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Biomedical subjects

T Oguri

Publications and source records attributed to T Oguri.

At least 145 records · Page 8Linked to original sources

[Late phase II study of MST-16 (sobuzoxane) on malignant lymphoma].

Late phase II trial of MST-16 for malignant lymphoma was conducted by the multi-institutions collaboration. Out of 34 patients entered, 29 were evaluated for efficacy as well as side effects. One complete response and 8 partial responses were achieved by the treatment of MST-16. The factors which affect the response rate were prior chemotherapies, stage of disease and performance status. The main toxicities were bone marrow suppression and G-I disorders. Leukopenia was observed in 72.4% of patients, thrombocytopenia in 44.8% and nausea/vomiting in 31.0%. Patients recovered from these side effects by discontinuation of the MST-16 therapy.

Adult↗

Cloning and restriction analysis of DNA conferring new quinolone antimicrobial agent resistance from Staphylococcus aureus and other coagulase-negative Staphylococcus species.

DNA conferring resistance to new quinolone antimicrobial agents (NQR) in clinical isolates of Staphylococcus aureus and coagulase-negative staphylococci (CNS), S. epidermidis and S. haemolyticus, was analyzed after cloning in Escherichia coli. The NQR phenotypes were expressed in E. coli at lower levels. NQR gene(s)-carring HindIII fragments were very similar to each other among S. aureus or CNS, although the S. aureus fragments differed from the CNS fragments in terms of the NQR phenotypes and restriction endonuclease maps. The data suggest the possibility that the NQR genes have disseminated in evolutionarily distinct routes among S. aureus and CNS.

4-Quinolones↗

[Susceptibility of bacteria isolated from patients with lower respiratory tract infections to antibiotics (1987)].

Since 1981, in cooperation with research institutions across the nation, Ikemoto, et al. have been collecting clinical isolates from patients with respiratory tract infections and conducting an annual retrospective survey of patients' background factors and of isolated strains and their sensitivities to various antibacterial agents and antibiotics. In the period from October, 1987 to September, 1988, 17 institutions participated in the survey and a total of 706 strains which were demonstrated to be causative organisms were isolated from 562 patients with respiratory tract infections. Strains were mostly isolated from the sputum. The taxonomic breakdown of these strains was: Staphylococcus aureus (69 strains), Streptococcus pneumoniae (120), Haemophilus influenzae (170), Mucoid-producing Pseudomonas aeruginosa (42), Non-mucoid-producing P. aeruginosa (87), Escherichia coli (11), Klebsiella pneumoniae (35), Brahamella catarrharis (72), etc. Of these strains, 629 were used to determine MICs of various antibacterial agents and antibiotics for susceptibility analyses. Relationships between patient backgrounds and diagnoses and between infections diseases and causative organisms were also investigated. Most of the major causative organisms, such as H. influenzae and P. aeruginosa, showed no substantial changes from previous years, with regard to their sensitivities to antibiotic agent, but S. aureus, particularly methicillin/cephem-resistant strains of S. aureus (MCRSA) showed somewhat lower sensitivity to beta-lactams, and as in recent years, to ofloxacin, a new quinolone drug, as well. Regarding background factors of patients, the age distribution was heavily concentrated in age brackets of 50 years and older, thus patients in these age group accounted for 75.2% of all the patients, which was comparable to 73.5% in 1985 and 77.9% in 1986. Among infections encountered, bacterial pneumonia was most frequent at 28.3%, followed by chronic bronchitis (27.2%) and bronchiectasis (16.0%). Bacterial pneumonia was actually the most frequent, throughout the entire age groups accounting for 34.3% of patients up to 29 years, 26.6% in the group of 30-69 years and 30.7% in patients aged 70 years and older. Chronic bronchitis was next most frequent and accounted for 20.0%, 26.4% and 30.7% among the three age groups, respectively. Breaking down clinical isolates by diagnosis, H. influenzae, S. pneumoniae and P. aeruginosa were isolated frequently from most of the infectious diseases.(ABSTRACT TRUNCATED AT 400 WORDS)

Anti-Bacterial Agents↗

[Clinical evaluation of imipenem/cilastatin sodium in infectious complications of hematological malignancies. Tohkai Research Group on Infections in Hematological Disorders].

Imipenem/cilastatin sodium (IPM/CS), a newly developed carbapenem antibiotic, was administered to a total of 152 patients with severe infections complicating hematological disorders, of whom 138 patients are included in the present analysis of efficacy and 152 in that of safety. Most of the underlying diseases were acute leukemia (76/138), and most patients suffered from sepsis or suspicion of sepsis (84/138). Out of 138 patients in whom efficacy was evaluable, responses were excellent in 41 patients, good in 55, fair in 19, and poor in 23. The overall clinical efficacy rate was 69.6% (96/138). Prior antibiotic treatment and peripheral neutrophil count had significant effects on the clinical response. The overall eradication rate of bacteria was 76.2%. Adverse reactions were observed in 15 patients (9.9%) and abnormal laboratory test results in 19 patients (12.5%). From the above findings, IPM/CS is considered to be a useful antibiotic for the treatment of severe infections accompanying hematopoietic disorders.

Adolescent↗

[Effect of remission induction chemotherapy on blood coagulability in patients with gynecological malignancies].

In 12 patients (38 courses) with gynecological malignancies who had been treated with remission induction chemotherapy, we measured the levels of ESR, Platelet, PT, APTT, Hepa T, AT III, alpha 2 PI, FDP and D-dimer, and we also measured such molecular markers as Fibrinopeptide A (FPA), Fibrinopeptide B beta 1-42 (FPB beta 1-42), and Fibrinopeptide B beta 15-42 (FPB beta 15-42) before and after chemotherapy. Then the relation between the post chemotherapeutic trends and prognosis for patient with gynecological malignancies were investigated. 1) Before chemotherapy, the levels of ESR, FDP, D-dimer and FPB beta 1-42 were increased, PT and APTT were shortened significantly in cases on groups IIIrd and IVth stage compared with in cases on groups Ist and IInd stage (p less than 0.05). The levels of FPA were also high, but there was no significant differences. The levels of FPB beta 15-42 were almost same in both groups. However, the each markers indicated the existence of chronic DIC in cases of group IIIrd and IVth stage. 2) One week after chemotherapy, the levels of ESR, fibrinogen, FDP and FPA were decreased, while FPB beta 1-42 and FPB beta 15-42 were increased, suggesting elevated fibrinolytic activity. Two weeks after chemotherapy, there was stronger tendency to coagulation dominant again, but it was only temporary. Three weeks after chemotherapy, the hemostatic balance was regained. 3) In patient with complete remission after effective chemotherapy, their coagulability data were showed within normal range, however, some cases with poor prognosis were not able to obtain the recovery of hemostatic balance, and the levels of molecular markers were significantly elevated. Coagulative activity was more enhanced than fibrinolytic activity in patients with progressive gynecological malignancies, but hemostatic balance was maintained clinically. The hemostatic balance was disrupted by the chemotherapy, but this balance was regained for the IIIrd week. Accordingly, the recovery of hemostatic balance with effective chemotherapy is related to the prognosis for patients with gynecological malignancies, and the levels of molecular markers may be able to expect the prognosis for patients.

Adult↗

[Susceptibility of bacteria isolated from patients with lower respiratory tract infections to antibiotics (1986)].

Enlisting the help of various research institutions across the nation, Ikemoto et al. have been pooling cultures of clinical isolates of respiratory tract infections and mapping out the correlations between patient backgrounds and the causative bacteria and the changes in the sensitivity spectra of the bacteria to various antibacterial and antibiotic agents annually since 1981. The following is a report of the 1986 findings. During the period from September, 1986 to March, 1987, 558 cases of respiratory infections were reported at 17 institutions across the nation and a total of 657 apparent causative strains were isolated from sputum samples. Of these strains, 75 strains of Staphylococcus aureus, 108 of Streptococcus pneumoniae, 150 of Haemophilus influenzae, 107 of Pseudomonas aeruiginosa (non-mucoid production type), 21 of P. aeruginosa (mucoid production type), 32 of Klebsiella pneumoniae, 8 of Escherichia coli, and 55 of Branhamella catarrhalis were subjected to MIC determination of various antibacterial and antibiotic agents to map drug sensitivities. In addition, diagnoses, age distributions by diagnoses, frequencies of infectious diseases, types of isolated bacteria, and usage statuses of the antibacterial and antibiotic agents the times of at isolation were also investigated. MIC determinations were carried out to investigate susceptibilities of causative organisms of respiratory tract infections to various antibacterial and antibiotic agents. From the 558 cases of respiratory tract infections, 657 strains were detected at concentrations not less than 10(4-6)/ml and identified to be the causative organisms. Of these strains, 603 could be used for MIC determination. An overwhelming majority of major causative bacteria, inclusive of H. influenzae and S. pneumoniae, showed sensitivity patterns similar to the sensitivity patterns found a year earlier, P. aeruginosa alone, however, showed some increase in its susceptibility to penicillin and cephem antibiotics. Regarding patient backgrounds, the age distribution was heavily biased towards the higher end of the scale, which patients with ages of 50 or higher accounting for 77.9%, compared to 73.5% in 1985. When the patients were classified by diagnoses, chronic bronchitis, bacterial pneumonia and bronchiectasis accounted for the majority of the infections: 28.7%, 23.3%, and 19.0%, respectively. The percentages of chronic bronchitis and bacterial pneumonia 28.7% and 23.3%, respectively, were somewhat higher in 1986 than in 1985. The disease which was comparatively frequent in all age groups was bronchiectasis, which accounted for 44.0% in patients with ages 29 years or lower, 18.4% in patients between 30 years and 69 years, and 16.7% in patients with ages 70 years or higher. The next most frequent infection was bacterial pneumonia.(ABSTRACT TRUNCATED AT 400 WORDS)

Anti-Bacterial Agents↗

[Susceptibility of bacteria isolated from patients with lower respiratory tract infections to antibiotics (1985)].

Collaborated studies on species of respiratory tract infection (RTI)-related organisms for their identification and drug susceptibilities have been carried out since 1981 at about 20 centers in Japan. On this occasion, the data obtained between 1982 and 1985 were reanalyzed to determine whether or not drug susceptibilities differed depending upon diseases, from which the organisms were isolated. The results summarized below were obtained in this study. 1. Among Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella pneumoniae and Pseudomonas aeruginosa examined, differences in drug susceptibilities according to different diseases were found among S. aureus and also mucoid strains of P. aeruginosa. 2. Susceptibility to beta-lactam antibiotics was definitely lower in S. aureus strains isolated from pneumonia than in those isolated from chronic bronchitis and bronchiectasia. 3. The isolation frequency of methicillin-and cefazolin-resistant strains of S. aureus was 30.3% and 25.9%, respectively, and was especially high among strains isolated from pneumonia. The antibiotic potency of minocycline against S. aureus, including methicillin resistant S. aureus, was the strongest among 9 drugs examined; S. aureus maintained relatively sufficient sensitivity to dicloxacillin among beta-lactam antibiotics. 4. Mucoid producing strains of P. aeruginosa isolated from chronic bronchitis had slightly lower drug susceptibility than those isolated from bronchiectasia. 5. When drug susceptibilities of H. influenzae were compared among groups separated according to diseases using MIC50, MIC80 and MIC90 as indicators, there were no clear differences. The isolation frequency of ampicillin (ABPC)-resistant strains, however, was clearly different among diseases; namely, resistant strains were the most and the least frequently isolated from chronic bronchitis and from pneumonia, respectively. In addition, the drug susceptibility of H. influenzae isolated in 1985 was analyzed in relation to the production of beta-lactamase. As a result, it was suspected that some factors, other than beta-lactamase, participated in the mechanism of ABPC-resistance. 6. These results suggest that drugs to be used for the chemotherapy of RTI should be selected considering the fact that drug susceptibilities of the pathogens differ, even among the same species, according to diseases.

Bacteria↗

[Susceptibility of bacteria isolated from the patients with lower respiratory tract infections to antibiotics (1985)].

It has been more than 4 years since third-generation cephems were introduced into clinical practice. The range of our drug selection definitely tends to increase, because we today have more antibiotics with wider spectrum, antibiotics with strong activities only against Gram-negative strains, such as monobactams, and those with tremendously high activities such as quinolone carboxylic acid derivatives, in comparison to those we had in the past. Among isolates obtained mainly from sputa of 567 patients with lower respiratory tract infections at 16 institutions throughout Japan between September of 1985 and March of 1986, 741 strains were determined to be causative organisms. MIC's of various antimicrobial agents were determined against 67 strains of Staphylococcus aureus, 100 strains of Streptococcus pneumoniae, 199 strains of Haemophilus influenzae, 92 strains of non-mucoid Pseudomonas aeruginosa, 40 strains of mucoid P. aeruginosa, 29 strains of Klebsiella pneumoniae, 10 strains of Escherichia coli and for 42 strains of Branhamella catarrhalis out of the above 741 strains to determine their drug sensitivities. As for types of lower respiratory tract infections found in 1981--1983, 57.9--64.5% of the infections were chronic respiratory infections; i.e., chronic bronchitis, chronic bronchiolitis and bronchiectasis. These chronic infections, including diffuse panbronchiolitis (DPB), were found in 63.1% of lower respiratory tract infections in 1984. Their incidence dropped to 54.0% in 1985, even though DPB was included; i.e., the incidence of chronic bronchiolitis was 5.5%, that of DPB was 7.1%, and that of bronchial asthma associated with lower respiratory tract infections in 1985 was 8.8% which was twice as much as that found in 1981--1984. Although bacterial pneumonia was found in 24.8% of all the cases in 1981, its incidence was reduced to 11.0% in 1983, 15.1% in 1984, and 17.6% in 1985. This reduction seemed to have resulted from gradual decreases in the occurrence of bacterial pneumonia among the young population. As with usual years, a high incidence rate in a total lower respiratory tract infections in 1985 was found among older patients; namely, 73.5% was at the age of 50 or over (417/567). Next, we determined relationships between clinical isolates and isolates from respiratory infections, including chronic bronchitis, chronic bronchiolitis, bronchiectasis and DPB. H. influenzae was isolated from 50.5% of patients with these infections in 1981; however, the detection rate decreased by about 20% to 29.7% in 1985. P. aeruginosa was consistently isolated, between 24.1% and 30.4% every year.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

[Susceptibility of bacteria isolated from the patients with lower respiratory tract infections to antibiotics (1984)].

Bacterial isolates from patients with pulmonary infections have been collected over the last 4 years in collaboration with investigators at 14 hospitals in various parts of Japan to study isolation frequency of pathogens from patients and drug susceptibilities of these isolates. Possible causative pathogens mainly isolated from sputum of patients with lower respiratory tract infections were collected during a period from September 1984 to March 1985. We first determined types of respiratory diseases and found that, between 1981 and 1983, 57.9 approximately 64.5% of the examined diseases were chronic respiratory infections such as chronic bronchitis, chronic bronchiolitis and bronchiectasis, and that these infections including diffuse panbronchiolitis accounted for 63.1% in 1984. Bacterial pneumonia was found to be 24.8% in 1981, but it was 11.0% in 1983 and 15.1% in 1984. These results seemed to reflect decreases in the occurrence of bacterial pneumonia in young population. We then investigated the correlations between these infections and isolates and found that distributions of causative organisms of chronic bronchitis and bronchiectasis during the 4 years were similar while the detection rate of Staphylococcus aureus from bacterial pneumonia increased in 1982 and 1983, and that of Gram-positive organisms such as Enterococcus faecalis rose in 1984. Branhamella catarrhalis was considered to be a non-pathogenic organism normally harbored in the upper respiratory tract. Recently, however, respiratory infections caused by this organism have been reported by some investigators. In our research also, this Gram-negative diplococcus was isolated as a causative organism of respiratory infections as 6 strains were found in 1983 and 29 strains in 1984, hence an increase was observed.

Adult↗

In vitro susceptibility of Pseudomonas maltophilia to antimicrobial agents.

Reports on the isolation and pathogenicity of some species of Gram-negative and glucose-nonfermentative bacilli have appeared in the literature since 1962. The infections caused by those organisms have become important problems as an opportunistic infection in immunosuppressed patients. Pseudomonas maltophilia is a glucose-nonfermentative aerobic Gram-negative rod widely dispersed in nature. The role of Pseudomonas maltophilia as an opportunistic pathogen is not thoroughly established, but a few papers on clinical infections associated with P. maltophilia have been published. P. maltophilia is considerably less susceptible to certain of the most commonly-used antibiotics. We have reviewed the susceptibilities of P. maltophilia to antimicrobial agents currently available and yearly changes of the strains in resistance to the antibiotics that have been extensively used.

Anti-Bacterial Agents↗

[Clinical and bacteriological studies of Streptococcus pneumoniae. Yearly changes in isolation frequencies from clinical specimens, serotype distributions and drug susceptibilities, especially those of beta-lactam-resistant strains].

Although chemotherapeutics have markedly reduced the mortalities of infectious diseases caused by Streptococcus pneumoniae, it has recently been recognized that S. pneumoniae is still clinically significant for the infants, highly-aged and high-risk patients. This work was planned to examine the isolation frequency of S. pneumoniae from clinical specimens and its drug-susceptibilities, especially to beta-lactam antibiotics. The strains were obtained from in- and out-patients in Main and Branch Hospitals of Juntendo University from 1961 to 1985. Drug-susceptibility tests were carried out against 39 different drugs including 10 penicillins, 16 cephalosporins, 3 tetracyclines, 3 macrolides, chloramphenicol, gentamicin, vancomycin, 3 pyridone carboxylic acids and sulfamethoxazoletrimethoprim using agar dilution method. The sero-typing of the isolates was made by the Quellung technique using Diagnostic Pneumococcal Anti-Sera (Statens Seruminstitut, Copenhagen). The following results were obtained: S. pneumoniae was isolated mostly from sputum and throat swabs, but rarely from the blood and cerebrospinal fluid. S. pneumoniae was also isolated from the pus and discharges of ears, sinuses and eyes. The isolation frequency of S. pneumoniae was higher in Branch Hospital where subjects were mostly out-patients than in the Main Hospital. Frequent sero-types of S. pneumoniae were groups 23, 6, 19, and type 3, regardless of clinical specimens and years. Against tetracycline and chloramphenicol, approximately 40 to 70% of the strains were resistant, while against maclorides, resistant strains were few. Resistant strains were still fewer against beta-lactam antibiotics. Tetracycline- and chloramphenicol-resistant strains are recently decreasing, while macrolides- and beta-lactam-resistant strains are somewhat increasing. Nine beta-lactam-resistant strains of S. pneumoniae were isolated from sputum and throat swabs, with benzylpenicillin-MICs ranging from 0.39 to 3.13 micrograms/ml. Three (2 of 23F and 1 of 23A) out of the 9 strains were resistant to beta-lactams, tetracycline, chloramphenicol, erythromycin and lincomycin. Four strains (3 of 23F and 1 of group 23) were resistant to beta-lactams, tetracycline, erythromycin and lincomycin. One strain (type 45) was resistant to beta-lactams, tetracycline and chloramphenicol. One strain (23A) was resistant to beta-lactams only. Those 9 beta-lactam-resistant strains were isolated mostly from children. Most of the patients had been given beta-lactam antibiotics before those resistant strains were isolated.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗