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Biomedical subjects

T Hirose

Publications and source records attributed to T Hirose.

At least 217 records · Page 12Linked to original sources
PubMed1997

[A clinical study on combination therapy of antimicrobial agents for complicated urinary tract infection--with special reference to combination with clarithromycin].

PURPOSE: To confirm the clinical efficacy of the combined therapy to complicated urinary tract infection (UTI), we conducted a comparative clinical study of the combined therapy with ciprofloxacin (CPFX) and clarithromycin (CAM) acting an biofilm elimination or CPFX alone in patients with complicated UTI. PATIENTS AND METHODS: The study was carried out in patients with complicated UTI having WBCs with 5/hpf or more in urinary sediment and bacteriuria at least 10(4) CFU/ml. The combined therapy was CPFX and CAM, each 600 mg/day, for 14 days, and the single therapy group CPFX, 600 mg/day, for 14 days. On Day 7 and 14, the eradication rate and efficacy rate (according to the criteria of the Japanese UTI committee) were determined. In the patients with indwelling catheter, the surface of the catheter tip was observed under a scanning electron microscope (SEM) on Day 14. RESULTS: In both cases with and without catheters, clinical efficacy was higher in the combined therapy group than in the single therapy group. In particular, the efficacy rates at 14 Day were significantly higher in the former group. Furthermore, we investigated the therapeutic effect in the below MIC breakpoint of CPFX in complicated UTI. The combined therapy group showed a higher clinical efficacy in both cases with and without indwelling catheter than the single therapy group, although there was not statistically significant. Biofilm on the surface of the catheter tip was eliminated in 75% of the combined therapy group. However, none of the biofilm was eliminated in the single therapy group. CONCLUSION: From the above results, we surmise that the combined use of CPFX and CAM will show some degree of efficacy in eliminating both the causative organism and its biofilm in the complicated UTI.

Adult↗
PubMed1997

[The combination of amoxicillin-clavulanic acid and ofloxacin in the treatment of multidrug-resistant Mycobacterium tuberculosis].

A 67-year-old [correction of 53] man with multidrug resistant tuberculosis (MDR-TB) had been persistently positive for acid-fast bacilli (AFB) both on sputum smear and also on culture with the Ogawa egg medium for 30 years since 1951. The case had been treated previously with isoniazid, rifampin, streptomycin, ethambutol, kanamycin, ethionamide, paraaminosalicylate and cycloserine; however, M. tuberculosis strains isolated from this patient acquired a high resistance to all of these agents. Then, a new regimen of chemotherapy, INH combined with ofloxacin (OFLX) and amoxicillin-clavulanic acid (AMPC/ CVA), was applied to the case. He was successfully treated with this regimen, and a marked decrease in the amount of AFB on smear as well as on culture was observed during the course of chemotherapy. No adverse effects were seen meanwhile. These data suggest that it is worth while to try a regimen containing AMPC/CVA and OFLX in the treatment of MDR-TB.

Aged↗
PubMed1997

[Involvement of enhanced glutamate release in halogenated volatile anesthetic-induced excitation in mouse brain].

The present experiments aimed to elucidate the mechanisms of excitatory effects of volatile anesthetics. In ddN mice, enflurane (2% in air), sevoflurane (2%) or isoflurane (1.2%) induced opisthotonus. In ddY mice, a halogenated ethane, tetrachlorodifluoroethane (CCl2FCCl2F:DF-112, 2%) induced tonic-clonic convulsion. These CNS excitatory effects were suppressed by pretreatment with an N-methyl-D-aspartate antagonist, MK-801 (0.5mg.kg-1). Halogenated volatile anesthetics (enflurane, sevoflurane, isoflurane and halothane) increased glutamate release from synaptosomes of the mouse cerebral cortex at concentrations corresponding to those used clinically. The convulsive gas, DF-112, released glutamate more potently than the anesthetics. These data suggest the involvement of enhanced glutamate release in the mechanisms of excitatory effects of halogenated volatile anesthetics.

Anesthetics, Inhalation↗
PubMed1997

[Tuberculous pleuro-peritonitis showing increased levels of CA125].

A 53-year-old woman was admitted because of dyspnea and coughing of about 8 months duration. On examination she had left pleural effusion and ascites. The serum CA125 level was high (1150 U/ml) but gynecological examinations were negative. Radiological and ultrasonic studies revealed bilateral pleural effusions and ascites. Cytological and bacteriological studies of the pleural effusions and ascites were all negative. The pleural fluid was exudate with high lymphocyte counts and elevated ADA (87.4 IU/l) and CA125 (1800 U/ml). Tuberculous pleuritis was diagnosed based on the findings of sputum culture and of pleural biopsy. The latter revealed epithelioid cell granulomas and giant cells. Cells in both pleural effusion and ascites were stained with antibodies to CA125. Antituberculous chemotherapy was started and the patient responded well. Both pleural effusions and ascites decreased; the level of CA125 also decreased to the normal range in about two months.

CA-125 Antigen↗
PubMed1997

CD34 expression by inflammatory fibroid polyps of the stomach.

The phenotype of the proliferated spindled cells and the histogenesis of inflammatory fibroid polyp (IFP) have been a matter of debate. To clarify the immunohistochemical profile of the main cellular component, we reviewed histologically and studied immunohistochemically 11 cases (12 lesions) of IFP of the stomach. The lesions ranged in size from 0.4 to 3.0 cm (mean, 1.0 cm). All of the IFPs occurred in the antrum. Seven cases (63.6%) were accompanied by carcinoma or adenoma, which in two cases was present in covering epithelium. Grossly, eight IFPs were sessile, and four were polypoid. Microscopically, seven (58.3%) occupied both the mucosa and submucosa. Four (33.3%) were confined to the mucosa, and one was localized only in the submucosa. They were characterized by proliferation of relatively uniform spindled cells, often in a whorl-like arrangement around the blood vessels and glands. Eosinophilic and lymphocytic infiltration of varying degree was always present. The spindled cells in all of the IFPs were diffusely immunoreactive for vimentin and CD34. Seven (58.3%) were focally positive for histiocytic markers, such as KP1 and HAM56. Three (25%) showed focal immunoreactivity for alpha smooth muscle actin. Cytokeratin, desmin, S100 protein, Factor VIII RAG, and Ki-67 were negative in these spindled cells. The principle proliferating cells in IFPs in this study showed variable degrees of histiocytic and myofibroblastic lines of differentiation. Under the influence of some etiologic factors, the primitive, uncommitted spindled mesenchymal cells exhibiting CD34 immunoreactivity around the blood vessels and glands in the lower portion of mucosa and submucosa might play a role in development of IFP.

Actins↗
PubMed1997

Histological and immunohistochemical diversities, and proliferative activity and grading in osteosarcomas.

To examine the differentiation and proliferative activity of tumor cells, 30 osteosarcomas, including osteoblastic, chondroblastic, fibroblastic, malignant fibrous histiocytoma-like, telangiectatic, giant cell-rich low-grade central, and epithelioid types, were studied immunohistochemically. A variable number of tumor cells in all cases showed osteocalcin immunoreactivity. In four preparations of the frozen sections, osteoblastic, fibroblastic, and chondroblastic tumor cells were positive for bone-type alkaline phosphatase antibody 2D3. S-100 protein immunoreactivity was found not only in seven tumors of the chondroblastic type, but also in four of nine osteoblastic tumors and each of the low-grade central, giant cell-rich, and epithelioid types. A histiocytic marker, CD68, was negative for tumor cells in all cases. Some cells of 17 tumors were positive for desmin and/or alpha-smooth muscle actin; this was regarded as an indication of myofibroblastic differentiation. Tumor cells of the epithelioid type and those of two osteoblastic tumors expressed cytokeratin (CAM5.2) and epithelial membrane antigen. Proliferating-cell nuclear antigen (PCNA) reactivity was found in the cell nuclei of 22 tumors, most of which were high grade. Many cells in six high-grade tumors also showed the nuclear staining for p53 protein. Of these tumors, PCNA and p53 positivities tended to be more numerous in osteoblastic cells, atypical spindle-shaped, and bizarre giant cells than in well-developed chondroid cells. From these findings, osteosarcomas are concluded to be composed basically of osteoblastic cells, that are indispensable for diagnosis of osteosarcomas, with a variable number of chondroblastic, myofibroblastic, and, rarely, epithelioid cells, and this manifold cellular differentiation corresponds to the histological and clinical diversities. The osteoblastic, fibro- or myofibroblastic, and undifferentiated cells mainly participate in proliferation of osteosarcomas. The p53 gene alterations may play a part in the neoplastic transformation and proliferation of osteosarcomas.

Alkaline Phosphatase↗
PubMed1997

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1995). III. Differences in susceptibilities from previous years].

Susceptibilities to various antimicrobial agents were examined for Enterococcus faecalis, Staphylococcus aureus, Escherichia coli, Klebsiella spp. and Pseudomonas aeruginosa that were isolated from patients with urinary tract infections (UTIs) in 11 hospitals during June, 1995 through May, 1996, and the results were compared with those obtained during the same period in earlier years. 1. Macrolide resistant E. faecalis isolated from uncomplicated UTIs during the latest study period appeared to have increased compared to those in previous study periods. More than 50% of the isolated E. faecalis during the latest study period were resistant to macrolide antibiotics, for the first time in our history. 2. No obvious changes were observed through the years for susceptibilities of S. aureus to various antimicrobial agents. Vancomycin (VCM) showed the highest activity against S. aureus, with MICs below 2 micrograms/ml or below. 3. Among E. coli strains, those with low susceptibilities to quinolones appeared to have increased over the years with MIC90 changed from between 0.125 microgram/ml or below and 0.5 microgram/ml in the 1989-1990 period to between 8 micrograms/ml and 128 micrograms/ml in the latest study period. 4. Klebsiella spp. showed higher resistance to most antimicrobial agents during periods of 1993-1994 and 1994-1995, but somewhat lower resistance during period of 1995-1996. No resistant Klebsiella spp. were detected from uncomplicated UTIs during the latest study period. 5. Among P. aeruginosa isolates from complicated UTIs, resistance isolates to gentamicin appeared to be increasing over the years. Resistant strains to quinolones were isolated at lower frequencies during periods of 1991-1994, but higher frequency was observed in the latest period, and MIC50s were between 0.5 and 4 micrograms/ml during 1991-1994, but were 16-32 micrograms/ml during 1995-1996. These susceptibility changes should be utilized in determining clinical treatments.

Anti-Bacterial Agents↗
PubMed1997

[Adipocyte differentiation and nuclear receptor].

The roles of nuclear receptors in differentiation and function of adipocytes were reviewed and discussed. Expression of peroxisome proliferator-activated receptor (PPAR) gamma have been reported to be strongly induced during adipocyte differentiation and maintained in matured adipocytes. Forced expression of PPAR gamma converted NIH3T3 fibroblasts to adipocytes, indicating PPAR gamma regulates essential genes to obtain the adipocyte phenotype. Newly developed antidiabetic thiazolidinediones known as high affinity ligands for PPAR gamma improved insulin resistance. This finding suggests that PPAR gamma contributes regulation of insulin action. Several genes regulated by troglitazone, one of the most potent thiazolidinediones, in matured 3T3-L1 adipocytes-were obtained by differential display PCR method. Orphan receptors ROR alpha/gamma and Rev-ErbA which bind to the same response element are also induced during adipocyte differentiation but their function is still to be investigated.

Adipocytes↗
PubMed1997

Voiding dysfunction in ileal neobladder.

PURPOSE: We attempt to understand better the voiding mechanism and determine the causes of voiding dysfunction in ileal neobladder patients. MATERIALS AND METHODS: The voiding condition in 12 bladder cancer patients who had undergone neobladder construction after radical cystectomy was examined by pressure-flow study and voiding cystourethrography. The patients were classified into 2 groups based on the maximum flow rate in a pressure-flow study: fine voiders (6), with a maximum flow rate of 15 ml. per second or more, and poor voiders (4), with a maximum flow rate of less than 15 ml. per second. RESULTS: Maximum flow rate in the fine voiders was 26.2 +/- 8.7 ml. per second (mean plus or minus standard deviation) compared with 9.4 +/- 0.9 ml. per second in the poor voiders. The fine voiders strained 1.5 +/- 0.9 times to void 100 ml. of urine, whereas the poor voiders strained 7.0 +/- 6.3 times. The bladder capacity, vesical opening pressure and vesical pressure at the maximum flow rate were similar in both groups. Pelvic floor electrical activity was amplified when the neobladder was either full or close to its capacity, and it was relaxed in coordination with abdominal straining in all patients. Voiding cystourethrography revealed that, in fine voiders, the neobladder outlet was funnel-shaped when the bladder was full and opened wider when the patient strained to void. However, in poor voiders, the neobladder outlet did not funnel even on abdominal straining. CONCLUSIONS: Neobladder patients void by abdominal straining and relaxing the pelvic floor musculature. To obtain smooth voiding in such patients, it is crucial to locate the neobladder opening at the most caudal portion and preserve neobladder outlet elasticity.

Adult↗
PubMed1997

[Recent progress in surgical management for urogenital cancers--improvement of patients' QOL following surgery].

We report our experience of urinary reconstruction with ileal neobladder, and nerves-paring radical cystoprostatectomy or radical prostatectomy in an attempt to improve quality of life (QOL) in patients following surgery. While the ileal neobladder is not always indicated for patients who require cystectomy for invasive bladder carcinoma, voiding through the urethra in this urinary reconstruction contributes to improvement of post-cystectomy QOL. Daytime continence is achieved in 90% of patients. However, nighttime incontinence was found in 30%, which indicates a need for further refinement of the operative procedures or more investigations into the mechanism of continence in this condition. Recovery of erectile function following nerve-sparing radical cystoprostatectomy or prostatectomy was found in 50% of the patients who received this procedure. Subjective and objective erectile capacity before operation partly determine post-operative erectile function. Several patients whose post-operative erectile function was recovered had not had sexual intercourse after surgery. Anxiety about the disease, still inadequate penile rigidity and a non-cooperative attitude of the sexual partner were involved in the results, suggesting that more careful care and counseling before and after operation are required.

Adult↗
PubMed1997

Giant plexiform schwannoma: a report of two cases with soft tissue and visceral involvement.

We report two cases of massive, solitary, plexiform schwannoma. One was a 9-cm subcutaneous lesion on the hip of a 72-year-old man who had become aware of the slow-growing tumor 50 years earlier; the other is the first reported plexiform schwannoma to arise in a visceral organ: it arose in the ascending colon of a 54-year-old man and exhibited a dumbbell configuration with submucosal and subserosal components. Neither patient had neurofibromatosis or schwannomatosis. Both tumors were well-circumscribed and multinodular, and both showed a plexiform architecture. Microscopically, the nodules were composed primarily of Antoni A tissue, replete with nuclear palisading and Verocay bodies. Examination by immunohistochemistry and electron microscopy demonstrated the features of well-differentiated Schwann cells; nodules were surrounded by attenuated, residual perineurium. Both patients followed a benign clinical course, without recurrence or metastasis. Neither the large tumor size nor the unusual locations affected the biologic behavior of these neoplasms. A massive plexiform schwannoma must be distinguished from a malignant peripheral nerve sheath tumor and from a plexiform neurofibroma, a tumor prone to malignant transformation.

Aged↗
PubMed1997

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1995). I. Susceptibility distribution].

The frequencies of isolation and susceptibilities to antimicrobial agents were investigated on 704 bacterial strains isolated from patients with urinary tract infections (UTIs) in 11 hospitals during the period of June 1995 to May 1996. Of the above bacterial isolates, Gram-positive bacteria accounted for 29.8% and a majority of them were Enterococcus faecalis. Gram-negative bacteria accounted for 70.2% and most of them were Escherichia coli. Susceptibilities of several isolated bacteria to antimicrobial agents were as followed; 1. Enterococcus faecalis Ampicillin (ABPC) and imipenem (IPM) showed the highest activities against E. faecalis isolated from patients with UTIs. The MIC90S of them were 1 microgram/ml. Vancomycin (VCM) and piperacillin (PIPC) were also active with the MIC90S of 2 micrograms/ml and 4 micrograms/ml, respectively. The others had low activities with the MIC90S of 16 micrograms/ml or above. 2. Staphylococcus aureus including MRSA VCM showed the highest activities against S. aureus isolated from patients with UTIs. Its MIC90 was 1 microgram/ml against both S. aureus and MRSA. Arbekacin (ABK) was also active with the MIC90 of 2 micrograms/ml. The other except minocycline (MINO) had very low activities with the MIC90S of 64 micrograms/ml or above. 3. Staphylococcus epidermidis ABK and MINO showed the strongest activities against S. epidermidis isolated from patients with UTIs. The MIC90S of them were 0.25 microgram/ml. VCM was also active with the MIC90 of 1 microgram/ml. The MIC90S of cephems ranged from 2 micrograms/ml to 16 micrograms/ml in 1994, but they ranged from 8 micrograms/ml to 128 micrograms/ml in 1995. These results indicated that some resistances existed among S. epidermidis to cephems. 4. Streptococcus agalactiae All drugs except gentamicin (GM) were active against S. agalactiae. ABPC, cefmenoxime (CMX), IPM, erythromycin (EM), clindamycin (CLDM) and clarithromycin (CAM) showed the highest activities. The MICs for all strains were lower than 0.125 microgram/ml. The MIC90S of the others were 2 micrograms/ml or below. 5. Citrobacter freundii IPM showed the highest activity against C. freundii isolated from patients UTIs. Its MIC90 was 1 microgram/ml. GM was also active with the MIC90 of 2 micrograms/ml. Cefpirome (CPR), cefozopran (CZOP) and amikacin (AMK) were also active with the MIC90S of 4 micrograms/ml. Penicillins and cephems except CMX, CPR and CZOP showed low activities with MIC90S of 256 micrograms/ml or above. 6. Enterobacter cloacae IPM showed the highest activity against E. cloacae. The MICs for all strains were equal to or lower than 1 microgram/ml. MINO and tosufloxacin (TFLX) were also active with the MIC90S of 8 micrograms/ml. Penicillins and cephems except CPR and CZOP showed lower activities with the MIC90S of 256 micrograms/ml or above. 7. Escherichia coli. Most of the antimicrobial agents were active against E. coli. Particularly CPR, CZOP and IPM showed the highest activities against E. coli. The MICs for all strains were equal to or lower than 0.5 microgram/ml. CMX and TFLX were also active with the MIC90S of 0.125 microgram/ml or below. Penicillins were slightly active with MIC90S of 128 micrograms/ml or above. 8. Klebsiella pneumoniae K. pneumoniae was susceptible to all drugs except penicillins, with MIC90S of 2 micrograms/ml or below. Carumonam (CRMN) had the strongest activity against K. pneumoniae, the MICs for all strains were equal to or lower than 0.125 microgram/ml. Comparing with the result of 1994, the sensitivities of K. pneumoniae against all drugs had obviously changed into a better state. For example, the MIC90S of cephems ranged from 0.25 microgram/ml to 16 micrograms/ml in 1994, but they were all lower than 2 micrograms/ml in 1995. 9. Proteus mirabilis P. mirabilis was susceptible to a majority of drugs. CMX, ceftazidime (CAZ), cefixime (CFIX), and CRMN showed the highest activities against P. mirabilis isolated from patients with UTIs. MICs of CRMN for all

Anti-Bacterial Agents↗
PubMed1997

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1995). II. Background of patients].

Clinical background was investigated on patients with urinary tract infections (UTIs) from whom 785 bacterial strains were isolated in 11 hospitals during the period from June, 1995 through May, 1996. 1. Distributions of age and sex of patients and type of infections. Among the patients examined, those with ages 50 years or older were the most frequent (males: 80.5%, females: 69.7%), and, among females, those with ages in the 20's were 12.6%. With regard to types of infections, more than a half of infections among males were of complicated types, but most of infections among females were of uncomplicated types, especially among females of ages less than 60 years. 2. Ages of patients and types of pathogens. The higher the ages of patients, the lesser became the isolation frequencies of Proteus spp. and Serratia spp., but the higher were those of Klebsiella spp. and Pseudomonas spp. 3. Effect of antibiotic use on isolation frequencies of pathogens. Use of antibiotics decreased pathogens isolated from patients with uncomplicated UTIs drastically (237 isolates before antibiotics compared to 33 after). Even isolated pathogens from patients with complicated UTIs decreased drastically with the use of antibiotics when indwelling catheters were not in use (200 isolates before antibiotics compared to 83 after), but when indwelling catheters were in use, antibiotics apparently failed to decrease the isolation frequency. 4. Surgical procedures and types of causative organisms for UTIs. Escherichia coli was the most frequently isolated organism from uncomplicated cases of UTIs. From cases of complicated UTIs without indwelling catheters, Enterococcus faecalis was the most frequently isolated, followed by E. coli, P. aeruginosa and Klebsiella spp. When a surgical procedures were not done, E. coli was isolated most frequently. From cases of complicated UTIs with indwelling catheters, P. aeruginosa, E. faecalis and S. aureus were the organisms that were mainly isolated, with isolation frequencies of 23.9%, 17.3% and 12.7%, respectively. When no surgical procedures were used, isolation frequencies of P. aeruginosa, Klebsiella spp. and E. faecalis were 25.7%, 14.3% and 14.3%, respectively.

Adolescent↗