The efficacy and safety of sulbactam/cefoperazone (SBT/CPZ) was studied in 94 patients with severe infections and concomitant hematologic diseases. All of the study patients were included in the evaluation for safety, and 76 cases were evaluable for efficacy. Clinical efficacy was excellent in 13 cases (17.1%), good in 27 cases (35.5%), fair in seven cases (9.2%), and poor in 29 cases (38.2%). The bacteriologic eradication was 66.7% for Gram-negative bacilli and 50.0% for Gram-positive bacteria. The efficacy rate for neutropenic patients with counts less than 50 mm3 and 100 mm3 were 47.5 and 42.9%, respectively. Efficacy in patients for whom other antibiotic therapy before treatment with SBT/CPZ had been ineffective was 46.2%. Side effects were reported in one case (1.1%), and abnormal serum liver tests in five cases (5.3%); both returned to normal after discontinuation of the study medication. SBT/CPZ was an effective antibiotic for the treatment of severe infections in the presence of concurrent hematologic diseases.

Adolescent↗

PubMedDate not supplied

Efficacy and safety of the 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor fluvastatin in hyperlipidemic patients treated with probucol.

The objective of this open trial was to investigate the efficacy and safety of the 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor fluvastatin in hypercholesterolemic patients already receiving probucol. All of the participants had hypercholesterolemia. i.e. serum total cholesterol > or = 220 mg/dl, despite administration of probucol, 500 mg/day, for more than 4 weeks. After this, fluvastatin, 30 mg/day, was added to probucol treatment for 12 weeks. Twenty-seven patients were recruited into this study; all were evaluated for safety, and 22 were evaluated for efficacy. The addition of fluvastatin to the probucol regimen produced a significant further reduction in serum total and low-density lipoprotein cholesterol concentrations (of 18 and 20%, respectively; p < 0.001); these effects were fully established within 4 weeks of treatment and were maintained throughout the treatment. Fluvastatin did not affect the serum high-density lipoprotein cholesterol concentration. Fluvastatin treatment decreased serum triglyceride concentrations slightly in all patients (not significant); in patients with hypertriglyceridemia, triglyceride levels were decreased significantly by 34% (p < 0.01; serum triglycerides > or = 150 mg/dl). In addition, fluvastatin significantly decreased serum apolipoprotein B, C-II, C-III and E levels, whereas serum apolipoprotein A-I and A-II levels were unaffected. One patient complained of slight abdominal discomfort during fluvastatin administration, but relationship to fluvastatin remains unclear. One patient had slight elevation of the serum alanine aminotransferase level, and another patient had an elevated gamma-glutamyl transferase level. The addition of fluvastatin to probucol treatment can be considered to be an effective and well tolerated treatment in hypercholesterolemic patients.

Adult↗

PubMedDate not supplied

A unique variant of hairy cell leukemia in Japan.

We studied 25 Japanese patients with hairy cell leukemia (HCL) and found a manner in which HCL can be divided into two subtypes. In each patient, hairy cells (HC) showed striking surface hairs and reacted with HC-specific antibodies (alpha Leu-M5 and alpha HC-M). Twenty of the 25 patients had HC characterized by round nuclei with dense nuclear chromatin, weak tartrate-resistant acid phosphatase (TRAP) activity and the phenotype of low density surface immunoglobulin (SIg)+, Tac-. In this group of 20 patients, the male to female ratio was low, and there was frequent leukocytosis. On the other hand, the remaining 5 patients showed a high male to female ratio and a normal or decreased leukocyte count. HC had folded nuclei, strong TRAP activity and the phenotype of high density SIg+, Tac+. The features of the latter patients are consistent with those of HCL in Western countries, while those of the former group appear to indicate a unique variant of HCL.

Adult↗

PubMedDate not supplied

Case of a child with paroxysmal nocturnal hemoglobinuria diagnosed by flow cytometry.

A case of a child with paroxysmal nocturnal hemoglobinuria (PNH) is characterized by an increased sensitivity of the erythrocyte to hemolytic action of complement. The widely used Ham test may not always be reliable. Recently, a panel of monoclonal antibodies has become available to detect various glycosylphosphatidylinositol (GPI)-linked proteins by flow cytometry (FCM) and the deficiency of GPI-anchored proteins on the various kinds of cell membranes is implicated as the pathogenesis of PNH. We diagnosed a case of a child with PNH by FCM and complement lysis sensitivity (CLS) test, which showed the increased sensitivity of PNH erythrocytes to complement. His diagnosis was delayed because of Ham test negativity and rarity of PNH cases in children.

Child↗