) was significantly lower than that of mice given the parent strain (78.8%). These data indicate that ETA may be an important factor in the occurrence of P. aeruginosa bacteremia and/or the death of mice. Also, ETA may be responsible for enhancing the production of a lethal dose of TNF in the presence of endotoxin in P. aeruginosa bacteremia.

ADP Ribose Transferases↗
PubMed1993

Nested polymerase chain reaction for detection of Mycobacterium tuberculosis in clinical samples.

The nested polymerase chain reaction technique was compared with the conventional smear and culture methods for detection of Mycobacterium tuberculosis. The nested polymerase chain reaction used in this study showed excellent specificity, sensitivity, and agreement with the conventional methods for 417 clinical samples, indicating a contribution to the rapid diagnosis of mycobacterial infectious diseases.

Base Sequence↗
PubMed1993

Topical treatment of pulmonary aspergilloma by antifungals. Relationship between duration of the disease and efficacy of therapy.

Twelve patients with aspergilloma were treated with intracavitary or endobronchial administration of antifungals. Patients with successful therapy had significantly shorter mean duration of the disease course (3.6 months) than the less effective group (44.4 months, p < 0.01). Minimal inhibitory concentrations of antifungal agents against isolated strains of aspergilli were considerably lower than estimated intracavitary concentrations of the antifungals. A pathologic examination suggested that the old mycetoma was for the most part comprised of dead mycelial cells, against which antifungal agents were not effective. However, clinical improvement was obtained, regardless of the roentgenographic improvement. Our study suggested that early diagnosis and therapy are recommended to achieve better therapeutic effect.

Aged↗
PubMed1993

A clinical comparison between Mycobacterium avium and Mycobacterium intracellulare infections.

Susceptibility, clinical features, and response to treatment were compared between 29 cases of Mycobacterium avium infection and 43 cases of Mycobacterium intracellulare infection detected in the Nagasaki (Japan) area and identified by a DNA probe method. In vitro susceptibility of two species to antituberculous agents was determined by a microdilution method, and M avium was more resistant to enviomycin at 25 mg/L than M intracellulare, while M intracellulare was more resistant to isoniazid at 5 mg/L and to cycloserine at 20 mg/L. No significant difference was found between infections caused by two species as to background factors, laboratory data, clinical symptoms, and chest radiographic findings at the onset of the disease. Approximately 70 percent of the patients in each group had underlying diseases; among them, pulmonary tuberculosis was the most common. Negative conversion of bacilli during the 6-month treatment was seen in 17 of 29 patients (59 percent) with M avium infection and in 21 of 43 patients (49 percent) with M intracellulare infection. Bacilli-negative conversion was slightly faster in the former than in the latter. However, these differences were statistically not significant. In conclusion, most M avium-intracellulare complex organisms are clearly identified as M avium or M intracellulare by the DNA probe method, and there was no significant difference in clinical features and response to treatment between infections caused by the two species.

Aged↗
PubMed1993

Amphotericin B-induced resistance to Pseudomonas aeruginosa infection in mice.

We evaluated the effects of amphotericin B (AmB) against Pseudomonas aeruginosa (P. aeruginosa) infection in mice. Pretreatment with 2 mg/kg of AmB 24 hours before infection significantly increased the survival rates of mice intraperitoneally infected with either P. aeruginosa or Escherichia coli. To evaluate the mechanism of this AmB-induced resistance to infection, we conducted a number of experiments. Peritoneal macrophages exposed in vitro to AmB showed superior bactericidal activity compared to that of control macrophages. Interleukin-1 production by peritoneal macrophages from mice pretreated with 2 mg/kg of AmB was significantly higher than that in control mice. Serum tumor necrosis factor level after intravenous injection of P. aeruginosa was also higher in mice pretreated with 2 mg/kg of AmB than in control mice. These data indicate that AmB induces resistance to P. aeruginosa in mice. Furthermore AmB-induced activation of peritoneal macrophages and their production of interleukin-1 and tumor necrosis factor appeared to play important roles in this phenomenon.

Amphotericin B↗
PubMed1993

[Pulmonary cryptococcosis treated by combination therapy of fluconazole plus flucytosine].

The efficacy of the combination therapy of fluconazole plus flucytosine against pulmonary cryptococcosis was investigated. The minimal inhibitory concentrations of antifungal agents were measured by growth inhibition on Yeast-morphology agar plates, and the fractional inhibitory concentration index of each antifungal combination were calculated by checker-board titration. Eight of Cryptococcus neoformans clinical isolates showed sensitivity for AMPH, 5-FC, MCZ and ITZ. C. neoformans showed resistance against FLCZ. The combination of FLCZ plus 5-FC showed synergistic effect against C. neoformans. Three cases of pulmonary cryptococcosis were treated by combination therapy of fluconazole plus flucytosine. After treatment, C. neoformans isolates were eradicated and the chest X-ray improved remarkably. The combination therapy of fluconazole plus flucytosine was effective for the treatment of pulmonary cryptococcosis.

Aged↗
PubMed1993

[A case of pulmonary aspergilloma successfully treated with combination therapy of intracavitary injection of amphotericin B and intravenous administration of urinastatin].

A 57-year-old man with pulmonary tuberculosis underwent left upper lobectomy in 1984. In 1987, chest X-ray showed a fungus ball, and Aspergillus species was isolated from sputum. He was treated by intracavitary injection of amphotericin B (AMPH) in June, 1992. However, no change was observed in the chest CT scan after a total dose of 1,000 mg of AMPH. Combination therapy of intravenous administration of 100,000 units of urinastatin and intracavitary injection of AMPH resulted in complete disappearance of the fungus ball on chest CT scan. This report describes case of pulmonary aspergilloma successfully treated with the combination of AMPH and urinastatin.

Amphotericin B↗
PubMed1993

[Incidence of fungal isolation in clinical specimens from the respiratory tract].

The incidence of fungal isolation in 711 clinical specimens from the respiratory tract was investigated in 159 patients with pulmonary diseases. Fungi were isolated from 14/19 pharynx swab samples, 246/342 sputum samples, 34/147 bronchial aspirate samples, 18/97 bronchial lavage samples, 4/17 transbronchial lung biopsy samples, and 5/60 plugged catheter brush samples. Contamination by fungi in normal flora was prevented by using an aseptic procedure for sampling specimens from the respiratory tract. The isolation rate of Candida spp. from sputum was 70.0% (C. albicans: 151 strains, C. glabrata: 43 strains, C. tropicalis: 25 strains, C. lusitaniae: 4 strains, C. krusei: 3 strains, C. guilliermondii: 3 strains and C. paraspilosis: 1 strain). The isolation rates of C. neoformans and A. fumigatus from sputum were 6.4% and 8.8%, respectively. Isolated fungi from bronchial aspirate included 12 strains of C. albicans, 6 strains of C. tropicalis, 5 strains of A. fumigatus and 2 strains of C. neoformans. Isolated fungi from bronchial aspirate revealed 6 strains of C. albicans, 2 strains of C. glabrata, 1 strain of C. neoformans and 6 strains of A. fumigatus. The isolation rates of fungi from sputum obtained from patients with pulmonary aspergilloma and cryptococcosis were 66.5% and 50.0%, respectively. The isolation rate of fungi from sputum of patients with underlying diseases was higher than that of patients with no underlying disease.

Adolescent↗
PubMed1992

Inbreeding effect on morbidity: IV. Further data in Brazilian populations.

The analysis of the data on 5677 children of 1063 couples from a fourth sample of consanguineous and nonconsanguineous marriages among whites and nonwhites living in the State of Minas Gerais, Brazil led to the following estimates: B (number of abnormal equivalents per gamete) around 0.5; A (morbidity in the non-inbred subsamples) 2-3 percent; B/A 13, 15, and 27 (this suggests that the morbidity disclosed by inbreeding may predominantly represent a mutational load); RR (relative risk) about 2 (this means that among the children of consanguineous marriages there is about double the frequency of abnormalities than in those with nonconsanguineous marriages); AR (attributable risk) for the whole sample about 7% (5% for nonwhites and 15% for whites). These last values show the amount that the frequency of abnormalities would decrease in the population if the risk factor (consanguineous marriages) would be eliminated. AR is higher in whites because the frequency of the risk factor is higher among whites.

Brazil↗
PubMed1992

G test, a new direct method for diagnosis of Candida infection: comparison with assays for beta-glucan and mannan antigen in a rabbit model of systemic candidiasis.

An indirect method to measure beta-glucan, a major structural component of yeast cell walls, is available, but has the disadvantage of requiring the combined use of two assays. Recent reports describe the fungal index, which measures the difference between the conventional limulus test, in which factors C and G react with endotoxin and beta-glucan, and a new endotoxin-specific test, in which only factor C reacts with endotoxin. The G test was developed as a direct method to measure beta-glucan, and contains only factor G reacting with beta-glucan alone. In this study, the G test was examined in sera of rabbits with experimental systemic candidiasis, and compared with the fungal index and mannan assay. The G test showed positive in all rabbits with systemic candidiasis faster and with higher titers than with the fungal index. Three rabbits with fulminant systemic candidiasis showed higher levels of reactivity with the G test and the fungal index than two rabbits with mild reactions. Mannan was positive by at least one serum in four of five rabbits by the latex agglutination test, and there was a good correlation between these assays. The G test is a good serodiagnostic method for the detection of candidiasis.

Animals↗
PubMed1992

[Limulus test (factor G) and polysaccharides from fungus].

Picogram quantifies per ml of endotoxin showed a positive limulus test. The concentration more than ten pg/ml of curdlan ((1-3)-beta-D-glucan) was also positive to a conventional limulus test, which contains a factor G. One nanogram per ml of CM-curdlan was positive, but higher concentration of 10 pg/ml of CM-curdlan decreased its optical density of the conventional limulus test. More than one hundred ng/ml of mannan from Saccharomyces cerevisiae did not react with factor G. However, a culture supernatant of Saccharomyces cerevisiae activated factor G. This result suggested that beta-glucan activated factor G. In addition, culture supernatant of Aspergillus fumigatus, Rhodotorula rubra, Candida parapsilosis, Candida tropicalis, Candida krusei also activated factor G, but Cryptococcus neoformans did not activate it.

Antimicrobial Cationic Peptides↗
PubMed1992

[Role of capsular polysaccharide and lipopolysaccharide of Klebsiella pneumoniae in experimental mice pneumonia model].

In this study, role of capsular polysaccharide (CPS) and lipopolysaccharide (LPS) of Klebsiella pneumoniae was investigated in experimental mice pneumonia model. Inoculation with K. pneumoniae mucoid strain DT-S into mice lung induced expansive, voluminous lethal pneumonia characterized with thickening of the alveolar septa caused by infiltration of inflammatory cell and packing of bacteria within alveolar spaces. On the other hand, mice lung inoculated with K. pneumoniae DT-X, which was non-mucoid mutant isolated from DT-S during natural passage, showed infiltration of inflammatory cell into alveolar spaces but there was no death of mice during the course of this pneumonia. Inoculation of CPS 100 micrograms of DT-S strain into mice lung induced lesser extent of accumulation of inflammatory cell than that of LPS 4 micrograms of this strain. Stimulation of alveolar and peritoneal macrophage with CPS, even at a concentration of 100 micrograms/ml, induced weaker Interleukin-1 (IL-1) activity than stimulation with LPS 4 micrograms/ml. These results suggest that since CPS of K. pneumoniae DT-S encapsulate bacteria including LPS, CPS may inhibit chemotaxis of inflammatory cell and IL-1 production of macrophage to be induced by LPS during course of pneumonia. It is speculated that existence of CPS have important role in modulating host response to bacterial LPS, and this effect of CPS may be related with difference of pathological findings of lung and lethality between K. pneumoniae DT-S and DT-X.

Animals↗
PubMed1992

[Antigen detection in the murine models of systemic candidiasis].

We compared two latex agglutination tests for serum candidal antigen in murine models of systemic infection and gastrointestinal colonization. In the intravascular-infection model, mannan detection test was positive at 2 hours after inoculation, but Cand-Tec was less sensitive than mannan detection test in this model. In the gastrointestinal colonization model followed by systemic infection in neutropenic mice, the mannan antigen test became positive after 3 weeks of colonization with increased number of Candida of the stool, and Cand-Tec became positive after 5 weeks in neutropenic mice.

Animals↗