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Biomedical subjects

S Ichiyama

Publications and source records attributed to S Ichiyama.

At least 91 records · Page 5Linked to original sources
PubMed1994

Clinical and epidemiologic investigations of nosocomial pulmonary infections caused by methicillin-resistant Staphylococcus aureus.

We evaluated the clinical features of 32 patients with pulmonary infections caused by methicillin-resistant Staphylococcus aureus (MRSA). Most of the patients were elderly, postoperative, and had severe underlying diseases. Chest radiograph typically showed bilateral and multilobar involvement. Empyema was not common and no abscess was identified. Mortality rate was 38 percent. We also performed an epidemiologic study of MRSA infections by chromosomal DNA analysis using pulsed-field gel electrophoresis. Thirty-two strains were classified into 20 different types by chromosomal DNA pattern, and 5 epidemic strains were observed. These strains were considered to be transmitted among patients by hospital personnel.

Cross Infection↗
PubMed1994

[Clinical epidemiology of nosocomial MRSA infections].

We have compared genomic DNA fingerprinting patterns among isolates of methicillin-resistant Staphylococcus aureus (MRSA) by using pulsed-field gel electrophoresis (PFGE). Chromosomal fragment profiles digested with Sma I were most suitable for discriminating between isolates which could not be differentiated by phenotypic methods. We also constructed a typing system for MRSA strains on the basis of the macrorestriction analysis by PFGE. A total of 563 strains of MRSA were collected from all of the 43 national university hospitals in Japan. Based on the gel profiles, 136 types were identified. Genotyping by the DNA fingerprinting patterns is proposed as a useful method for study of the epidemiology on nosocomial infections caused by MRSA.

Cross Infection↗
PubMed1994

[Clinical efficacy of arbekacin on MRSA infections].

Clinical efficacy of arbekacin (ABK) was examined on patients with MRSA infection during hospitalization in Nagoya University Hospital. A total of 15 analysed cases of 5 sepsis, 3 pneumonias, 6 wound infections and one abdominal abscess. ABK was administered intravenously by drip infusion of 200 mg per day divided into 2 doses with or without other antibiotics. Overall clinical efficacy rate was 76.9%, and eradication rate for the MRSA was 54.5%. Adverse effects were noted in 3 cases (one each case of urticaria, disorder of liver function, and renal disorder). The renal disorder was found in the case where ABK was used in combination with vancomycin.

Adolescent↗
PubMed1993

Comparative study of a biphasic culture system (Roche MB Check system) with a conventional egg medium for recovery of mycobacteria. Aichi Mycobacteriosis Research Group.

OBJECTIVE: The clinical utility of a new biphasic culture system (Roche MB Check system) for the recovery of mycobacteria was evaluated in comparison with a conventional egg based medium. DESIGN: A total of 905 clinical specimens (mainly sputum samples) were tested in 9 clinical microbiology laboratories in Aichi Prefecture, Japan. The recovery rate and detection time of mycobacteria from the specimens were compared between the biphasic system and the egg medium. RESULTS AND CONCLUSION: Of the 905 samples, 311 were positive in the culture of mycobacteria. The recovery rate of the biphasic system was superior to that of the egg medium (99.0% versus 74.0%, P < 0.0001). In addition, the biphasic system showed a considerable decrease in the number of days required for isolation compared with the egg medium (18.8 days vs. 23.1 days for Mycobacterium tuberculosis, P < 0.0001; 13.4 days vs. 19.8 days for M. avium complex, P = 0.007). The biphasic system is therefore proposed as a feasible and practical method for the recovery of mycobacteria from clinical specimens.

Bacteriological Techniques↗
PubMed1993

Polymerase chain reaction for the differentiation of Mycobacterium intracellulare and Mycobacterium avium.

Polymerase chain reaction (PCR) amplification was performed using DNA purified from 15 mycobacterial type strains and from 21 specimens isolated from patients suspected to have non-tuberculous mycobacterial diseases. Using a primer set of MTB1-MTB2, 11 specimens out of 21 were Mycobacterium avium and 8 were M. intracellulare, which were verified by the Gen Probe Rapid Diagnostic System for the M. avium complex (MAC). One of the remaining 2 specimens which did not hybridize with the probe for the MAC was identified as M. kansasii and the other was not specifically identified by the conventional culture method. PCR amplification, using a primer set of TB1-TB3, was also performed for the specific identification of M. tuberculosis complex.

Base Sequence↗
PubMed1993

Sexually transmitted diseases in a HIV infected patient.

We report a case of HIV infection with herpes simplex, syphilis, and condyloma acuminatum in a 66-year-old heterosexual man. The patient was an asymptomatic carrier (group II) of HIV infection. Herpes simplex on his penis was controlled by aciclovir. Secondary syphilis was treated with penicillin G, after which skin lesions disappeared. These four diseases were all sexually transmitted diseases (STD). One should consider the possible existence of other STD in similar cases.

Aged↗
PubMed1993

Plasmid-mediated AmpC-type beta-lactamase isolated from Klebsiella pneumoniae confers resistance to broad-spectrum beta-lactams, including moxalactam.

Klebsiella pneumoniae NU2936 was isolated from a patient and was found to produce a plasmid-encoded beta-lactamase (MOX-1) which conferred resistance to broad spectrum beta-lactams, including moxalactam, flomoxef, ceftizoxime, cefotaxime, and ceftazidime. Resistance could be transferred from K. pneumoniae NU2936 to Escherichia coli CSH2 by conjugation with a transfer frequency of 5 x 10(-7). The structural gene of MOX-1 (blaMOX-1) was cloned and expressed in E. coli HB101. The MIC of moxalactam for E. coli HB101 producing MOX-1 was > 512 micrograms/ml. The apparent molecular mass and pI of this enzyme were calculated to be 38 kDa and 8.9, respectively. Hg2+ and Cu2+ failed to block enzyme activity, and the presence of EDTA in the reaction buffer did not reduce the enzyme activity. However, clavulanate and cloxacillin, serine beta-lactamase inhibitors, inhibited the enzyme activity competitively (Kis = 5.60 and 0.35 microM, respectively). The kinetic study of MOX-1 suggested that it effectively hydrolyzed broad-spectrum beta-lactams. A hybridization study confirmed that blaMOX-1 is encoded on a large resident plasmid (pRMOX1; 180 kb) of strain NU2936. By deletion analysis, the functional region was localized within a 1.2-kb region of the plasmid. By amino acid sequencing, 18 of 33 amino acid residues at the N terminus of MOX-1 were found to be identical to those of Pseudomonas aeruginosa AmpC. These findings suggest that MOX-1 is a plasmid-mediated AmpC-type beta-lactamase that provides enteric bacteria resistance to broad-spectrum beta-lactams, including moxalactam.

Amino Acid Sequence↗
PubMed1993

Postoperative pneumonia in elderly patients: incidence and mortality in comparison with younger patients.

To determine whether elderly patients have an increased incidence of postoperative pneumonia and/or an increased mortality, we conducted a retrospective study of 4,380 patients who underwent thoracic, abdominal or neurosurgery under general anesthesia. Thirty of these patients developed postoperative pneumonia (incidence, 0.68%). The elderly patients aged 65 years or older who underwent thoracic surgery had the highest incidence of pneumonia. Nine of the 30 patients with pneumonia died (mortality, 30%). Elderly patients did not show a higher mortality than the younger patients. The extent of pulmonary infiltrates on chest roentgenogram and the serum bilirubin level, both of which were determined at the onset of pneumonia, independently had a significant association with mortality. Our study suggests that advanced age is a risk factor for postoperative pneumonia in patients who undergo thoracic surgery.

Adult↗
PubMed1993

Cisplatin, etoposide, and vincristine combination chemotherapy in the treatment of non-small cell lung cancer.

Thirty patients with previously untreated, inoperable non-small cell lung cancer (NSCLC) were treated with cisplatin, etoposide and vincristine. Among twenty-nine evaluable patients, eight patients achieved partial response and the overall response rate was 28%. No patient achieved a complete response. The median survival time was 51 weeks. Myelosuppression was the dose-limiting toxicity. Four patients had a leukocyte nadir of less than 1000/mm3, and one died from severe myelosuppression and sepsis. The other toxicities were nausea/vomiting, peripheral neuropathy, and alopecia. We conclude that cisplatin, etoposide, and vincristine combination chemotherapy offers moderate activity for inoperable non-small cell lung cancer.

Adult↗
PubMed1993

[A clinical study on lomefloxacin to find appropriate dose levels in the treatment of respiratory tract infections].

A comparative clinical study of lomefloxacin hydrochloride (LFLX) was performed to confirm the optimal dose of LFLX for treatment of respiratory tract infections. Daily dosages of LFLX, 400 mg (200 mg b.i.d.) and 600 mg (200 mg t.i.d.) were allocated by the randomization method. Treatment period was 7-14 days. Of a total of 136 cases, 14 cases were excluded from evaluation of clinical efficacy and 4 cases from evaluation of safety. There were no differences in the background factors of the patients between the 2 dosage groups. The clinical efficacy rates, judged by a committee, were 76.4% (42/55) for the 400 mg group and 74.6% (50/67) for the 600 mg group. No significant difference was observed between the 2 groups (P = 1.000). Incidences of adverse effects were 1.6% (1/64) for the 400 mg group and 2.9% (2/68) for the 600 mg group. Incidences of abnormal laboratory test values were 3.4% (2/58) for the 400 mg group and 1.6% (1/63) for the 600 mg group. No significant differences were found between the 2 groups. These adverse effects and abnormal laboratory test values improved with the cessation of the administration of the drug. From these results, a dose of 400 mg (200 mg b.i.d.) LFLX seems to be better than that of 600 mg (200 mg t.i.d.) LFLX in the treatment of respiratory tract infections.

Adolescent↗
PubMed1992

Bacteriostatic and bactericidal activity of antituberculosis drugs against Mycobacterium tuberculosis, Mycobacterium avium-Mycobacterium intracellulare complex and Mycobacterium kansasii in different growth phases.

Bacteriostatic and bactericidal activities of rifampicin, isoniazid, streptomycin, enviomycin and ethambutol against Mycobacterium tuberculosis, Mycobacterium avium--M. intracellulare complex and Mycobacterium kansasii were studied in different growth phases. Bacteriostatic activities of the drugs were similar in different growth phases, except isoniazid. M. tuberculosis was much less susceptible to isoniazid in the lag phase than in the log and the stationary phases. In contrast, bactericidal activity was influenced by the growth phase. M. tuberculosis was killed by isoniazid, streptomycin and rifampicin. The bactericidal activity of isoniazid was strongest. The bactericidal activity of isoniazid and streptomycin was most marked in the log phase. M. avium complex and M. kansasii resisted the bactericidal activity, but some strains of M. avium complex were killed by streptomycin and enviomycin, and the activities of these two drugs were most marked in the lag phase.

Antitubercular Agents↗
PubMed1992

[Molecular epidemiological study on Escherichia coli O114 by DNA analyses].

Four strains of Escherichia coli O114:non-motile (NM) were isolated from patients supposed to have endemic diarrhea in 1989. The plasmid DNA profiles and restriction fragment patterns of chromosomal DNA digested with Not I analysed by pulsed-field gel electrophoresis (PFGE) of E. coli O114:NM strains were compared with those of other 9 strains of E. coli O114 isolated elsewhere (O114:H2, 1 strain; O114:H4, 2 strains; O114:H9, 2 strains; O114:H10, 1 strain; O114:H11, 1 strain; O114:H21, 1 strain; O114:H32, 1 strain). All of E. coli O114:NM strains showed the same plasmid DNA profile and chromosomal DNA fragment patterns. The strains of E. coli O114:NM and O114:H11, and O114:H21 and O114:H32 showed the same plasmid DNA profiles, respectively. On the other hand, these strains could be differentiated by the chromosomal DNA fingerprint patterns. The chromosomal DNA fragment pattern of all E. coli O114:NM strains is completely different from those of the other 9 control strains. We suggest that chromosomal DNA fingerprinting is useful for the epidemiological study of E. coli O114 associated endemic diarrhea.

DNA, Bacterial↗
PubMed1992

Chest roentgenogram classification and clinical parameters in patients with active pulmonary tuberculosis.

The relationship between the clinical parameters and chest film appearance was studied in patients with active pulmonary tuberculosis. Patients with extended disease were often malnourished and had weak tuberculin reaction accompanied by lymphopenia. They excreted a large amount of mycobacterial bacilli and a longer period was required for negative conversion of sputum culture. We confirmed that the criteria for chest roentgenogram classification established by the Japanese Society for Tuberculosis ("Gakkai Classification") is useful in the estimation of the risk of infection and the prognosis of tuberculosis patients.

Adolescent↗
PubMed1992

[Genomic DNA fingerprinting by pulsed-field gel electrophoresis for study of nosocomial infection caused by methicillin-resistant Staphylococcus aureus].

In this study, we have compared genomic DNA fingerprintings among isolates of methicillin-resistant Staphylococcus aureus (MRSA) by using pulsed-field gel electrophoresis (PFGE). Chromosomal fragments digested with Sma I were most suitable for the PFGE separation, giving 15-20 fragments of sizes ranging from about 30-1,500 kb. Thirty-one distinctive fragment patterns were identified in 111 isolates of MRSA. On the basis of the genomic typing by PFGE, we performed an epidemiological investigation of an outbreak of nosocomial MRSA infection among 18 inpatients in Nagoya University Hospital. Ten types of chromosomal digestion were identified in 21 isolates of MRSA. The clarity and polymorphism of the chromosomal digestion patterns enabled us to discriminate between isolates. Classification of the genomic DNA fingerprinting patterns by PFGE is therefore proposed as a useful method for investigating the source, transmission, and spread of nosocomial MRSA infections.

Cross Infection↗