[Comparative studies of T-1982 (cefbuperazone) and cefmetazole in complicated urinary tract infections].
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Biomedical subjects
Publications and source records attributed to Y Kawada.
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Using 121 patients with bladder cancer operated on at our institutes, the relationship between lymphocyte infiltration and grading, staging or patients' prognosis was studied for evaluating regional immunocompetence in bladder cancer. There was no correlation between number of infiltrating lymphocytes and tumor grading or staging. However, the patients with high grade or advanced stage showed high recurrence rate and mortality. The same tendency was observed in patients whose tumor had few infiltrating lymphocytes. A lymphocyte subset was detected in both peripheral blood and tumor extracts in 15 cases of bladder cancer. Compared with the normal controls, T cell percent was lower and T gamma cell ratio was higher in peripheral blood of bladder cancer patients. T cell percent was almost equal in peripheral blood and in cancer tissue, but the T gamma cell ratio in the cancer patients was much higher than that in blood. In the tumor tissues, high T cell and lower T gamma cell percentages were observed at basal areas than those at superficial portions. These results suggest that infiltrating lymphocytes may take part in the host response to the tumor in bladder cancer. Classification of these lymphocytes based upon function will be necessary for further study.
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A clinical trial of radiation therapy combined with hyperthermia for various superficial tumors was performed. For the local hyperthermia, heating modalities with microwave, radiofrequency and ultrasound can be used. Some are still insufficient for clinical application in terms of tumor size and site; there fore, for ther studies through a phase II study are necessary to determine a future direction of hyperthermia in clinical case.
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The response to Beta-lactam antibiotics of mixed cultures of Escherichia coli and Staphylococcus epidermidis was studied in static culture and in an in vitro model which simulates the dynamic conditions in which bacteria are exposed to antibiotics in the treatment of urinary infection. In static cultures, the concomitant presence of staphylococci exhibiting inducible Beta-lactamase activity substantially reduced the efficacy of benzylpenicillin and ampicillin (but not cefuroxime) against E. coli. In the conditions of the bladder model some interference with the activity of Beta-lactam antibiotics by Beta-lactamase producing staphylococci was also demonstrated. Nevertheless, relatively modest doses of ampicillin were still able to suppress growth of susceptible E. coli for periods exceeding the normal interdose interval, even in the presence of enzyme-producing staphylococci.
Experimental and clinical data from which dosage regimens can be rationally deduced are generally lacking. As an approach to this problem, an in vitro model of the urinary bladder has been constructed in which the conditions of exposure of bacteria to antibacterial drugs which exist in the treatment of cystitis are simulated. Results obtained so far correlate well with such clinical information as we possess and have helped to define more accurately the conditions which govern successful therapy of urinary infection. The most recent data suggest that much lower doses of some beta-lactam antibiotics than have been contemplated hitherto may be effective in the treatment of uncomplicated cystitis.
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High, but transient, antibiotic levels are achieved in bladder urine if a rapidly excreted agent is given to a patient with frequency of micturition and a normal residual bladder volume. Lower, but more prolonged levels are achieved if the drug is slowly excreted, if micturition is infrequent, or if the residual volume is increased. The magnitude of these effects has been calculated mathematically for various combinations of circumstances. Such considerations have implications for treatment, particularly with drugs, such as the beta-lactam group, that are rapidly excreted into urine.