[Acinetobacter calcoaceticus infection--bacteriological and clinical studies of septicemia].
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Biomedical subjects
Publications and source records attributed to R Soejima.
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A 19-year old man was hospitalized suspected of a mediastinal tumor with superior vena caval syndrome. As the chest X-ray film and thoracic CT scan on admission revealed a huge anterior mediastinal tumor, and the value of serum alpha-fetoprotein (AFP) was high, we made a diagnosis of malignant mediastinal tumor from the germ cell. Radiation therapy was not effective, but a combination chemotherapy consisted of cis-platinum, adriamycin, and vincristine was clearly effective, decreasing the size of the tumor and normalizing the value of serum AFP. As the tumor acquired tolerance to the anticancer drugs before long, the chemotherapy became ineffective and the patient died 9 months after the initiation of the treatment. This tumor had endodermal sinus structure, Schiller-Duval body, and eosinophilic hyaline globulus which were histological characteristics of yolk sac tumor, and was confirmed to be originated from anterior mediastinum.
We administered miconazole to patients with deep-seated fungal infections, to investigate into the clinical and mycological responses to the drug and also into its clinical safety. We also looked into the responses of amphotericin B (AMPH), flucytosine (5-FC) and the combination of the 2 drugs to deep mycoses in the past 10 years, for retrospective comparison of the findings achieved in the treatment with miconazole. A clinical response rate of 85% (29/34 patients) was achieved in the treatment of deep-seated fungal infections with miconazole. Mycologically, a fungus eradication rate of 79% (22/28 patients) and a fungus decrease rate of 11% (3/28) were achieved with the miconazole treatment, comparison of the response to miconazole alone and that to AMPH alone revealed that the former was significantly preferable. Side effects of miconazole were observed in 23% of the treated patients (15/66). Statistical analysis of the incidence of side effects of miconazole and that of AMPH showed that the former was significantly lower.
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Cefoxitin (CFX) was used in 9 patients who had respiratory tract infections and following results were obtained: CFX was used in 2 patients with acute pneumonia, 2 with lung abscess, 3 with a mixed infection of lung cancer, 1 with a mixed infection of pulmonary tuberculosis and 1 with empyema. The overall efficacy rate was 77.8%; results were excellent in 2, good in 5 and poor in 2. Bacteriologically, all strains except P. aeruginosa were eradicated after treatment. No side effects were observed. A slight transient elevation of transaminase was observed in 1 patient after doses of 4 approximately 8 g daily. From the above, CFX seems to be a useful and safe drug as an initial choice in the treatment of respiratory tract infections.
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The long-acting amoxicillin granules (L-AMPC) was administered to 12 patients with respiratory tract infections and the following results were obtained. 1. L-AMPC was administered to 6 cases of acute upper respiratory tract infection, 2 of lower respiratory infection with lung cancer, 2 of bronchiectasis, 1 of lower respiratory infection with diffuse interstitial fibrous pneumonia and 1 of chronic bronchitis, and the overall efficacy rate was 83.3% (10/12), excellent in 2, good in 8, fair in 1 and poor in 1. 2. Bacteriologically, H. influenzae (5 strains), S. aureus (3 strains), S. pneumoniae (1 strain) and S. faecalis (1 strain) were eradicated and each 2 strains of K. pneumoniae and C. diversus appeared after treatment. 3. No side effect was observed and a slightly transient elevation of GPT was observed in only 1 case. From the above, L-AMPC seems to be a useful and safety drug in respiratory tract infections.
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